Prescription Assistance

Medicare

The Enrollment Periods for Medicare Part D Plans according to www.Medicare.gov

  • October 15 through December 7 of each year- If you currently have Medicare Hospital or Medicare Medical Insurance (Parts A and/or B), you can enroll or re-enroll in a Medicare Part D Prescription Drug Plan (PDP) or Medicare Advantage Plan with Prescription Coverage. Your newly chosen Medicare Part D plan begins on January 1 of the following year.
  • January 1 through February 14 – If you’re in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare. If you switch to Original Medicare during this period, you will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.

Medicare provides comprehensive support to help beneficiaries make a confident decision about drug coverage. That support includes community-based resources offering personalized counseling, materials on www.medicare.gov and through 1-800-MEDICARE, and the annual Medicare & You handbook with information about coverage in the local area. You can get general or personalized information about plans on the Medicare Plan Finder site. A personalized search may provide you with more accurate cost estimates and coverage information.

Benefits Check-up Rx – A decision support and enrollment service.

This National Council on Aging (NCOA) web site offers information on federal, state and private benefits programs available to help pay for prescription drugs, health care, utilities, and other basic needs. Go to www.benefitscheckup.org/ and “answer some questions to find benefit programs that can help you pay for medications, health care, food, utilities and more.”

SHINE (Serving Health Insurance Needs of Elders)

“SHINE (Serving Health Insurance Needs of Elders) is a free program offered by the Florida Department of Elder Affairs and your local Area Agency on Aging. Specially trained volunteers can assist you with your Medicare, Medicaid, and health insurance questions by providing one-on-one counseling and information. SHINE services are free, unbiased, and confidential.” http://www.floridashine.org/

Locally, SHINE provides information about prescription assistance programs and Medicare Part D through The Area Agency on Aging of Pasco-Pinellas. To contact SHINE anywhere in Florida, call 1-800-963-5337.

Extra Help

Seniors who meet income and asset criteria are eligible for Extra Help. The extra help benefit can increase their cost savings by paying for part of the monthly premiums, annual deductibles and prescription co-payments under the new prescription drug program. According to Social Security, the extra help is estimated to be worth an average of $3,900 per year.

Visit the Social Security website at www.socialsecurity.gov/prescriptionhelp/ for more information or to apply online.

Florida Prescription Drug Prices

www.myfloridarx.com/ “This website was developed by the Florida Attorney General and the Agency for Health Care Administration (AHCA) to help consumers shop for the lowest price in their area for their prescription drugs. The Florida Prescription Drug Price website provides pricing information for the 150 most commonly used prescription drugs in Florida. The prices are the “usual and customary prices, “also known as retail prices, reported monthly by pharmacies. This is the price that an uninsured consumer, with no discount or supplemental plan, would normally pay. Prices at your local pharmacy may change daily, so this website is only meant to help you compare prices at different pharmacies and are not a guaranteed price.”

Florida Discount Drug Card

SHINE publishes information on the Florida Discount Drug Card. It is designed to lower the cost of prescription drugs for residents who lack insurance coverage or who may reach the Medicare prescription drug plan “gap.” This fact sheet includes contact and application information.

Pharmaceutical Assistance Programs

Some pharmaceutical companies offer assistance programs for the drugs they manufacture. See this Medicare.gov page for more information. www.medicare.gov/pharmaceutical-assistance-program/Index.aspx

Charitable Programs (Medicare Rights Center)

The Medicare Rights Center provides a list of charitable programs that may be able to help individuals with the cost of prescription drug co-pays. www.medicarerights.org/pdf/copay_charities.pdf It provides information on benefits provided and eligibility, as well as contact information and instructions on how to apply. These charitable programs are available for those enrolled in Medicare and individuals who are not enrolled in a Medicare drug plan.

“What these charities pay will count towards the…out-of-pocket costs you must spend (not including premiums) before you get catastrophic coverage… However, for it to count, you must fill the prescription at a pharmacy in your drug plan’s network and it must be for a drug on your Medicare drug plan’s list of covered drugs (‘formulary’).”

“To decide if you are eligible, these programs may also consider your income, cost of living (dependent on your family size), and medical expenses (including insurance premiums, doctor and hospital expenses, and what you pay for your prescription drugs). You may qualify even if your income is high if your medical expenses are also high or you have a lot of people in your household.”