Medicare Offers Help with Prescription Drug Costs
Well prescriptions can be very costly, but you might qualify for this program called Extra Help. This article gives you the information you need to see if you qualify.
If you have additional questions please don’t hesitate to contact my office at (909)792-3300. I will be happy to help anytime.
Have a blessed day!
Medicare Plan Specialist
Extra Help is a Medicare program that assists qualified beneficiaries with paying for their prescription drugs. You could get help paying your Part D premiums, deductibles and copays.
For most people who qualify, 2013 copays will be no more than:
- $2.65 for each covered generic drug
- $6.60 for each covered brand name drug
Other qualified individuals may pay only a portion of their 2013 Part D premiums and deductibles based on their income level.
Do You Qualify?
You need to meet certain income and resource limits to qualify for the Extra Help program. In 2013, you may qualify if you have up to $17,235 in yearly income ($23,265 for a married couple) and up to $13,300 in resources ($26,580 for a married couple).
Resources that count toward your total include:
- Money in checking, savings, IRA and investment accounts
Your primary residence, car, burial plot and up to $1,500 (per person) for burial expenses, life insurance policies, furniture and other household and personal items do not count.
You may automatically qualify for Extra Help if you have Medicare and meet any of these conditions:
- You have full Medicaid coverage.
- You get help from your state Medicaid program paying your Part B premiums (in a Medicare Savings Program).
- You get Supplemental Security Income (SSI) benefits.
Contact your Part D plan sponsor if you think you may qualify automatically. They can help you understand what information you need to provide in order to get started.
Even if you automatically qualify for Extra Help one year, you may not another year if your income or resources change. If you no longer automatically qualify in a given year, you’ll get a notification (on grey paper) by the end of September. You may still qualify for the program, but you’ll need to apply to find out.
–This information is provided by Medicare Made Clear
GeorgeLitchfield.com – If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (909)792-3300 or (888)891-5557 or go to our website GeorgeLitchfield.com and we will give you a quote and help you keep money in your pocket
Generic Drugs: Can You Trust Them? Medicare Supplements, Redlands, Yucaipa
A generic drug is a copy of a brand name drug. It’s identical to the brand name drug in dosage, strength, safety, performance and use. Both prescription and non-prescription drugs may have generic versions.
Separate But Equal
The US Food and Drug Administration (FDA) regulates the pharmaceutical industry, including the approval and manufacture of generic drugs. To gain FDA approval, a generic drug must:
Contain the same active ingredients as the brand name drug (inactive ingredients may vary)
Be identical in strength, dosage form and route of administration
Have the same indications for use
Have the same effect on the body (bioequivalent)
Meet the same manufacturing batch requirements for identity, strength, purity and quality
Be manufactured under the same strict manufacturing practice standards
In short, FDA-approved generic drugs meet the same standards as the brand name drugs they emulate. All generic drugs go through a rigorous review process before achieving approval. In addition, the FDA inspects manufacturing plants and monitors quality, even after a generic drug is approved.
Looks Aren’t Everything
Generic drugs look different from their brand name counterparts. In fact, United States trademark laws state that they must look different. A generic can be any color, size or shape, as long as it doesn’t look exactly like the brand name drug.
But it’s what’s on the inside that counts. Generics have the same type and amount of active ingredients as the brand name drug, and they are usually less expensive. Many are even manufactured by the same company that makes the brand name drug.
Generics in Use
Some Medicare prescription drug plans may require that you try a generic before they will pay for a brand name drug. Or you may be able to request a generic version of a drug you take. But not every brand name drug is offered as a generic.
Your doctor or pharmacist can help you understand what drugs are available and whether a generic may be right for you based on your needs. In addition, your Medicare prescription drug plan customer service representative can explain which generics your plan covers.
–This information is provided by Medicare Made Clear
Turning65-NewtoMedicare.com – If you or someone in your family is 65 or older and is in need of a Medicare Supplemental Plan or already has a plan, but wants to make sure that it is the right plan please give us a call (888)891-5557 or go to Turning65-NewtoMedicare.com and we will give you a quote and help you keep money in your pocket.
All About Medicare Part D – What you Should Know to Get Coverage
In general, prescription drug coverage isn’t included in Original Medicare. To get this coverage, many people enroll in a Medicare Part D plan. There are two main ways to get Medicare prescription drug coverage: a standalone Medicare Part D plan or a Medicare Advantage (Part C) plan with a prescription drug benefit. Which option might be right for you?
Am I eligible?
To be eligible for Part D prescription drug coverage through Medicare, you must first be enrolled in Original Medicare (Medicare Parts A and B) and paying your Medicare Part B premium. You can enroll in a Part D prescription drug plan during your Initial Enrollment Period (IEP) when you first become eligible for Medicare or during the Medicare Annual Enrollment Period (AEP), which is October 15 – December 7th. If you dropped your Medicare Advantage plan to go back to Original Medicare, you can enroll in a Part D prescription drug plan from January 1 to February 14 each year. Some people may qualify for a Special Enrollment Period that doesn’t fall during one of these other enrollment periods.
What’s the difference between coverage types?
Medicare Part D prescription drug coverage is not automatic. You must enroll in a plan if you want coverage. If Original Medicare meets your other coverage needs and you just need extra help paying for your prescriptions, you can purchase a standalone Medicare Part D prescription drug plan (PDP). Another way to get Part D prescription drug coverage is to purchase a Medicare Advantage (Medicare Part C) plan that offers a prescription drug benefit. Not all Medicare Advantage plans offer this benefit, and coverage can vary widely from plan to plan.
How do I get the most value for my health care coverage needs?
It’s important to consider your health needs when thinking about the prescription drug benefit that might be right for you. Keeping your Original Medicare coverage and purchasing a separate prescription drug plan may be a good option. If your health care coverage needs include a wider range of benefits plus help paying for prescriptions, however, a Medicare Advantage plan with prescription drug benefits may offer greater value. Medicare Advantage plans include hospital and medical benefits, but many also include additional benefits like vision, hearing, dental and wellness care. Which plan you choose depends on your individual coverage needs.
What will my plan costs be?
Prices for Part D prescription drug coverage in both Medicare Advantage plans and standalone plans differ. You should research the plans you’re interested in to find out specific costs to you. All plans have similar types of cost sharing, though:
- Premiums – A premium is the amount you pay each month to be covered by a certain plan. These costs can vary widely from company to company.
- Deductible – The deductible is the set amount you have to pay out of your own pocket before the plan begins to cover a portion of the costs.
- Copayment – Your copayment is the amount you pay at the time of service for your prescription drug order. For example you might pay $10 or $15 each time you pick up your prescriptions at the pharmacy.
- Coinsurance – Defined in percentages, coinsurance indicates the split in health costs between you and your insurance company. For example, you pay 20% of the bill and your plan pays 80%.
What happens if I delay signing up for Part D coverage or my coverage lapses?
If you don’t sign up for Medicare Part D coverage as soon as you are eligible, you may pay a penalty on your premium, unless you qualify for an exception. This penalty is set by Medicare. For each month you delay, you may pay an additional 1% (of the average premium) per month. You will pay that penalty for as long as you’re enrolled in Medicare Part D. If you had prescription drug coverage from another source, such as an employer or union, remember that your coverage may lapse or end when you become eligible for Medicare. If you are without coverage for more than 63 days, you may also have to pay a penalty.
–This information was provided by Medicare Made Clear
Serving Redlands, Banning, Yucaipa and the Inland Empire.