HHS Answers Your Prescription Drug Benefit Questions

Question from Sharon: On Sunday's program, Secretary Leavitt said that all medically necessary drugs are required to be covered by the new Medicare prescription-drug program. That is a misleading statement, if not a deliberate untruth. I need vitamin supplements, ordered by my doctors for tested medical conditions. One is for vitamin B-12 and others are calcium, magnesium, vitamin D, and others to treat osteoporosis. Because of new research about using vitamin D to fight MS, my neurologist has ordered it. In other cases, drugs like basic painkillers are "necessary" for a decent life, but available over the counter. Medicare is not required to buy them and doesn't. They will buy some, but not all, prescription drugs manufactured by phARMA, but not other needs like OTCs and vitamins, even if they are "medically necessary". Many of us can't afford even these and this isn't the kind of program we need. Will you please ask Secretary Leavitt about this and urge him to include these coverages in the program? Otherwise, it is a farce, because doctors try to keep costs down by ordering OTC drugs instead of pharmaceuticals when they can, and in some cases, the necessary treating chemicals are vitamins.

Answer from HHS: When Congress wrote the law designing the prescription-drug benefit, it specifically excluded certain types of medications from coverage, including vitamins and certain lifestyle drugs such as those for weight loss or hair loss, and some potentially addictive medications known as benzodiazepines. Within the confines of the law, we don't have authority to cover these medications, or, for that matter, over-the-counter medications. You may consider talking with your physician about alternative prescription-drug options. In addition, certain prescription-drug plans may make coverage for certain over-the-counter or other excluded medications available to beneficiaries as a "supplemental benefit" for an additional premium.

Question from Marcy: There are several prescription drugs that I take only occasionally (Ambien for one -- I take one or two a month at most) and one I take every three months (estring). How can I fit these into your computer Medicare program so that I can be sure that the insurance company the computer recommends is the right one for me? It tells me I take 30 Ambien a month rather than one or two, for example. I can't seem to adjust the number to accord with my reality. Help!

Answer from HHS: The Web-based prescription-drug plan comparison tool at www.medicare.gov does allow users to enter dosages for each prescription. Once you have entered the names of the medications, you'll need to look for the button that says "Change/Update My Drug Dose & Quantity." The comparison tool defaults to a typical dosage and quantity for the drugs that you enter, but once you select "Change/Update My Drug Dose & Quantity" button, you will be able to modify the dosage and quantity. You can also call 1-800-MEDICARE to get this information.

Question from Maxine: I am retired from General Motors and the union said we do not have to sign up for part D because we have drug coverage. With GM being so unstable, if they cancel our drug coverage do we get penalized for signing up late?

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