New Medicare drug plans may help many save on prescription costs especially if you formerly had no drug coverage.  But far too often there's been a lack of simple information from Medicare or drug plans when something goes wrong — and a lot can go wrong.  How can you avoid coverage denials or improper charges?  Here are just a few tips that can help you avoid problems:

• Allow plenty of time for your drug coverage to start.  No matter what you're promised about when coverage will start, the reality is that enrolling and using a new Part D drug plan may be full of pitfalls and delays.  If you're switching coverage from a previous drug plan and need prescriptions that you take on a regular basis, get at least a 60-90 day supply filled before your old coverage ends from your current drug plan.
• Continuously follow up on your enrollment status.  Before you can fill your first prescriptions and have the charges covered by your new drug plan, you need to get the ID card from your new drug plan or a letter confirming your enrollment.  If you have not received it within two to three weeks after enrolling, call the 1-800 customer service number of your insurer and ask about it.  The customer service representative will ask for your Medicare number. The problem may be that your Medicare number was entered incorrectly, or you may be told "your number's not in the system."  Make sure you read to the customer service representative any letters that precede your number exactly as they appear on your Medicare card.
• Get help.  Call Medicare or your local Area on Aging.  If your Medicare number is not showing up with the insurer or if there is some other problem you can't resolve with your drug plan, you may need to check with Medicare at 1-800-633-4227.  This is a speech-automated system that some beneficiaries may have trouble using, especially when you need to speak to a live customer service agent.  You will need to listen carefully through a long menu of options.  If you have problems reaching a live Medicare agent, try calling your local Area Agency on Aging and ask for help from a Medicare benefits counselor.  The program is free and in many areas you can get one-on-one help to trouble shoot your problems.  The number of your local agency is in your phone book.
• Find out whether your drug plan requires "pre-authorization" for any of your prescriptions.  Although your drug plan advertises that it covers most or all your prescriptions, find out if there are restrictions or if pre-authorization is required from your doctor for any of your prescriptions before going to the pharmacy.  A recent study found that compared to commercial drug plan offerings, Medicare drug plans are more restrictive, and likely to require prior authorization or to have quantity limits.
• Contact your Members of Congress.  If you have unresolved problems, contact your Members of Congress.  Each Representative and your Senators have staff members that specialize in helping to resolve constituent problems.  In addition, our elected lawmakers need to hear the extent to which Part D is not working in order to be able to legislatively correct problems. 

Sources:  "Avalere Health Releases Comprehensive Medicare Marketplace Report," Avalere Health," February 6, 2006.

May 2006