Medicare makes health care more affordable for qualifying individuals, but figuring out what it covers can be a challenge. If you’re calculating costs for a pharmacy visit, refer to your Medicare plan for details about what it includes. To get a general idea of what you can expect, consider the answers to these frequently asked questions about Medicare coverage for pharmacy products.

Answers to FAQs About Medicare’s Pharmacy Coverage

What Medicare Plan Includes Pharmacy Coverage?

There are different parts of Medicare plans that won’t apply to every individual. Each group is designated to a specific area of health care. For example, Medicare Part A reduces hospital costs and Part B primarily focuses on all other medical care. For lowering prescription drug expenses, you need to have Medicare Part D.

What Does Medicare Part D Cover?

When you enroll in Part D, you have several options for individual drug plans. Each has a different formulary, a list of covered medications.  Although you can find formularies that apply to nearly every approved prescription drug, no plan covers everything.

Each formulary has tiers of drugs; lower-tier drugs like generics cost less than higher-tier brand-name or specialized products. Review formularies before you enroll in a plan and stay up to date with annual changes that could affect your coverage.

Can I Use Medicare Part D at Any Pharmacy?

You must fill your prescriptions at a drugstore in your network. If you go outside your network, your drugs probably won’t be covered by Medicare. Fortunately, many national and regional chains qualify under Part D.

Could Other Factors Affect My Drug Coverage?

Since Medicare is individualized to each person’s circumstances, you must be mindful of factors that could impact your drug coverage. For example, people who require a higher-tier medication can seek authorization from a doctor to reduce their copay. In other cases, you could rely on another insurance plan to fill gaps in your coverage and keep costs manageable. If you need medication on a regular basis, you often can get a discount for filling a 90-day prescription at an approved pharmacy.

While figuring out the specifics of your Medicare Part D coverage can be difficult, there are many resources for help, including the Medicare website. An approved pharmacy also will provide excellent guidance about managing your prescription medication under the plan.  

If you live in Statesboro, GA, and need assistance with your Medicare prescriptions, the specialists at Medical Center Pharmacy can provide the answers you need. They offer efficient medication refills as well as a variety of products ranging from first aid items to cards and jewelry. Visit them online for more details about their services and call (535) 104-0140 to speak with a pharmacist. Like them on Facebook to stay up to date with the business.