Understanding Your drug Insurance can be a daunting task
insurance in general can be very confusing-no dout,and prescription drug insurance can be some of the most Confusing.the insurance companies like it that way.the more difficult it is the harder for the patient to understand and the more profitable for the insurance company.as a pharmacist i see the games they play daily and, Know they could care less about the insured and the pharmacies doing the work,its all about their profits.
The Process you’ll go thru
The way the process usually works is we start out with a drug plan through our employer or private insurance. Then once we hit 65 years of age we turn to medicare.medicare is a government insurance plan for folkes 65 and older.
Thats when it gets tricky.there is no prescription drug plan that is part of the original medicare program. A few years ago the goverment added an optional drug benefit to medicare called”part d plans”. Many insurance companies participate in these medicare drug plans.some of the big players include aetna,aarp,and
Silver scripts just to name a few.you will also hear terms like aarp benefits and aarp medicare,they are all referring To the part d plans.like all insurance there are pros and cons to each plan.it is important that each person compares
Plans bases on there situation.things to be considered are copays,premiums and deductibles. There is a unique feature to the part d plans known as “the dount hole” or as i like to call it “the butt hole”.
For 2014,when you hit $2850 in rx costs (both patient and insurance company) you are in a coverage gap at this point you would get a discount on your prescriptions equal to 52% on brand name drugs and 28% on generics.then at $4550 out
Of pocket you qualify for “catastrophic coverage”and you only pay 5% till the end of the year.so if you take a lot of medication or very expensive ones you could hit the donut hole after only a few months.thats why i call it the butt hole.
there are many sources to help you with choosing a prescription drug plan.as a community pharmacist we help our
Customers all the time.i have found an excellent medicare plan finder called i-medicare.with this computer software
Program we can in-put a patients medications and then evaluate every part d plan out there.the program will tell us
The monthly premium,the annual deductible,and the co-pays for each rx.it will also list any restrictions a plan might have. just remember that is can be complicated stuff,so seek out people or programs that can help you make the best discussion possible.