U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced that three million Medicare beneficiaries nationwide have received prescription drug cost relief through the Affordable Care Act. To date, three million eligible beneficiaries who fell into the drug coverage gap known as the donut hole during 2010 have been mailed a one-time, tax-free $250 rebate check.
“For too long, many seniors and people with disabilities have been forced to make impossible choices between paying for needed prescription medication and necessities like food and rent,” said Secretary Sebelius. “The Affordable Care Act offers long overdue relief by lowering prescription drug costs each year until the donut hole is closed.”
Eligible beneficiaries who fell into the coverage gap during 2010 are continuing to automatically receive rebate checks. These checks are only the first step in how the Affordable Care Act will reduce prescription drug costs for beneficiaries in the donut hole each year until it is closed in 2020. Starting this year, eligible beneficiaries in the coverage gap will receive a 50-percent discount on covered brand name medications while in the donut hole. In addition, in 2011 Medicare will begin paying 7-percent of the price for generic drugs during the coverage gap.
Also today, Secretary Sebelius released a new video message on the new benefits the Affordable Care Act provides in 2011 for people on Medicare. You can watch the video message here.
The closing of the donut hole is just one of the ways seniors benefit from the Affordable Care Act. In addition to savings on prescription drugs, the law provides new benefits to Medicare beneficiaries when they visit their doctor starting this year:
* As of January 1, 2011, Original Medicare no longer charges out-of-pocket costs for the “Welcome to Medicare” physical exam and, for the first time since the Medicare program was created in 1965, Original Medicare now covers an annual wellness visit with a participating doctor, also at no cost.
* In addition to these annual wellness visits, most people with Medicare can now receive critical preventive services, including certain cancer screenings such as mammograms and colonoscopies, for free.
* Also this year, the Affordable Care Act will provide qualifying doctors and other health care professionals providing primary care to people on Medicare a 10-percent bonus for primary care services. This will help ensure that those primary care providers can continue to be there for Medicare patients.
People with Medicare can learn more about these new benefits, search for participating doctors in their area, and find other helpful information by contacting a trained customer service representative toll-free at 1-800-MEDICARE (1-800-633-4227) or visiting www.Medicare.gov.
Additionally, the Affordable Care Act makes Medicare stronger and more secure for all beneficiaries. These provisions under the new law increase benefits to beneficiaries and help to extend the life of the Medicare Trust Fund by 12 years.
* An analysis issued by the Department of Health and Human Services estimates that under the Affordable Care Act, average savings for those enrolled in traditional Medicare will amount to more than $3,500 over the next 10 years. Savings will be even higher – as much as $12,300 over the next 10 years – for seniors and people with disabilities who have high prescription drug costs. Total savings per beneficiary enrolled in traditional Medicare are estimated to be $86 in 2011, rising to $649 in 2020. For a beneficiary in the donut hole, estimated total savings increase from $553 in 2011 to $2,217 in 2020.
* The Affordable Care Act establishes a new Innovation Center that will research, develop, test, and expand innovative payment and delivery arrangements to improve the quality and reduce the cost of care provided to patient with Medicare, Medicaid or Children’s Health Insurance Program (CHIP) coverage. Innovations that are found to work can be rapidly expanded and applied more broadly—helping to transform the health care system into one that provides better care at lower cost.
· The Affordable Care Act contains important new tools to help crack down on criminals seeking to scam seniors and steal taxpayer dollars. The law strengthens the screenings for health care providers who want to participate in Medicare, Medicaid, or CHIP, enables enforcement officials to see health care claims data from around the country in a searchable database, and strengthens the penalties for criminal wrongdoing. The reduction in waste, fraud, and abuse returns savings to the Medicare Trust Fund to strengthen the program into the future. Seniors are encouraged to contact 1-800-MEDICARE to report any solicitations of personal information or suspected fraud, waste, or abuse, or go to www.StopMedicareFraud.gov.
For more information on how the Affordable Care Act benefits seniors, visit www.HealthCare.gov.
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Showing posts with label prescription. Show all posts
Showing posts with label prescription. Show all posts
Friday, January 21, 2011
Wednesday, January 12, 2011
Long Term Care Pharmacy Alliance Concerned with Proposed CMS Rule; New Study Confirms LTCPA Position
/PRNewswire/ -- The Long Term Care Pharmacy Alliance (LTCPA) expressed concern with CMS's proposed rule on short-cycle dispensing within the long-term care (LTC) setting. In comments submitted to CMS Tuesday, LTCPA explained that any cost savings generated by implementing a short-cycle, 7-day fill dispensing regimen, would be overwhelmingly eliminated by additional dispensing fees resulting from the quadrupling the number of dispenses needed to move from 30-day to 7-day cycles.
A study conducted by Managed Solutions, LLC and released today supports this conclusion and finds that moving all Medicare Part D prescriptions to a 7-day fill would result in increased costs to Part D payers of over $800 million annually. Even moving more expensive brand products to a 7-day fill would still increase costs to Part D payers of $154 million annually.
"While LTCPA supports the goal of reducing waste, we also recognize the need to consider all costs associated with the proposed rule, so that unintended consequences do not result from the application of the rule. Given that it's the American taxpayer ultimately shouldering the burden of paying for this statute, it is critical that calculations such as those provided in our study be factored into the drafting of regulations," stated Bill Daniel, Executive Director for LTCPA.
The study derived its analysis from information received from eight LTC pharmacies. The findings estimated the amount of unconsumed medication among Medicare Part D residents in skilled nursing facilities and the potential cost reductions that could be achieved through shorter fill times.
In addition to the increased cost to payers, other key findings included:
* "Wasteful dispensing" to nursing home residents covered by Medicare Part D, only amounts to approximately 2.9% of total dispensed value. Short cycling this percentage of waste would save only $125 million annually and cost over $900 million in additional dispensing fees. This is in stark contrast to the $712.5 million in annual savings estimated by the Congressional Budget Office in their scoring of the short-cycling provision.
* The tradeoff between reduced waste associated with unused medication and increased pharmacy operating costs due to more frequent medication dispensing only becomes favorable to the taxpayer for prescriptions with original dispensed value of over $400.
In its comments, LTCPA stated that CMS's approach on short-cycle dispensing is contrary to Congress' intent that Section 3310 of the Patient Protection and Affordable Care Act result in savings to Medicare Part D. "We believe that it was Congress' intent to decrease costs associated with unused medications for Part D residents in LTC facilities. Implementing short cycle dispensing for long term care patients with an average length of stay of 835 days who are primarily taking maintenance medications does not meet this financial goal. While we applaud CMS's initial proposal to short cycle traditionally more expensive brand products, we believe that this limitation isn't narrow enough. Our data clearly shows that there is a prescription value threshold of $400 that must be met in order to achieve any cost savings," continued Bill Daniel.
In the proposed regulations, CMS calls for data collection by Part D plans in order to study the efficiencies of various dispensing methodologies and to estimate the cost of unused drugs and possible savings. As CMS has identified their lack of data on unused Part D drugs in this population, LTCPA recommends that before drafting any final regulations CMS conduct a study to determine the causes, frequency and cost of unused medications and also consider alternatives to 7-day dispensing cycles.
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A study conducted by Managed Solutions, LLC and released today supports this conclusion and finds that moving all Medicare Part D prescriptions to a 7-day fill would result in increased costs to Part D payers of over $800 million annually. Even moving more expensive brand products to a 7-day fill would still increase costs to Part D payers of $154 million annually.
"While LTCPA supports the goal of reducing waste, we also recognize the need to consider all costs associated with the proposed rule, so that unintended consequences do not result from the application of the rule. Given that it's the American taxpayer ultimately shouldering the burden of paying for this statute, it is critical that calculations such as those provided in our study be factored into the drafting of regulations," stated Bill Daniel, Executive Director for LTCPA.
The study derived its analysis from information received from eight LTC pharmacies. The findings estimated the amount of unconsumed medication among Medicare Part D residents in skilled nursing facilities and the potential cost reductions that could be achieved through shorter fill times.
In addition to the increased cost to payers, other key findings included:
* "Wasteful dispensing" to nursing home residents covered by Medicare Part D, only amounts to approximately 2.9% of total dispensed value. Short cycling this percentage of waste would save only $125 million annually and cost over $900 million in additional dispensing fees. This is in stark contrast to the $712.5 million in annual savings estimated by the Congressional Budget Office in their scoring of the short-cycling provision.
* The tradeoff between reduced waste associated with unused medication and increased pharmacy operating costs due to more frequent medication dispensing only becomes favorable to the taxpayer for prescriptions with original dispensed value of over $400.
In its comments, LTCPA stated that CMS's approach on short-cycle dispensing is contrary to Congress' intent that Section 3310 of the Patient Protection and Affordable Care Act result in savings to Medicare Part D. "We believe that it was Congress' intent to decrease costs associated with unused medications for Part D residents in LTC facilities. Implementing short cycle dispensing for long term care patients with an average length of stay of 835 days who are primarily taking maintenance medications does not meet this financial goal. While we applaud CMS's initial proposal to short cycle traditionally more expensive brand products, we believe that this limitation isn't narrow enough. Our data clearly shows that there is a prescription value threshold of $400 that must be met in order to achieve any cost savings," continued Bill Daniel.
In the proposed regulations, CMS calls for data collection by Part D plans in order to study the efficiencies of various dispensing methodologies and to estimate the cost of unused drugs and possible savings. As CMS has identified their lack of data on unused Part D drugs in this population, LTCPA recommends that before drafting any final regulations CMS conduct a study to determine the causes, frequency and cost of unused medications and also consider alternatives to 7-day dispensing cycles.
-----
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Monday, November 15, 2010
Open Enrollment for 2011 Medicare prescription drug and health plans begins Nov. 15th
The Centers for Medicare & Medicaid Services (CMS) is encouraging all Medicare beneficiaries to take advantage of the annual Open Enrollment period to make sure they have the best coverage available to meet their health care needs in 2011.
The Medicare Open Enrollment Period this year begins on November 15th and runs through December 31st. During the Open Enrollment period, current or newly eligible Medicare beneficiaries, including people with Original Medicare, can review current health and prescription drug coverage, compare health and drug plan options available in their area, and choose coverage that best meet their needs.
"The Affordable Care Act will make Medicare stronger and more sustainable. There will be new benefits available to nearly every person with Medicare starting in January 2011, including free annual wellness visits and free recommended preventive services like mammograms and colonoscopies. Seniors who fall into the donut hole in 2011 will be eligible for a 50 percent discount on brand-name prescription drugs. These new benefits make this year's Medicare Open Enrollment Period especially important," said HHS Secretary Kathleen Sebelius. "Every year, the Medicare Open Enrollment Period gives Medicare beneficiaries a chance to evaluate their current plans and see what other options might be out there that serve their needs, especially if their health status has changed. Those enrolled in Medicare can think of the Open Enrollment Period as a yearly coverage "check-up." It is important for people with Medicare to look closely at their plan, look at the options available to them, consider their health status, and find what works for them."
"There's never been a better time for Medicare beneficiaries to check out their Medicare coverage," said CMS Administrator Donald Berwick, M.D. "With better plan choices available for 2011, Medicare beneficiaries can think of Open Enrollment as their yearly coverage 'check-up'."
"During Open Enrollment, AoA's national network of community-based organizations will work with seniors, individuals with disabilities and their caregivers across the country to help them understand the new benefits available under the Affordable Care
Act," said Kathy Greenlee, Assistant Secretary for Aging. "In addition, we urge seniors to protect themselves from potential fraud and identity theft. We know there are people who use this time to scam seniors and rip off Medicare. Seniors should protect their Medicare number the same way they do their Social Security number or credit cards."
Resources for Medicare Beneficiaries
People with Medicare, their families and other trusted representatives can review and compare current plan coverage with new plan offerings, using many proven resources, including:
. Visiting www.medicare.gov, where they can get a personalized comparison of costs and coverage of the plans available in their area. The popular Medicare Plan Finder and Medicare Options Compare tools have been enhanced for an efficient review of plan choices. Multilingual Open Enrollment information and counseling is available.
. Calling 1-800-MEDICARE (1-800-633-4227) for around-the-clock assistance to find out more about coverage options. TTY users should call 1-877-486-2048.
. Reviewing the 2011 Medicare &You handbook. It is also accessible at www.medicare gov and has been mailed to the homes of people with Medicare benefits.
. Getting one-on-one counseling assistance from the local State Health Insurance Assistance Program (SHIP). Local SHIP contact information can be found:
o At http://www.medicare.gov/contacts/organization-search-criteria.aspx or
o On the back of the 2011 Medicare &You handbook or;
o By calling Medicare at 1-800-MEDICARE (1-800-633-4227; TTY, 1-877-486-2048)
o Through a listing of national stand-alone prescription drug plans and state specific fact sheets can be found at: http://www.cms.hhs.gov/center/openenrollment.asp
Medicare beneficiaries who cannot meet the costs of prescription drugs may be eligible for additional resources. Based on eligibility for "extra help," some people Medicare will pay no more than $2.50 for each generic drug and no more than $6.30 for each name brand drug. The program, called Medicare's Limited Income Newly Eligible Transition (NET) Program, can also help pay for premiums and other out-of-pocket costs.
There is no cost to apply for this extra help. Medicare beneficiaries, family members, trusted counselors or caregivers can apply online at www.socialsecurity.gov/prescriptionhelp or call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778) to find out more.
Protecting Against Fraud and Identity Theft
The new health care law also provides better tools to help fight waste, fraud and abuse to help protect Medicare. CMS offers tips to help beneficiaries protect themselves against fraud and identity theft during the Open Enrollment period. Medicare recommends thatpeople treat their Medicare number as they do their social security number and credit card information.
Beneficiaries should not give personal information to anyone arriving to their home uninvited or making unsolicited phone calls selling Medicare-related products or services. Beneficiaries who believe they are a victim of fraud or identity theft should contact 1-800-MEDICARE (1-800-633-4227; TTY, 1-877-486-2048). More information is available at www.stopmedicarefraud.gov.
More information is available at www.healthcare.gov, a new web portal from the U.S. Department of Health and Human Services.
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The Medicare Open Enrollment Period this year begins on November 15th and runs through December 31st. During the Open Enrollment period, current or newly eligible Medicare beneficiaries, including people with Original Medicare, can review current health and prescription drug coverage, compare health and drug plan options available in their area, and choose coverage that best meet their needs.
"The Affordable Care Act will make Medicare stronger and more sustainable. There will be new benefits available to nearly every person with Medicare starting in January 2011, including free annual wellness visits and free recommended preventive services like mammograms and colonoscopies. Seniors who fall into the donut hole in 2011 will be eligible for a 50 percent discount on brand-name prescription drugs. These new benefits make this year's Medicare Open Enrollment Period especially important," said HHS Secretary Kathleen Sebelius. "Every year, the Medicare Open Enrollment Period gives Medicare beneficiaries a chance to evaluate their current plans and see what other options might be out there that serve their needs, especially if their health status has changed. Those enrolled in Medicare can think of the Open Enrollment Period as a yearly coverage "check-up." It is important for people with Medicare to look closely at their plan, look at the options available to them, consider their health status, and find what works for them."
"There's never been a better time for Medicare beneficiaries to check out their Medicare coverage," said CMS Administrator Donald Berwick, M.D. "With better plan choices available for 2011, Medicare beneficiaries can think of Open Enrollment as their yearly coverage 'check-up'."
"During Open Enrollment, AoA's national network of community-based organizations will work with seniors, individuals with disabilities and their caregivers across the country to help them understand the new benefits available under the Affordable Care
Act," said Kathy Greenlee, Assistant Secretary for Aging. "In addition, we urge seniors to protect themselves from potential fraud and identity theft. We know there are people who use this time to scam seniors and rip off Medicare. Seniors should protect their Medicare number the same way they do their Social Security number or credit cards."
Resources for Medicare Beneficiaries
People with Medicare, their families and other trusted representatives can review and compare current plan coverage with new plan offerings, using many proven resources, including:
. Visiting www.medicare.gov, where they can get a personalized comparison of costs and coverage of the plans available in their area. The popular Medicare Plan Finder and Medicare Options Compare tools have been enhanced for an efficient review of plan choices. Multilingual Open Enrollment information and counseling is available.
. Calling 1-800-MEDICARE (1-800-633-4227) for around-the-clock assistance to find out more about coverage options. TTY users should call 1-877-486-2048.
. Reviewing the 2011 Medicare &You handbook. It is also accessible at www.medicare gov and has been mailed to the homes of people with Medicare benefits.
. Getting one-on-one counseling assistance from the local State Health Insurance Assistance Program (SHIP). Local SHIP contact information can be found:
o At http://www.medicare.gov/contacts/organization-search-criteria.aspx or
o On the back of the 2011 Medicare &You handbook or;
o By calling Medicare at 1-800-MEDICARE (1-800-633-4227; TTY, 1-877-486-2048)
o Through a listing of national stand-alone prescription drug plans and state specific fact sheets can be found at: http://www.cms.hhs.gov/center/openenrollment.asp
Medicare beneficiaries who cannot meet the costs of prescription drugs may be eligible for additional resources. Based on eligibility for "extra help," some people Medicare will pay no more than $2.50 for each generic drug and no more than $6.30 for each name brand drug. The program, called Medicare's Limited Income Newly Eligible Transition (NET) Program, can also help pay for premiums and other out-of-pocket costs.
There is no cost to apply for this extra help. Medicare beneficiaries, family members, trusted counselors or caregivers can apply online at www.socialsecurity.gov/prescriptionhelp or call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778) to find out more.
Protecting Against Fraud and Identity Theft
The new health care law also provides better tools to help fight waste, fraud and abuse to help protect Medicare. CMS offers tips to help beneficiaries protect themselves against fraud and identity theft during the Open Enrollment period. Medicare recommends thatpeople treat their Medicare number as they do their social security number and credit card information.
Beneficiaries should not give personal information to anyone arriving to their home uninvited or making unsolicited phone calls selling Medicare-related products or services. Beneficiaries who believe they are a victim of fraud or identity theft should contact 1-800-MEDICARE (1-800-633-4227; TTY, 1-877-486-2048). More information is available at www.stopmedicarefraud.gov.
More information is available at www.healthcare.gov, a new web portal from the U.S. Department of Health and Human Services.
-----
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Friday, November 12, 2010
Humana to Offer Savings and Broad Choice with 2011 Medicare Plans
(BUSINESS WIRE)--Humana Inc. (NYSE: HUM) will offer a wide variety of Medicare Advantage (MA) and Prescription Drug Plans (PDP) to people with Medicare in 2011, including the new Humana Walmart-Preferred Rx Plan (PDP) that offers the nation’s lowest monthly premium in all 50 states and Washington, D.C.
Humana will offer people with Medicare choices that include MA plans with more benefits than Original Medicare, an affordable monthly premium, an extensive list of doctors in many areas, and predictable costs that are easy to budget.
The Annual Election Period when Medicare beneficiaries will select their Medicare coverage for 2011 runs from Nov. 15 through Dec. 31, 2010. In recent years, people with Medicare were allowed to change plans during the first three months of the year. Beginning in 2011, the January-to-March enrollment period has been eliminated.
“At a time when people are still coping with the impact of our challenging economy, especially senior citizens and disabled people living on a fixed income, it is critical to have medical and prescription-drug coverage that’s affordable,” said Tom Liston, senior vice president, senior products, and the leader of Humana’s Medicare organization. “Humana continues to offer a variety of choices across the country enabling Medicare beneficiaries to select a plan that meets their needs while receiving comprehensive benefits and value people have come to expect from Humana.”
Medicare Advantage Plans
Humana’s MA plans can help people get more out of their health care dollar. Most Humana MA plans:
* Offer additional benefits beyond Original Medicare
* Have copayments offering predictable costs that are easy to budget no matter which health care services are used
* Come with worldwide coverage for emergency care
With drug coverage, health-and-wellness offerings and disease-management programs also available with MA coverage, Humana MA plans remain an excellent value in 2011. Plans, benefits and premiums vary by state and county. Plans include local and regional PPO plans, as well as HMO and Private Fee-For-Service plans. Humana is committed to informing its members of the various benefits and savings options that are available to them for 2011. All Humana MA plans have annual out-of-pocket maximums in 2011, protecting beneficiaries against catastrophic costs.
Benefits with most Humana MA plans include:
* Care coordination and disease-management programs
* Affordable deductibles
* Affordable copayments
* 24-hour nurse hotline
* SmartSummary Rx benefits statement (available to both MA and PDP members)
* No-cost preventive services
* No-cost diabetic-monitoring supplies, including test strips, lancets and glucometers
Well-Being Benefits for Members
Humana is dedicated to supporting its Medicare members on their lifelong pursuit of well-being. As evidence of this commitment, most Humana MA members enjoy access to programs that encourage healthy behaviors such as gym memberships through SilverSneakers or Silver & Fit, and the WellDine Food Program, which delivers meals following a hospitalization. Over the long-term, these programs aid members in achieving a greater quality of life.
Prescription Drug Plans
In all 50 states, Washington, D.C. and Puerto Rico, Humana offers stand-alone PDPs, meaning they’re separate from Medicare medical coverage. Stand-alone PDPs enable people with Medicare to add drug coverage to their Original Medicare coverage.
New this year is the Humana Walmart-Preferred Rx Plan, which features a monthly premium of just $14.80, making it the lowest-premium plan available in all 50 states and Washington D.C. Copayments start at just $2 for preferred generic prescriptions filled at any Walmart, Sam’s Club or Neighborhood Market pharmacy. Copayments of $0 are available for many generic drugs filled via Humana’s home-delivery (mail-order) pharmacy, RightSource. Humana and Walmart estimate that the new co-branded plan will save members an average of more than $450 a year.
People with Medicare who prefer first-dollar coverage (no annual deductible) for preferred generics and a broader network of pharmacies should consider Humana’s Enhanced PDP Plan. With more than 62,000 pharmacies in Humana’s national pharmacy network, and $0 copayments for many generic drugs when using mail-order, this plan typically appeals to people who want that additional coverage.
Also New in 2011
In addition to the new Humana Walmart-Preferred Rx Plan (PDP), Humana is offering new MA plan options in multiple markets across the U.S. Here’s an overview of the various plan options Humana is offering for 2011:
* HMO plans in 27 states and Puerto Rico
* Local PPO plans in 39 states and Puerto Rico
* Regional PPO plans in 23 states (in 14 Medicare Advantage regions)
* Full−network Private Fee-for-Service (PFFS) plans in 34 states. All services are available in and out of network, taking full advantage of any Humana contracted discounts when the member uses in-network providers.
* Partial-network PFFS plans (networked for ancillary services only) in 28 states
* Non-network PFFS plans in 2 states
* PDP offerings approved for 2011 are statewide in 50 states, the District of Columbia and Puerto Rico and include the new nationwide PDP co-branded with Walmart.
For more information about Humana’s 2010 Medicare offerings, visit www.humana-medicare.com or call toll free 1-800-611-1481. TTY users call 1-877-833-4486.
-----
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www.FayetteFrontPage.com
Twitter: @FayetteFP
Humana will offer people with Medicare choices that include MA plans with more benefits than Original Medicare, an affordable monthly premium, an extensive list of doctors in many areas, and predictable costs that are easy to budget.
The Annual Election Period when Medicare beneficiaries will select their Medicare coverage for 2011 runs from Nov. 15 through Dec. 31, 2010. In recent years, people with Medicare were allowed to change plans during the first three months of the year. Beginning in 2011, the January-to-March enrollment period has been eliminated.
“At a time when people are still coping with the impact of our challenging economy, especially senior citizens and disabled people living on a fixed income, it is critical to have medical and prescription-drug coverage that’s affordable,” said Tom Liston, senior vice president, senior products, and the leader of Humana’s Medicare organization. “Humana continues to offer a variety of choices across the country enabling Medicare beneficiaries to select a plan that meets their needs while receiving comprehensive benefits and value people have come to expect from Humana.”
Medicare Advantage Plans
Humana’s MA plans can help people get more out of their health care dollar. Most Humana MA plans:
* Offer additional benefits beyond Original Medicare
* Have copayments offering predictable costs that are easy to budget no matter which health care services are used
* Come with worldwide coverage for emergency care
With drug coverage, health-and-wellness offerings and disease-management programs also available with MA coverage, Humana MA plans remain an excellent value in 2011. Plans, benefits and premiums vary by state and county. Plans include local and regional PPO plans, as well as HMO and Private Fee-For-Service plans. Humana is committed to informing its members of the various benefits and savings options that are available to them for 2011. All Humana MA plans have annual out-of-pocket maximums in 2011, protecting beneficiaries against catastrophic costs.
Benefits with most Humana MA plans include:
* Care coordination and disease-management programs
* Affordable deductibles
* Affordable copayments
* 24-hour nurse hotline
* SmartSummary Rx benefits statement (available to both MA and PDP members)
* No-cost preventive services
* No-cost diabetic-monitoring supplies, including test strips, lancets and glucometers
Well-Being Benefits for Members
Humana is dedicated to supporting its Medicare members on their lifelong pursuit of well-being. As evidence of this commitment, most Humana MA members enjoy access to programs that encourage healthy behaviors such as gym memberships through SilverSneakers or Silver & Fit, and the WellDine Food Program, which delivers meals following a hospitalization. Over the long-term, these programs aid members in achieving a greater quality of life.
Prescription Drug Plans
In all 50 states, Washington, D.C. and Puerto Rico, Humana offers stand-alone PDPs, meaning they’re separate from Medicare medical coverage. Stand-alone PDPs enable people with Medicare to add drug coverage to their Original Medicare coverage.
New this year is the Humana Walmart-Preferred Rx Plan, which features a monthly premium of just $14.80, making it the lowest-premium plan available in all 50 states and Washington D.C. Copayments start at just $2 for preferred generic prescriptions filled at any Walmart, Sam’s Club or Neighborhood Market pharmacy. Copayments of $0 are available for many generic drugs filled via Humana’s home-delivery (mail-order) pharmacy, RightSource. Humana and Walmart estimate that the new co-branded plan will save members an average of more than $450 a year.
People with Medicare who prefer first-dollar coverage (no annual deductible) for preferred generics and a broader network of pharmacies should consider Humana’s Enhanced PDP Plan. With more than 62,000 pharmacies in Humana’s national pharmacy network, and $0 copayments for many generic drugs when using mail-order, this plan typically appeals to people who want that additional coverage.
Also New in 2011
In addition to the new Humana Walmart-Preferred Rx Plan (PDP), Humana is offering new MA plan options in multiple markets across the U.S. Here’s an overview of the various plan options Humana is offering for 2011:
* HMO plans in 27 states and Puerto Rico
* Local PPO plans in 39 states and Puerto Rico
* Regional PPO plans in 23 states (in 14 Medicare Advantage regions)
* Full−network Private Fee-for-Service (PFFS) plans in 34 states. All services are available in and out of network, taking full advantage of any Humana contracted discounts when the member uses in-network providers.
* Partial-network PFFS plans (networked for ancillary services only) in 28 states
* Non-network PFFS plans in 2 states
* PDP offerings approved for 2011 are statewide in 50 states, the District of Columbia and Puerto Rico and include the new nationwide PDP co-branded with Walmart.
For more information about Humana’s 2010 Medicare offerings, visit www.humana-medicare.com or call toll free 1-800-611-1481. TTY users call 1-877-833-4486.
-----
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Thursday, September 23, 2010
Medicare beneficiaries in donut hole will see 50-percent discount on brand name drugs in 2011
Vice President Joe Biden, the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services (CMS) today announced that the nation's pharmaceutical manufacturers will provide 50 percent discounts on the cost of covered brand-name prescription drugs for beneficiaries in the Medicare Part D coverage gap, or donut hole, starting in 2011.
Vice President Biden and Secretary Sebelius made the announcement on a grassroots conference call with seniors from across the country. On the call, the Vice President and the Secretary discussed the benefits of the Affordable Care Act for seniors including the prescription drug discounts and provisions in the law that help fight fraud and make certain preventive care and annual wellness exams, free for most Medicare beneficiaries.
"Thanks to the Affordable Care Act, millions of people with Medicare who will fall into the Part D donut hole next year will pay less for their prescription drugs," said Vice President Biden. "The discount manufacturers will pay on brand-name drugs, helping millions of seniors who are struggling to make ends meet at the end of the month, and it's just one of the ways the new health care law helps make Medicare stronger."
The Affordable Care Act has helped reduce costs for Medicare beneficiaries, beginning with one-time rebate $250 rebate checks for beneficiaries who hit the donut hole in 2010.
"More than 1.2 million beneficiaries who have hit the donut hole so far this year have received their $250 rebate checks as part of the cost savings provisions in the Affordable Care Act, and millions more are on deck to get a check," said HHS Secretary Kathleen Sebelius. "Now, with these new agreements, people who rely on Medicare will see even more savings off their drug costs next year, and savings will continue even after the coverage gap is closed in 2020."
Seniors and people with disabilities enrolled in Medicare drug plans will also find next year that through the use of the new tools provided by the Affordable Care Act, premiums are stable and the number of prescription drug plans that voluntarily help fill the donut hole has increased. In August, CMS reported that the average 2011 Medicare prescription drug plan premium will remain similar to rates beneficiaries are currently paying this year - an increase of $1.
"Most Medicare prescription drug plan premiums will remain stable next year and beneficiaries will find there are clearer plan options and many plans that can help them save even more - like those plans that are offering benefits that help fill the donut hole," said CMS Administrator Donald Berwick, M.D. "They will find that the Affordable Care Act improves the value of drug coverage they get next year."
Beneficiaries will soon receive their 2011 Medicare & You handbook and find updated information at www.medicare.gov and 1-800-Medicare in mid-October. Users of the Medicare Plan Finder, available at www.medicare.gov, will be able to compare plans' quality summary rating from the previous year, identify which drugs are included on a plan's formulary, and compare the cost ranges for plans available in their communities.
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Vice President Biden and Secretary Sebelius made the announcement on a grassroots conference call with seniors from across the country. On the call, the Vice President and the Secretary discussed the benefits of the Affordable Care Act for seniors including the prescription drug discounts and provisions in the law that help fight fraud and make certain preventive care and annual wellness exams, free for most Medicare beneficiaries.
"Thanks to the Affordable Care Act, millions of people with Medicare who will fall into the Part D donut hole next year will pay less for their prescription drugs," said Vice President Biden. "The discount manufacturers will pay on brand-name drugs, helping millions of seniors who are struggling to make ends meet at the end of the month, and it's just one of the ways the new health care law helps make Medicare stronger."
The Affordable Care Act has helped reduce costs for Medicare beneficiaries, beginning with one-time rebate $250 rebate checks for beneficiaries who hit the donut hole in 2010.
"More than 1.2 million beneficiaries who have hit the donut hole so far this year have received their $250 rebate checks as part of the cost savings provisions in the Affordable Care Act, and millions more are on deck to get a check," said HHS Secretary Kathleen Sebelius. "Now, with these new agreements, people who rely on Medicare will see even more savings off their drug costs next year, and savings will continue even after the coverage gap is closed in 2020."
Seniors and people with disabilities enrolled in Medicare drug plans will also find next year that through the use of the new tools provided by the Affordable Care Act, premiums are stable and the number of prescription drug plans that voluntarily help fill the donut hole has increased. In August, CMS reported that the average 2011 Medicare prescription drug plan premium will remain similar to rates beneficiaries are currently paying this year - an increase of $1.
"Most Medicare prescription drug plan premiums will remain stable next year and beneficiaries will find there are clearer plan options and many plans that can help them save even more - like those plans that are offering benefits that help fill the donut hole," said CMS Administrator Donald Berwick, M.D. "They will find that the Affordable Care Act improves the value of drug coverage they get next year."
Beneficiaries will soon receive their 2011 Medicare & You handbook and find updated information at www.medicare.gov and 1-800-Medicare in mid-October. Users of the Medicare Plan Finder, available at www.medicare.gov, will be able to compare plans' quality summary rating from the previous year, identify which drugs are included on a plan's formulary, and compare the cost ranges for plans available in their communities.
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Monday, August 30, 2010
Sebelius announces 1 million Medicare beneficiaries have received prescription drug cost relief under the Affordable Care Act
U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced that more than 1 million Medicare beneficiaries have received prescription drug cost relief through the Affordable Care Act. As part of the health insurance reform law's step-by-step efforts to close the Medicare Part D prescription drug coverage gap, eligible beneficiaries who fall in this "donut hole" this year are mailed a one-time, tax-free $250 rebate check. More than a quarter of the 4 million checks Medicare expects to distribute have been received by eligible Medicare beneficiaries.
"Many seniors and people with disabilities on Medicare face extraordinary prescription drug costs, and too often stop following the drug regimens that their doctors have recommended as a result," said Secretary Sebelius. "These checks will make a difference in helping seniors continue to get the medications they need, and are one of many ways that the Affordable Care Act is helping seniors."
Nationwide, 1 million Medicare beneficiaries have already been mailed their rebates and more beneficiaries will be receiving checks in the coming months as they enter the coverage gap. Eligible beneficiaries receive these checks automatically in the mail when they reach the donut hole, and they don't have to sign-up to be eligible for the rebates.
Rebate checks will help people with their drug costs this year. Next year, those who fall into the donut hole will receive a 50-percent discount on covered brand name medications while in the donut hole. Every year, the amount Medicare beneficiaries pay in cost sharing will decrease markedly until the coverage gap is closed.
The closing of the donut hole is just one of the ways seniors benefit from the Affordable Care Act. In addition to savings on prescription drugs, the law provides new benefits to Medicare beneficiaries when they visit their doctor. All beneficiaries will receive free preventive care services like mammograms and certain colon cancer tests and a free annual physical starting in 2011 in Original Medicare. Additionally, seniors can expect to save an average of nearly $200 per year in premiums by 2018 compared to what they would have paid without the new law, and most beneficiaries will also see a significant reduction in their Medicare coinsurance as a result of the Affordable Care Act.
The Affordable Care Act also contains important new tools to help crack down on criminals seeking to scam seniors and steal taxpayer dollars. Last week, HHS and the Department of Justice held their second regional fraud prevention summit in Los Angeles that brought together law enforcement experts, providers and seniors to help utilize these new tools to fight fraud and protect seniors.
The Affordable Care Act strengthens the screenings for health care providers who want to participate in Medicaid or Medicare, enables enforcement officials to see health care claims data from around the country into a single, searchable database, and strengthens the penalties for criminals. The reduction in waste, fraud and abuse returns savings to the Medicare Trust Fund to strengthen the program into the future.
Seniors are encouraged to contact 1-800-MEDICARE to report any solicitations of personal information, or go to www.stopmedicarefraud.gov.
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"Many seniors and people with disabilities on Medicare face extraordinary prescription drug costs, and too often stop following the drug regimens that their doctors have recommended as a result," said Secretary Sebelius. "These checks will make a difference in helping seniors continue to get the medications they need, and are one of many ways that the Affordable Care Act is helping seniors."
Nationwide, 1 million Medicare beneficiaries have already been mailed their rebates and more beneficiaries will be receiving checks in the coming months as they enter the coverage gap. Eligible beneficiaries receive these checks automatically in the mail when they reach the donut hole, and they don't have to sign-up to be eligible for the rebates.
Rebate checks will help people with their drug costs this year. Next year, those who fall into the donut hole will receive a 50-percent discount on covered brand name medications while in the donut hole. Every year, the amount Medicare beneficiaries pay in cost sharing will decrease markedly until the coverage gap is closed.
The closing of the donut hole is just one of the ways seniors benefit from the Affordable Care Act. In addition to savings on prescription drugs, the law provides new benefits to Medicare beneficiaries when they visit their doctor. All beneficiaries will receive free preventive care services like mammograms and certain colon cancer tests and a free annual physical starting in 2011 in Original Medicare. Additionally, seniors can expect to save an average of nearly $200 per year in premiums by 2018 compared to what they would have paid without the new law, and most beneficiaries will also see a significant reduction in their Medicare coinsurance as a result of the Affordable Care Act.
The Affordable Care Act also contains important new tools to help crack down on criminals seeking to scam seniors and steal taxpayer dollars. Last week, HHS and the Department of Justice held their second regional fraud prevention summit in Los Angeles that brought together law enforcement experts, providers and seniors to help utilize these new tools to fight fraud and protect seniors.
The Affordable Care Act strengthens the screenings for health care providers who want to participate in Medicaid or Medicare, enables enforcement officials to see health care claims data from around the country into a single, searchable database, and strengthens the penalties for criminals. The reduction in waste, fraud and abuse returns savings to the Medicare Trust Fund to strengthen the program into the future.
Seniors are encouraged to contact 1-800-MEDICARE to report any solicitations of personal information, or go to www.stopmedicarefraud.gov.
-----
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Tuesday, July 13, 2010
Enactment of New FSA Restriction Will Pose Problems for Consumers, Retailers and Benefit Providers
/PRNewswire/ -- A provision of health care reform could blindside consumers and create an administrative nightmare for providers and retailers as its January 1, 2011 implementation date draws closer. Without intervention, the Patient Protection and Affordable Health Care Act, passed earlier this year, will require consumers to obtain a physician's "prescription" in order to use their pre-tax flexible spending accounts (FSAs) to pay for over-the-counter (OTC) medicines other than insulin. Rep. Earl Pomeroy (D-ND) and industry groups have called for clarification of the new regulations to give providers and retailers an opportunity to educate consumers and develop compliance procedures.
In a letter to U.S. Treasury Secretary Timothy Geithner, Rep. Pomeroy encouraged the Treasury "...to work with consumers and stakeholders to address certain compliance issues in advance of the mandated implementation date." Without clarifying the policy, "...consumers are left confused and frustrated and benefit administrators and retail merchants will be left with increased processing and consumer service costs," wrote Rep. Pomeroy.
An industry group responsible for establishing standards for electronic payment processing for health spending accounts, such as those used to identify eligible OTC purchases, argues additional guidance is needed to clarify how the new regulations will work in practice before it can be implemented. The law currently states that only "prescribed" OTC drugs are eligible for reimbursement; however, it does not specify whether a prescription is required or if a letter of medical necessity will suffice.
"Without clarification on the type of permission needed for FSA reimbursement for OTC drugs, consumers, retailers and third party administrators will be confused and unlikely to fully comply with the new regulations by the start of the new year. Meanwhile, we're likely to see doctor's offices overwhelmed with patients seeking prescriptions to use their spending accounts for Claritin, Zyrtec and other OTC items," said Jody Dietel, president and chair of the Special Interest Group for Inventory Information Approval System Standard (SIGIS). "A delay in implementation will provide time for all parties to be better educated on the issue and prepared to comply with the new rules."
Both Rep. Pomeroy and SIGIS warn that forcing retailers to quickly change their distribution practices for a January 1, 2011 start date will be difficult given the current electronic systems structure, which, in turn, will lead to processing errors, consumer frustration and major challenges for FSA administrators.
"This restriction will hurt millions of consumers who rely on their FSAs to manage their out of pocket health care costs and pay for necessary over-the-counter therapies," noted Joe Jackson, CEO of WageWorks Inc., a benefits company based in San Mateo, California. "If Congress is intent on putting this provision into effect, they should at least push back the deadline so that consumers and especially retailers are ready for the transition."
Currently, consumers may contribute money to their FSAs to cover out-of-pocket medical expenses not covered by insurance, including co-pays and over-the-counter items such as asthma and allergy supplies, aspirin and flu medications.
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In a letter to U.S. Treasury Secretary Timothy Geithner, Rep. Pomeroy encouraged the Treasury "...to work with consumers and stakeholders to address certain compliance issues in advance of the mandated implementation date." Without clarifying the policy, "...consumers are left confused and frustrated and benefit administrators and retail merchants will be left with increased processing and consumer service costs," wrote Rep. Pomeroy.
An industry group responsible for establishing standards for electronic payment processing for health spending accounts, such as those used to identify eligible OTC purchases, argues additional guidance is needed to clarify how the new regulations will work in practice before it can be implemented. The law currently states that only "prescribed" OTC drugs are eligible for reimbursement; however, it does not specify whether a prescription is required or if a letter of medical necessity will suffice.
"Without clarification on the type of permission needed for FSA reimbursement for OTC drugs, consumers, retailers and third party administrators will be confused and unlikely to fully comply with the new regulations by the start of the new year. Meanwhile, we're likely to see doctor's offices overwhelmed with patients seeking prescriptions to use their spending accounts for Claritin, Zyrtec and other OTC items," said Jody Dietel, president and chair of the Special Interest Group for Inventory Information Approval System Standard (SIGIS). "A delay in implementation will provide time for all parties to be better educated on the issue and prepared to comply with the new rules."
Both Rep. Pomeroy and SIGIS warn that forcing retailers to quickly change their distribution practices for a January 1, 2011 start date will be difficult given the current electronic systems structure, which, in turn, will lead to processing errors, consumer frustration and major challenges for FSA administrators.
"This restriction will hurt millions of consumers who rely on their FSAs to manage their out of pocket health care costs and pay for necessary over-the-counter therapies," noted Joe Jackson, CEO of WageWorks Inc., a benefits company based in San Mateo, California. "If Congress is intent on putting this provision into effect, they should at least push back the deadline so that consumers and especially retailers are ready for the transition."
Currently, consumers may contribute money to their FSAs to cover out-of-pocket medical expenses not covered by insurance, including co-pays and over-the-counter items such as asthma and allergy supplies, aspirin and flu medications.
-----
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Friday, December 04, 2009
Medicare Open Enrollment Begins: Now Is The Time To Review Your Plan
(NAPSI)-You may know that new Medicare prescription drug and health plan choices are offered each year. Medicare's Open Enrollment Period runs through December 31.
Open Enrollment is your chance to review your current plan-including your Original Medicare coverage-compare it with your other options and make sure you're getting the best available coverage for your health care needs.
Your current health plan may have changed its cost or coverage for 2010, or maybe you'd like a plan with a lower deductible.
If you've had any changes in your health, it's particularly important for you to double-check your coverage during Open Enrollment so you can make sure that any new treatments or drugs are covered by your plan.
Since coverage varies by plan, know what's important for you. For example, make a list of the drugs you take so you can make sure they're covered by the plans you're considering.
If you are in Original Medicare and don't have prescription drug coverage, you can join a Medicare drug plan during Open Enrollment.
Medicare has several ways to get you the help you need to find a plan that works for you.
• Visit www.medicare.gov, where you can get a personalized comparison of the costs and coverage of the plans available in your area.
• Call 1-800-MEDICARE (1-800-633-4227) to find out more about your coverage options. TTY users should call 1-877-486-2048. Medicare customer service representatives are available 24 hours a day, seven days a week with multiple language options and resources for people with disabilities.
• Watch your mailbox for the 2010 "Medicare & You" handbook. The handbook is mailed to all Medicare households each fall and includes a listing of all plans in your area. This handbook is also conveniently available online at www.medicare.gov.
• Meet one on one with a trained expert for personalized assistance. Call 1-800-MEDICARE or visit www.medicare.gov to find a Medicare specialist in your area. Select "Find Helpful Phone Numbers and Websites."
Important Medicare Enrollment Dates:
Dec. 31: Open Enrollment ends. Last day to join or change your Medicare drug plan.
Jan. 1: Your new plan coverage begins.
This message is brought to you by the U.S. Department of Health & Human Services.
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Open Enrollment is your chance to review your current plan-including your Original Medicare coverage-compare it with your other options and make sure you're getting the best available coverage for your health care needs.
Your current health plan may have changed its cost or coverage for 2010, or maybe you'd like a plan with a lower deductible.
If you've had any changes in your health, it's particularly important for you to double-check your coverage during Open Enrollment so you can make sure that any new treatments or drugs are covered by your plan.
Since coverage varies by plan, know what's important for you. For example, make a list of the drugs you take so you can make sure they're covered by the plans you're considering.
If you are in Original Medicare and don't have prescription drug coverage, you can join a Medicare drug plan during Open Enrollment.
Medicare has several ways to get you the help you need to find a plan that works for you.
• Visit www.medicare.gov, where you can get a personalized comparison of the costs and coverage of the plans available in your area.
• Call 1-800-MEDICARE (1-800-633-4227) to find out more about your coverage options. TTY users should call 1-877-486-2048. Medicare customer service representatives are available 24 hours a day, seven days a week with multiple language options and resources for people with disabilities.
• Watch your mailbox for the 2010 "Medicare & You" handbook. The handbook is mailed to all Medicare households each fall and includes a listing of all plans in your area. This handbook is also conveniently available online at www.medicare.gov.
• Meet one on one with a trained expert for personalized assistance. Call 1-800-MEDICARE or visit www.medicare.gov to find a Medicare specialist in your area. Select "Find Helpful Phone Numbers and Websites."
Important Medicare Enrollment Dates:
Dec. 31: Open Enrollment ends. Last day to join or change your Medicare drug plan.
Jan. 1: Your new plan coverage begins.
This message is brought to you by the U.S. Department of Health & Human Services.
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Thursday, November 12, 2009
New CVS/pharmacy Data Reveals Older Americans Could Save an Average of $612 Annually by Switching Medicare Part D Plans
/PRNewswire/ -- With the Annual Enrollment Period for Medicare Part D beginning on November 15, CVS/pharmacy and the National Council on Aging (NCOA) are urging older adults and their caregivers to review their Medicare Part D options in order to find the lowest cost plan that meets their needs.
Confusion around the number and variety of prescription drug plans often becomes a barrier to identifying and selecting the most cost effective plan. Free online tools like the CVS/pharmacy Medicare Part D Savings Calculator at www.cvs.com/medicare simplifies the comparison process, helping seniors more readily identify the plan with the lowest overall costs.
"Plan review can seem cumbersome, but completing a plan comparison each year is an essential step toward saving," said Fernando Gonzalez, R.Ph at CVS/pharmacy. "Tools like the Medicare Part D Calculator are designed to simplify the process to help older adults and their caregivers select a plan that provides them with the greatest value and peace of mind."
A CVS/pharmacy analysis of more than 10,000 older Americans using the Medicare Part D Savings Calculator last year revealed plan participants could save an average of $612 in annual drug costs just by switching to their optimal Medicare Part D plan.(1)
"This data underscores the importance for older adults and their caregivers to review Medicare Part D plans each year," said Wendy Zenker, Vice President of the NCOA Benefits Access Group. "With the number of changes to Part D plans from year to year, Medicare beneficiaries can expect to see significant savings and receive better coverage, if they compare and shop around."
To that end, CVS/pharmacy today launches a campaign with the goal of helping millions of seniors and their caregivers realize savings on 2010 prescription costs through education and assistance in Medicare Part D plan comparison. Starting November 12, CVS/pharmacy and the NCOA are offering Medicare Part D educational events throughout Annual Enrollment period at senior centers across the country.
Consumers can also go online at CVS.com/medicare to use the free Medicare Part D Savings Calculator. And, CVS pharmacists will be available throughout the enrollment period to provide plan comparisons in stores for those who would like assistance.(2)
Remembering the Three Cs: Cost, Coverage and Convenience
CVS/pharmacy and NCOA recommend considering three factors when evaluating plans:
-- Cost - What is the plan deductible, monthly premium and prescription
co-pay for the prescriptions you regularly take? Evaluate the total
cost and not just the co-pays. And, identify in advance if you fall
into the doughnut hole.
-- Coverage - Are the prescription medications you regularly take covered
in the plan? Are there restrictions such as prior authorization? Each
year insurance plans change, including premiums, co-pays, and the list
of covered drugs. Your own prescription needs change as well.
-- Convenience - Can you fill the prescription at the pharmacy of your
choice?
Before starting the plan selection process, older Americans should review their current medications with their pharmacist. Often, prescription costs can be lowered by switching to a generic alternative, consolidating pills or by switching to an over the counter alternative. Having these changes in place before selecting a plan can help in choosing the most affordable option and potentially avoiding the doughnut hole -- the gap in coverage if your prescription costs reach $2,830.
-----
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Confusion around the number and variety of prescription drug plans often becomes a barrier to identifying and selecting the most cost effective plan. Free online tools like the CVS/pharmacy Medicare Part D Savings Calculator at www.cvs.com/medicare simplifies the comparison process, helping seniors more readily identify the plan with the lowest overall costs.
"Plan review can seem cumbersome, but completing a plan comparison each year is an essential step toward saving," said Fernando Gonzalez, R.Ph at CVS/pharmacy. "Tools like the Medicare Part D Calculator are designed to simplify the process to help older adults and their caregivers select a plan that provides them with the greatest value and peace of mind."
A CVS/pharmacy analysis of more than 10,000 older Americans using the Medicare Part D Savings Calculator last year revealed plan participants could save an average of $612 in annual drug costs just by switching to their optimal Medicare Part D plan.(1)
"This data underscores the importance for older adults and their caregivers to review Medicare Part D plans each year," said Wendy Zenker, Vice President of the NCOA Benefits Access Group. "With the number of changes to Part D plans from year to year, Medicare beneficiaries can expect to see significant savings and receive better coverage, if they compare and shop around."
To that end, CVS/pharmacy today launches a campaign with the goal of helping millions of seniors and their caregivers realize savings on 2010 prescription costs through education and assistance in Medicare Part D plan comparison. Starting November 12, CVS/pharmacy and the NCOA are offering Medicare Part D educational events throughout Annual Enrollment period at senior centers across the country.
Consumers can also go online at CVS.com/medicare to use the free Medicare Part D Savings Calculator. And, CVS pharmacists will be available throughout the enrollment period to provide plan comparisons in stores for those who would like assistance.(2)
Remembering the Three Cs: Cost, Coverage and Convenience
CVS/pharmacy and NCOA recommend considering three factors when evaluating plans:
-- Cost - What is the plan deductible, monthly premium and prescription
co-pay for the prescriptions you regularly take? Evaluate the total
cost and not just the co-pays. And, identify in advance if you fall
into the doughnut hole.
-- Coverage - Are the prescription medications you regularly take covered
in the plan? Are there restrictions such as prior authorization? Each
year insurance plans change, including premiums, co-pays, and the list
of covered drugs. Your own prescription needs change as well.
-- Convenience - Can you fill the prescription at the pharmacy of your
choice?
Before starting the plan selection process, older Americans should review their current medications with their pharmacist. Often, prescription costs can be lowered by switching to a generic alternative, consolidating pills or by switching to an over the counter alternative. Having these changes in place before selecting a plan can help in choosing the most affordable option and potentially avoiding the doughnut hole -- the gap in coverage if your prescription costs reach $2,830.
-----
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Fayette Front Page
www.georgiafrontpage.com
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