Your Pharmacist is a Valuable Medicare ResourcePosted by Medicare Made Clear
As part of National Medicare Education Week, we asked leaders from organizations and companies in the health and aging fields about preparing for Medicare Annual Enrollment, which runs from Oct. 15 to Dec. 7. This is the time each year when you can change your coverage choices for the following year. Today we focus on Medicare Part D prescription drug coverage and the help that you might find at your local pharmacy.
We spoke with Mike Suwalski, director of Medicare operations for Walgreens. Walgreens operates approximately 9,800 stores throughout the United States, Puerto Rico and the U.S. Virgin Islands.
Q. What kinds of Medicare questions do pharmacists get from people most often? What are the areas of greatest confusion or concern?
Suwalski: One of the most frequently asked questions we hear is, “What is the difference between PDP and MAPD?” A standalone Part D Medicare prescription drug plan, or PDP, covers only prescription drugs. A Medicare Advantage plan that includes prescription drug coverage, or MAPD, is a comprehensive plan that covers complete Medicare benefits, including inpatient and outpatient care, plus prescription drugs. Many MAPD plans cover dental, vision and hearing care as well. PDP and MAPD plans are offered by private insurance companies approved by Medicare.
People also ask how Medicare plan benefit changes will affect their out-of-pocket costs. For example, prescriptions covered under a plan one year might not be covered the same way the following year. Plans may change the copay amount or stop covering a medication entirely. It’s a good idea to review your plan annually to make sure your prescriptions are covered and your pharmacy is in your plan’s pharmacy network.
Q. As people get older, they may take more medications. How can pharmacists help people manage their medications and avoid any potential problems?
Suwalski: Pharmacists can help to identify possible drug interactions, especially if you use the same pharmacy for all your medication needs. They can also help answer questions and warn you about potential side effects and expected outcomes. Pharmacists can provide guidance on the best time to take your medication, offer tips to help you remember when to take it, and be an accessible resource in case you forget the instructions. When cost is a concern, pharmacists can sometimes recommend a less expensive option, such as a generic substitute or an alternate brand name drug.
Q.What tips do you have to help people save money on their prescription drugs?
Suwalski: Saving money on your prescriptions is a great way to bring down your overall health care costs. Fortunately, there are ways to do that.
- Ask your pharmacist or doctor about generic or other low-cost substitutes for any expensive medications you’re taking. Drugs on the low tiers of your plan’s list of covered drugs (formulary) cost lessand could work as well as their high-cost counterparts.
- Think about getting 90-day refills when offered. They typically cost less per dose than 30-day supplies.
- Check to see if your plan has a preferred pharmacy network. Your copay is usually less when you fill prescriptions at preferred pharmacies.
Q. Is there anything else Medicare enrollees should know about using their pharmacy as a resource?
Suwalski: Pharmacists are highly educated medication and immunization experts, and they stay current on the latest advances in medical science. They can help Medicare beneficiaries stay healthy by providing medications, immunizations and information to help them better understand their drug therapy. Pharmacists are local, easy to reach and ready to answer questions and offer tips on what to expect from medications and how to maximize their results.
Making decisions about your Medicare prescription drug coverage does not have to be overwhelming. Guidance is available, including from your local pharmacist.
To get started, check out this overview of Medicare prescription drug coverage and other resources such as Medicare.gov.
For more information, explore www.NMEW.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.