It’s important to understand that pharmacies are not treated the same by your Medicare plan. Whether you have a standalone Part D plan (where you pay a premium each month) or a Part D component to a Medicare Advantage (Part C) plan, many Medicare members don’t realize that there are networks of pharmacies to adhere to and in some cases one drug could cost four different amounts if a member goes to four different outlets for their drugs. Many Part D plans have four different types of pharmacies—1. Preferred, 2. Non-preferred, 3. Non-network, and 4. Mail-Order.
Medicare Subsidies and Aid programs
When it comes to Medicare there are two main forms of aid—Medicaid and Low Income Subsidy (LIS). Both programs are income-based programs run by the state but each assists a Medicare Beneficiary in different ways. Medicaid helps an individual with Medical costs (doctors, hospitals, outpatient procedures, etc.) whereas Low Income Subsidy (also called, “Extra Help”) is specifically designed to help an individual with prescription drug copays and coinsurance on his/her Part D plan.
When to start the Medicare Process
It is recommended that potential Medicare beneficiaries start the process of enrollment three months prior to their 65th birth month. For example, if an individual turns 65 on July 4, he or she will most likely become Medicare eligible on July 1; therefore, he or she should contact Social Security after April 1. You can contact Social Security via telephone, the internet, or in person to check the status of your Medicare enrollment.