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Tag: Medicare Part D

  • Medicare Part D: Lower Deductibles Might Not Save Money

    Medicare Part D: Lower Deductibles Might Not Save Money

    With Medicare prices rising and U.S. prescription drug prices still safe from government bargaining, it’s understandable that seniors might be searching for the best deal possible when it comes to healthcare. For those who require a constant supply of medications the higher tiers of Medicare Part D drug plans might seem like a cost-saving option, but a new study has found that saving money on deductibles might not justify higher premiums.

    HealthPocket, a health insurance plan comparison website, this week released an internal study showing that the higher premium cost Medicare Part D plans are, on average, “much more expensive” despite their lower deductible costs.

    The website’s study found, of course, that deductible costs for Medicare Part D plans tend to decrease as premiums rise, making it easier on the wallet when care is actually needed. Some plans even offer zero deductible costs when picking up medications. The site looked at premiums and deductibles for every stand-alone Medicare Part D plan in the U.S.

    The site found that the plans with the lowest one-third of premium costs were priced with an average monthly premium of $36.08 and carried an average deductible of $209.77. The middle third of premium costs averaged an $88.66 premium and an average of $33.18 in deductible costs. The top third averaged a $130.87 premium and had no deductible.

    Based on these numbers HealthPocket concluded that the average deductible savings between the plans in the lowest third of premiums and the highest third was $209.77. However, the plans in the highest third of premiums added an average of $1,137.48 in premium costs over those in the lowest third.

    The website also found that plans with higher premiums tend to offer better coverage during Medicare Part D’s “donut hole” coverage gap. With this and other considerations in mind, HealthPocket recommends that seniors not emphasize deductible costs when selecting their drug plan.

    “Selecting a Part D plan based on a lower deductible could result in paying a higher premium than necessary for the coverage a senior needs,” said Kev Coleman, head of Research & Data at HealthPocket. “This added premium expense could cost much more annually than the value of the deductible reduction.”

  • Medicare Drug Premiums Set to Rise Yet Again

    In a sign of what may become the new normal over the next few decades, the U.S. Department of Health and Human Services this week announced that the price of Medicare premiums for prescription drugs will be rising again this year. This would mark the second year in a row that the average monthly Medicare prescription drug plan premium has risen.

    According to an Associated Press report, the average monthly Medicare drug plan premium will hit $32 next year. This represents a one-dollar increase over this year’s average monthly premiums.

    The rise in drug costs for Medicare comes as seniors are living longer and prices for some drugs are increasing significantly in the U.S. As more of the baby boomer generation begins to retire and take up Medicare for their medical costs, the expenses incurred by the government program are expected to rise accordingly. Medicare is currently in its 49th year of operation.

    To counter the news of higher Medicare drug premiums, the Department of Health and Human Services this week released statistics claiming that millions of seniors have saved money since the Patient Protection and Affordable Care Act (ACA, colloquially known as Obamacare) was signed into law in 2010. The department claims that 8.2 million seniors on Medicare currently have prescription drug plans due to the ACA. The department also claims that the ACA has saved those seniors a combined $11.5 billion over the past four years, an average of around $1,407 per patient.

    This savings amount refers to out-of-pocket drug costs saved by patients via the “donut hole” (drug plans coverage gap) rebates and discounts that began in 2010. Average savings due to donut hole discounts and rebates has risen over $340 since last year.

    “Thanks to the Affordable Care Act, seniors and people with disabilities are saving on needed medications,” said Sylvia Burwell, secretary of the Department of Health and Human Services. “By making prescription drugs more affordable, we are improving and promoting the best care for people with Medicare.”

    Image via ThinkStock

  • Medicare Part D: Is Obama Going To Limit Coverage?

    There are proposed changes to Medicare Part D that have come under fire from groups ranging from drug providers to physicians to patient advocacy groups.

    It began with a proposal put forth by the Centers for Medicare and Medicaid Services with regard to private insurance coverage for certain drugs as well as changing up the network of physicians available to patients under Part D Medicare.

    One major concern is that adjustments to Medicare Part D will result in patients being unable to get much needed medication because they are no longer covered. Others fear that the changes will lead to a severe reduction in available medication and quality physician care.

    According to the testimony of Medicare chief Jonathan Blum, the adjustments are a necessary measure to head off even higher costs in the future brought on by expensive new biological treatments and rising insurance premiums. At the same time Blum insists that seniors will not be cut off from essential medication.

    “In order for Part D to remain successful, we have to celebrate its successes and address its vulnerabilities,” said Blum when he spoke before the House Energy and Commerce Health Subcommittee.

    The proposal remains terribly unpopular and has been a major source of political controversy. What’s happening with Part D coverage has been a topic of major discussion ahead of 2014 elections. Republicans are claiming that Part D changes will throw off the entire system and leave seniors in jeopardy. The fear of loss of coverage could play a part deciding which party controls Congress after fall elections.

    Blum maintains that there will be no cataclysmic losses resulting from the proposed changes to Medicare Part D.

    “Once the requirement to cover all drugs in a class was removed, we would expect manufactures to negotiate for their products to remain on [as many plans as possible],” said Blum.

    He believes that the adjustments will in fact lower prices through market driven competition.

    Image via Wikimedia Commons

  • Obamacare’s Medicare Part D Disparities

    According to new information from U.S. News and World Report, the Affordable Care Act Medicare Part D is feasible, but extremely “wasteful.”

    This information comes after months of problems with Obamacare, including the failures of the ACA website.

    On Tuesday, the CMS reported that the new plan is saving senior citizens billions of dollars, but ProPublica, an investigative journalism organization says that these “savings” are not substantive, and are actually costing consumers billions of dollars.

    The Centers for Medicare and Medicaid Services says that the result of Medicare Part D under Obamacare will allow seniors to utilize social security benefits as they wish, instead of on expensive prescriptions. The idea of one of the major changes made to the healthcare law is to cut down, and eventually terminate, the “donut hole” that seniors are now falling into.

    The “donut hole,” according Laurie Tarkan, the executive director of WellBeeFile.com is a result of Medicare recipients’ obligation to pay full price for their medications and prescriptions on their own for a period of time. When a certain point known as “catastrophic drug coverage,” has been met, the government will then resume assistance.

    The waste that has been taking place through Medicare Part D, according to experts, are the result of certain provisions which allow beneficiaries a largely varied amount of aid based on different parts of the country.

    For example, the benefits allotted to low income beneficiaries grants these beneficiaries the right to pay only $7 per prescription, no matter the actual market price of the drug.

    Many inconsistencies have also been found in the amount of assistance that is given to patients who have been released from a hospital, reside in a nursing home, or require in-home care.

    According to the Washington Post, the gaps in coverage allotted by state or area are astronomical. According to their report, a patient requiring home care in New Jersey receives an estimated $3,800, while their Louisiana counterpart receives $8,800.

    In Chicago, 1 out of every 4 Medicare patients receive further assistance after a hospital stay, more than three-times what Phoenix beneficiaries receive, to be exact.

    Main image courtesy njnewsfeed via YouTube.