Medicare and Migraines
Medicare, the health insurance provided to people age sixty-five and older in the United States, has been administered by law since 1965. All sixty-five-and-over permanent residents (or citizens) of the United States who worked for at least ten years in a Medicare-covered place of work are eligible. In addition, some people younger than sixty-five may be eligible if they are disabled and receive Social Security benefits.
Medicare consists of four basic parts:
Part A: Hospital insurance — states that any hospitalization and nursing home stays longer than three days are covered
Part B: Medical insurance — states coverage for physician and nursing services, lab tests, flu vaccines, and a host of other procedures
Part C: Medicare Advantage coverage — states that Medicare recipients can receive their coverage through private health insurance plans
Part D: Prescription drug coverage — requires enrollment in a Prescription Drug Plan (PDP) or Medicare Advantage with prescription drug coverage
One of the more important things to realize about Medicare is that it does not cover all costs. Medicare patients are still responsible for co-pays, premiums, and deductibles. In order to relieve some of the burden of these out-of-pocket fees, many people choose to also purchase a supplemental coverage plan called Medigap. What Medicare does, however, is allow retired adults with medical conditions such as migraines to continue to receive care and treatment in a similar fashion to their employer-provided health insurance during their working years.
Medicare and Medicaid are not the same thing. Medicare is the health insurance provided to individuals aged sixty-five and over. Medicaid is health insurance for low-income individuals and families. Medicaid has been in existence since 1965 and is funded by both states and the federal government.
As with any other large, government-run program, Medicare is a system that can be confusing and full of bureaucracy. With the recent availability of private health plans and prescription drug coverage for Medicare recipients, the number of choices, and therefore the potential for confusion, is higher than ever. However, with an investment of time, or the help of a trained Medicare advocate, migraineurs can find coverage that allows them to receive high-quality medical care and appropriate prescription drugs.
When choosing a Prescription Drug Plan, remember that not all plans cover the same medications. To choose a PDP that will cover your migraine medications, start by making a list of the medications you currently take. Consider dosages and how many pills you take per month. Next, look at the Standard Benefit for the different PDPs you are considering to get a sense for how deductibles will work when compared to the amount you expect to spend on migraine and other medications each year.
There are a vast number of plans available, and they will all be competing for your business. The best way to make an educated decision is to consult an expert; the AARP (American Association of Retired Persons) and Medicare both offer online tools to compare drug plans and search for particular prescription drugs. Remember that there is an annual enrollment period for Medicare Part D Drug Coverage, so research and make choices well in advance of the deadline.
