What You Need to Know About Medicare Prescription Coverage

What You Need to Know About Medicare Prescription Coverage

The American Public Health Association reports that while older adults only make up 12 percent of the U.S. population, they account for 34 percent of all prescription drug use and 30 percent of all over-the-counter drug use. It’s important to understand your Medicare plan’s prescription drug coverage to ensure your drug needs are met.

Ask yourself: Does your current plan offer prescription drug coverage that protects you from the high cost of medications? Original Medicare, for example, doesn’t cover prescription drugs. Nor does Medicare supplement plans (also known as Medigap plans). If you are worried about getting your prescription drugs covered, many of our Medicare Advantage plans offered by Blue Cross Blue Shield of Michigan and Blue Care include prescription drug coverage. We also offer standalone Part D prescription drug plans that help cover the high costs of medications. Both types of plans have low copays for many drugs, and include discounts that help you through the coverage gap, also known as the “donut hole.”. With drug coverage through either a Medicare Advantage plan or a standalone Part D plan, you can go to nearly any pharmacy in Michigan and get your prescription filled. You can also use many pharmacies around the U.S., too.

Each Medicare Part D drug plan has its own list of covered drugs called a formulary. Most drug plans place drugs into different “tiers” on their formularies. The cost of a prescription drug will depend on which tier it falls within.  A drug in a lower tier will cost you less than a drug in a higher tier.

It pays to be informed about your prescription drug coverage when enrolling in a Medicare plan. Spend some time thinking about your health needs and find a Blue Cross Medicare Advantage or Part D Prescription Drug Plan that works best for you.

With Medicare’s annual enrollment currently taking place, you can call 1-855-339-9231 between the hours of 8 a.m. and 9 p.m. Monday through Friday for more information, visit our website, or visit one of Blue Cross’s walk-in centers for support:

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits may change on January 1 of each year.

Medicare Plus BlueSM, Blue Cross® Medicare Private Fee for Service, BCN AdvantageSM and Prescription BlueSM are PPO, PFFS, HMO-POS, HMO and PDP plans with Medicare contracts. Enrollment in Medicare Plus Blue, Blue Cross Medicare Private Fee for Service, BCN Advantage and Prescription Blue depends on contract renewal.   

Photo credit: Ajay Suresh

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