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5 Tips to Managing Your Insurance Coverage

March 26, 2013 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

Don’t use providers that aren’t in your network. Most plans have lowered how much they will pay for doctors or facilities not in your network, while some won’t pay for out-of-network providers at all.

Review how prescriptions are reimbursed under your coverage. Many plans are now offering reimbursement based on a percentage of the retail cost of a drug, which can add up quickly. If you pay a percentage instead of a co-pay, compare prices at different pharmacies.

Prepare for a doctor visit ahead of time if you anticipate a prescription, diagnosis or treatment plan. You should have your benefits summary with you as well as your drug formulary to know how much you’ll pay for a prescription before you leave the office. You can also pull up prices at local facilities on your tablet or phone at www.medtipster.com to discuss choices with your doctor.

Read your benefits summary carefully to know what’s in your plan, and what isn’t.

Shop for the lowest priced facility for diagnostic tests. Hospital-based services are often priced higher than independent facilities.

 

Meijer’s Free Pre-Natal Vitamin Program Fills Millionth Prescription

July 06, 2011 By: Nadia Category: Free Prescriptions, HealthCare, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: prnewswire.com – 6.29.2011

Delivering a healthy dose of good news to Midwest families, Meijer announced today that its free pre-natal vitamins prescription program has filled its 1,000,000th prescription, at a cost savings of nearly $14 million to Midwest families.

The announcement, made by Hank Meijer, Co-Chairman and CEO, came as the Midwest retailer reported that its pharmacies had hit the million-mark milestone earlier this week.

Meijer gave birth to the program in May 2008 when it announced it would fill select pre-natal vitamin prescriptions at no cost to customers. The no-strings-attached program enables any customer, regardless of insurance or co-pay, to have their pre-natal prescription filled free of charge.

“Meijer has always been a strong advocate for safe and healthy families, and we’re very proud to offer a program that works to ensure the health of an expectant mother and her child,” said Meijer. “In addition, offering free pre-natal vitamins helps Midwest families cope with rising health care costs, complementing the many other ways families can save money throughout our stores.”

It has been shown that pre-natal vitamins play an important role in healthy pregnancies and healthy babies. These supplements have typically been prescribed for women who have become pregnant, however, many members of the medical community believe they also play an important role for women in the months leading up to conception.

Prior to launching its free pre-natal vitamins initiative, Meijer successfully introduced a program in October 2006 offering to fill select antibiotics at no charge. That program, still in use, covers leading oral generic antibiotics with a special focus on the prescriptions most often filled for children.

The Michigan-based retailer followed up its free pre-natal program in 2010 with a similar program providing no-cost prescriptions for metformin, the most commonly prescribed drug for type 2 diabetes.

Since its inception, the Meijer free antibiotics program has filled more than seven million prescriptions, saving families almost $120 million. The free metformin program has helped nearly 500,000 people battle diabetes, at a cost savings of more than $4 million.

“In less than five years, our free antibiotics, pre-natal and diabetes prescription programs have saved our customers nearly $140 million,” said Meijer. “In total, we have helped hundreds of thousands of people throughout the Midwest receive free prescriptions to help them, and their families, lead healthier lives.”

The Meijer free pre-natal vitamins program features several well-known brands of pre-natal vitamins, including TriAdvance, Trinatal GT, Trinatal Ultra, Vol-Nate, Vol-Plus, and Vol-Tab.

Find a qualifying Meijer Pharmacy near you at www.medtipster.com!

IRS adjusts rules on health insurance debit cards

December 27, 2010 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Accounting Today, a SourceMedia publication – 12.27.2010

The Internal Revenue Service issued new guidance allowing the continued use of flexible spending arrangement and health reimbursement arrangement debit cards for the purchase of prescribed over-the-counter medicines and drugs.

The new guidance modifies previous guidance to permit taxpayers to continue using FSA and HRA debit cards to purchase over-the-counter medications for which the taxpayer has a prescription.

Effective after Jan. 15, 2011, in accordance with the new guidance, this use of debit cards must comply with procedures reflecting those that pharmacies currently follow when selling prescribed medicines or drugs.

The procedures include requirements that a prescription for the medication be presented to the pharmacy or the mail-order or web-based vendor that dispenses the medication and that proper records be retained.

In accordance with the Affordable Care Act, the cost of over-the-counter medicines or drugs can be reimbursed from a health FSA or HRA if a prescription has been obtained. The requirement to obtain a prescription does not apply to insulin.

The prescription requirement applies to purchases made on or after Jan. 1, 2011, and not to purchases made in 2010 even if reimbursed after Dec. 31, 2010. Because the requirement applies only to over-the-counter medications, it does not apply to other health care expenses such as medical devices, eye glasses or contact lenses.

The new guidance, IRS Notice 2011-5, as well as answers to frequently asked questions on IRS.gov, also contain further details on health FSA and HRA debit card purchases, including purchases from health care providers other than pharmacies and mail order and web-based vendors.

For guidance on health FSA and HRA debit card purchases at “90 percent pharmacies,” see IRS Notice 2010-59. More information on health care reform provisions can be found on the Affordable Care Act page on IRS.gov.

Excellus Blue Cross Blue Shield study estimates e-prescriptions could save money and lives

July 16, 2010 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: The Post Standard – by Charley Hannagan – 7.14.2010

A study released Tuesday estimates that 35 deaths a year could be prevented in Upstate New York if more doctors sent prescriptions electronically to pharmacies.

Yet, less than a quarter of the doctors nationally, and in Upstate, e-prescribe.

The study by Excellus BlueCross Blue Shield shows that 24.3 percent of doctors and 20.6 percent of physicians assistants in Upstate electronically send prescriptions to pharmacies, called e-prescriptions. In Central New York, the number drops to 21.8 percent of doctors and 17.3 percent of physician assistants.

E-prescribing is important to keep patients safe, prevent prescription forgeries, save money and make the system more efficient, said Dr. Arthur Vercillo, of Excellus.

“You can try and write as neatly as possible on a prescription form, but the call-backs (from pharmacists seeking clarification) still come in,” he said.

The study estimates that if all doctors sent e-prescriptions, and acted on the alerts provided about drug interactions, it would prevent 35 deaths, 161 permanent disabilities, 391 emergency room visits and 449 hospitalizations.

If doctors followed the generic prescription recommendations that pop up when they e-prescribe just 1 percent of the time, it could cut health care spending in Upstate by $64 million, Vercillo said.

The federal government is encouraging doctors to computerize patient medical records to make the system more efficient. E-prescribing is one part of that.

The federal government offers incentives to doctors to e-prescribe.

Excellus also offers an incentive to doctors to e-prescribe as a part of a package of incentives, Vercillo said.

Yet only about 25 percent of doctors nationally e-prescribe even though 85 percent of the pharmacies nationwide can accept e-prescriptions, according to Excellus.

Among other advantages are it allows doctors to retrieve a patient’s prescription history, it prevents forgeries and patients from going to many different doctors for the same prescription and it allows doctors to see a patient’s insurance coverage for drugs.

Publix offering free generic diabetes medicine

March 16, 2010 By: Nadia Category: Free Prescriptions, Medicine Advice, Medtipster, Prescription News, Prescription Savings

Publix Super Markets Inc., which offers eight types of generic prescription antibiotics for free, on Monday extended the offer to one of the most popular drug treatments for Type II diabetes.

Publix pharmacies now offer for free three prescription strengths of metformin, a generic form of Glucophage. Until now, Publix charged $21 a month for the maintenance drug. It’s part of broader effort the grocer unveiled to help diabetics monitor and manage their lives with online educational resources, recipes, cooking classes and a monthly e-newsletter.

“We expect to build on this diabetic management system,” Publix spokeswoman Shannon Patten said.

Use Medtipster.com to find a Publix Pharmacy closest to you home.

Stater Bros. Free antibiotic program to continue

March 08, 2010 By: Nadia Category: Free Prescriptions, Medicine Advice, Medtipster, Prescription News, Prescription Savings

Medtipster source: http://drugstorenews.com/story.aspx?id=132803&menuid=333

Stater Bros., a retailer based in Southern California said its offering of free 14-day supplies of selected antibiotics, including refills will continue.

In September 2009, all 28 Stater Bros. Super Rx Pharmacies throughout Southern California began offering a free 14-antibiotics program. Since the program began, thousands of prescriptions have been filled. Due to this overwhelming success, the program will continue its efforts to offer customers access to selected antibiotics.

The free antibiotic program offers eight different classes of antibiotics. Stater Bros. also offers a $4 generic prescription program. Over 300 commonly prescribed medications are $4 for a 30-day supply.

Find Stater Bros. and thousands of other pharmacies offering these and similar discounted generic drugs at www.medtipster.com.

Pharmacy Benefit Manager Fees Must Be Reported on Schedule C

February 22, 2010 By: Nadia Category: Medtipster, Prescription News

Source: U.S. Department of Labor, 2/2010

The Department of Labor published FAQs to supplement FAQs published in July 2008, and to provide further guidance in response to additional questions from plans and service providers on the requirements for reporting service provider fees and other compensation on the Schedule C of the 2009 Form 5500 Annual Return/Report of Employee Benefit Plan. Inquiries regarding these supplemental FAQs may be directed to EBSA’s Office of Regulations and Interpretations at 202.693.8523.

The new FAQs — numbers 26 and 27 — note that PBMs perform many services for which they are compensated, including services as a third-party administrator, claims processor, and developer of the plan’s formulary and pharmacy network. The FAQs make clear that fees for these services would be reportable as direct compensation on Schedule C.

Q26: Pharmacy Benefit Managers (PBMs) provide services to plans and are compensated for these services in various ways. How should this compensation be reported?

PBMs often act as third party administrators for ERISA plan prescription drug programs and perform many activities to manage their clients’ prescription drug insurance coverage. They are generally engaged to be responsible for processing and paying prescription drug claims. They can also be engaged to develop and maintain the plan’s formulary and assemble networks of retail pharmacies that a plan sponsor’s members can use to fill prescriptions. PBMs receive fees for these services that are reportable compensation for Schedule C purposes. For example, dispensing fees charged by the PBM for each prescription filled by its mail-order pharmacy, specialty pharmacy, or a pharmacy that is a member of the PBM’s retail network and paid with plan assets would be reportable as direct compensation. Likewise, administrative fees paid with plan assets, whether or not reflected as part of the dispensing fee, would be reportable direct compensation on the Schedule C. Payments by the plan or payments by the plan sponsor that are reimbursed by the plan for ancillary administrative services such as recordkeeping, data management and information reporting, formulary management, participant health desk service, benefit education, utilization review, claims adjudication, participant communications, reporting services, website services, prior authorization, clinical programs, pharmacy audits, and other services would also be reportable direct compensation.

Q27: PBMs may receive rebates or discounts from the pharmaceutical manufacturers based on the amount of drugs a PBM purchases or other factors. Do such rebates and discounts need to be reported as indirect compensation on Schedule C?

Because formulary listings will affect a drug’s sales, pharmaceutical manufacturers compete to ensure that their products are included on PBM formularies. For example, PBMs often negotiate discounts and rebates with drug manufacturers based on the drugs bought and sold by PBMs or dispensed under ERISA plans administered by a PBM. These discounts and rebates go under various names, for example, “formulary payments” to obtain formulary status and “market-share payments” to encourage PBMs to dispense particular drugs. The Department is currently considering the extent to which PBM discount and rebate revenue attributable to a PBM’s business with ERISA plans may properly be classified as compensation related to services provided to the plans. Thus, in the absence of further guidance from the Department, discount and rebate revenue received by PBMs from pharmaceutical companies generally do not need to be treated as reportable indirect compensation for Schedule C purposes, even if the discount or rebate may be based in part of the quantity of drugs dispensed under ERISA plans administered by the PBM. If, however, the plan and the PBM agree that such rebates or discounts (or earnings on rebates and discounts held by the PBM) would be used to compensate the PBM for managing the plan’s prescription drug coverage, dispensing prescriptions or other administrative and ancillary services, that revenue would be reportable indirect compensation notwithstanding that the funds were derived from rebates or discounts.

More information to follow via our blog at www.medtipster.com

E-Prescriptions Versus Handwritten Prescriptions

February 09, 2010 By: Tylar Masters Category: Medicine Advice

Many prescriptions are transmitted electronically, however, does this mean your privacy and safety are at risk? Or is this a safer, more secure and more beneficial method of prescribing medications?

With the age of technology and electronic, well, everything, we’re seeing a lot of changes in every day life, and in every day business. We’ve seen newspaper circulations drop, paper mail decrease, and who doesn’t have an email address or a home computer?

Your physician’s office most likely has an electronic version of your medical records by now, instead of the old school manilla folders. If not, trust me, it will happen sooner versus later. There are a lot of benefits to this method, the biggest being saving trees and helping the environment. Let’s take a closer look at how this may affect the one piece of paper you typically walk out the physician’s office door with – a prescription.

E-prescriptions are the same as the hand written prescription, only computer generated by your physician. The electronic prescription is sent directly to the pharmacy of your choice. Privacy has been a key concern for many patients with this change in how prescriptions are handled, however, rest assured that the network (transmitting) between your physician’s computer and your pharmacy is a secured and private route.

E-prescribing is more efficient and is faster in most cases. Most of the time, your prescription arrives at your pharmacy before you leave your doctor’s office. It doesn’t always mean it will be ready for you when you arrive, as sometimes pharmacies are busy or you arrive before the pharmacist has had time to fill the script. But, you won’t be waiting around the pharmacy or having to leave and come back. Plus the risk of errors with traditional hand written prescriptions is almost obsolete with e-prescriptions.

Also, remember that all e-prescriptions meet the requirements of Health Insurance Portability and Accountability Act (HIPAA). Your medical history has always contained the record of your prescription, and it being electronic or hand written makes no difference. All medical and prescription information is protected by federal and state laws.

If you have questions about your prescription, your physician or pharmacist will be able to address your concerns. Specific questions about e-prescriptions can be answered by either professional as well. Remember if you’re unsure which pharmacy has your prescription at the lowest cost available, tell your exit nurse at your physician’s office to use Medtipster.com to find the pharmacy to transmit your e-prescription.

Pharmacists are Among the Most Trusted Professionals

February 04, 2010 By: Tylar Masters Category: Medicine Advice

Pharmacies work hard to bring you in as a customer, not just once, but for life. They want to be your trusted source for questions and concerns, as well as fill your doctor’s written prescription.

Think about the last time you took a 10-minute drive somewhere. How many CVS, Rite Aid or Walgreens did you pass? The fact is there’s a pharmacy on nearly every other corner! The pharmacy industry is crucial to healthcare.

Within every pharmacy, there is a trusted professional called a pharmacist. Otherwise the pharmacy wouldn’t be able to operate. The National Association of Chain Drug Stores (NACDS) states that on average there is a pharmacy within two and a half miles of every resident in the U.S. Many have drive-thru and 24-hour access, meaning whenever you’re in need of a medication, your pharmacist is there for you.

Pharmacists dispense pills, sure, but that’s not all they do. They consult with you regarding your specific prescription, other medications you are taking, side effects, possible alternatives, and answer any questions you have about your health. Many times I’ve walked into my pharmacy looking for an over-the-counter drug for a cold or flu like symptoms, and the pharmacist on duty helps me find the best option for my symptoms.

This shows me a high level of kindness and concern, which healthcare professionals should absolutely carry at all times. I believe in most cases, people find that pharmacy professionals are always willing to answer questions and spend time getting to know their patients. Often this is why pharmacies entice customers to stay with them for refills and ongoing prescriptions, the pharmacist wants to get to know you, and help you determine the right medications for you.

Sources: National Association of Chain Drug Stores

Switch it Up and Save

February 02, 2010 By: Tylar Masters Category: Medtipster, Prescription Savings

The idea of saving money is the sole reason why people go to different stores for different items, if they know ahead of time they can spend less to get the same item. Why would prescriptions be any different, I suppose?

We at Medtipster.com encourage you to use our database to find the pharmacy with your specific prescription available on a pharmacy’s $4 generic program close to your home. If you’re taking several medications, this could mean you have several different pharmacy visits every month or every three months. It seems like it makes sense, but then again, does it have to be this way?

Pharmacies want your business. They want to keep you as a customer. Many offer gift cards and incentives to get you in there once, with every intention of keeping you. Next time you have a prescription, you’re already in the database, the pharmacy technician is familiar with your prescription history, and the hassle of a new pharmacy is obsolete. So, why wouldn’t they do what they have to do to keep you?

Price matching is something we hear all the time. This takes me back to my original question, why would prescriptions be any different, I suppose? They are not. Ask your pharmacy technician to match the price being offered at the next pharmacy! It can’t hurt to ask, and all they can say is, “no.”

Find your generics on Medtipster.com first then make a note of where the other generics are available on a generics program. Print the list, or go directly to the competing pharmacy and ask for a print out of the generic’s cost. Take that to the pharmacy of your choice and simply say, “I want to keep all of my prescriptions here, can you match the price of this competing pharmacy’s generic equivalent?”

Switch it up and save! Save time, gas money, and frustration.

Source: MSN Money http://articles.moneycentral.msn.com/SmartSpending/blog/page.aspx?post=1349052

Tylar Masters

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