The PSC-CUNY Welfare Fund works closely with our retired members to remind them they have choices about prescription drug coverage. We know every dollar counts and we always search for ways to save.
For retired members over age 65 who are prescribed medications administered by a health care professional – such as pain-relief drugs, migraine medication, chemotherapy medications, osteoporosis or antibiotics – the Fund has identified a way to keep more money in your pocket.
The Center for Medicare Services (CMS) Medicare Part B also covers these medications if they are administered at a doctor’s office, hospital outpatient department or at an infusion center.
SAVE MONEY
Using Medicare Part B this way can save you money. Here’s how:
Medications administered in any of the clinical settings mentioned above are covered at 80% of the Medicare-approved amount, leaving 20% coinsurance for the patient. The 20% coinsurance is covered by GHI Senior Care.
Let’s consider a drug that costs $1,000, and you’ve already met your annual Medicare Part B deductible ($240) and your GHI/Senior Care deductible ($50).
Here’s a cost breakdown:
- Drug Cost: $1,000
- Medicare Part B covers
80% → $800 - Member pays 20% coinsurance → $200, which is usually covered by GHI Senior Care supplemental insurance
- Member cost after deductibles have been met: $0.
Note that the $240 Medicare Part B annual deductible and the $50 annual Senior Care deductible can be met easily, since it can include costs like office visits, X-rays, blood work or physical therapy.
Now let’s break down the out-of-pocket costs of the same $1,000 drug using a Medicare Part D (like SilverScript) plan.
Medicare Part D usually covers self-administered prescription drugs, but, under some circumstances, may offer coverage for some of the Medicare B medications. Coverage varies by plan, based on the drug formulary, tier pricing and out-of-pocket expenses such as copays and deductibles.
Cost breakdown for the $1,000 drug:
- No annual deductible.
- Member copay: 25% ($250). Unlike the Medicare Part B deductible, this copay cannot be submitted to GHI Senior Care for reimbursement.
- Your cost is $250, compared to $0 using the Medicare Part B option.
- Out-of-pocket limit: $2,000.
The Fund hopes you will consider this strategy, which can save you money on your medications administered by a health-care professional. Discuss this option with your physician and show them this letter. Contact the Fund at [email protected] with any questions. Due to the complexity of the calculations, we encourage you to email your questions to our office and include your contact information. This will allow us to follow up directly and help you in determining your potential savings.
Check out the Fund’s website, www.psccunywf.org, to learn more information about medical benefits, retirement and other health and welfare information.
Published: December 11, 2025
