Posted At Philly.com

BY : John Sullivan

When David Ogle went to get the pills he has taken for years to smooth his heartbeat and lower his cholesterol, he left empty-handed. Chalk it up to the Medicare drug program that began this week.

The huge federal plan was supposed to make drugs cheaper for many seniors and disabled people. And it still may. But Sunday's start-up created discouraging snafus for many patients and tense scenes at pharmacies across the region.

This is a... fiasco. The pharmacies are going nuts, and we can't get our drugs," said Ogle, of Rosemont.

Across the region and the country, patients and pharmacists gave mixed reviews to the most sweeping change to Medicare in decades. Many patients complained that they could not get their medications, while pharmacists said they were often unable to verify customers' coverage.

Ogle, 69, said he had given up trying to fill his prescription after spending much of yesterday trying to prove he is covered. His pharmacy told him that he could pay the full amount and try to get reimbursed. Ogle said missing the pills for a few days would not threaten his life.

"I don't have the time to fight them to get paid back," said Ogle, who used to sell insurance.

Most agencies involved in the government drug program said yesterday that they had resolved many of the glitches. Insurers still asked patients to be understanding as they tried to untangle each case. In the end, they said, millions of Americans who had not had the safety net of a prescription-drug insurance program now had one.

"Once we get over the learning curve, it's all good news," said Daniel Lyons, a senior vice president for government programs at Independence Blue Cross in Philadelphia.

The changes are part of the largest expansion in Medicare since it started 40 years ago, with some similar stumbles.

For the first time, Medicare is offering widespread prescription-drug coverage, which officials estimate will cut the cost of drugs for participants in half.

Enrollment will continue through May 15 for most people. Many already have drug coverage through other plans, and many others will have to choose whether to enroll. Those who fail to sign up before the deadline will pay a penalty of 1 percent for each month they delay - if they choose to enroll.

"The bottom line is that tens of thousands of people have successfully been able to access drug benefits," said Lorraine Ryan, spokeswoman for the Philadelphia regional office for the federal Centers for Medicare and Medicaid Services. "With any program like this, you'll have bumps in the road. We addressed some of the glitches from over the weekend, and today was better than the day before."

Health advocates for senior citizens encouraged them to persist despite the problems.

"I can see why people would be disconcerted," said Rebecca Nurick of the nonprofit Center for Advocacy for the Rights and Interests of the Elderly in Philadelphia. "But they should try to look at how this could be a bigger benefit to them in the long run and not worry so much about temporary problems."

Some pharmacists said they had been besieged by anxious customers and often had been unable to get answers from the government or insurers.

"Can you use expletives?" joked pharmacist Bruce S. Sigman, past president of the Pennsylvania Pharmacists Association, when asked how the program was faring.

Sigman said he had customers who had not received their cards, and customers whose cards did not seem to work. He said he could not get through on the phone to insurance companies that the government hired to provide the benefits. And he said customers were confused by the complex and sometimes misleading information provided about the drug program.

Sigman, who works at Genuardi's Pharmacy, a Safeway-owned store in Glenside, said he was doing whatever he legally could to ensure that customers got medication, including giving a small supply free.

"The problems are monumental," he said, adding that two employees spent Tuesday and yesterday waiting on hold for insurance companies and government agencies to answer questions.

The extra people Blue Cross hired to handle the extra calls were soon overwhelmed, Lyons said.

"The program is complicated," he said. "It's a double challenge because of the large volume of lengthy calls. We think we've worked through glitches."

Ed Eisen, 69, of Northeast Philadelphia, said it had taken him four days to get the six medications he takes to keep his heart beating normally.

"I need this medication. I'm glued together with toothpicks," he said.

For years, Eisen said, he bought drugs from Canada for about $1,500 a year. At first, he embraced the new plan as his salvation. But despite signing up in November shortly after enrollment began, he was unable to get his medications after the program kicked in.

"I called and called for three days," he said. By yesterday evening, Eisen said, Blue Cross had resolved a glitch that caused some problems for people in two plans, and he got his medication.

"It was aggravating," he said, "but I'm thankful that I walked in my home tonight with the drugs I needed to stay alive... and I'll save money."