Swap Shop

22 SOUTHERN SENIOR MAGAZINE | Winter 2023 Medicare prescription drug coverage (also known as Part D) is the part of Medicare that covers most outpatient prescription drugs. If you have a Medicare Advantage plan, your benefits could include prescription drug coverage as part of your plan. Medicare Part D is a separate insurance plan that is offered through private insurance companies for those enrolled in Original Medicare (parts A and B). The availability varies by state. These plans cover prescription medications for outpatient services. 1} Most prescription drug plans charge a monthly fee that differs from plan to plan and you pay this fee in addition to your Part B premium. Pharmacy and prescription drug fraud is a consistent trend in Medicare. Criminals, ranging from health care providers to drug trafficking organizations, con- tinue to commit prescription drug fraud because it is profitable. Unfortunately, there is a strong illegal mar- ket for prescription drugs – including controlled drugs such as opioids and expensive prescriptions. Types of pharmacy/prescription drug fraud and scams are: A pharmacy intentionally provides you with less medication than you were prescribed. A pharmacy issues you expired medications. You are provided with and billed for an ex- pensive compounded medication, including topical pain creams, when a traditional or less expensive prescription was ordered by your physician. A company offers you “free” or “discount” pre- scription drugs without a treating physician’s order and then bills Medicare. A pharmacy automatically refills a prescription you no longer need. You do not pick up the prescription, but the pharmacy still bills Medicare. An individual offers to pay for the use of your Medicare number to bill for prescription drugs or offers you cash or other compensation to pick up prescriptions on your behalf. How to protect yourself from prescription drug/pharmacy fraud: Be sure your doctor has assessed your condi- tion before prescribing you any medication. Do not give out your Medicare number or other personal information to unknown individuals requesting it for prescription drug services. Review your Medicare Summary Notice (MSN) or Ex- planation of Benefits (EOB) charges for the following: Prescription drugs (including refills) that were never picked up, delivered, or even pre- scribed. Prescription drugs (occasionally controlled substances such as opioids) that were pre- scribed by a health care provider you have never seen. Amounts beyond the quantity you were pre- scribed. A different prescription drug (often a more ex- pensive drug) than the one you were originally prescribed or a drug that is not approved by the U.S. Food and Drug Administration (FDA). If you want to avoid becoming a victim of phar- macy/prescription fraud or think you’ve been a victim, you should follow Senior Medicare Patrol’s message which is to Protect, Detect and Report! It’s also very important that you care about what is going on with your Medicare benefits. If you suspect pharmacy or prescription drug fraud, you must REPORT it. Senior Medicare Patrol (SMP): Call 18772728720 or visit www.stopmedicare­ fraud.org . Funded by the U.S. Administration for Commu‐ nity Living (ACL), Administration on Aging (AoA), Grant Number 90MP0194‐01‐01 Pharmacy and Presciption Drug Fraud