Kaiser Permanente To End Coverage for Brand-Name Prescription Drugs in Medicare+Choice Plan
Effective Jan. 1, Oakland-based Kaiser Permanente's Medicare+Choice plan, called Senior Advantage, will end coverage of brand-name prescription drugs and raise copayments for various services, the San Francisco Chronicle reports. The insurer will offer unlimited coverage for generic drugs and will lower beneficiaries' monthly premium to $80 from $85. Denise Hanson, director of Medicare and state programs for the California division of Kaiser, said, "The elimination of brand-name drugs is not a decision this organization made lightly, and it's not one we really wanted to do. It goes back to financial reimbursements and keeping pace with cost trends." She added that the health plan will help make its members aware of prescription drug assistance programs. Kaiser also will begin charging copays of $10 to $50 for radiology and laboratory tests, services that previously did not have copays, and will start charging members $200 per day for inpatient care, with a $3,000 cap on out-of-pocket costs, instead of $500 per admission. Kaiser officials did not say how much the company will save because of the changes. According to the Chronicle, the insurers' action is "part of the continuing shrinking act of Medicare HMOs" nationwide (Colliver, San Francisco Chronicle, 10/25).
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