Medicare Blog: Moorestown, Cranford NJ

HR3 - the Lower drug costs now act

10/25/2019

Nancy Pelosi recently introduced a bill to lower the cost of drugs in the United States.

There are several key section to this bill.

Ends the ban on Medicare negotiating directly with the drug companies, and creates powerful new tools to force drug companies to the table to agree to real price reductions, while ensuring seniors never lose access to the prescriptions they need.
Makes the lower drug prices negotiated by Medicare available to all Americans, including those with private insurance, not just Medicare beneficiaries.
Stops drug companies ripping off Americans while charging other countries less for the same drugs, limiting the maximum price for any negotiated drug to the average price in countries like ours, where drug companies charge less for the same drugs – and admit they still make a profit.
Creates a new, $2,000 out-of-pocket limit on prescription drug costs for Medicare beneficiaries, and reverses years of unfair price hikes above inflation across more than 8,000 drugs in Medicare.
Reinvests in innovation and the search for new cures and treatments, using some of the savings from lowering the unjustified drug prices that are bankrolling Big Pharma’s stock-buybacks to reinvest billions of dollars in the search for new breakthrough treatments and cures at NIH.

The $2,000 out of pocket limit would be great for Medicare Beneficiaries since there is currently No out of Pocket Maximum. However, we do have some concerns with the proposed solution which would put most of the financial burden on the Part D Plans. The concern is that the Part D Plans will need to increase Part D Premiums to offset the increased financial burden above the $2,000 maximum. Currently about 4% of Medicare Beneficiaries reach the Catastrophic Phase of Part D. This $2,000 cap on Part D would definitely help those individuals, but the concern is that the other 96% of beneficiaries would see significant premium increases to their Part D Plans to offset this new Cap. Conceptually we are fully supportive of reducing drug costs and a cap on Part D would be great, but we believe it should be more of a shared burden with the Government so it doesn't negatively impact the other 96% of Medicare Beneficiaries.

This bill will likely go to a Vote in the House in the next 1-3 weeks.

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Medicare Plan Finder - justin continues to work with CMS

10/18/2019

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Since the government released the new Medicare Plan Finder on August 27, our frustration and stress level has been very high.

As a member of the Medicare Advisory Group of National Association of Health Underwriters, I was given an opportunity to have twice weekly calls with the CMS Requirements & Technical teams to discuss a list of key open items with the new Medicare Plan Finder.

In the last couple of weeks there have been significant improvements to the new Medicare Plan Finder including the addition of the Total Cost Calculator & Sort, and the fix for Mail Order Pricing Costs as well.

Click here to listen to the NAHU Happy Hour Podcast where I joined as a Special Guest discussing the ongoing process working with CMS.

I will continue to work with CMS to review key open items for resolution.

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Medicare Plan Finder - Total Cost Added!

10/11/2019

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When the new Medicare Plan Finder was launched on August 27, 2019 we had several concerns with missing functionality.

Our biggest concern was the fact that the new Medicare Plan Finder tool did not include the Total Cost Calculator and Sort function (Premium + Drug Cost). The function allows a user to quickly understand the Total Projected annual cost for each of the ~30 different Part D Plans available in each state, and thus enroll in the most cost-effective option.

On October 10, 2019 the Total Cost Calculator and Sort was added to the new Medicare Plan Finder. This is a significant milestone which allows us to complete the Part D Plan Analysis for our clients.

Below is a short video that shows how to use the new Medicare Plan Finder.

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HR3 - the Lower drug costs now act

Medicare Plan Finder - justin continues to work with CMS

Medicare Plan Finder - Total Cost Added!

Justin Lubenow

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