Medicaid-eligible seniors: Call your pharmacy today

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If you use Medicaid and if you have not checked out your assigned prescription plan, please listen.

Call your pharmacy now. Call today or Saturday to make certain your pharmacy participates in your newly assigned prescription plan.

That’s the urgent message from state leaders, who want to make sure that all Medicaid-eligible seniors can get the drugs they need when those new prescription plans take effect on Sunday.

The pharmacy is the key, according to Chris Peterson, policy secretary for Nebraska’s Health and Human Services System.

Starting Sunday, the state can no longer pay for drugs for these seniors, Peterson said. So people who have relied on Medicaid need to make sure their new plan is adequate, she said.

About 31,000 senior Nebraskans, who currently get their medicine through Medicaid, have been randomly assigned one of 14 new prescription drug plans, under the new federal prescription program (generally referred to as Medicare Part D).

But the assigned plan may not be the best plan for you. The pharmacy you use may not participate in that plan. The drugs you take may not be covered by that plan, said Peterson.

However, you can switch to a plan that better suits you. And many Medicaid-eligible Nebraskans have switched, according to Dick Nelson, an HHSS administrator.

But seniors who haven’t done any checking should at least find out whether they can use their regular pharmacy on Jan. 1.

“Call the pharmacy to see if that pharmacy is part of your plan,” said Peterson.

There are options if the prescription plan doesn’t cover a specific drug.

People can get at least a 30-day transitional supply, under most plans. (HHSS was unable to verify Thursday that the three United Healthcare plans provide a 30-day transitional drug supply.)

And during that 30 days seniors can change prescription plans, or contact their doctor to help get that specific drug covered or get a prescription for an equivalent drug.

The options are much more limited if the prescription plan doesn’t cover your pharmacy, Peterson said.

If the pharmacy isn’t covered, seniors must go to another pharmacy — one that is part of their plan. Or the senior must pay for the prescription, then apply for reimbursement.

After Jan. 1, Medicaid-eligible seniors can switch to a different plan, but the change doesn’t occur until the beginning of the next month.

The state Health and Human Services System has mailed out 55,000 informational letters to seniors who get their prescriptions through Medicaid, Nelson said.

HHSS workers have answered thousands of telephone calls, trying to help people sort through the complex program.

“This is the most massive public information campaign I’ve seen,” Nelson said.

And Thursday afternoon HHSS leaders asked local newspapers to help them get the word out to Medicaid-eligible seniors and their relatives before that Jan. 1 deadline.

Check on your new prescription plan.

Call your pharmacy.

Message to seniors who use Medicaid

* Call your pharmacy to make sure it participates in your Medicare prescription drug plan. Call before Sunday.

* Before Sunday, switch to a plan that allows you to use your pharmacy. The pharmacist can give you toll-free telephone numbers for those plans and you can call and switch plans.

Help by telephone:

1-800-633-4227 (federal line)

1-800-685-5456 (state Medicaid office)                                                              

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