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Prescription drug coverage and medications can be complex territory.
Enter UnitedHealthcare Medicare & Retirement’s Chief Pharmacy Officer Mike Anderson, PharmD, who has spent his career navigating the ins and outs of the Rx world.
Below, Anderson answers some questions people frequently ask about drug coverage and prescriptions.
Q. What’s the difference between PDP and MA-PD plans?
A. Original Medicare doesn’t provide coverage for most prescription drugs, so for help paying for medications, you have two options: a standalone Part D prescription drug plan (PDP) in addition to Original Medicare or Original Medicare and a Medicare supplement plan; or a Medicare Advantage plan with prescription drug coverage (MAPD). Medicare Advantage plans can include additional benefits like dental, vision and hearing coverage, and combine your coverage into a single plan. Both types of plans are offered by private insurance companies through Medicare.
Q. How do I know if my prescriptions are covered by my Medicare plan?
A. Whether you get coverage through Medicare Advantage or a standalone Part D plan, each has a formulary, a list of prescription drugs covered. Look closely to make sure your medications are covered. Health insurers post plan formularies online, or you can call your plan to request a printed version. Plans can change from year to year, so don’t assume that prescription drugs covered this year will always carry over.
Q. How can I save money while remaining on my medications?
A. There are many ways to do that:
Home-delivery pharmacy benefits can save money and a trip to the pharmacy. Some mail-order pharmacies offer the convenience of ordering a three-month supply of drugs delivered to your home for less than purchasing at a retail location.
If you prefer to visit a pharmacy, check if your plan offers programs or preferred pharmacy networks to help you save on prescriptions.
Switching to generic drugs or drugs on a lower tier of the formulary could also save money. If you are taking brand-name medications now, discuss generic alternatives with your doctor.
Q. Can I split my pills in half?
A. Talk to your doctor about whether pill splitting for your medication is medically advised. Also, consult your pharmacist on whether the actual pill form presents risks. Some pills are dangerous when split, because splitting affects how quickly the drug is released into your body. Other pills become ineffective when split, because the pill contains a coating to protect it from stomach acid, and splitting the pill breaks that coating.
Q. I take a lot of pills daily. One I take three times a day. Some I just take once. I get busy and forget to take my pills. Can I just take them all in the morning?
A. It’s important to take your medicine as your doctor prescribed it. Some medications need to be taken at specific times to be effective. Plus, taking all your medications at one time can be dangerous as you run the risk of potential adverse interactions, side effects and even overdosing.
Q. I drink smoothies with supplements and take vitamins. Can these have a bad interaction with my prescriptions?
A. If an iron supplement was added to the smoothie, for example, that could reduce the effectiveness of thyroid medication and medication for reflux disease. Talk to your pharmacist and doctor about vitamins and supplements to learn if they could cause a reaction or make your medications less effective.
Q. I just got my medication refilled. It used to be a different color and shape. Why does it look different?
A. More than likely, the pharmacy you use bought their supply from a different manufacturer. Drug companies that make the same medication must keep the chemical formula the same but may change the shape or color. If you verify it’s the same medication and dose, it should work just like before. If you have concerns, talk with your pharmacist.
For more information to help you navigate prescription drug coverage, visit MedicareMadeClear.com.
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