Are You Covered Under the Medicare Prescription Program?

Published: April 16, 2021
Revised: January 29, 2021
Han Feng
By Han Feng, PharmD, PGY2 medication safety resident, Johns Hopkins Hospital, Baltimore

In my work, I often run across patients who are confused by the in’s and out’s of the complicated federal Medicare prescription drug program. Recently, a gentleman came into my pharmacy with prescriptions for both an antibiotic and cough syrup. When asked if he had insurance, this patient pulled out his Medicare card. I politely explained that Medicare pays for antibiotics and cough syrup under a separate program called “Medicare Part D.

I run into this situation quite often. Since the Medicare Part D program began in January 2006, many Americans have tried to figure out what it means to them in terms of drug coverage. For example, seniors covered under Medicare often don’t realize that they should have received a separate Part D identification card. This card contains information that allows pharmacies to process prescriptions claims and make sure the patient is charged the correct co-payment for their medications.

Luckily, the gentleman did have a Part D prescription drug card and fished it out of his pocket. I was really glad that he had it because he had mentioned earlier that he would have had to go without the medication if he had had to pay the non-insured price. I processed his claim and got him moving along to a warm bowl of chicken noodle soup.

So, don’t forget that when signing up for Medicare Part D, you should be on the lookout for a prescription benefits card. It may not look like the usual Medicare mailings.

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