TIPS WHEN APPLYING FOR THE MEDICARE PRESCRIPTION BENEFIT






There are a variety of ways to apply for this benefit:

  • Medicare's web site(www.medicare.gov)
  • Medicare's phone(1-800-medicare- 633-42273)
  • The SHINE program(contact your Senior Center or Area Agency on Aging)

The application process for the new Medicare prescription benefit has been a challenge for consumers and providers.

There is some information you should always have no matter where you go for assistance.

The following will describe what you should bring with you and also identify some questions to ask when you choose a plan(for yourself or others).

If and when you apply consider using the FAST method. Organize the following about each individual medication.

 

Frequency

Know the frequency or how often you take each medication. For example, is it taken once a day, twice a day, once a week, etc?

Amount

Know how much is taken. Is it 5mg, 10 mg, 100 mg, etc.?

Spell

Spell the medication exactly as it is printed on the package. In some cases there may be a few letters after the name of the medication. Include those letters.

Type

Know the type of medication. Is it a pill, capsule, liquid, patch, etc.?

Check all this information on the container(bottle, box,etc.) and bring it when you apply.

ASK THE FOLLOWING QUESTIONS:

1. What are the up-front costs?

The monthly premiums and annual deductibles are costs which will be incured.They will differ from one plan to another. Lower up-front fees may cost less but may or may not be helpful to meet medical needs.

2. Does the plan cover all of the medications prescribed by the physician?

Check each plan being considered and be sure each medication is covered.

3. Are there restrictions on any of the medications?

Some plans may:

  • Restrict how often a prescription may be filled.
  • Limit use to a generic version.
  • Require a physician to affirm that the medication is need(prior authorization).

4. What is the co-pay foreach medication on each plan?

The co-pay can be different with each and every medication on each plan.

As complex as this is it will simplify matters if you are prepared knowing all of the above about the medications and also come prepared to ask the previous questions.

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