Many Arkansas pharmacists are concerned that Medicare Part-D coverage plans do not have the correct networks or providers listed.Currently, millions of Americans age 65 and older are choosing their prescription drug coverage plans for the upcoming year through the Medicare.gov federal website. The enrollment deadline is Dec. 7, 2023.Arkansas Pharmacists Association President Josh Vinson told 40/29 News that he’s been contacted by more than 50 pharmacists across the state who have reported errors on many coverage plans, listing their pharmacies as out-of-network providers. “It’s very concerning, very concerning. We’re right smack dab in the middle of open enrollments, so it’s a real issue,” said Daniel Lunsford with Prince Drug Store in Fort Smith. “When patients are looking at my pharmacy, it shows that either I’m not in their network or I have unpreferred copays or higher copays than if they went to a different pharmacy. It might make someone believe that they need to switch pharmacies if they want to stay on the same plan. It could be anywhere from a small amount or several thousand dollars difference depending on which plan you pick.”Pharmacist and business owner Andrew Mize, with Debbie’s Family Pharmacy in Rogers, told 40/29 News that he is experiencing similar issues for patients they serve who are in long-term care and assisted living facilities.”Most of them (coverage plans) show that we’re out of network. But Medicare.gov has the incorrect information,” Mize said. “When a senior is trying to find the best plan for themselves, maybe they’re on a limited income, and so they need to save every dollar they can, but they’re not getting accurate information on how much their drugs are going to cost the next year.”The cost of prescription drugs can vary greatly between in-network and out-of-network providers.”One of the examples we looked at, an in-network plan showed their out-of-pocket cost for the year a little over $2,000. The same exact medications out of network were upwards of $11,000,” Mize said.An emergency notification from the Arkansas Pharmacists Association urged people to contact their national representatives and senators to try and help address the issues that could be confusing to patients and caregivers.Until the problems are fixed, pharmacists told 40/29 News that the best option for patients is to call their local pharmacy with questions concerning Medicare Plan-D coverage questions.”And so there’s a level of trust in us because they’re signing up for a plan. We’re telling them we’re in network even though Medicare.gov is telling them we’re not,” Mize said. “We’ve even asked to at least stop giving the wrong information, turn it off so that people aren’t seeing the wrong information and then we can at least help answer questions as we get them.”In Fort Smith, Lunsford said his pharmacy is seeing more common issues with certain Medicare coverage plans.”We’re seeing it more with Etna, Silver Script, Well Care. Those are the ones that we’ve seen that aren’t displaying correctly on the website,” he said.According to the Centers for Medicare and Medicaid Services (CMS.gov), more than 50 million people utilize Medicare coverage to help cover the cost of their medications. 40/29 News has not yet received a response from CMS.gov concerning the problems that Arkansas pharmacies are reporting. “Our store alone, we service over 2,000 seniors and that’s the largest demographic in the United States,” Mize said. “This is not just a local Northwest Arkansas issue. This is statewide, potentially national issue that needs a remedy very quickly.”When asked, some pharmacies in eastern Oklahoma told 40/29 News that they were also experiencing similar issues with Medicare.gov coverage plan information.
Many Arkansas pharmacists are concerned that Medicare Part-D coverage plans do not have the correct networks or providers listed.
Currently, millions of Americans age 65 and older are choosing their prescription drug coverage plans for the upcoming year through the Medicare.gov federal website. The enrollment deadline is Dec. 7, 2023.
Arkansas Pharmacists Association President Josh Vinson told 40/29 News that he’s been contacted by more than 50 pharmacists across the state who have reported errors on many coverage plans, listing their pharmacies as out of network providers.
“It’s very concerning, very concerning. We’re right smack dab in the middle of open enrollments so it’s a real issue,” said Daniel Lunsford with Prince Drug Store in Fort Smith. “When patients are looking at my pharmacy it shows that either I’m not in their network or I have unpreferred copays or higher copays than if they went to a different pharmacy. It might make someone believe that they need to switch pharmacies if they want to stay on the same plan. It could be anywhere from a small amount or several thousand dollars difference depending on which plan you pick.”
Pharmacist and business owner, Andrew Mize, with Debbie’s Family Pharmacy, in Rogers, told 40/29 News that he is experiencing similar issues for patients they serve who are in long term care and assisted living facilities.
“Most of them (coverage plans) show that we’re out of network. But Medicare.gov has the incorrect information,” Mize said. “When a senior is trying to find the best plan for themselves, maybe they’re on a limited income and so they need to save every dollar they can, but they’re not getting accurate information on how much their drugs are going to cost the next year.”
The cost of prescription drugs can vary greatly between in network and out of network providers.
“One of the examples we looked at, an in network plan showed their out of pocket cost for the year a little over $2,000. The same exact medications out of network were upwards of $11,000,” Mize said.
An emergency notification from the Arkansas Pharmacists Association urged people to contact their national representatives and senators to try and help address the issues that could be confusing to patients and caregivers.
Until the problems are fixed, pharmacists told 40/29 News that the best options for patients is to call their local pharmacy with questions concerning Medicare Plan-D coverage questions.
“And so there’s a level of trust in us because they’re signing up for a plan. We’re telling them we’re in network even though Medicare.gov is telling them we’re not,” Mize said. “We’ve even asked to at least stop giving the wrong information, turn it off so that people aren’t seeing the wrong information and then we can at least help answer questions as we get them.”
In Fort Smith, Lunsford said his pharmacy is seeing more common issues with certain Medicare coverage plans.
“We’re seeing it more with Etna, Silver Script, Well Care. Those are the ones that we’ve seen that aren’t displaying correctly on the website,” he said.
According to the Centers for Medicare and Medicaid Services (CMS.gov), more than 50 million people utilize Medicare coverage to help cover the cost of their medications.
40/29 News has not yet received a response from CMS.gov concerning the problems that Arkansas pharmacies are reporting.
“Our store alone, we service over 2,000 seniors and that’s the largest demographic in the United States,” Mize said. “This is not just a local Northwest Arkansas issue. This is statewide, potentially national issue that needs a remedy very quickly.”
When asked, some pharmacies in eastern Oklahoma told 40/29 News that they were also experiencing similar issues with Medicare.gov coverage plan information.
