Q: I oversee my fathers care, since he had a stroke two years ago. He is covered by Medicare and I have also gotten him supplemental coverage from his previous insurer, but where do Medicare recipients get prescription drug care? I cant seem to find any information on it anywhere.A: Sorry to be the one to tell you, there is no prescription drug coverage under traditional Medicare. You can find it in certain Medicare Supplement Plans and if you sign up for particular Medicare HMOs, but youre on your own if youre among the two-thirds of beneficiaries who have the original insurance plan.
of prescription drug coverage for Medicare recipients has long been a burden for the
elderly, but it's gotten even heavier in recent years as drug costs have risen and new
breakthroughs have made new, expensive medications available for many ailments that plague
Meanwhile, cross your fingers that Congress comes up with some help for seniors and disabled people who have to pay for their medications. Nearly 20 percent of disabled people on Medicare pay more than $100 a month for drugs, according to a recent survey by the Henry J. Kaiser Family Foundation. So at least you aren't alone.Q: My husband had stage 111B lung cancer that was found in October and since then the cost has just about wiped us out. We are now on a program for his medicines, but we were wondering if there is any reimbursement plan for what we have already put out in medicines? We are both on Social Security with no other income. A: Unfortunately, insurance coverage isnt retroactive. Its always worth a try to ask your current health plan, but its highly doubtful theyd be willing to spring for coverage you didnt pay for. Diane Archer of the Medicare Rights Center recommends you also check with your Congressional and Senate offices to find out if there are other resources for people in your situation. And she notes its good for politicians to know that the lack of prescription drug coverage for seniors is a problem. Because you have a limited income, though, you might qualify for Medicaid, which provides health care to low-income people of all ages. Check with your state to see if you qualify. Also, some states have special funds to help low-income Medicare recipients with the costs of prescription medicine. Check with your state department on aging to find out if such a fund exists where you live.
Another idea: Pharmaceutical companies sometimes offer medications at low or no cost in hardship cases. The U.S. Senate Special Committee on Aging has compiled a list; to get it go to the committee's Web site publications page and look for publication 105-DRG.
Also, keep in mind there are some exceptions to Medicare's no-prescriptions rule. For instance, if you're in the hospital, the drugs prescribed there are paid for. Also, certain oral chemotherapy agents are covered. And in the unhappy event that your husband's cancer is terminal, Medicare will pay for hospice care in your home, providing medications and home care workers to help him through the last months of his life.
As always, if you have a Medicare problem or question, there is local help available. Contact your area's Medicare Insurance counseling service, which goes under various names but can be tracked down by calling (800) 434-0222. On the Web, try the government's Medicare site, or the Medicare Rights Center.