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Pharmacies help patients make transition to ACA

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NEW YORK — Community pharmacy chains across the country have been offering patients who recently secured insurance under the Affordable Care Act advice and payment breaks on prescriptions.

CVS/pharmacy, Walgreen Co., Rite Aid Corp., Kinney Drugs Inc. and Walmart are just a few of the community pharmacy operators who are offering prescriptions at no up-front costs to newly insured patients without ID cards.

In addition, discounter Shopko Stores Operating Co. and such supermarket-based pharmacies as those operated by Ralphs Grocery Co. and other chains owned by Kroger Co. are providing newly covered patients with prescriptions until their insurance gets them the documents they need.

“We understand that all the changes that come with health care reform may create some questions for newly enrolled individuals,” Walgreens president of pharmacy, health and wellness Kermit Crawford says. “We are deeply committed to helping these patients get, stay and live well by helping them to get their medications without interruption.”

Walgreens and most of the other chains who have vowed not to charge up-front payments are giving newly covered patients 15- to 30-day prescriptions to ensure that there are no interruptions in their medication schedules.

Most of the chains’ transitional prescription benefit plans, however, are excluding complex and expensive medications like cancer drugs or treatments for rare diseases.

With millions of people signing up for health insurance late last year through state-based exchanges and the problem-plagued federally operated website, many patients were left without insurance cards and other documents needed to ensure coverage of their prescriptions as the plans went into effect on January 1.

Community pharmacy chains immediately stepped up to the plate, saying that newly covered patients would not face any up-front costs.

Under most of the pharmacies’ plans patients do not have to pay anything at the pharmacy, but may receive a bill later for their required co-payment. The drug store chains also will collect payment from the insurer once it verifies enrollment.

Ensuring that patients get proper medications should not be hampered by delays in getting insurance cards, say the retailers.

“Every pharmacist knows how important it is for people to take their medications as prescribed, without any interruption,” Rite Aid executive vice president of pharmacy Robert Thompson says. “Each year, Rite Aid pharmacy teams work with and help guide customers through first-of-the-year insurance plan changes, and that’s especially true this year, as we know that those newly enrolled may have questions or concerns about their prescription coverage.”

The so-called bridge supplies being offered by the chains are also being supplied by independent drug stores across the country.

“While health plans are the payer of first resort for the newly insured, most independent community pharmacists will provide emergency medication supplies, when appropriate, to their patients confirmed with new insurance coverage through the marketplaces, so that these patients don’t fall through the cracks,” National Community Pharmacists Association chief executive officer Douglas Hoey says.

The rollout of the ACA, he notes, is not the first time that pharmacists have had to deal with the problems caused by the introduction of a new government program.

“During the 2006 implementation of the Medicare Part D drug benefit, community pharmacists helped patients with emergency supplies thousands of times,” Hoey says. “A 2006 survey of over 500 independent community pharmacists found that 58% provided 50 or more emergency supplies to seniors during the early days of Part D. Another 21% reported doing so 21 to 50 times.”


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