Q&A about Medicare and privacy law

Question: I understand that the Medicare drug-discount cards use drug formularies. Please explain what this means.

Answer: Basically, a drug formulary is a list of prescription drugs. For example, HMOs use formularies and generally cover, in part or in full, only drugs included in their formularies. If you buy a Medicare-sponsored discount card, you will receive discounts on drugs listed in the issuing company's drug formulary.

Whether you're in an HMO or buy a Medicare-approved discount card, you'll be encouraged to use generic rather than brand-name drugs. In HMOs, brand-name drugs often require higher copays. With the cards, discounts on brand-name drugs may be lower and prices higher. For example, if your doctor prescribes a brand-name drug for which there is a generic substitute, the brand-name drug is likely to cost significantly more than the generic. Ask your doctor about generic options when he or she writes your prescription.

Question: I meet the military's requirements for participating in Tricare for Life, but I appear to be stuck with paying higher Medicare Part B premiums. Is there a way around this?

Answer: You're in luck. For a limited time only, military retirees eligible for Tricare for Life, or TFL, will be permitted to enroll in Medicare Part B without penalty. This change was included in Section 625 of the Medicare Act of 2003. TFL is the military's equivalent of a top-of-the-line Medigap policy. To buy a Medigap policy, you must be enrolled in Medicare Part B. Likewise, to join TFL, you must have Medicare Part B. The special-enrollment period for military retirees runs until the end of this year. Stay tuned at www.tricare.osd.mil.

Question: I take care of my mother, who has several health problems. Will the new medical-privacy rules prevent her doctors from talking to me and sharing important medical information?

Answer: Not unless the doctor or hospital believes that your mother is being abused or that giving you information is not in her best interest. Under the new federal privacy rules, a doctor can share medical information with a spouse, family member or other person involved with the patient's care, particularly in emergency situations.

Your mother should consider signing a medical power of attorney naming you as her agent. That way, both you and she can be more confident that you can help her and carry out her wishes.

For more information on medical privacy rights, visit www.hhs.gov/ocr/hipaa.