Barbara Fradkin – FLORIDA TODAY
Q: Yikes! How can I get help paying for prescription drugs?
A: Paying for medication is difficult for many seniors. There are heartbreaking stories of people who regularly choose between taking their medication or paying the utility bills! Managing drug costs starts with your doctor. Most know how Medicare drug plans work –and what they will pay for. Always ask for generic brands when medication is prescribed. Sometimes, they are even free! Yay!
Looking for a Medicare D prescription plan? There are 22 different plans in the Brevard County area. Four of these plans have a zero (0) deductible, while 16 plans have a $480 deductible. Huh? “Taking the plan with the lowest premium may not work for you”, says Chris Kowalchuk from Viera Insurance Professionals. Find the best plan for YOU, by entering all of your medications. Prices for Medicare D plans factor the allowable medications, deductible, premium and co-pay. Don’t forget to compare local pharmacies– are they preferred, standard or out-of-network?
People with Medicare and limited income/assets may qualify for “Extra Help” with prescription drug costs, through the Part D Low Income Subsidy (LIS) — a program by the Social Security Administration and the Centers for Medicare & Medicaid Services. Note: If you have dual eligibility for Medicare and Medicaid, or qualify for a Medicare Savings Program, you are already getting some extra help with your Part D plan. For additional information, go to www.medicare.gov.
Another way to save on your medications is with Good RX –free coupons that can save you up to 80%. Just ask your pharmacist or visit www.Goodrx.com.
Buckle up for the “Donut Hole.” This is a gap in prescription drug coverage. More specifically, it is the point in the year when your prescription benefits change –because you and your Medicare Part D plan have reached the Initial Coverage Limit. This is based on the actual retail cost of the prescription, not the co-pay. Once you’re in the donut hole, you may pay more out-of-pocket for the cost of your prescriptions, until you reach the yearly limit ($7,050 retail prescription costs). You then enter the “catastrophic” stage of coverage. So, the rest of the calendar year you’ll only have to pay (whatever is higher): 5% of the prescription’s cost or a small co-pay ($3.95 for generics, $9.85 for name brands). Personally, I think donut holes should only be eaten and not part of our health plans!
Have I succeeded in confusing you? It’s a tough subject! Luckily, One Senior Place is just a phone call away at 321-751-6771. We are The Experts in Aging.
One Senior Place is a marketplace for resources and provider of information, advice, care and on-site services for seniors and their families. Questions for this column are answered by professionals in nursing, social work, care management and in-home care. To submit a question, send an email to askOSP@OneSeniorPlace.com or visit One Senior Place, The Experts in Aging at OneSeniorPlace.com. Barbara Fradkin is a Social Worker, Certified Care Manager and the Director for One Senior Place, Viera.