By Patricia Prewitt
My Personal Rx Adviser
Prescription coverage, pricing, and insurance rules can be confusing, especially at the start of the year when deductible costs vary widely – from zero (some Medicare Advantage Plans) to $250 (certain commercial plans) to $590 (standard Medicare Part D) to thousands for high-deductible plans.
With such a variety of prescription plans and coverage rules, it is simply impossible to offer advice in this column that will work for everyone. Have you tried the usual tactics of asking your pharmacist, or contacted your prescription insurance plan for clarity about costs? Have you found yourself wondering if there is someone you could just talk to about your medication costs? Are you curious about patient assistance programs, but you have no idea if they might help you? Why not find out by contacting one of these resources who staff their phone lines with live representatives? But before you call…
Be prepared: Be sure to have the names of your prescriptions, doses, and pricing information, along with the prescription insurance coverage information. Be patient; you may have to leave a phone number for a return call when lines are busy.
What to expect: A representative is likely to ask you some basic questions about household size, income, and what you have (or don’t have) for prescription insurance coverage. These questions determine which program you may qualify for. Be honest. Some programs offered through philanthropic arms of pharmaceutical companies have income guidelines that are higher than you might think, and are not restricted to people 65 and above.
Here are some options for live help via telephone:
MCPHS pharmacy (MA residents only): 866-633-1617, M-F, 8:30 a.m. to 5 p.m.
Mass College of Pharmacy and Health Sciences Pharmacy Outreach Program offers community support through case managers, licensed pharmacists, and students. This program provides medication education, management, and guidance on cost-saving options through state and federal programs, including Medicare benefits.
www.mcphs.edu/patient-centers-and-clinics/pharmacy-outreach-program
NCOA benefits checkup hotline: 800-794-6559, M-F, 8 a.m. to 7 p.m.
Since 1950, the National Council on Aging has supported older adults. Their secure website, www.benefitscheckup.org, connects individuals to programs that may help reduce costs, including prescription assistance. The site is easy to navigate and designed in such a way that caregivers may easily assist others.
Limited Income Net Program (federal/newly eligible ACA): 800-783-1307. A new hotline for individuals and families newly eligible for expanded benefits under the Affordable Care Act. Wait times may be shorter than the Social Security Administration’s Extra Help line (800-722-1213). Visit www.ssa.gov for details.
Readers of The South Shore Senior News can book a free, 10-minute consultation at 508-507-8840 or book on my website. Please leave your name, callback number, and preferred time. Due to scam/spam calls, I may not answer unknown numbers.
Content provided is for educational purposes only, and is not intended as a substitute for advice from a qualified medical professional. The opinions expressed within are those of the author.
About the Author: Patricia Prewitt is a local Massachusetts resident who spent more than 30 years in the pharmaceutical industry. Tricia is a consumer education advocate, and loves helping people find ways to save money on their prescriptions. More information and free resources are available on her website at https://mypersonalrxadvisor.com/resources or call her at 508-507-8840. Favorite Quote: “Act as if what you do makes a difference. It does.” – William James
