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Prescription Medicine & Medicare

Prescription Medicine & Medicare

I have a live call-in radio show every Thursday at 7:00 pm EST on an Oldies station in Palm Beach Florida. To listen in go to trueoldisfla.com. On the upper right on the homepage, you will see a listen live button. Just click on that button and you can listen to the Mr. Medicare show live every Thursday at 7:00 pm EST.

The topic of last week’s show was Medication – Prescriptions. I will review some of the questions that came up regarding prescriptions.

One question was, ”How do I know if my prescription will be covered?” All prescription drug plans must cover a wide range of prescription drugs that people with Medicare take, including most drugs in certain “protected classes,” like drugs to treat cancer or HIV/aids. Every prescription drug plan has a formulary that shows the plan's list of covered drugs. Before you enroll in a Medicare prescription drug plan, you must search the plan's formulary to make sure your medications are covered by the plan.

One question was, “Do I have to enroll in a prescription drug plan?” The answer is, not necessarily. Medicare mandated that when you enroll in Medicare you must have a prescription drug plan. However, if you get your prescriptions from the VA, you do not need to enroll in a prescription drug plan.

If you decide to enroll in a Medicare Advantage plan, in most cases your prescriptions will be covered in that plan. Some people turn 65 and enroll in part A of original Medicare yet use an existing employer health plan that covers their prescriptions. Medicare is designed to help every individual turning 65 decide what works best for them.

One question was, “What is the Part D Late Enrollment Period?” Very few people understand this Late Enrollment Penalty. Medicare realizes that as people age, it is highly likely that they will need prescription medication. By having everyone enroll in a prescription drug plan it spreads the cost of covering prescription drugs across a larger number of people. So if you enroll in Medicare but do not take any prescription medication, you pay a minimum monthly premium that offsets those people who take prescription medications.

Sometimes when people turn 65, they enroll in original Medicare and get Medicare supplemental coverage then tell me they will not enroll in a prescription drug plan and pay a monthly premium because they do not take any prescription medication. I explain the Part D Late Enrollment Period to them and tell them, as they age it is highly likely that at some point they will need prescription medication and they will have to pay a late enrollment penalty forever, from that point forward.

Prescriptions are a large part of Medicare. It is very important that you have a licensed, certified, experienced Medicare specialist to help you make the right decisions. I talk to many people who say they were told what they did when they enrolled in Medicare was okay and then they find out that is not the case and then they pay the late enrollment penalty for the rest of their lives.

Be careful, if you are not sure what to do, call me. I will help you figure out what is best for you, for your individual situation. Call me toll free: (844) 466-7283(SAVE) or email me at: harold@thesolomoninsurancegroup.com.