Question: I have mail order with my current coverage and get most of my medication through that service. My prescription drug company is different for 2017. How do I handle that?

Answer: More and more I find that individuals are using mail order to get their maintenance medication. This 90-day supply is useful for many reasons, and it saves time in driving to the pharmacy. When your insurance coverage changes, you must then think about the change to this convenient service.

Locally there are some pharmacies that offer to fill your medications for a 90-day supply and then mail them to you from the local pharmacy. If this is what is happening, you don’t have to change much, simply show the local pharmacy your new insurance card, so they know which company to run your medications through.

The question asked today, I believe has to do with traditional Mail Order Medication procedures.

Each Insurance Company, or Prescription Drug Plan has its own procedure for using Mail Order. There are hundreds of mail order pharmacies in the country. So when you switch from one insurance carrier to another, you may have to change your mail order company. More and more of these Part D plans have one particular Mail Order Company they deal with.

When you sign up for your new insurance choice, they always mail you a whole packet of information. In that packet is the answer to your question. Buried in that booklet of information about your insurance coverage is how the company would like you to handle your mail order option of filling your medications.

If you can’t find that book, threw it out, or simply can’t find the information in the book, look at your insurance card. On the back of the card is a list of numbers to call for different concerns. One of them may be customer service, prescription drug questions, or a name like that. This is usually a toll free number you can call to ask questions. Call your customer service department and ask how they handle getting started with your mail order medications.

You can also talk with your doctor’s office staff. Remember that there are quite a lot of you Medicare covered seniors in our community. Your doctor’s office may already know the procedure for how to contact your company and get your medications started coming through the mail. To review your options with your doctor’s office, you must have your Prescription Drug Coverage in their system or show them the new card you just got. Once they have the prescription drug coverage information, your ID number and the insurance company contact information they can inform the company what you take and it will be mailed to you.

You will need to call the mail order pharmacy after your physician sends in your prescriptions. You will need to tell them to fill these prescriptions. Your insurance carrier already knows all it needs to know about you, where you live, what is your name, Date of Birth, ID #, contact information, etc. Once you contact the mail order company and confirm you want the medications, they will fill your prescriptions and mail them to your address on record. The refill information will come along with your medications instructing you how to refill them. This can usually be done on-line or with a phone call. This process may require that you give them credit card information to bill your medication through. You can decide if that system works for you. Some mail order companies will allow you to be billed and then you can send payment back to them once the medications are received.

As you may realize, we rarely get paper prescription slips anymore. The doctor’s offices and pharmacies are required to use an electronic system. This was designed to save time and money, as well as reduce medication errors. The mail order option requires attention and processing from your physician’s office. You can no longer take the paper scripts and deliver them/mail them/fax them to your pharmacy. The doctor’s office will need to do that for you.

Getting your medications using the mail order method may work very well for you. It often saves your money on the cost of your medications. It also gets you a 90-day supply, so you don’t have to fill your medications as often. The shipment of medications can be sent to different addresses, depending on where you are when you need them.

One of the downsides to many mail order pharmacies is that they don’t or can’t bill your medications through EPIC. EPIC is the New York State Elderly Pharmaceutical Insurance Coverage Program available to seniors who live in New York State, have Prescription Drug Coverage and make less than $75,000 a year as a single person or $100,000 for a married couple.

EPIC would be secondary coverage to your Part D (Prescription Drug) Plan. If your medications are expensive and you hit the coverage gap with your Part D plan, EPIC could save your money on your co-pays. If you use mail order, the medications are often coming from other states, so your medications might not be billed through this New York State benefit. Once you know your mail order pharmacy, you can call EPIC and see if they have a contract with that company. EPIC may, as they are collaborating with more and more companies all the time.

If you have EPIC and are interested in using mail order, call EPIC they may be able to tell you if your insurance carrier has a Mail Order option that EPIC can work with. EPIC would be more likely to be able to answer that question. If you call your insurance carrier, they may have a national product and would have no idea about particular benefits in New York State.

For some of the Medicare Part D Plans mail order can save you a significant amount of money. They may provide you with free or lower cost generic medication, or a 3-month supply for less than three co-pays. This could save your household money over the course of the year. It also saves you the time of going to the pharmacy.

A down side to the mail order process is that you will lose that face to face contact you may get with the pharmacist as the local pharmacy. This face to face contact is an opportunity to ask questions about your medications, or interactions between your medications.

You may choose to use both mail order and the local pharmacy. You don’t have to do all or nothing. You can get some from the local pharmacy and some from Mail Order. Look over the information sent to you and make your own decision based on what works best for you. Just be sure to let your pharmacists know that your insurance coverage has changed.

Hoping that 2016 was a wonderful year as you look back. Knowing that 2017 can be great if we work together to make it that way!

To contact Janell Sluga, GCMC with questions or concerns, please call 720-9797 or e-mail her at janells@lutheran-jamestown.org.