Pharmacists say marketing of Medicare drug plans is misleading

A community pharmacy association has asked the Centers for Medicare & Medicaid Services to allow disgruntled patients to switch Part D plans midyear.

By Charles Fiegl amednews staff — Posted Feb. 2, 2012

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Pharmacists have called on the agency overseeing the Medicare program to allow patients to switch their prescription drug plans outside of the normal open enrollment season after beneficiaries say they were misled by insurers.

Beneficiaries report that they were promised zero co-pays upon enrolling in Part D drug plans online or using Medicare Plan Finder on the Centers for Medicare & Medicaid Services website. However, some of those patients found out only after enrollment had closed that the discounted rates apply only at pharmacies in certain box stores.

"Now seniors are going to the community pharmacy that they have relied on for years, sometimes decades, only to be told that they must travel 20 miles or more to obtain the lowest-advertised co-payments for their medication," said B. Douglas Hoey, CEO of the National Community Pharmacists Assn. in Alexandria, Va.

The association has asked CMS to create a special enrollment period that allows for patients who are dissatisfied with their Part D choices to select other plans, according to a Jan. 9 letter to the CMS Center for Medicare Director Jon Blum.

CMS did not respond to a request for comment on the letter by this article's deadline.

The annual enrollment period for selecting Part D plans runs from October to December. The pharmacists association previously had complained that some plans were marketed without clearly stating that the lowest prices are available only at select pharmacies.

For instance, a Wisconsin man went to pick up refills on his prescriptions recently and found his co-pays had increased after Jan. 1, the association reported. The patient's pharmacist called the insurance company and was told the patient needed to travel to a large chain pharmacy 25 miles away to obtain the lower co-pays.

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