Medicare Patients Find Drug Restrictions
By KEVIN FREKING, Associated Press Writer
WASHINGTON - Thousands of elderly patients are learning the hard way that it isn't enough to check whether their medicines are covered under a new Medicare drug plan they have chosen.
Insurers are using a broad range of tools to get customers to take the cheaper drugs they want them to take, and failure to follow their instructions can be costly.
In many cases, a patient's doctor has to get prior approval for a drug before the plan will cover it. In others, the plan will limit the quantity of a drug the patient can get.
Plans also divide drugs into tiers. The lowest level requires only nominal out-of-pocket costs, while the highest — called specialty tiers — require the customer to pay for a quarter, a third or even more of the costs.
The tools are not unique to Medicare. The Veterans Affairs Department uses them, and almost all workplace drug plans — including the health plan used by members of Congress — have them.
However, the Medicare plans have taken the tools to a whole new level, said Dan Mendelson, president of Avalere Health, a consulting firm.
The article continues at
http://news.yahoo.com/s/ap/20060330/ap_on_he_me/medicare_drugs_accessAnd it is illustrated again: Medicare "reform" has nothing whatsoever to do with benefiting patients, only the insurance industry.