Important Details to Know for Senior's Prescription Drug Plans

By: Thomas Hunter

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.

DISCLAIMER: This information is for educational and informational purposes only. The content is not intended to be a substitute for professional advice. Always seek the advice of a licensed Insurance Agent or Broker with any questions you may have regarding any Insurance Matter.

About the author of: Important Details to Know for Senior's Prescription Drug Plans

Thomas Hunter is an Internet marketer, author and publisher and has helped hundreds of people save money on their health insurance. Visit us at spend 5 minutes and get your no obligation Health Insurance Quote.
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