Yesterday I got this 12 oz packet from my Part D provider… including three different paper booklets about various things and changes for 2015. In previous years, I have just filed these as “I’ll read that later” and never touch it again… This year I started paging thru it.. The image is of one page , I found very interesting..
You can click on the image to enlarge to make it more readable… It is about a person’s rights having a Part D Program. I suspect that this is boilerplate required by Medicare. So no matter which Part D provider – or Medicare Advantage provider – that you are enrolled in.. they are all required to meet the same standards.
Pay attention to Section 1.3 WE MUST ENSURE THAT YOU GET TIMELY ACCESS TO YOUR COVERED DRUGS
It goes on to say that “As a member of our plan, you have the right to get your prescriptions filled or refilled at any of our network pharmacies without long delays.”
Further back in the book it explains how a covered person can file a complaint or as they call it “filing a grievance”
Apparently there is also a QUALITY IMPROVEMENT ORGANIZATION where you can file a grievance for any services provided by any Medicare provider ( doctor, pharmacy/pharmacist/hospital, etc,etc )
There is also a on line complaint form to file a complaint directly with Medicare/CMS https://www.medicare.gov/MedicareComplaintForm/home.aspx
People who are covered by Medicaid and other health insurance may/might have the same/similar protections.
The DEA is using THE LAW that may be interfering with your appropriate/necessary care… There is a SIMILAR LAW… that should help protect you from being denied….BUT.. only those that are directly being adversely affected can do something about it.
Filed under: General Problems
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