Nursing home resident needs to change plans

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Q. My grandpa lives in a nursing home. We signed him up for a Medicare drug plan earlier this year. We just learned that the nursing home uses a pharmacy that is not covered by his Medicare drug plan. What should we do?

Many nursing homes contract with one pharmacy to provide medications for all residents of the facility. This means that an important consideration for nursing home residents is finding a Medicare drug plan that includes the pharmacy in its network. If your grandfather’s Medicare drug plan does not contract with the pharmacy used by his nursing home, it would probably be a good idea to switch to another plan. Otherwise, your grandfather will likely have to pay more for using an out-of-network pharmacy to fill his prescriptions. And this could be quite costly.

You may want to ask the nursing home staff for a list of Medicare drug plans that work with the pharmacy the facility uses.

Plans may be switched only once before May 15; after that enrollees are locked into their plan for the remainder of the year.

This column was prepared by the Kaiser Family Foundation. Send questions to Medicare Q&A, The Kaiser Family Foundation, 1330 G St., N.W., Washington, DC 20005, or [email protected]

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