Pharmacists can be a helpful resource for people with Medicare drug plans. In addition to advising on what medications to take, they can help decode Medicare plan documents to ensure coverage meets a person’s needs.
Pharmacists are some of the most accessible healthcare providers, making them an excellent resource for helping with Medicare drug coverage questions.
In addition to sharing knowledge about medications, pharmacists can offer tips for saving money on medications. They also know how to work with health insurance companies.
Here are some common questions pharmacists can answer about Medicare prescription drug plans.
Pharmacists are often knowledgeable about Medicare drug coverage, which people can get through a privately-administered Medicare Part D or Medicare Advantage plan.
Many Medicare plans have a preferred pharmacy. Pharmacists at these locations are typically familiar with which medication brands a plan covers and how to work within plan guidelines.
When choosing a Medicare Part D plan, many Medicare shoppers want to confirm a plan covers their preferred brand of medication.
Pharmacists are well-positioned to answer questions about medication coverage since they know what medications a person takes and how to understand a health plan’s formulary.
What is a formulary?
A formulary is a list of medications covered on a health insurance plan. Medicare Part D plans must cover at least two drugs in each category, with a few exceptions.
If a plan does not cover the brand a person wants, the pharmacist can determine whether an alternative brand would be appropriate for that person.
Pharmacists can also help explain the differences between plans.
Additionally, they can answer questions about drug costs by looking up the copay or out-of-pocket cost of medications for different Part D plans.
During a CMR, a pharmacist looks at all the prescription and over-the-counter (OTC) medication and supplements a person takes and evaluates whether:
- the medication is appropriate and effective for the person
- any medications they are taking may interact with one another
- a person should stop medications meant for temporary use
The pharmacist will also invite the person to ask questions during the review and voice any concerns. This is the right time for a person to mention any side effects they are experiencing or whether they are having difficulty remembering to take medications.
Pharmacists can recommend strategies to make managing multiple medications easier. They can even provide a list of medications the person can share with other healthcare professionals and a schedule for them to follow.
Medicare requires that health plan companies offer people on Part D plans a yearly medication review.
They can provide guidance on taking generic medications instead of pricier brand-name drugs. Pharmacists also have the knowledge to work within a health plan’s rules and a person’s budget to help cut prescription drug costs.
Having one pharmacy for all prescriptions can also help save money. Pharmacists can arrange to refill all of a person’s medications on the same day, saving them from taking multiple trips. They may also recommend mail-order services, which could save people money.
A CMR is another potentially money-saving service. During the review, the pharmacist can identify medications a person is no longer using or may no longer need in the future and make recommendations to their healthcare professional. They may also find less-expensive versions of the same drug.
Taking the time to consult with a local pharmacist can help a person find the right Medicare prescription drug plan, better manage medications, and save money on prescription drug costs.