Evaluate your prescription drug coverage under Medicare and find out if you can save
By Michelle Waldron, Independent Agent; Health Insurance for Seniors
According to a 2019 KFF Tracking Poll, 89% of people over the age of 65 have reported that they take at least one medication regularly, with more than half of those taking more than four medications regularly. 28% of seniors say it’s difficult to purchase their medications due to cost.
Fortunately, as of January 1, 2023, with the passing of the Inflation Reduction Act, there were several key changes to prescription drug coverage for those on Medicare. First, all preventive vaccines recommended by the Advisory Committee of Immunization Practices will be covered at no cost. These include Shingles, Pneumonia, Tetanus and Influenza.
Another change that started in January is that all insulin will have a $35 copay for a 30-day supply. Keep in mind that it must be an insulin listed as covered on your prescription drug plan’s formulary (list of covered medications). Medications like Ozempic and Trulicity are not considered insulin.
Each year, insurance carriers can change how your medications are covered. Your doctor does not know how or if the medications they prescribe to you are covered. The reason why is because there are way too many different plans and formularies. Bring a copy of your prescription drug plan or Medicare Advantage Plan’s formulary with you when you see your doctor.
Many insurance companies have online tools available at the touch of your smartphone for easy access. Your doctor can then work with you to find an affordable and safe option to suit your needs.
Save Money on Meds
Another way to save money is to use mail order whenever possible. All prescription drug plans and Medicare Advantage Plans have mail-order options. You can contact the member service number on the back of your card to request details on how to get mail-order delivery started.
Did you know the U.S. Food and Drug Administration requires all active ingredients in pharmaceuticals and over-the-counter medications be identical in brand-name and generic versions? Generics must also meet the same strength, purity, quality, safety and dosage requirements. Basically, they are identical other than what is binding the active ingredients, and possibly the color and shape of the pill.
Generics tend to be much more affordable than brand-name medications because with brand-name medications there is the built-in cost of initial testing, filing for patents, and marketing. Generics do not incur these costs, which is why they cost less.
Evaluating your prescription drug coverage should be done every year. There are many different plans and options available to you and I recommend working with a licensed insurance agent to help you with this decision. It’s easy to make a mistake when trying to evaluate how your medications are covered and insurance agents will offer this service for free.
As an independent agent with Health Insurance for Seniors, Michelle Waldron specializes in Medicare and health insurance solutions. She works with major carriers and helps clients understand their Medicare options and how to avoid misconceptions and penalties. Call 216-387-3293 or email her at mwaldronmedicare@gmail.comto schedule a free consultation. For more information, visit MedicarewithMichelle.com.