Oops! I Enrolled Someone in the Wrong PDP

[selfgen]

Can they appeal to medicare for an SEP? My assistant went on the Medicare Website and recommended a PDP for one of my clients and two of her meds are NOT on the formulary! one costs over $100. And, no, she doesnt get extra help. Its my fault for not verifying everything was correct. I'd like to help her switch, has anyone heard of medicare allowing an enrollment for hardship cases like this?

this is why these PDPs aren't worth the trouble. I better have a signed scope, eh? i'm toast man.

 

[MedSuppPro]

i'm toast man.

DON'T ASSUME!!!

Stand your ground!

Go back to the Medicare Website and look at her drug profile. It might be that she had no other choice. It might be that the other plans were not the "best" or "better" plans.

Today, I also had an unhappy PartDer call. I'm dealing with an under-65 Morphine addict. Trust me, I'd gladly trade you for your problem.

 

[G.Gordon]

Look at other plans. Are the other medications on ANY plan's formulary? I've had a client bitch cause they seen the list where it says NON-FORMULARY. I had to educate them the the three drugs she was concerned about were non-formulary in her 2010 plan and for 100% of the 2011 plans.

If they would have been covered by other plans... yep... you're toast. Make goody goody with her as best you can. Are you the actual "agent" for the plan. If so she can file a complaint against your help and probably get a slide. We aren't agents for any of the plans so that releases us from some of the possible liability.
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DON'T ASSUME!!!

Stand your ground!

Go back to the Medicare Website and look at her drug profile. It might be that she had no other choice. It might be that the other plans were not the "best" or "better" plans.

Today, I also had an unhappy PartDer call. I'm dealing with an under-65 Morphine addict. Trust me, I'd gladly trade you for your problem.

We were close to having one (or someone that seemed to have serious problems) as a client during AEP. An FMO referred him to us since we were closer. Called, introduced myself, got a feel for what would be best for him, list of meds, etc. Told him I'd put some stuff together and get back to him. Not an hour later he calls wondering where the information was. And again. And again. I was busy as hell and told him. He didn't start Medicare until 2/1/11 so there was no real hurry.

I never called him back. Some times you have to limit your exposure to PITA clients.

 

[Guest]

Give your client one of Lobach's $99 binders and maybe he or she will forget about it!

 

[walleyeb1]

or tell your client to forget the whole thing and get their scripts out of Canada!

 

[Josh]

Give your client one of Lobach's $99 binders and maybe he or she will forget about it!

Could that be considered rebating? Allegedly it's rebating if the retail value is more than $15, regardless of what you pay for it. So if the retail value of the binder is $10 and you actually paid almost $100 for it, then you should be safe?