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Provider Perspectives
The Quandary of Medicare Part D
The transition to Medicare Part D has been anything but simple for Maricela Hernandez of Access Living.
The impact of the new Medicare Part D legislation that went into effect at the beginning of this year has not only given headaches to seniors; it has affected all people with disabilities as well. Just ask Maricela Hernandez. She is the Latino Health Care Outreach Coordinator at Access Living, a non-residential disability organization in Chicago that works to advocate and provide independent living resources for people with all types of disabilities. At the beginning of this new year, one of the central topics at Access Living is Medicare Part D, and Hernandez has observed the layers of trouble consumers are having with access to critical Medicare Part D information.
Hernandez's main problem with Part D is the chaos accompanying the transition. The information that Medicare consumers need to know about Part D has not been distributed in a timely fashion. By the end of December, days before Part D went into effect, some Medicare consumers still did not know which prescription drug plans they had been facilitated into. After January 1, many people have gone to pharmacies with their Medicaid cards, unaware that their Medicaid coverage has been cancelled and that they are now enrolled in a Part D plan. Some people have still not been notified of which Part D plans they are enrolled in.
Other people received wrong information about Part D throughout the entire course of 2005. There has also not been enough information for the visually impaired, or for people with other limiting disabilities. Not enough information has been provided in Spanish, and there is only one Spanish helpline in Illinois. Many individuals have told Hernandez that they received inaccurate Spanish information in the mail. Furthermore, the only real way to access simplified and extensive information about Part D is through the internet. But many people affected by these Medicare changes are low-income, or cannot maneuver the internet. Of the people that have been facilitated into new Part D plans, many have medications that are not covered by their new prescription plans, and have no idea how to pick a plan that does fit their needs.
One serious problem that Access Living is attempting to address is pharmacy confusion and backup. Pharmacists are dealing directly with the confusion of Part D, and do not have the appropriate information or time to properly address each individual's pressing and specific needs. If consumers walk into pharmacies unaware of the Part D transition, of their prescription coverage, or of the status of their benefits, pharmacists have the ability to look up individual consumers' Medicare status and check their benefit eligibility. While this remains a possibility, it is extensively time-consuming, particularly at a time when pharmacies are overrun with confused Medicare beneficiaries. There is also a program for pharmacists to check consumers' benefits and give them their medications if they are eligible for coverage. But many pharmacists have not been given the information for this process.
The very few telephone resources that are available to address this confusion are overrun with phone calls everyday. Maricela Hernandez called the Medicare helpline the first week in December, and a message noted that call volume was not allowing her to get through. This helpline presently continues to be bombarded with calls, still making it difficult for people to access information. Non-internet savvy people, Spanish-speakers, people with disabilities, and many others have been left in the dark. The result of these barriers to information is total disorder, and people are in a panic. Maricela Hernandez is concerned for her clients. She explains that many places in Chicago like Access Living and Alivio Medical Center are totally overwhelmed with concerns about Part D, and they are stretching to the max to try to help Medicare consumers get the correct information they need. The volume of Medicare calls to Access Living has forced Hernandez to take on the cases of non-Latino callers, which is not a part of her role at the organization.
Maricela Hernandez is working diligently, conducting as much outreach as she capably can amidst Part D confusion. But the work of advocates like her is not enough. There is not enough support to deal with Part D disorder. The Part D confusion can be mended with proper information, proper accessibility, proper language and disability requirements, and proper education. As Hernandez emphasizes, "There should be more done about making sure there are alternative ways of providing information to consumers" (Hernandez, 2005). In order for this program to stand a chance of survival, comprehensive access is the key to determining whether or not Medicare Part D has any positive potential for the Medicare program.
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