Deprecated: Creation of dynamic property ET_Builder_Module_Comments::$et_pb_unique_comments_module_class is deprecated in /home/csmediatexas/wylienews/wp-content/themes/Divi/includes/builder/class-et-builder-element.php on line 1417
NTMWD 2025 Summer

Make the most of Medicare’s drug coverage

by | Jul 19, 2017 | Opinion

By Bob Moos

Southwest public affairs officer for the U.S. Centers for Medicare and Medicaid Services

Medicare offers prescription drug coverage to everyone with Medicare.

It’s a good deal. Medicare subsidizes the outpatient drug benefit, generally paying about 75 percent of the program’s costs. Unless you already have comparable drug coverage through another source, you should consider getting it when you sign up for Medicare’s health care coverage at 65.

There are two ways to get drug coverage. If you’re in Medicare’s traditional fee-for-service program, you can purchase a “stand-alone” drug plan from an insurance company. Or, if you decide to buy a private Medicare Advantage health plan, you can choose one that includes drug coverage.

To find the “stand-alone” drug plans and the Medicare Advantage health plans with drug coverage available in your area, visit Medicare’s “plan finder” at www.medicare.gov/find-a-plan. You can also call Texas’ Health Information Counseling and Advocacy Program for help at 1-800-252-9240.

You’ll see there are significant differences in premiums and deductibles, in the co-payments the plans charge, in the particular drugs they cover and in the pharmacies they use. That’s why it’s important to look at your prescriptions and individual circumstances when comparing plans.

Ask yourself: Which plans cover the drugs I take? Which plan gives me the best overall price on all my drugs? Which plans allow me to use the pharmacy I want? Which plans let me get drugs through the mail? What are the plans’ quality ratings, such as for customer service?

You’ll discover that many plans place drugs into different “tiers.” The higher the tier, the greater your share of the cost will usually be. If you find that a prescription of yours is in a higher tier, you may want to ask your doctor whether there’s a drug in a lower tier that would work as well.

You may also encounter plans that follow “step therapy.” That means you must first try a less-expensive drug that’s been proven effective for most people with your condition before you can move up to a costlier drug. However, your doctor can request an exception if the costlier drug is medically necessary.

Medicare drug coverage is just like other kinds of insurance – you buy it to protect yourself if and when you need it. Even if you’re not on any prescriptions now, enrolling in a drug plan with a low premium guarantees you’ll have coverage should your health decline and you require medication.

After you pick a plan that meets your needs, call the company offering it and ask how to join. You may be able to join online, by phone or by paper application. Don’t be alarmed when you’re asked to provide the number on your Medicare card during the enrollment process. In this case, it’s OK.

The plan that’s best for you this year may not be the best next year. If so, you can switch to another plan between Oct. 15 and Dec. 7 each year. Indeed, it’s smart to check all your options every fall to make sure you have the plan that best fits your needs and pocketbook. Your new coverage then begins on Jan. 1.

If you’re having difficulty affording medications, you may qualify for the government’s “extra help” program. Your annual income can’t be more than $18,090 if you’re single or $24,360 if you’re married. Also, your resources can’t exceed $13,820 if you’re single or $27,600 if you’re married.

Generally, you’ll pay no more than $3.30 for each generic drug and $8.25 for each brand-name prescription in 2017. Thirty-five percent of Texans with a Medicare drug plan get extra help. To apply, visit the Social Security website, at www.socialsecurity.gov/i1020, or call Social Security at 1-800-772-1213.

People with Medicare have saved hundreds or even thousands of dollars each year thanks to their drug coverage. Be sure to make the most of yours.

For more stories like this subscribe to our print or e-edition.

Collin Fall 2025

0 Comments

Subscribe RH Love

Related News

Gardens and Grandma

Gardens and Grandma

Columnist John Moore didn’t like gardens as a kid. That’s changed thanks to his grandmothers. Photo: John Moore As a kid, I hated the vegetable garden. If you stood on our back porch, it was to your left. It took up the entire corner of our large yard. To me, gardens...

read more
Insurance crisis hitting public schools

Insurance crisis hitting public schools

Severe weather from hurricanes and other weather events has not spared the state’s public schools, resulting in skyrocketing property insurance costs, the Houston Chronicle reported. Insurance costs for districts have increased by 44% statewide in the past five years,...

read more
A numbers game

A numbers game

You don't see phone books much anymore. But even when they were around, columnist John Moore was nowhere to be found in one.Courtesy John Moore For those of us who once made our living working on the radio, one of the main competitors we had for advertising dollars...

read more
Kitsch me if you can

Kitsch me if you can

Columnist John Moore grew up with yard art, and still proudly displays a concrete gargoyle out on the front porch. Photo: John Moore Pink flamingos. Chalk and concrete figures. Cast iron pots with flowers. Old school bells. Cars on blocks. The yard art of yesterday....

read more
Put a pencil to it

Put a pencil to it

Columnist John Moore loves pencils. Even pencils that cost $30. Courtesy John Moore They call it, “click bait.” It’s when you come across something online that sounds amazing, so you click on it to learn more. Click bait is something that turns out to be nothing as...

read more
Time for a Change

Time for a Change

Last weekend, I did something I don’t think I’ve ever done before—I forgot to discuss the time change with my husband, the chief clock changer in our house. So when I woke up at 7:30 a.m. Sunday, I approached the day as “business as usual” and went downstairs to let...

read more
House proposes $7.5 billion in new school funding

House proposes $7.5 billion in new school funding

Critics say a House bill proposing $7.5 billion in new funding for public education doesn’t go far enough, The Dallas Morning News reported. House Bill 2 would raise the per-student allotment by $220, to $6,360 a year. It would also invest $750 million in teacher pay...

read more
Voucher bill has backing of House majority

Voucher bill has backing of House majority

A slim majority of Texas House members have indicated they will back House Bill 3, which creates education savings accounts that allow families to use taxpayer money for private school education. The Dallas Morning News reported that 75 Republican legislators have...

read more
Order photos