Thu, Jan 08 2009
|
Published December 01, 2008 05:23 pm - Seniors' issues: Medicare, drug plan confusing to reader By Judy Benge DEAR JUDY: I am on Medicare and have the Medicare drug plan too. There are so many rules and terms that I am not sure what they mean. This is true even after I read the brochure I received from the insurance company. Can you explain what some of these terms mean, like tiers, etc.?
ANSWER: It is important that anyone covered by the Medicare prescription drug plans know what their particular Medicare insurance company rules are in order to save money on their drug costs. This is especially true when it comes to drugs. Drugs covered by Medicare prescription plans are placed in tiers. It is important for you to know which tier the drug you are ordering is on is that is what determines price. For example, a drug in a lower tier will cost you less than a drug in a higher tier. Also, a higher cost prescription drug plan covers some added drugs that are not placed on the regular plan. In these plans, Tier 1 is where most of the lower cost generic drugs are placed. Generic drugs are safe. Many seniors are reluctant to switch to the lower cost generic drugs thinking they are unsafe. Remember that the Food and Drug Administration requires a generic drug to have the same active ingredients, strength and purity as its brand-name drugs. Here is an example of the costs one company charges: Tier one has the lowest copay of $7. If you decide to get your prescription through the company’s preferred mail service pharmacy that requires a 90-day order, there is a zero copay. This tier has the highest savings at zero cost for a 90-day prescription. The other tiers do save you money, but not as much as the first tier. Tier two for a 30-day supply costs $39. Tier three is $95. The specialty tier, which is for unique and very high cost drugs, requires that the patient pay 33 percent of the drug’s cost. For your preferred mail service pharmacy for 90-day prescriptions, as I previously stated, you pay zero for tier one drugs; for tier two you pay $102; for tier three you pay $270; and for specialty tier you pay 30 percent of the drug’s cost. The cost of shipping is zero. You also have the option of going to other participating mail service pharmacy, but you will pay more, for example, you would pay $21 for a tier one 90-day supply. There are other terms that are used in your prescription plan that you need to know. Quantity limits (QL) means the amount of a drug that the prescription plan will cover for a single copay or within a defined time period. Prior Authorization (PA) requires the patient or the doctor get approval from the plan before a drug can be covered. Just ask your doctor or his staff since most know which drugs require approval. I hope this information helps you understand the complicated prescription coverage. There are so many plans and choices that you need to keep checking each year to ensure you are enrolled in the best plan for your drug needs. 
•
Click to discuss this story with other readers on our forums.
More from the Features section
Gardening: Book helps keep everything green and growing |
Print this story
E-mail this story
Post to del.icio.us
Discuss this story
 |
 |
 |
||||||||
|
||||||||
 |
|
|
© 2008, The Muskogee Phoenix P.O. Box 1968; Muskogee, OK 74402 (918) 684-2828 Email News tips & feedback |
|
Popular Business directory links - Muskogee Apartments | Muskogee Attorneys | Muskogee Auto Dealers | Muskogee Auto Parts | Muskogee Auto Repair | Muskogee Beauty Salons | Muskogee Car Rental | Muskogee Dentists | Muskogee Doctors | Muskogee Flowers | Muskogee Hotels | Muskogee Insurance | Muskogee Loans | Muskogee Mortgages | Muskogee Movers | Muskogee Pizza | Muskogee Realtors | Muskogee Restaurants | Muskogee Storage | Muskogee Tax Preparation | Muskogee Travel | Muskogee Featured | More...
|
|
Community Newspaper Holdings, Inc. • CNHI Classified Advertising Network • CNHI News Service |
