January 15, 2014
Pharmacists Help “Bridge the Gap” With ACA Prescription Coverage Delays

Alexandria, VA—If pharmacists have a sense of déjà vu about helping consumers bridge coverage gaps during Affordable Care Act implementation, it’s because they actually have been in a similar situation before.

“During the 2006 implementation of the Medicare Part D drug benefit, community pharmacists helped patients with emergency supplies thousands of times,” said Douglas Hoey, chief executive of the National Community Pharmacists Association.  “A 2006 survey of over 500 independent community pharmacists found that more than half (58%) provided 50 or more emergency supplies to seniors during the early days of Part D. Another 21% reported doing so 21-50 times.”

Hoey pointed out that helping customers navigate new or revised health insurance coverage is “business-as-usual for independent community pharmacies year-round and especially each January. Now more than ever that is the case with the advent of these new health plans.

“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,” he added.

Pharmacy chains also have gotten into the act. Walgreens said it will provide medications to patients who are enrolled in new insurance coverage but haven’t yet received their plan identification numbers. Through the end of this month, those customers will be able to use confirmation of their enrollment in the public health insurance marketplace to receive up to a month of traditional brand and generic medication at no upfront cost. The pharmacy chain also is offering to verify eligibility for customers who don’t have verification with them.

CVS Caremark, meanwhile, is offering to assist patients in some situations with a “bridge” supply of 15 to 30 days of medications while they are experiencing a temporary disruption in coverage. CVS said the transitional supply might be provided free of charge in some cases of financial hardship.

Similar flexibility will be offered by MinuteClinic, the medical clinic inside some CVS pharmacy stores, for patients in transition with their healthcare coverage.

Other chains—national, regional, and local—have made comparable offers.

U.S. Pharmacist Social Connect