Despite living with migraine disease and being recently diagnosed with rheumatoid arthritis, Yvonne is an active and resilient health advocate who donates her time to such causes as CreakyJoints, Poor Peoples Campaign, and Miles for Migraine. Enrolled in Medicare, Yvonne often faces significant hurdles in accessing the medications her doctors prescribe. Many require prior authorization, despite there being no generic equivalent. Delays in treatments are worrisome and, even worse, some medications are not covered by Medicare Part D, which creates additional out-of-pocket costs. So before Yvonne selects her drug coverage plan annually, she’s learned that it’s valuable to consult a list of all of her medications and compare it with the formularies available in different Medicare Part D plans, so she can pick the plan that gives her the best coverage and minimizes her out-of-pocket costs. Click on the link below to learn more about formularies for Medicare and other important things to consider while choosing a health insurance.
There are a few important things to consider when choosing a health insurance plan that is right for you, especially if you are living with a chronic illness.
Find out the different parts of Medicare available. There are four parts of Medicare insurance.
Find out what information you need before applying for insurance. Make sure you have all of this information before you start in order to make this process as fast as possible.
Find out if your medication is covered. Each health insurance plan has a list of covered drugs, known as a formulary. Read our step-by-step instructions on how to find out if your prescription is on a plan’s formulary.
Find out what out-of-pocket costs you’re responsible for. Your health insurance plan’s deductible, copayment, coinsurance, and out-of-pocket maximum determine how much you will end up paying for care. Learn more about each of these factors.
Learn about the various financial assistance programs available. If you have a private insurance plan through Medicare Part C or D or in addition to Medicare, there are several ways that you can find financial assistance to help cover your out-of-pocket costs.
Find out if you should expect a delay in getting your prescription. Find out if your medication requires prior authorization. If it does, your healthcare provider must fax a request to the insurance company for approval before you can pick it up from the pharmacy.
Avoid plans with a copay accumulator adjuster program. These programs, which can be found in some health insurance plans, do not allow copay cards to go towards your final deductible. Learn more about copay accumulator adjuster programs.