Ok all you old Medicare geezers, I’m now officially one of you and I don’t like it!
Specifically I’m going nuts trying to get all my prescriptions changed over from my employer-based coverage to my shiny new SilverScripts PDP plan. I made sure to get everything I could filled before the change took effect (April 1) in order to avoid any gaps in medication, but I find myself in a loop that even Kafka might have admired as a model of sheer bureaucratic futility.
Problem 1: both my old insurance and new PDP use CVS Caremark. There is no way to update existing Caremark account to the new coverage; you have to create a new account using a different email address. Ok fine, done. So how do you get your prescriptions into the new account? Apparently you have to have your Dr issue all new ones. Leading to Problem 2.
Problem 2: I use Patient Gateway to manage my visit appts., medications, payments and all that. It sits on the very widespread EPIC medical database. I can enter my new insurance info for Medicare (Part A & B) and my Medicare Supplement plan (UnitedHealthCare) . But when I go to enter my PDP (Aetna Silverscripts) the screen says “pending” and then the info just disappears. So I call my Dr (Endo) prescription line. They refer me to the network-wide patient registration office, which says they can’t add a PDP—they can do the other stuff, but not that. Why??? Who knows—and they refer me back to the Endo’s office, which sends me to Prescriptions, which sends me to Registration, which… you get the picture.
And then there’s…
Problem 3: Dexcom. CGM is DME now, not pharmaceutical. Will they be covered? Medicare says I need to prove that I have paid for and “own the monitor device.” Meaning what??? There is no “device,” just the transmitter and sensors. Wait, do they mean the quasi-mythological “receiver” that Dexcom never sold me and most people don’t use, and back when you had to have for Medicare but now I think it’s ok to just use your phone like 90% of us do? The guy couldn’t say. He did say I’d need to present some kind of documentary evidence showing that I had paid for the thing in the past. Like my old Caremark has records of my payments for transmitters and sensors, so is that good enough? And present to whom, exactly? Well, the pharmacy, the guy says. So I call Walgreens. They have no idea what I’m talking about.
Problem 4: Pump Supplies. This one—I think—might be straightforward. Same nonsense about proving I’ve bought the stuff in the past, but I use Edgepark, and they seemed to think there wouldn’t be any problem. Just enter my new Medicare A/B info into their system (done) and they should be able to check it through and fulfill it.
Question 1: Has anyone else done the Caremark prescription transfer thing, and how did you do it? Just have your dr submit the whole list of scripts using the new PDP info (if I can ever figure out how to get it into the system)? Or something else?
Question 2: Has anyone else gone through the Dexcom changeover from private/pharmaceutical to Medicare B/DME? What documentation did you have to scrape up and whom did you submit it to?
Finally: thank GOD I’ve got a pretty decent zombie-apocalypse stash built up, particularly of the Dexcom stuff. But I’m starting to wonder if it’s going to hold me up until I can get all these knots untangled. Uggh.