I heard Medicare covers preventive services. Does
Medicare cover glaucoma screenings? ~Emily
Dear Emily,
Yes, Medicare covers glaucoma screenings if you are at
high-risk for glaucoma. Glaucoma is a group of eye diseases in which damage to
the optic nerve results in loss of eyesight.
If you are at high-risk for glaucoma, Original Medicare
covers 80 percent of an annual (every 12 months) glaucoma screening, after
you’ve met your annual Part B deductible (the amount you must pay out-of-pocket
before your health insurance begins to cover your services). Keep in mind that
in order for the screening to be covered, the screening must be performed or
supervised by an eye doctor who is licensed to provide this service in your state.
People are considered at high risk for glaucoma if they:
Have a family history of glaucoma
Have diabetes
Are African American and age 50 or older
Are Hispanic and age 65 or older
If you have a Medicare private health plan, also known as
a Medicare Advantage plan, you should contact your plan to see what rules and
costs apply. ~Marci
Dear Marci,
I heard that certain medications that were excluded from
Medicare coverage in the past will soon be covered under Medicare Part D in
2013. Is this true? ~Ashley
Dear Ashley,
That’s a great question. Benzodiazepines and
barbiturates, medications that were formerly excluded from Medicare coverage,
will now be covered under Medicare Part D prescription drug plans beginning
January 1, 2013.
Keep in mind that benzodiazepines are covered as a
treatment for all medically necessary conditions. However, barbiturates will
only be covered in 2013 to treat epilepsy, certain cancers and chronic mental
health conditions. Check to make sure the barbiturate or benzodiazepine
you take is covered on your drug plan’s formulary.
If your Medicare Advantage or Part D plan does not cover
your drug, your plan should provide you with a 30-day transition fill at some
time during the first 90 days of the year. A transition fill is a one-time,
30-day supply of a Medicare-covered drug that Medicare prescription drug plans
must cover, when you’re in a new plan or when your existing plan changes its
coverage. You should also talk to your doctor about switching your drug to one
that is covered by your plan or ask for help in sending a formal request to
your plan to cover the drug. If you have questions about whether your Medicare
Advantage or Part D plan covers those medications and if there are any rules
you must follow in order to get the medications, you should contact the plan
directly. ~Marci
Dear Marci,
I need help paying for my prescription drugs. I do not
qualify for Extra Help. Are there any programs that can help me? ~Daniel
Dear Daniel,
If you don’t qualify for Extra Help, the federal
assistance program that helps people with Medicare pay their prescription drug
costs, you may still qualify for other prescription drug assistance programs.
Some states have State Pharmaceutical Assistance Programs
(SPAPs) to help residents pay for their prescription drugs. While most state
assistance programs work with Part D plans, not all do. Each program works
differently and has different eligibility requirements. To find out if there is
an SPAP in your state or if you may qualify, contact your State Health
Insurance Assistance Program (SHIP).
You may also want to take a look at Patient Assistance
Programs (PAPs), which are pharmaceutical programs that offer low-cost or free
prescription drugs to people with low incomes. While many PAPs do not accept
people with Part D, some do. Go online and visit www.needymeds.org or www.rxassist.orgto learn more about these programs. ~Marci
Marci\'s
Medicare Answers is a service of the Medicare Rights Center
(www.medicarerights.org), the nation’s largest independent source of information and assistance
for people with Medicare. To subscribe to \"Dear Marci,\" MRC\'s free
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