09-27-2023 Primtime Living - Flipbook - Page 21
A Special Advertising Section of Baltimore Sun Media Group | Wednesday, September 27, 2023
from a Canadian pharmacy. A spokesperson
for the Center for Medicare and Medicaid
Services (CMS) said, “If an enrollee must use
an out-of-network pharmacy, they will generally pay the full cost of the drug and can ask
their Part D plan to reimburse them for the
plan’s share of the cost.”
One article on bringing in medications
from outside the country starts off: “It’s illegal
(nudge, nudge) to buy prescriptions drugs
(wink, wink) from other countries.” It points
out that it’s illegal except when it’s not. Then
it adds, “Confused? Yes, so are we.”
Medicare Part D enrollees can look in their
plan’s Pharmacy Directory for information on
which pharmacies are in-network. The reality
is other countries negotiate their costs so that
is why it is often a lot less expensive for the
exact same medications
A few warnings: if you should choose
to use a pharmacy from outside the United
States, there are laws about importing medications. The U.S. Food & Drug Administration
says, “In most circumstances, it is illegal for
individuals to import drugs into the United
States for personal use.” But there are situations when it is OK:
• It’s for a condition “for which effective
treatment is not available in the U.S.”
• You’re not commercializing or promoting it.
• It is for your own personal use.
• You’re usually limited to a three-month
supply.
If you decide to use an out of country
pharmacy, this is a case of “Let the buyer
beware.” You should research your choice
thoroughly to make sure it is a legitimate
pharmacy. And leave enough time. Orders
may take much longer than you expect. Make
very sure you do your due diligence before
committing to an order.
KFF, formerly the Kaiser Family
Foundation, “is [now] an independent source
of health policy research, polling, and journalism.” In an article on prescription drug importation, it discusses efforts to reduce the high
cost of drugs and who is looking at what can
be done. “Current law allows for the importation of certain drugs from Canada under
defined, limited circumstances, and only if the
Secretary of the United States Department
of Health and Human Services (HHS) certifies that importation poses no threat to the
health and safety of the American public and
will result in significant cost savings to the
American consumer.”
The suit would allow “certain prescription drugs” to be imported from Canada as
long as they “(1) pose no additional risk to
the public’s health and safety, and (2) result
in a significant cost reduction to American
consumers for covered drugs.”
PhRMA, Pharmaceutical Research and
Manufacturers of America (https://phrma.
org/), is fighting back before anyone has
looked at how those companies are affected.
The government has filed a motion to dismiss
its suit against the U.S. Department of Health
and Human Services, et al. After two years,
there has been no disposition.
President Biden signed an executive order
that will allow states to move forward with
drug importation plans, and “instructs the
FDA to work with states to import prescription
drugs from Canada.” That’s where it stands
now. It’s a complicated situation, but finally
there is movement to do something about the
high costs in the U.S.
But Wait… There’s More!
September is Pain Awareness Month.
Medicare has one particular benefit that has
probably been around for a while, but one we
should remember is there for us: coverage for
Opioid Use Disorder treatment.
While prescription opioid pain medications can help treat pain after surgery or an
injury, they carry serious risks like addiction. If
you or a loved one are struggling with opioid
use disorder, Medicare covers treatment services that can help.
These services may include medication
coverage, counseling, drug testing, individual
and group therapy, and more. Certain services, like counseling and therapy, are available
both in-person and virtually.
The first step is talking with a doctor about
treatment options. People with Medicare can
also visit Medicare.gov to search for treatment locations nearby.
The link takes you to Medicare’s main site
and, from there, describes what it includes
and directs you to providers. With many
residents of our state (of all ages) suffering
from an opioid crisis, this information is good
to know.
Medicare, for most people over 65 and
those will disabilities, is a blessing. Still, it’s
complicated. As with most situations involving health care, you have to be your own best
advocate. Ultimately, it’s up to you to protect
yourself and your health. That’s all we can do.
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