Congress approved two bills last month that prohibit provisions keeping pharmacists from telling patients when they can save money by paying the cash price instead of the price negotiated by their insurance plan.
Federal officials are allowing the private insurance plans to use “step therapy” for drugs administered by doctors. In step therapy, patients must first use cheaper drugs to see if they work before receiving more expensive options.
Beneficiarios de Medicare pueden conseguir medicamentos más baratos si pagan en efectivo… pero por reglas mordaza el farmacéutico no puede decirlo.
Sometimes a drug plan’s copayment is higher than the cash price, and under a little-known federal rule, pharmacists have to tell Medicare beneficiaries that — but only if they ask.
Under new federal rules unveiled this week, these privately run alternatives to traditional Medicare might provide air conditioners, rides to medical appointments and home-delivered meals. In California, which has a high proportion of Medicare beneficiaries in private plans, a San Francisco-based nonprofit already offers similar services to disabled seniors and adults.
Los Centros para Servicios de Medicare y Medicaid ampliaron la forma en que definen los beneficios “relacionados directamente con la salud”, que las aseguradoras pueden incluir en sus pólizas.
Last month’s budget deal means Medicare beneficiaries are eligible for physical and occupational therapy indefinitely. Plus, prescription drug costs will fall for more seniors.
Agencies sometimes turn away Medicare beneficiaries with chronic health problems by incorrectly claiming Medicare won’t pay their services, say patient advocates.
Most beneficiaries have from Oct. 15 to Dec. 7 to decide on drug coverage and whether to switch from traditional Medicare to a Medicare Advantage plan.
Sept. 30 marks the end of Medicare’s temporary offer to waive penalties for certain late Medicare enrollees with Affordable Care Act insurance coverage.