How Can We Help?
Questions with the Keyword PRESCRIPTION
| Questions | Possible Answers |
|---|---|
| My mom thinks it is cheaper to buy some of her prescriptions at Target and pay $4.00 for a generic drug instead of using her insurance. If she enrolls in your plan, does she have to show her plan card and buy her drugs through your plan, or can she continue to pay for drugs on her own? | She may continue to pay out of pocket for her prescriptions without using the plan card, however, the total amount will not count towards her coverage gap amount. |
| Will my mom receive anything that summarizes which prescriptions she’s received and how much she’s paid? | Yes, Acme Medicare Rx sends its members a monthly explanation of benefits (EOB) document showing the member’s true out-of-pocket expenses (TROOP), in addition to the amount the plan pays and the total drug spending. |
| For Acme Medicare Rx, what is the maximum cost share for a one-month supply of a Tier 1: Preferred generic drug at an in-network pharmacy? | For a Tier 1: Preferred generic drug, the copay is $10 at our network pharmacy and $0 at our preferred pharmacy on all three plans. |
| My mom is paying an extra amount for her prescription drug coverage. If she joins your plan, can she pay this amount and the premium all together with one check? | No. You should not add this amount to your monthly plan premium payment. The extra amount can be withheld from SSA benefits, or it is billed directly by Medicare if SSA benefits cannot cover the amount. |
| My mother uses eye drops, but her hand shakes. If she runs out and needs to refill the prescription early, can she? | Yes. |