By Trish Pearson
Insure Your Future
Trish Pearson
I was recently away and discovered that I had not picked up a prescription at my local pharmacy. So I began the process of transferring it to the local CVS in Florida. After two days of calling, sitting on hold or standing in line at the pharmacy, I found that I could arrange for it to be transferred by using the CVS app and requesting the change.
When I went to pick up the prescription I also discovered that the cost had gone from $140 for three months to $37. Imagine my reaction to this pleasant news. What lessons does this hold for us?
First, it is important that your health coverage and prescription drug coverage will work easily in another state. This is particularly important if you will be away for an extended period, such as a month or more. Take the time to set up an online account with your insurance provider(s). If you have a Medicare Advantage plan you only need one account; if you have a Medicare supplement plan and prescription drug plan with two different companies, set up an account with each.
There is so much information pertaining to coverages, costs and frequently asked questions, such as: how do I fill a prescription if I am out of town? Some plans allow you to change your network to the area where you will be for a month or more. Again, having an online account can save time on hold waiting to speak to member services. If you need help setting this up, ask for guidance from your agent or your children or grandchildren.
Second, if your prescription drug plan has a coinsurance for name brand medications, it might end up costing you less than the standard $45-per-month copay. All medications are assigned a tier by the prescription benefit manager, such as Express Scripts or CareMark. Not all medications are classified as tier three or higher because of cost. The demand for that medication may be less, which also impacts the tier assignment. Such was the case with my prescription.
The cost could vary from month to month, depending on the retail cost. Medications are a commodity like gasoline, with equally frequent price changes. The easiest way to estimate the retail cost of a medication is to look at one of the prescription discount card sites, such as Good Rx or Single Care. The site will show the retail cost as well as the discount. Generally, if the retail cost is less than $200 per month, the medication will cost less if the coinsurance is 20 percent.
Medicare insurance plans today are designed to be more flexible and tailored to a variety of lifestyles. Even if your premium is $0, you are entitled to good service and competent answers without spending hours on the phone. Have your member information handy (take a picture and save it to your phone along with the online sign-on information), and call the agent first. Very often we can answer questions or get the answers quickly. Your time is valuable, even if you are retired.
Trish Pearson is a licensed independent insurance agent and certified long term care specialist. Contact her at 203-640-5969 or trishpearson281@gmail.com.