We have all been there. You went to the doctor and they tell you about a new drug that can drastically help your condition. You are excited… your doctor is excited… your spouse is ecstatic… your bank account not so much. It is unfortunate that some of the treatments that can help you most are prohibitively expensive. So what are your options? How can you benefit from the latest that medical science has to offer and protect your financial security?
For Medicare beneficiaries, the good news is that there are prescription drug plans available to you in your area. In fact, the majority of beneficiaries have 20 or more plans that service their area. But how do you go about finding the appropriate plan?
A broker is an insurance professional that works for you. It is important that you have an advisor that will do the research for you to ensure that your prescriptions are covered. One of the main things an advisor will do is compare all of the different drug formularies. These are specific lists, unique to each insurance company, that determine what each prescription will cost. Your broker will take your list of prescriptions and provide you with options that limit your cost. If there are decisions to be made, your broker should clearly outlay the pros and cons of each plan. In one instance, I was able to reduce insulin costs for a client of mine from $143 a month to $0. Furthermore, their premium was reduced by $27 monthly resulting in a total out-of-pocket savings of over $2,000.
Apply For Pharmaceutical Assistance Programs
Even the most comprehensive drug plans may not reduce the cost of newer drugs to an affordable level. As a service to our clients, we help in the leg work finding programs that can drastically reduce these costs. We are knowledgeable of programs that are available to clients on Medicare Part D and can direct and assist you in applying for the discount programs. Most of these programs require you to have prescription drug coverage through Medicare, so be sure that you have that in force prior to applying for benefits.
Apply For State Assitance Programs
States have programs in place to control the cost of drugs if your income is below a certain threshold. These are known as Low-Income Subsidies. You may be surprised to learn that you qualify for these programs as the threshold to begin triggering benefits is high than most beneficiaries realize. Once again, your broker should be able to direct you towards qualifying for these programs.
Review Your Plan
Each and every year, insurance companies bring new programs to the area and discontinue others. They also may make changes in the formulary that determines your coverage. It is paramount that you, in coordination with your broker, review your coverage and look at all the available plans. You may ultimately decide to stay on the plan you are currently enrolled in, but the information and review are certainly a wise decision. And quite frankly, it costs you nothing more than a 15-20 minute phone call.