Understand Your Medicare Prescription Drug Coverage


How well do you think you understand your prescription drug coverage?  Most people (myself included) defer to their doctor’s office to keep them informed of the insurance coverage for their products and services.  Well, what happens if they misinform you of the fine details of that coverage?  Are you responsible?  In an article written for, Joyce Frieden describes a recurring practice that is draining Medicare resources and taxpayer dollars.

Understand Your Medicare Prescription Drug Coverage

Seniors are using brand-name drug discount coupons even though their use is prohibited by Medicare, according to a survey from the National Coalition on Health Care.

And when they do, the prescription often ends up being more expensive for the insurer than it otherwise might have been, the coalition said in the statement.

That’s because “the consumer’s health plan must cover the remaining cost of the brand-name drug, often despite the availability of a much less expensive generic.”

“As policymakers balance the books in Medicare, our research confirms that drug coupons are wasting Medicare and taxpayer dollars,” said coalition president John Rother in the statement.

In a telephone survey of 1,000 seniors who were enrolled in a Medicare Part D or Medicare Advantage plan or who had drug coverage through a retiree health plan, 6% of respondents said they had used a manufacturer’s coupon to put toward the copay for brand-name prescription drugs.

If that rate were projected to the entire group of 42 million Medicare enrollees, “coupon utilization would surpass two million beneficiaries,” noted a statement from the coalition, comprised of 80 organizations including medical societies, unions, businesses, consumer groups, and pension and health funds.

Of respondents who had used the coupons, 19% said they use them “very often,” 6% use them “somewhat often,” 28% “only occasionally,” and 42% “hardly ever.”

For the most part (93%), survey respondents were not aware of any Medicare restrictions on the use of such coupons.

When seniors were asked the source of their coupons, “physician” was named most often (by 13% of respondents); 11% cited a magazine as a source, and 10% got an offer in the mail. Other sources of coupons included pharmacists (9%), TV ads (9%), friends or family members (7%), pharmaceutical company websites (7%), and email offers from pharmaceutical companies (7%).  Original Story Here.

It is important to not only understand your Medicare prescription drug coverage, but all of your Medicare plans. A great way to be fully and accurately informed of your plan is to reach out to your insurance broker.  They are not only a good resource for information, but they are responsible for your plan. Develop an open and communicative relationship with your broker and everything will be fine.

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