Most Medicare plans that include prescription drug coverage also include the option for home delivery. Pharmacies that have a mail-order option will usually provide this service.
A person with Medicare Part D can get their prescriptions by home delivery. Those with Medicare Advantage may also get this benefit, but rules may apply.
A 2015
Older adults may take several medications prescribed by multiple providers, and filling prescriptions at one pharmacy may be helpful, especially if they offer home delivery.
In this article, we discuss how people may get their prescriptions delivered by mail-order from one pharmacy.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare does deliver prescription medication to a person’s home.
Prescriptions are paid for by Medicare Part D, also known as prescription drug plans (PDPs). Private insurance companies administer PDPs, and they must follow Medicare rules.
One of the rules for Medicare Part D plans is that they must have a network of pharmacies from which a person may choose. The plan cannot make a person order from a mail-order service, but they can offer this service as an option.
Mail-order pharmacy services can be a cost-saving and a straightforward way of getting medication, for both the initial prescription and refills.
Some services offer automatic refills. The mail-order service estimates when the prescription will run out based on the number and frequency of doses. The pharmacy will send out the new prescription before the old one runs out.
Some plans ask for confirmation before sending the next refill, while other plans ask for approval only once each year.
To avoid a delay in receiving a prescription, the pharmacy needs to have a person’s up-to-date contact information.
Medicare parts A and B are original Medicare. Part A pays for medication when a person is in the hospital or a skilled nursing facility.
Part B may pay for certain drugs, such as those that must be given in a doctor’s office.
A person needs Part D to help pay for the prescription drugs they take at home.
Medicare Part D is an optional benefit. A person is eligible for Part D when they are eligible for Medicare parts A and B.
A person can decide not to get Part D when they are first eligible, but joining later may result in a late enrollment penalty.
Usually, a person will pay the penalty for as long as they have the Part D plan, but the penalty can sometimes be avoided if:
- an individual has other medication coverage that pays at least as much as Medicare’s standard coverage
- a person qualifies for Extra Help by meeting the income limits
How to get coverage
A person has two ways of enrolling in a PDP.
- If an individual has original Medicare, they may enroll in a standalone PDP with a private insurance company.
- A person may enroll in a Medicare Advantage plan, which includes prescription drug coverage.
A person cannot have a standalone Part D plan at the same time as a Medicare Advantage or Medigap policy that includes coverage for prescription drugs.
Both plans will remove their drug coverage once a Part D plan begins, and this could result in an adjustment to monthly premiums.
A person can find and compare Part D plans in their area using the Medicare Plan Finder.
Part D and other insurance
Medicare has rules about how Part D plans can work with other insurance plans and a person may wish to check with their plan provider to see how other insurance may affect benefits.
Other insurance may include:
- employer coverage
- union insurance
- Medicaid
- Supplemental Security Income (SSI)
- state pharmaceutical assistance
- health insurance marketplace
- veteran’s benefits
- TRICARE
- Federal Employee Health Benefits (FEHB)
A person’s PDP will typically include a network of participating pharmacies.
To get prescriptions by home delivery, an individual should contact their plan provider. Many provide the option of enrolling online or by phone.
A membership with the service will be activated, and the pharmacy will contact the doctor for full prescription details.
Like other services, there are advantages and disadvantages to having prescription medication delivered to a person’s home.
Sometimes an individual may avoid having medication delivered as additional charges may apply. However, most pharmacies do not charge an extra amount to mail a person’s prescription. This is because it saves the pharmacy time and money also.
Local retail pharmacies may offer delivery systems, or a person may choose a national mail-order pharmacy.
Pros
- Saves time. There is no need for a weekly or monthly trip to a pharmacy. Often, with just a click on a computer, a person can order their medication.
- Saves money. Mail-order drugs may be less expensive. It also saves money on the cost of traveling to the pharmacy.
- Automatic refills. Most pharmacies will contact a person’s doctor directly.
- Safety. When one pharmacy fills all prescriptions, it may be easier to identify drugs that do not work well together.
- Face-to-face contact. A person using mail-order from a local pharmacy may still have the option to visit and ask questions in person.
Cons
- Delivery delays. Prescriptions can sometimes take up to 14 days to be delivered. A person may need to collect the first 2 weeks of their prescription from a local pharmacy.
- Lost medications. It is unusual, but occasionally, packages can go missing in the mail, and re-shipping the prescription may take time.
- Limited contact options. A person using a national mail-order pharmacy may only be able to contact the company by phone.
Medicare Part D pays for prescription drugs people take at home. Private companies sell part D policies. Most have the option of delivery at home.
A person’s Part D policy should have a network of pharmacies from which people can buy prescription medication.
Plans that offer delivery will have information on how people may sign up and get their prescribed drugs delivered.
There are pros and cons to having medication delivered at home. If a person chooses the service, they can cancel at any time.