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SolveYourProblem
Article Series:
Health Insurance
Senior
Prescription Drug Plans: Important Details
For those individuals over the age of 65 who
qualify for the Guaranteed Income Supplement an added benefit
can help them with their medication costs. This is the Drug
Subsidy Plan and it can help some people who cannot afford
extra coverage or qualify for any other help. This prescription
drug program helps pay for drugs that have been approved by
the government. It doesn’t cover all medications one might
have to take, but it does cover all drugs that require a prescription
from the doctor and a few over the counter drugs as long as
the doctor write a prescription for them. You are eligible
to apply at any time as long as you are at least 65 years old
and receiving Old Age Security. Even if you don’t qualify for
the full benefit amount, you may be able to receive partial
benefits.
The
government automatically sends a notice to all those who
are 65 or over that they might qualify for this plan and how
to get an application. Your identification card will automatically
come to you once you have been accepted into the plan. You
must present this card to your pharmacy to be able to get the
benefits. The only person who may use the card is the one whose
name is on it, no one else including a spouse can use it. If
you are at age 65 but don’t qualify for the Guaranteed Income
Supplement don’t worry, you may at a later time and can always
re-apply. You pharmacist will have a list of what items are
parts of your benefit and you can request a copy at any time
from the pharmacy.
Here
are some items that are not covered by the plan. Most
over the counter medications that don’t require a prescription,
such as cold and flu medicines, vitamins, supplements, bowel
medications, stomach medications, and pain and fever reducers.
If you ever are concerned that you cannot get a certain prescription,
ask the program director. Other medications and services that
are not covered are prescription cough syrups, drugs used in
habituation or addiction, and delivery, postal, or C.O.D. charges
if you choose to get medications delivered to your home. You
cannot receive benefits for any service if it should be covered
under the Department of Veterans Affairs or Worker’s Compensation.
You will not be covered for single-dose injections, such as
a flu shot, received by your doctor or other medical professional.
You are also responsible for any appliances, such as dentures,
eyewear, hearing aids, or prosthetic devices on your own.
How
much and what part of the approved prescriptions does the
government actually pay? The cost of prescription medications
comes in two parts, the ingredient and the professional service
charge. The government pays the cost of the ingredients only
and directly to the pharmacy so a claim form is not needed.
What ever you are paying out of pocket is what the pharmacy’s
handling fee is. Each pharmacy has a different fee, so be sure
to have your prescription filled at many different ones to
find out who has the lowest fee. If you refuse to take the
same drug with a different name at a cheaper cost you will
be responsible for the extra money to the pharmacy. The government
pays the minimum amount list for a particular ingredient. Make
sure your doctor writes your prescriptions in generic form
so this won’t be a problem. If you have a question between
what the doctor wrote on your prescription and what the pharmacist
is offering you at a lower cost, either ask them to explain
the ingredient to you or have them call your doctor to confirm
this medication can be used in substitute of the more expensive
one.
What
part of the plan do you pay? Nothing. This is a subsidy
plan, and not a fee plan. The only payment that the recipient
is due to pay is their portion of the cost of the medications
the government does not pay. This is the pharmacy’s personal
charge that includes the dispensing fee, expenses, and professional
service. This cost is decided by the actual pharmacy and subject
to change or be different at different places. The reason the
government pays for only the ingredients is because that will
entail the most cost most times. For most expensive drugs most
of the money is in the actual ingredient, not the handling
fee opposed by the pharmacy. Click here to to view health insurance quotes, compare plans side-by-side and apply for the most affordable health insurance within your budget. I did this myself (June 17, 2011) to change my health insurance policy. Saved me $84 per month (or $1,008 per year). It's my SolveYourProblem recommendation.
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by SolveYourProblem.com
: 2006
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