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More than 3M seniors may have to switch drug plans

August 25, 2010 By: Nadia Category: HealthCare, Medtipster, Prescription News

www.Medtipster.com Source: The Associated Press – By Ricardo Alonso-Zaldivar – 8.25.2010

A plan by Medicare to try to make it simpler for consumers to pick drug coverage could force 3 million seniors to switch plans next year whether they like it or not, says an independent analysis.

That risks undercutting President Barack Obama’s promise that people can keep their health plans if they like them.

And it could be an unwelcome surprise for many seniors who hadn’t intended to make a change during Medicare’s open enrollment season this fall.

The analysis by Avalere Health, a leading private research firm, estimated that more than 3 million beneficiaries will see their prescription plan eliminated as part of a new effort by Medicare to winnow down duplicative coverage and offer consumers more meaningful choices.

Seniors would not lose coverage, but they could see changes in their premiums and copayments.

Medicare officials dismissed the Avalere estimate without offering their own number. “Anybody who is producing that kind of analysis is simply guessing,” said Jonathan Blum, deputy administrator for Medicare.

But Bonnie Washington, a senior analyst with Avalere, said the company’s analysis used Medicare’s specifications.

For example, Medicare has already notified insurers they will no longer be able to offer more than one “basic” drug plan in any given location. Several major prescription plans, including CVS-Caremark and AARP, offered two basic options throughout the country this year, Washington said. Eliminating that particular form of duplication among the top plans would force 2.75 million beneficiaries to find new coverage, according to Avalere’s estimate.

When other changes are taken into account, as many as 3.7 million Medicare recipients may have to switch, the analysis concluded. That amounts to about 20 percent of the 17.5 million enrolled in stand-alone drug plans.

Avalere serves industry and government clients with in-depth research on Medicare and Medicaid. The company’s president was a health care budget analyst in the Clinton White House.

Former Medicare administrator Leslie Norwalk said the change might make things easier for people signing up for Medicare but harder for those already in the program.

“If you’re in a plan that you like and you have to change it, it will be disruptive,” said Norwalk, acting administrator under President George W. Bush. “It depends on how (Medicare) handles it to try to make it as seamless as possible.”

Reducing the number of Medicare drug plans has long been a goal for consumer advocates. This year, nearly 1,600 plans offered a dizzying range of options, many of which were not significantly different.

But Medicare is going ahead with the consolidation in a hard-fought election year. Republicans have barraged seniors with charges that Obama and the Democrats raided the program to expand coverage for younger generations under the health care overhaul. Obama’s promise that people can keep health plans they like was made in the context of that broader debate, but the president has repeatedly assured seniors their Medicare benefits are safe.

“Some opponents of the (health care) law may say that this is taking away choices, but we have heard from our members for years that the (drug coverage) options can be confusing,” said Nora Super, AARP’s top health care lobbyist. The seniors lobby supports the change. AARP’s public policy branch is separate from its business side, which sponsors Medicare and other insurance plans.

Medicare official Blum said the agency is working with insurers to keep disruptions to a minimum. For example, seniors could be automatically reassigned to a comparable plan offered by their insurance company. Premiums may not necessarily be any higher, Medicare officials said.

“We are not reducing the number of (insurers). We are not reducing the number of quality plans,” said Blum, adding that having fewer, more distinct choices will benefit seniors. “That puts beneficiaries in a stronger, rather than weaker position.”

Besides eliminating duplicative basic coverage, insurers that offer more than one enhanced coverage plan will have to show they are clearly different.

Medicare is expected to release its list of drug plans for 2011 late next month. Instead of 40 or more choices in each state, seniors may have around 30 plans to pick from.

Copyright © 2010 The Associated Press. All rights reserved.

Paying the highest brand co payment on your prescription drug plan

August 12, 2010 By: PharmaSueAnn Category: Medtipster

Tired of paying the highest brand co payment on your prescription drug plan! Ask your retail pharmacist for alternatives to discuss with your doctor at your next appointment. We are pretty friendly people and love to talk with our patient/customers. Here are just a few:

Brands without generics/therapeutic alternatives with generics
Uroxatrol. Vs. Tamsulosin (Flomax)
Prevacid sol tab vs. Lansoprazole caps (Prevacid)
Nexium vs. Omeprazole(Prilosec)
Ambien CR vs zolpidem (Ambien)

Does Your Employer Prescription Plan Cost You… Nothing At All?

February 03, 2010 By: Tylar Masters Category: Free Prescriptions, Prescription News, Prescription Savings

Generic drugs save people hundreds or even thousands of dollars each year, but did you know you could be paying absolutely nothing out of pocket, and your employer’s cost could be significantly reduced – both at the same time.

By now you’re familiar with Medtipster.com. We encourage generic drug purchasing over brand name drugs because they are just as effective, and cost less. You also know where to find your generic prescription at the lowest cost, right in your neighborhood.

If you have insurance, the cost of a generic for you could be a $15 co-pay, and your employer eats up the remainder of the cost, which is an average of $17.00. If you’ve found your generic on a $4 generic program by using Medtipster.com, you pay $4, and your employer pays nothing. We know you love Medtipster.com, but now we want your employer to love Medtipster.com too!

Free prescriptions have been our thing lately, in case you haven’t noticed. Thousands of Michigan residents have received free prescriptions since the beginning of December 2009. We are almost ready to take this free prescription giveaway nationwide, but first, we thought of another way to encourage generic drug purchasing, and you don’t have to be a Michigan resident to take advantage of this program. It’s called the Medtipster MVP.

With this program, employers partner with Medtipster.com to essentially give their employees free prescription cards, redeemable at pharmacies that employees themselves locate on Medtipster.com. The idea is to encourage generic drug purchasing over brand name drugs, and to reduce current and future healthcare costs to the employer.

It works like this example:

Sandy takes Zocor.

Sandy works for ABC123 Inc. and they have partnered with Medtipster.com.

ABC123 informs Sandy that her prescription is available for free if she logs on to the company website portal.

Sandy locates her generic equivalent at her neighborhood pharmacy, then prints out her custom ID card from the company’s privately labeled Medtipster.com site.

Sandy takes her ID card to this participating pharmacy and receives her prescription for Zocor generic equivalent for free.

Because the participating pharmacy has Zocor on a $4 generic program, Medtipster sends ABC123 an invoice for $4, plus a small administration fee.

Looking back at the example in the second paragraph above, this saves the employer an average of $17 per employee’s generic prescription. If you work for a company that employees 1,000 people, and half of those employees take a monthly generic prescription, they spend on average $102,000 each year covering “remaining” costs of their employees’ prescriptions. With the Medtipster MVP, the same company would spend an average of just $24,000 each year, for the SAME generic prescriptions! That’s $78,000 A YEAR!

$78,000 A YEAR.

I like to repeat myself when it sounds that good.

If you would like to see your employer save this kind of money every year, and get free prescriptions, let us know what you think. Let us know who we should talk to at your company about implementing this program. Let’s save some money, and change the way we think about prescription plans.

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