Categories
Medicare

Medicare policy on antirejection drugs imperils kidney transplants

“Medicare spends $86,300 a year per patient on dialysis” “The upfront cost of a kidney transplant is about $110,000.” “…coverage of immunotherapy under Medicare Part B is approximately $2,300 per year.” But, apparently, Medicare Part B limits immunotherapy to three years after which the transplant patient must choose between i) paying for the immunotherapy out […]

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Part C Medicare Advantage

What Is the Medicare Advantage Open Enrollment Period?

Medicare Advantage Open Enrollment Period, which begins January 1 and ends March 31, allows individuals already enrolled in Medicare Advantage to i) switch to another Medicare Advantage plan or, ii) drop Medicare Advantage and return to Original Medicare and join a Medicare Part D prescription drug plan. This is separate from the widely advertised Annual […]

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Part C Medicare Advantage

Ellis joins Aetna Medicare Advantage Network

  On February 1, 2020, Medicare beneficiaries in New York’s Central and Capital Regions will have even more providers to choose from when they select a 2020 Aetna Medicare Advantage plan. On that day, Ellis Medicine and its affiliated physicians will be part of Aetna’s Medicare Advantage preferred provider network – including the following facilities: Bellevue Women’s […]

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Part C Medicare Advantage

Bassett Healthcare joins Aetna Medicare Advantage Network

On January 1, 2020, Medicare beneficiaries in New York’s Central, Upstate and Capital Regions will have even more providers to choose from when they select a 2020 Aetna Medicare Advantage plan. On that day, Bassett Healthcare Network and its more than 400 affiliated physicians and other advanced practice clinicians will be part of Aetna’s Medicare Advantage preferred […]

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Part C Medicare Advantage

Medicare and Veterans

This spring I received calls for help from several veterans who were paying a monthly premium to be enrolled in a MAPD, a Medicare Advantage with Prescription Drug Plan. These veterans are not eligible for CHAMP or TRICARE, are enrolled in Medicare Parts A and B and pay the Part B premium. Since these veterans […]

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Medicare A & B Medicare supplement Part D Prescription Drug

What is the “Medicare Savings Program?”

Individuals enrolled in Medicare Parts A and B may apply for the Medicare Savings Program. If eligible you will receive help paying the Medicare Part B premium, currently $135.50. In some instances, (QMB) the program will pay your Part A and Part B deductible and co-insurance amounts. (And possibly a percentage of your Part C […]

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Part D Prescription Drug

Eli Lilly Will Sell Half-Price Version of Humalog Insulin

This is a step in the right direction. Drug manufacturer Eli Lilly is introducing Insulin Lispro, a generic version of Humalog – an insulin to treat Type 2 diabetes. However don’t expect for this to appear on your health insurance generic drug formulary anytime soon. “…those with drug coverage will either experience no change or […]

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Case Studies Part D Prescription Drug

A Medicare Advantage case study.

If you, a loved one, friend or neighbor has experienced “sticker shock” with your Medicare Part D prescription drug co-payment, the following case study may interest you. Earlier this week, I received this message from an Albany New York County couple: “We were talking with our neighbor Kathy about the sudden and unaffordable cost of […]

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Part D Prescription Drug

The $9 billion in Extra Cash From Medicare

On January 4, 2019 the Wall Street Journal published a powerful article written by Joseph Walker and Christopher Weaver describing how Medicare Part D insurers kept $9.1 billion more in taxpayer funds than they would have had their estimates been accurate from 2006 to 2015. In the WSJ  article, the writers do a deep dive […]

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Part D Prescription Drug

Medicare Prescription Drug Plan Deductible – How Does It Work?

A client called this morning and asked this question: “Dan, I went to refill my prescription and was quoted almost double what I paid in 2018.“ Medicare Part D Prescription Drug plans reset each year on January 1. What that means is the prescription drug benefit levels start over at what is called the Deductible […]