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4 Tips: Insurance for HIV Patients

Four key tips for navigating health insurance plans when living with HIV

Publisher’s note:  This guest blog is written and submitted by Mallory Schmoll, an HIV specialist at Walgreens in Louisville, Ky.  After reviewing this post, we believe our readers will find it very informative and helpful.  This is not a sponsored post.  

Choosing a prescription drug plan can be confusing, especially for aging adults with HIV. In addition to managing HIV treatment, they may also be facing the need to treat other chronic conditions commonly associated with aging such as hypertension, high cholesterol and diabetes.  With the Medicare Annual Enrollment Period coming to a close on Sunday, Dec. 7, Walgreens market HIV specially trained pharmacist, Mallory Schmoll, offers a few things to keep in mind when selecting a Medicare Part D plan:

Make a monthly budget

Before selecting a plan, it’s important that enrollees look at how much they will be spending each month on prescriptions and other health-related expenses. For those who are taking multiple medications, a plan that offers a higher monthly premium and low deductible (which can mean lower co-pays) may be a good option. Others who don’t incur many monthly health expenses may choose a plan with a low monthly premium and a higher deductible. This means they may pay more for prescriptions and the occasional doctor visit, but their fixed monthly insurance payment can be lower.
Walgreens offers free, personalized plan comparison reports in its pharmacies nationwide and online at walgreens.com/medicare to help beneficiaries understand which Medicare prescription drug plan best meets their budget and lifestyle needs.

Use preferred or in-network pharmacies

When selecting a Medicare Part D plan, it’s important to pay attention to the preferred providers in a plan’s network. There can be significant cost savings when selecting a pharmacy in a plan’s preferred network for some of your prescriptions.
Walgreens is in-network with several plans and a part of preferred pharmacy networks with nine national Medicare Part D plan sponsors.

Beware the coverage gap

Most Medicare Part D plans have a gap in coverage, also known as a “donut hole,” which is a temporary period entered when a beneficiary and their plan have paid a specific amount. During this period a beneficiary’s out-of-pocket medication expenses will go up, which can be very difficult for those in the HIV community who are taking numerous prescriptions. In 2015, beneficiaries enrolled in standard prescription drug plans will enter the coverage gap when they and their plan spend $2,960 on covered drugs. Some plans offer financial assistance during this gap. Pharmacists can help beneficiaries determine if they’re eligible for one of these plans.

Communication is key

After enrolling in coverage, it’s important that beneficiaries maintain an accurate medication list and that they share this list with their doctors and pharmacists. Consistent communication between patients, doctors and pharmacists is essential in improving adherence to treatment plans and diminishing the risk of drug interactions.
Walgreens pharmacists can also help Medicare beneficiaries living with HIV by providing confidential, face-to-face medication therapy consultations and health and wellness guidance. HIV specially-trained pharmacists can also help patients access financial support programs to reduce medication costs.
Walgreens has more than 800 HIV-specialized pharmacies across the U.S. with pharmacists specially trained to support those in the HIV community. To find an HIV-specialized pharmacy, visit Walgreens website for more information.

Biography

Mallory Schmoll Mallory Schmoll is a market HIV specialist at Walgreens in Louisville, Ky. She is certified through the American Academy of HIV Medicine as an HIV pharmacist. In the community, she provides regular in-services to medical case managers at Volunteers of America and works with their prevention outreach specialists who offer free HIV testing at two Walgreens stores. She currently serves as vice president of the Kentuckiana AIDS Alliance and is a board member of the Kentucky HIV/AIDS Planning and Advisory Council. She received a doctor of pharmacy from Purdue University and completed a two-month HIV specialty rotation in Kenya.

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