Over two million people have now enrolled to obtain insurance coverage via insurance exchanges, with the effective date of January 1, 2014. Due to the late enrollment surge in December, many people do not yet have an identification card or plan number.

The government considers people “enrolled” after they select a health plan. The first month’s premium for people that signed up in December is due no later than January 10, 2014, and identification cards and plan numbers will be issued only after the premium is paid.

Retail pharmacy is often where healthcare coverage is first experienced. Prescriptions needed in January before the new identification cards arrive create a conundrum for retail pharmacy. Walgreens, CVS, and Walmart have all announced that they will help patients verify coverage, answer questions, and provide up to a 30-day supply of medication during the month of January, at no upfront cost, to patients who demonstrate they have signed up for an exchange plan.

Putting a month’s supply of medication at risk to support a smooth transition and ensure that patients do not go without their medication is a strong demonstration by these retailers that they place great importance on patient care.

A concern exists about potential sticker shock when patients find out their medication is not covered, they have a 20% or 50% co-insurance for prescription medications, or that they have no reduction in costs until their deductible is met. Will these pharmacies have an uncollectable receivable for a medication that has already left the pharmacy and been consumed? Time will tell. Retailers may engage CMS in discussions on resolving these issues, if they have not done so already, in order to support the ACA rollout.