You picked a Medicare drug plan in December. Then in January, the pharmacist tells you your medication isn’t covered, or that it needs approval first. It happens more often than you’d think, and it’s especially hard on families managing a serious illness like Alzheimer’s disease.

With Medicare open enrollment running through December 7, host Meryl Comer sits down with Rosemary Maxwell and Monique Nolan, health policy attorneys at Arnold & Porter in Washington, DC, to cut through the confusion. Monique spent years at the U.S. Department of Health and Human Services working on Medicare and Medicaid. Together they explain what the new annual cap on Part D out-of-pocket costs really covers, and why a drug that isn’t on your plan’s formulary won’t count toward it at all. 

For caregivers, the conversation gets practical. You’ll learn what “protected class” actually guarantees for antipsychotics and other critical drugs. You’ll also hear what a doctor should include when requesting a coverage exception, and when to push back if your plan steers you toward a cheaper substitute. The guests explain why some Alzheimer’s treatments fall under Part B instead of Part D, how the Medicare Prescription Payment Plan can spread out a large January bill.

If you or someone you love relies on prescription medications, listen before you choose a plan, and before the pharmacy counter becomes a crisis.

Support for BrainStorm by UsAgainstAlzheimer’s comes from Lundbeck US. Lundbeck is dedicated to advancing brain health and transforming lives through focused innovation in neuroscience.

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