Medicare provides health insurance to adults 65 years and older, younger adults who have been receiving Social Security disability benefits for 24 months, and people with end-stage renal disease. It is important to have health insurance when you are living with a chronic disease such as psoriasis or psoriatic arthritis. This is because health insurance can help you pay for appointments, prescriptions, lab work, and more.
Medicare Resources
Frequently Asked Questions
What are Medicare Parts A, B, C, and D?
Medicare coverage is divided into parts which allows you to choose how you get your Medicare Coverage. You do not need all the Medicare parts listed below, instead, you will pick one or a few parts to get the coverage that best fits your health needs.
• Medicare Part A is hospital insurance. This covers inpatient hospital visits, skilled nursing facilities, home health, and hospice care.
• Medicare Part B is medical insurance. This covers necessary visits to your health care provider, preventive services, durable medical equipment, laboratory tests, and x-rays.
• Medicare Part C (also called Medicare Advantage) is a different way to get your Medicare benefits otherwise covered by Original Medicare (Parts A and B).
• Medicare Part D provides prescription drug coverage. This covers prescription treatments that you may use to treat your psoriatic disease such as topicals, phototherapy, oral systemic, and biologic treatments.
To learn more about Medicare, including supplemental coverage options, request your free Health Insurance Quick Guide.
When can I join, switch, or drop a Medicare health plan?
You can join, switch, or drop a Medicare health plan or Medicare Advantage plan during 3 periods:
1. Initial Enrollment Period: the 7-month period around your 65th birthday
2. Open Enrollment Period: October 15th – December 7th every year
3. Medicare Advantage Open Enrollment Period: January 1st – March 31st every year. You can switch to a different Medicare Advantage plan or switch to Original Medicare (Parts A & B)
Some people are automatically enrolled in Medicare. Those include people who are receiving Social Security benefits and Railroad Retirements benefits. If you are not automatically enrolled, you will have to sign up. You can sign up at medicare.gov or by contacting Social Security.
How can keep my prescription treatment costs low on Medicare?
When some people switch from commercial health insurance to Medicare, they may notice that the cost of their prescription treatments goes up. Luckily, there are some options that may lower your prescription drug costs, including:
• Requesting a formulary exception. If you are prescribed a treatment that is not on your plan’s formulary, you and your health care provider can make a special request that your insurance plan cover the treatment.
• Requesting a tiering exception. Prescription treatments on a formulary are grouped into tiers (or levels). A tiering exception means that the insurance company would bill your specialty drug at a lower tier (and lower cost).
• Looking for other treatment options. Your provider may be able to help you find another treatment that could be more affordable and still manage your psoriatic disease effectively.
Request your free Switching from Commercial Health Insurance to Medicare guide to learn about more options that may lower your prescription drug costs.
Resources
Medicare 2025 Changes Town Hall Discussion
Not sure what plan options are best for you or how the 2024 or 2025 changes impact coverage of your psoriatic disease medication?
Psound Bytes™ Podcast: Let’s Talk 2025 Medicare Changes
Listen as Jason Harris, NPF VP of Government Relations & Advocacy, and dermatologist and rheumatologist Dr. Alice Gottlieb discuss issues and tips for transitioning to Medicare health coverage, the $2,000 expense cap, and smoothing expenses.
2025 Medicare Changes & What They Mean For You
Learn more about:
• The Part D out-of-pocket cap
• The end of the “donut hole”
• What “smoothing” means
• Changes for premiums
When Affordability Isn’t a Possibility
Wayne Hauber learned firsthand how out-of-pocket costs can skyrocket when switching to Medicare from a commercial insurance plan.
Medicare Part A, B, C and D: What’s the Difference?
Understand which plans cover which services so you can make the best choice for you.
Pathways for Reducing Out-of-Pocket Costs in Medicare
Learn why people with psoriatic disease experience high out-of-pocket costs when they switch from commercial insurance to Medicare Part D.
Still Have Questions About Medicare?
Contact the Patient Navigation Center to learn more about Medicare, find a health care provider, learn about treatments, locate programs that may lower the cost of treatments, and connect with others living with psoriatic disease.
Presenting Sponsor
Gold Sponsor
