Medicare Part D. The Hidden Evils: A Case Study

1224 Words5 Pages

Medicare Part D
The Hidden Evils

When one becomes sixty-five years of age a whole new world opens up to them. The elderly people of the US are offered discounts at a wide range of different places which include: salons, movie theaters, and drug stores. The reason behind the discounts offered for seniors unfortunately has nothing to do with people appreciating their elderly but it is because many people over the age of sixty-five are on a fixed income. Men and women over the age of sixty-five in the US are also enrolled in Medicare programs. Medicare can be very beneficial however it can also be very sneaky and costly. In theory, Medicare is a good idea. The goal of Medicare is simple: provide reasonably priced medical coverage to seniors. …show more content…

He had been wheezing and found it difficult to breathe. The man went to see his primary care physician who then wrote out a prescription for a nebulizer and for inhalation solution to go along with it. That same afternoon, the pharmacy received the doctor’s fax and they billed Medicare for the device and its solution. In a perfect world, Medicare would have covered the medications and the patient could pick them up from the pharmacy a few hours later. Unfortunately, this was not the case. Medicare originally denied the (expensive) prescriptions for the suffering patient. The pharmacist then called the insurance to get authorization and was told to wait for a call back. Days later, an adjuster from Medicare called the pharmacy and told them to rerun the prescription. The adjustor also said that the nebulizer the pharmacy had in stock would not be covered and that they had to order a different one for the following day(Lee). What should have been a simple pick up for the patient led to a week's worth of aggravation and suffering as he was at home coughing and going without his much needed medicine. Medicare claims to be efficient but it took over a week of back and forth faxing and calling between three parties to get one man’s medication