by Greg Dill
Medicare’s regional administrator for Arizona, California,
Hawaii, Nevada, and the Pacific Territories

Having practiced pharmacy for many years, I often find myself talking to people about their Medicare prescription drug, or Part D, plans.

People with Part D usually share their thoughts about a favorite pharmacy or pharmacist, or how their plan offers medicines at affordable prices. Sometimes they report problems with a Part D plan, ranging from the cost of drugs to difficulty in getting a specific medication their doctor prescribed.

A first step to correcting problems is always to contact your drug plan (contact information is on the back of your drug card). A call to the plan usually will resolve your issue. If that doesn’t work, you can file a complaint.

You can do that by calling 1-800-MEDICARE or going online at www.Medicare.gov. Complaints can be made against Part D drug plans as well as Part C health plans, also known as Medicare Advantage plans.

The online Medicare Complaint Form is easy to use. Medicare takes the information you send and directs it to your plan. Then we follow up and monitor how well the plan resolves your complaint.

To find the complaint form, go to www.Medicare.gov and locate the blue box near the top of the page that says “Claims & Appeals.” Place your cursor over that box until a dropdown menu appears and click on “file a complaint.” When the next page comes up, click on “Your health or drug plan.”

You can also lodge a complaint by calling or writing to your plan. Your complaint could involve a problem with customer service, difficulty in getting access to a specialist, being given the wrong drug, or being given drugs that interact in a negative way.

If you file a complaint about your Part D drug plan, certain requirements apply:

You must file your complaint within 60 days from the date of the event that led to the complaint.

You must be notified of the decision generally no later than 30 days after the plan gets the complaint.

If your complaint relates to a plan’s refusal to make a fast coverage determination or redetermination and you haven’t purchased or gotten the drug, the plan must give you a decision no later than 24 hours after it gets the complaint.

In addition, you can make a complaint if you have a concern about the quality of care or other services you get from a Medicare provider. This includes doctors, hospitals, or other medical providers; your dialysis or kidney transplant care; or a Medicare-certified supplier of durable medical equipment such as wheelchairs, walkers, and oxygen equipment.

How you file a complaint depends on what your complaint is about. For more information, go to www.medicare.gov/claims-and-appeals/file-a-complaint/complaint.html.

As a Medicare beneficiary, you also have certain appeal rights. What’s the difference between a complaint and an appeal?

A complaint is generally about the quality of care you got or are getting. For example, you may file a complaint if you have a problem contacting your plan or if you’re unhappy with how a staff person at the plan treated you. However, if you have an issue with a plan’s refusal to pay for a service, supply, or prescription, you file an appeal.

For more information on appeals, take a look at your “Medicare & You” handbook, mailed each fall to every Medicare household in the country.

Or go online at www.medicare.gov/claims-and-appeals/file-an-appeal/appeals.html.

You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

Parkinson’s disease is a chronic, degenerative neurological disorder that affects one in 100 people over age 60. While the average age at onset is 60, people have been diagnosed as young as 18. There is no objective test, or biomarker, for Parkinson’s disease, so the rate of misdiagnosis can be relatively high, especially when the diagnosis is made by a non-specialist. Estimates of the number of people living with the disease therefore vary, but recent research indicates that at least one million people in the United States, and more than five million worldwide, have Parkinson’s disease (stats from Michael J. Fox Foundation for Parkinson’s Research).

As many as one million Americans live with Parkinson’s disease, which is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease.

Approximately 60,000 Americans are diagnosed with Parkinson’s disease each year, and this number does not reflect the thousands of cases that go undetected.

An estimated seven to 10 million people worldwide are living with Parkinson’s disease.

Incidence of Parkinson’s increases with age, but an estimated four percent of people with PD are diagnosed before the age of 50.

Men are one and a half times more likely to have Parkinson’s than women.

As many as one million Americans live with Parkinson’s disease, which is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease.

Why A Tulip? On April 11, 2005, the red tulip with a fringe of white was launched as the official symbol of PD at the 9th World Parkinson’s disease Day Conference in Luxembourg.

The Ventura Parkinson’s Disease Support Group is pleased to announce that Dr. Sarah Kempe-Mehl will be presenting “Beyond the Tremor: Living with the Non-Motor Symptoms of Parkinson’s Disease” at their meeting Wednesday, April 12, from 1:00 to 3:00 pm at The Lexington Assisted Living, 5440 Ralston St,. Come participate in a brief round table at the beginning of the meeting.

Dr. Sarah Kempe-Mehl will be speaking from 2 to 3pm. She will be focusing on the non-motor symptoms of Parkinson’s Disease and also “Why see a movement disorder Specialist” along with the services available from her practice with Dr. Erin Presant, “Central Coast Movement Disorders Specialists”  which was established in March of 2016 in Santa Barbara. (http://www.movementdocs.com).

Dr. Kempe-Mehl is a board-certified neurologist and fellowship-trained in movement disorders. She subsequently completed a one-year fellowship in movement disorders at Stanford University.

Please check in at the front desk for directions to the meeting room. Extra parking is graciously available across the street from the Lexington in the Baptist Church parking lot. Call 766-6070 for further information. Reservations are not required.

As Congress and the new Trump Administration suggest they might repeal and replace the Affordable Care Act, fraudsters are taking advantage of the confusion it’s creating. They may pose as insurance company representatives or someone from Medicare or another federal agency. They will be on the hunt for personal information and money. Don’t fall for bogus requests to verify patient information, promises of refunds, or requests for payment of future premiums.

If you buy products on Amazon.com, you are not necessarily buying from Amazon.com. In fact, Amazon.com connects buyers to a wide array of third party sellers. While most of these sellers are legitimate, beware of scam artists lurking in the marketplace. It’s likely a fraud if a seller asks you to make your purchase in a way other than through the Amazon.com website. Amazon.com guarantees purchases made from third party sellers as long as the purchase is made via the Amazon.com website.

A utility scam is reaching record levels in some parts of the country this season. Fraudsters call homeowners, claiming that their gas or electric account is delinquent and threaten to shut off the service if payment is not immediate. The scammers typically ask for payment with a prepaid debit card. While more consumers are recognizing this as a scam, the callers can be very convincing. Know that your utility company will not call and threaten to shut off your service, and you’ll always receive written notification before your service is cut off.

Be a fraud fighter!  If you can spot a scam, you can stop a scam.  Don’t fall for the jury duty scam. This is when you get a call, supposedly from the courthouse, claiming you failed to show up for jury duty and you face a fine or immediate arrest. The fraudster will typically demand the victim pay by wire transfer or a prepaid card. These forms of payment should always raise alarm bells. If you have questions about jury duty, contact the court clerk in the county where your service was to take place. The court will never ask jurors for financial information, so never provide such information to someone claiming to be from the court.

As the price of prescription drugs continues to rise, you might find yourself searching online for more affordable medications. Beware of bogus companies that take your money and never send you the product, or worse, send you a product that could cause you harm. Also, be sure to read the fine print on prescription drug coupons you find online. You might discover your purchase won’t count toward your deductible, or that the coupon expires after a certain number of refills.

Report scams to local law enforcement. Contact the AARP Fraud Watch Network at www.aarp.org/fraudwatchnetwork for more information on fraud prevention.