There are several Medicare as well as charity run prescription drug plans that cater to serving senior citizens and that can often help them pay for any medications they need. The cost for the coverage varies, and some agencies may provide plans for free while others common with low costs. Many pharmaceutical companies also provide free financial assistance to the elderly in an effort to lower some of the costs for them.
The fact is that people age 65 and over account for about 35% of all prescription medications that are sold. However this age group makes up only about 15% of the total US population. So this means that each senior citizen spends, on average, about 200% more on prescription drugs than others. Since the amount of money they spend is so much higher, they often need help in buying their medications, and these senior prescription medication plans may be able to assist.
There are three main options. They are private ones, government benefits, as well as charitable assistance. Each has their own pros, cons, costs, and application processes. Some are free to sign up for, while others have minimal costs. Some help retirees or individuals that live on a fixed income, and some plans for seniors have no income restrictions. The primary programs are as follows.
Health insurance and other companies in the private sector offer Medicare Advantage Plans. There are a few different subcategories of these. Most of them are closely regulated as part of Medicare Part A and B. However even when someone is enrolled into that benefit, they can choose different “flavors” of these programs. The private plans will usually add some form of prescription coverage for the seniors, often as a component of Part D.
The most common senior prescription drug plans that run in partnership with Part A and B are part of the standard insurance industry. They are PPO (Preferred Provider Organization), HMOs (Health Maintenance Organization), HMOPOS (HMO Point of Service), Private Fee-for-Service (PFFS) as well as Special Needs Plans (SNPs). It is always recommended to compare them before enrolling. While there are ways to switch between these prescription drug plans by dialing 1-800-MEDICARE, the process is only available certain times of the year and if some milestones have been met.
Low income seniors can sign up for financial aid as part of Extra Help. This will help older adults pay for a prescription drug plan. The financial support can also assist by filling the infamous donuts hole in coverage. It will assist the client with paying for both the monthly Part D premiums as well as one-off, out-of-pocket costs when a prescription is filled. Find more details on how Extra Help pays for Medicare.
Low income elderly patients, including those that live in or near poverty, can also get help paying for plans from pharmaceutical companies. They will offer discounts for some of the prescription drug plans. Or they may offer direct financial aid to pay for them. All sorts of companies offer this solution to very low income elderly patients, which are often called Patient Assistance Programs.
Prescription drug coverage for seniors can also be partially paid for by charities. There are a few different resources available. Some of them are free to use, such as coupons or discount cards. Others may require the patient to pay for a portion of the bill that is due. Some of the options include:
There are a number of other programs that provide senior citizens with free medications. There are trials, vouchers from the Salvation Army, and also ways to enroll into a plan that offers generic medications either for free or at a low cost. Many other resources are also available, but these tend to focus on low to moderate income seniors (or those with a disability). Find a list of free prescription drug programs.
The prescription drug plans, including Medicare Part D and Part C, can help provide for some of the common medications (see below) as well as lesser known items. There are several categories of medications that are covered in that the elderly normally use. Whether it is a generic or brand name medication, the coverage and drugs covered are as follows.
About 75% of seniors that are enrolled into Medicare coverage pay for Cardiovascular drugs. There are plans that can help them pay for these medications. The most common used include Hydrochlorothiazide, Lisinopril, Metoprolol, Amlodipine, and Furosemide. Since the average cost to obtain these medications is usually under $50, the need for financial assistance for these is not as great as some others.
Seniors often need some form of prescription drug plan to afford Metabolic drugs. The reason being is that the average cost for a dose is around $120, and this can often be very difficult for someone over the age of 65 to afford. Maybe the senior lives on a fixed on limited income, or there Medicare Advantage Plan (Part C) does not pay the entire cost. So financial aid is usually needed.
The total cost for these category of Metabolic drugs make up almost 1/3 of the aggregate expense of a senior. Medications such as Lipitor, Simvastatin, Crestor, Metformin, or Pravastatin are very costly. Many private health insurance companies and their health insurance plans are passing more of these expenses to the patient. So seniors often need a plan to help pay for them.
About 40% of people that receive benefits from Medicare use central nervous drugs such as Alprazolam, aspirin, Hydrocodone, Ibuprofen, and Gabapentin. These tend to be more affordable and many senior prescription drug plans do not assist with paying for them.
The most expensive category of prescription drugs for seniors are respiratory medications. The highest demand ones, including Singulair, lbuterol, Advair, Fexofenadine, and Proair have an average out of pocket cost of $150. This can be very challenging to pay for, put public aid programs including Medicare Part D can help offset the cost. There are tend to be more charity assistance available for them from the major pharmaceutical companies.
Some prescription drug plans for senior citizens also cover gastrointestinal drugs. This medical bill often tends to be on the high side, with the average cost of about $115 per prescription. Therefore there is some assistance to pay for Nexium, Omeprazole, Pantoprazole Famotidine, or Ranitidine among many others.
The federal government Medicare Part D plan also helps subsidize several other medications, including Ativan, Lisinopril, Zoloft, Lasix, Synthroid, Aricept, Protonix and Remeron among many others. The list continues to change and evolve over time as well. Or if the patient finds that Part D does not help them, they can try a charity program.
As noted above, there are many options available. It can be difficult to keep up with all the changes in the pharmaceutical industry and it can be difficult to understand the pros and cons of each prescription medication plan that is targeted at a senior. Medicare Part D is always involving, and there are constant changes to the government benefit programs. In order to get more information, individuals can try a medical billing advocate for information.
Another resource available to learn about senior citizen prescription coverage will be a local social service office that provides applications for public assistance. They often have on site (or are aware of) health care advocates that are fully versed in everything including Medicare Part D as well as national charities. There are centers located in most towns and counties.
The federal government also has an intake line that senior citizens can call. This will mostly provide information on Medicare though, and especially Part D. The information line is 1-800-MEDICARE.
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