With the rising costs of medications, many seniors are struggling to afford the basic necessities they require. Fortunately, there are ways for those on Medicare to access hidden savings opportunities when it comes to their prescription drugs. By understanding these options and taking advantage of them, individuals can enjoy significant savings and peace of mind when managing their healthcare expenses. In this article, we will look at a little-known money-saving tip that can help unlock hidden savings on Medicare prescriptions.
This tip is particularly useful for people whose medications are on a higher tier, but medications on lower tiers that treat your condition are not a good fit for you. If you are in this situation a tiering exception might allow you to receive the same exact medication at a lower cost than what is typically charged for it. This is a rather simple process but does involve getting your doctor to complete a simple form and submit it to your insurance company. Once approved, you can enjoy significant savings on your medications and peace of mind knowing that you are taking advantage of all the savings opportunities available to you.
In order to qualify for a tiering exception, it is important to understand that there must be medications on lower tiers that treat your condition, but these medications on lower tiers must also not be a good fit for you. This means that the medication prescribed by your doctor may provide better treatment and have fewer side effects than those found on lower tiers. If the medications on a lower tier would be a good fit for you, then a tiering exception would not apply. In this case, you would likely be better off switching to the lower-tier medication.
If you are taking a brand-name drug and your tiering exception is approved, you could expect to pay the lowest tier cost that contains brand-name alternatives for treating your condition. This means that you might be able to get your Tier 4 drugs at the Tier 3 pricing or maybe lower.
If you are taking a generic drug and your tiering exception is approved, you could expect to pay the lowest tier cost that contains brand-name or generic alternatives for treating your condition. This means that you might be able to get your Tiers 2-4 drugs at Tier 1 or 2 pricing.
If your tiering exception is approved and there are more than one lower cost-sharing tiers with alternative drugs you cannot take, then the lowest amount will usually apply.
While you cannot request a tiering exception for medications you already received, if you are approved, tiering exceptions are generally good for the remainder of the plan year. On Medicare that typically means will be good until December 31st of that year.
To get started download this form [LINK: https://bit.ly/3GTLZOG] and ask your doctor to complete it and fax it to your insurance company. If you need the right fax number for your insurance company please reach out, and I will be happy to track that down for you. You can also watch the video below where I go over all of this information and walk through the request form.
If you have any questions about how to go about this process, please reach out and I would be more than happy to help guide you through it. By being proactive and taking advantage of these opportunities, you can better manage your healthcare expenses with greater ease and peace of mind.
Thanks for reading!