- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Medicare Beneficiaires May Struggle with Web Enrollment
Finding a health plan on the Medicare website could be troublesome for some seniors.
Finding a health plan on the Medicare website could be troublesome for some seniors. According to Gina Upchurch, executive director of Senior PharmAssist, a nonprofit group in North Carolina, a plan finder tool on the government’s website is showing higher prices for a prescription filled every 2 or 3 months compared with the same drug bought every month under 2014 drug policies. “You’re buying less and paying more,” she said.
Prescriptions such as eye drops, creams, or inhalers can last for more than a month, yet some insurers cap discounting for prescription drugs other than for 30-day regimens. Dr Upchurch found one plan that charged a beneficiary with a monthly prescription for eye drops $7 a month during the initial coverage period to get the drug, while another person who has a prescription for the drops to be filled every 60 days would pay $51. Another 2 plans she compared charge $40 or $45 for 3 vials of insulin every month in the initial coverage period, and $575 every 2 months.
Fred Riccardi, director of client services at the Medicare Rights Center, says elderly patients should call their insurers to seek out alternative plan options that might reduce costs, such as ordering through the mail order pharmacy. However, Dr Upchurch argues, “People shouldn’t have to run around to different pharmacies” and that “It would be better if Medicare required plans to cover whatever supply a provider prescribes.”
Elderly beneficiaries may encounter additional barriers to affordable healthcare due to their lack of access to the Internet. A study released in September by the Pew Internet & American Life Project found that a disproportionate amount of older Americans do not use the Internet. Kathryn Zickuhr, who wrote the Pew study, found 49% of non-Internet users are older than 65 years.
Around the Web
Strange Pricing Details Can Bedevil Medicare Beneficiaries [Kaiser Health News]
Gap Between Those Who Use Internet and Those Who Don’t is Widening
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen
The Federal Trade Commission's (FTC's) vote to ban most employers from issuing and enforcing noncompete clauses could have varying impacts on the health care workforce; federal regulators vastly under-enforced antitrust laws in the hospital sector during the last 2 decades, resulting in increased health costs; the FDA recently found genetic evidence of the H5N1 bird flu virus in pasteurized commercially purchased milk.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
What We’re Reading: Abortion Privacy Rules; Alzheimer Drug Hurdles; Nursing Home Staffing Overhaul
April 23rd 2024New health privacy rules aim to protect patients and providers in an evolving abortion landscape; some physicians express concerns about efficacy, risks, and entrenched beliefs in treating Alzheimer disease; CMS addresses longstanding staffing deficits in nursing homes.
Read More
