Feb 21, 2012
Am self employed and pay for own med insurance. Turn 65 in two years. Will Medicare pay for meds? (truvada, norvir, prezista). Will I need to get supplemental insurance to have this coverage? Right now have a huge 4000 dollar deductable which obvious gets used up fast, then all the meds are taken care of with no further copay. What should I expect once on medicare?
| Response from Mr. Chambers
Coverage for medications under Medicare is provided by private insurance companies under Medicare Part D. When you become eligible for Medicare, or shortly before, you can enter your medications at www.medicare.gov (search for health or drug coverage).
That will tell you the plan with the least out-of-pocket expense to you based on your then current medications. Under the law that created the Part D coverage, insurance companies are required to cover virtually all medications for certain medications including HIV/AIDS so I have no doubt the drugs you mentioned will be covered.
Once you find the right plan for you, you can enroll directly with the insurance company or at the Medicare site. The premiums can be withheld from your Social Security payments.
Should you choose to go with one of the alternates to original Medicare, called Medicare Advantage plans, most will include drug coverage in their package of benefits.
You should also double check to see if you are also eligible for ADAP (AIDS Drug Assistance Program). Based on what state you live in, it may be able to pay for what the drug plan doesn't cover, which can be quite a bit for the expensive medications.
Good luck, Jacques
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