Understanding Your Prescriptions
Florida Blue’s Dr. Cynthia Griffin answers some common questions about prescription drug coverage, mail order and how to manage your medications more effectively.
What should I do if my medication is not covered or is too expensive?
Each year, your health plan provides a formulary, which is a list of drugs covered under your pharmacy benefits. If your drug isn’t on that list or costs too much, ask your doctor or pharmacist about covered drugs that might work for you and be more affordable.
I can’t get to the pharmacy to pick up my medication. Are there any other options?
Florida Blue offers mail-order pharmacy service so you can get your medications delivered right to you. Florida Blue’s mail-order service is provided by PrimeMail by Walgreens. It’s easy to sign up, and you can order refills over the phone or online. There is no extra cost for this service.
What questions should I ask my pharmacist?
You can ask your pharmacist any questions you have about your medication. Some questions you can ask are: What should I do if I miss a dose? Are there side effects? Are there any other special instructions for taking the medication, like how to take it or when to take it?
Why are some drugs covered and others aren’t?
A drug must meet Medicare’s guidelines before your plan can cover it. For example, federal law prohibits Medicare coverage of drugs for cosmetic purposes, for weight loss or weight gain and for symptomatic relief of cough and colds. Medications also have to meet the standards of the U.S. Food and Drug Administration (FDA). If the FDA doesn’t deem a drug to be effective or safe, Medicare won’t cover it. If many drugs are available to treat the same disease, your plan also may decide not to cover all of them. But if the plan doesn’t cover a specific drug, there are usually two or more alternatives to treat the same condition.
What is a comprehensive medication review, and why should I do this?
Your drug plan offers a service called the Medication Therapy Management Program. If you qualify for this program, you’ll get a letter telling you how to take advantage of a comprehensive medication review. A pharmacist will review your medications with you to help you understand and better manage your medications. You can call the number on the back of your member ID card to see if you qualify for this program.
Cynthia Griffin, Pharm.D., is Florida Blue’s vice president of pharmacy programs
Want your prescriptions by mail? Medicare Advantage members can call PrimeMail by Walgreens at 1-866-525-1590 (TTY 711) 24 hours a day, seven days a week to have your prescriptions delivered to you.
Filed under: Medicare News