What is Medicare

What should I do if I move out of my Medicare drug plan’s service area?

clewis — Tue, 06 Nov 2007 12:42:16 -0600

You can switch to a Medicare drug plan in your new area as early as the first day of the month before you move. This way, your new coverage will begin the first day of the month in which you move. Or, you can join up to two months after you move. If your previous employer or union pays for your Medicare prescription drug coverage, contact your benefits administrator to learn about your options.

How do I pay my Medicare drug plan premium?

clewis — Tue, 06 Nov 2007 12:41:26 -0600

There are three ways to pay your Medicare drug plan premium:

Are generic drugs as good as brand-name drugs?

clewis — Tue, 06 Nov 2007 12:40:09 -0600

Yes. According to the Food and Drug Administration (FDA), a generic drug is the same as a brand-name drug in dosage, safety, strength, quality, the way it works, the way it’s taken, and the way it should be used. Generic drugs use the same active ingredients as brand-name drugs and work the same way. So they have the same risks and benefits as the brand-name drugs.

What are “tiers or categories” on a Medicare drug plan’s drug list (formulary)?

clewis — Tue, 06 Nov 2007 12:37:34 -0600

Many Medicare drug plans place drugs into different “tiers.” Drugs in each tier have a different cost. Some plans may have more tiers and some may have fewer. Here is an example:

Tier 1
You pay: Lowest copay
What is covered: Most generic prescription drugs
Cost example*: $5.00

What if I’m taking a drug that isn’t on my plan’s drug list or a step-therapy drug when my drug plan coverage takes effect?

clewis — Tue, 06 Nov 2007 12:36:02 -0600

Your drug plan will provide a one-time, temporary supply of your current drug. During your first 90 days in a plan, Medicare requires Medicare drug plans to give you and your doctor time (30 days) to find another drug on the plan’s drug list that would work as well as the drug you are taking. Different rules may apply for people who move into an institution (like a nursing home).

What are some of the rules?

clewis — Tue, 06 Nov 2007 12:34:56 -0600

To be sure certain drugs are prescribed and used correctly and only when truly necessary, plans may have certain standard rules, including:

Why are there rules about whether and when certain drugs are covered?

clewis — Tue, 06 Nov 2007 12:33:39 -0600

There are many rules that can vary by plan. There are certain drugs that Medicare drug plans aren’t required to provide, such as benzodiazepines, barbiturates, and drugs for weight loss or gain. Some plans may choose to cover these drugs as an added benefit. In addition, drug plans aren’t allowed to cover drugs for erectile dysfunction or over-the-counter drugs for relief of colds.

What if I need to fill a prescription before I get my Medicare drug plan membership card?

clewis — Tue, 06 Nov 2007 12:32:25 -0600

You can take any of the following to the pharmacy as proof of membership in your Medicare drug plan:

An acknowledgement or confirmation letter from the plan
A welcome letter from the plan
An enrollment confirmation number that you got from the plan, and the name and telephone number of the plan

If you enroll early in the month, there is a better chance you will have your membership materials when your coverage starts.

Getting the Most Out of Your Medicare Prescription Drug Coverage

clewis — Tue, 06 Nov 2007 12:31:22 -0600

Once you have joined a Medicare drug plan, there are things you should know so you can get the most out of your Medicare prescription drug coverage. The following information can help answer questions that may come up as you begin to use your coverage.

How do I join a Medicare drug plan?

clewis — Tue, 06 Nov 2007 12:30:07 -0600

Once you choose a Medicare drug plan, you may be able to join