Getting The Most From Medicare Drug Plans

Thanks to Robin Smith for this informative article

While the majority of the healthcare delivery system is plagued by runaway costs and obtuse and arcane billing prac­tices, consumers often overlook aspects of their benefits that can actually save money, and possibly improve their health. All Medicare Prescription Drug Plans (aka “Part D”), include underutilized features that seniors who take multiple medica­tions may want to utilize. The first is medication manage­ment provided by the plan at no additional cost to the client. Details on this service, as practiced by individual plans, are in the membership booklet, or can be explained by calling cus­tomer service. Secondly, if the senior has a drug prescribed by the doctor which is not in (or has been removed from) the plan’s formulary, the senior does have avenues available to get the plan to cover the drug. Called “step therapy,” the patient’s doctor can write a letter to the plan, stating the rea­sons why the patient must receive the drug. Reasons can in­clude things like: all other drugs for the condition have been tried and failed, interaction with other drugs the client is tak­ing, etc. Once again, the membership book outlines how this benefit may be accessed.

Patients should always discuss whether or not they can afford the drug the doctor has prescribed, as cost is one of the main drivers of medication non-compliance. 78% of the drugs pre­scribed in the USA are now generics, although there is recent evidence that Big Pharma is fighting back by slowing the manufacturing of generics to create shortages. For seniors on multiple medications, consultations with pharmacists are free of charge. To prepare for a pharmacist consult, the FDA has a list of things the senior should bring. Seniors should always include non-prescription drugs on their lists, as drugs like Ty­lenol PM, with an active ingredient of Benadryl, can have very bad side effects when taken by the elderly.

When Medicare Open Enrollment comes around again, sen­iors can bring their medication list to Walgreens or CVS to determine the best PDP plan for them for 2012, free of charge

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