D-day

The Medicare Part D Drug Benefit offically began yesterday. The New York Times reports on the state of things, which is predictably mixed:

Within 10 minutes, Ms. Riney had her medications, having paid $3 for the eye prescription and $8.40 for the thyroid drug. Under her previous coverage, she often had to pay $96 for the same thyroid prescription and as much as $20 for the eye medication.

"I feel pretty good about things today," Ms. Riney said. "I just hope, as I need more medications, that it's this easy. I thought about not signing up for the plan because it was so confusing, but I was paying way too much for my pills. I think I did the right thing."

In Brooklyn, Seth Kaplan, a 36-year-old disabled Medicare recipient, reported a very different experience. He said he had struggled unsuccessfully to get his drug plan to pay for his asthma medication. He said that he and his pharmacist had spent two hours on the phone with the insurer, WellCare, and that he eventually had to pay for the drug with his credit card, at a cost of $191.

"At first, on the phone, they claimed it took Medicare two weeks to confirm my eligibility," Mr. Kaplan said. "Then they said one computer system said I was enrolled and another said I had not applied. Then they said I should pay for the prescription and wait to be reimbursed. I said I couldn't afford to do that."

Ronald J. Chase, pharmacy manager of Miller Drug in Bangor, Me., one of the state's busiest pharmacies, said he had virtually given up on Medicare's computer system and tried instead to call insurers directly. But he said: "The lines are overwhelmed and bogged down. We feel we've been handcuffed. So we give customers a three-day supply until we figure out who's in what plan."

It doesn't help that yesterday was a holiday for a good segment of the work force. But confusion is inevitable when millions of people sign up for new insurance plans (with hundreds of different incarnations) at once. Especially the crop of Part D plans which have a laundry list of ineligible drugs, pharmacies, and payment arrangments. A good portion of the people who showed up at their pharmacy are probably ineligible in one of those categories.