I’ve been using a Health Savings Account (HSA) to cover costs not covered by the health insurance I’ve had through work. Can I do the same under Medicare?

You can still use cash you’ve already put into your HSA to pay your share of Medicare out-of-pocket expenses, including your Medicare premium, deductibles, copays and coinsurance. What you can’t do is put new money into the HSA. For those not familiar, HSAs are offered by some employers (as well as some banks, credit unions and insurance companies) to people with high-deductible health plans as a way to accumulate money for when uncovered medical costs arise. You invest pretax dollars and they grow in the account until needed. Once you enroll in Medicare, you can no longer contribute to your HSA.

Is it true that I can’t use my Medicare Part D drug plan with a discount coupon provided by a drugmaker?

That’s true. Under a federal law called the Anti-Kickback Statute, Medicare enrollees cannot use a manufacturer coupon along with their Part D prescription drug plan. The rationale? Federal officials say such coupons could be an incentive to use higher-priced brand-name medications that have coupons available instead of cheaper alternatives, therefore costing Medicare—and taxpayers—more money. Drugmakers tend to make these coupons available for their newer and more expensive medications. However, you can use these coupons if you don’t use your Part D plan to pay for your prescription. A few cautions: Medicare requires pharmacists to use your Part D plan when filling a prescription unless you tell them otherwise. Also, often these coupons have an expiration date and/or a maximum amount they will pay. So you might consider that, especially if you are likely to take the drug for a long time. If you’re having trouble deciding which path to take for a particular medicine, consider getting your pharmacist’s advice.