Medicare Savings Programs
To make sure your provider knows you have QMB, show both your Medicare and Medicaid or QMB card each time you get care. If you get a bill for medical care Medicare covers, call your provider or plan about the charges. Tell them that you have QMB and can’t be charged for Medicare deductibles, coinsurance and copayments. If this doesn’t resolve the billing problem, call 1-800-MEDICARE (1-800-633-4227).
Prescription Drug Assistance Programs
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and subsequent regulations require coordination between CMS, State programs, insurers, employers, and all other payers of prescription drug benefits to ensure that the prescription drug benefits provided to Medicare beneficiaries enrolled in Medicare Part D are maximized and the integrity of the Medicare program is assured. CMS has implemented data exchanges with Prescription Drug Assistance Programs including State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs (ADAPs), and Patient Assistance Programs (PAPs) to coordinate Medicare Part D prescription drug benefits with other coverage a Medicare beneficiary may have. This allows CMS to facilitate accurate claims payment and the calculation of the Medicare Part D True Out of Pocket (TrOOP) expenses incurred by Medicare beneficiaries.
Contact Information and Websites of Organizations for Medicare
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Extra Help with Medicare Prescription Drug Plan Costs
Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
Medicare Information and Plan Comparisons
While health care was not central to the 2016 Presidential campaign, the election’s outcome will be a major determining factor in the country’s future health care policy. A number of issues have garnered media attention, including the future of the Affordable Care Act (ACA), rising prescription drug costs, and the opioid epidemic.
Medicare Prescription Drug Resources
Websites accessible from Humana.com may provide information about current medical procedures, services, pharmaceuticals, medical devices, and other treatment and therapies that may not be covered under your health plan. The information on these sites doesn’t necessarily represent the views of Humana. It isn’t an endorsement by Humana. The information on these Websites isn’t a substitute for professional healthcare. For personal medical guidance, please consult your doctor. If you have questions about your Humana health plan benefits, please call Humana Customer Service at the number on your member ID card.
Medicare Prescription Drug Coverage (Medicare Part D)
Medicare sets standard costs for the prescription drug benefit each year. Private companies approved by Medicare offer plans with different costs and selections of prescription drugs. You can select a plan based on the prescriptions you take and select a company that is most effective for you. To reduce your costs, enter your medications on Medicare’s secure online Find health and drug plans website. You will pay more if your prescriptions are not in the plan formulary or the plan restricts or limits their use.
The Medicare Part D Prescription Drug Benefit
Medicare Part D is a voluntary outpatient prescription drug benefit for people on Medicare that went into effect in 2006. All 57 million people on Medicare, including those ages 65 and older and those under age 65 with permanent disabilities, have access to the Part D drug benefit through private plans approved by the federal government; in 2016, nearly 41 million Medicare beneficiaries are enrolled in Medicare Part D plans. During the Medicare Part D open enrollment period, which runs from October 15 to December 7 each year, beneficiaries can choose to enroll in either stand-alone prescription drug plans (PDPs) to supplement traditional Medicare or Medicare Advantage prescription drug (MA-PD) plans (mainly HMOs and PPOs) that cover all Medicare benefits including drugs. Beneficiaries with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost sharing. This fact sheet provides an overview of the Medicare Part D program and information about 2017 plan offerings, based on data from the Centers for Medicare & Medicaid Services (CMS) and other sources.