Individual and family plans offered through Covered California in 2016 will include new pharmacy prescription drug benefits. The benefit, also mirrored in many off-exchange health plans, caps the amount a consumer must pay every month for a particular prescription. While that sounds straight forward, the rules surrounding any pharmacy deductible and tiered drug formulary can be complicated and confusing.
Before you talk to any insurance agent, prescription drug plan call center or sign up for a Part D Prescription (PDP) drug plan from a direct mail advertisement go to Medicare.gov and do a plan comparison. The Medicare prescription drug insurance plans are the most complicated and confusing of all the Medicare decisions a beneficiary must make. The Centers for Medicare and Medicaid Services has built one of the best online comparison tools for evaluating PDPs.
Even though health insurance plans have been greatly simplified with the introduction of the metal tiers of Bronze, Silver, Gold and Platinum under the ACA, careful consideration should still be given when comparing the coverage and benefits. In particular, for many people that have recurring brand name prescriptions medications, selecting the least expensive Bronze plan […]
Medicare Advantage plans have been encouraged by the Centers for Medicare and Medicaid Services (CMS) to include $0 copay prescription costs for medications that work to reduce heart attacks and strokes in the plans for 2014. Some plans will be including $0 copay drugs that fight high cholesterol and high blood pressure.
The Affordable Care Act set in motion a series of reforms to slowly close the coverage gap or “donut hole” that Part D members faced after they met their initial coverage dollar amount. Pharmaceutical manufacturers that wanted their Brand name drugs covered in the gap had to sign an agreement with Medicare to cover 50% of the cost of the drug. Medicare has had to assess civil monetary penalties on many companies that failed to cover the discount.
I now know that I have been having outbreaks of the shingles on my legs these past couple of years.
How can anyone make an informed Medicare decision when they are only presented with options from one insurance company?
There are times when you need someone to untangle the health insurance billing knot for you or a loved one. A professional insurance advocate will not sell insurance.
Medicare can seem confusing because they have tried to develop a system to accomodate a variety of lifestyles and financial situations across the country.