Say It Ain't So! Medicare Part-D Plan Finder Wrong?

Joe Moore

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100+ Post Club
Surely it is NOT wrong???????

Like an agent told me the other day: "Can't you see what a mess O'Bama has made of our health system, and he's not even President yet!" I didn't answer.

Seems to me this potential implosion of Part-D drug plans would be much more important to monitor than controlling agents commissions.

Print - Reference-Based Pricing - another Part D penalty

Medicare Part D: Penalties for Brand Drugs Hidden From Beneficiaries - AARP Bulletin Today

US health plans view reference-based pricing. | Goliath Business News

"Some US health insurers are experimenting with reference-based drug pricing plans, which offer prices based on actual cost instead of tiered co-payments and rebates, reports AP.

The new schemes, being offered by insurers such as Humana and WellPoint Health Networks, typically divide into medicines categories (eg, acute care, chronic care, lifestyle and drugs to boost workplace productivity) and set an allowance for each one, based on the average or lowest price of products in the group. Patients then pay the difference between the allowance and the drug's actual cost.

Meantime, market research firm Kline & Co reports that managed care organizations and pharmacy benefit managers are considering the possibility of extending coverage to certain classes of over-the-counter drugs, particularly those recently switched from prescription status. However, while this development offers opportunities for partnerships between drugmakers and MCOs, many insurers do not want to be seen endorsing specific brands or companies, comments the report."
 
Surely it is NOT wrong???????

Like an agent told me the other day: "Can't you see what a mess O'Bama has made of our health system, and he's not even President yet!" I didn't answer.

Seems to me this potential implosion of Part-D drug plans would be much more important to monitor than controlling agents commissions.

Print - Reference-Based Pricing - another Part D penalty

Medicare Part D: Penalties for Brand Drugs Hidden From Beneficiaries - AARP Bulletin Today

US health plans view reference-based pricing. | Goliath Business News

"Some US health insurers are experimenting with reference-based drug pricing plans, which offer prices based on actual cost instead of tiered co-payments and rebates, reports AP.

The new schemes, being offered by insurers such as Humana and WellPoint Health Networks, typically divide into medicines categories (eg, acute care, chronic care, lifestyle and drugs to boost workplace productivity) and set an allowance for each one, based on the average or lowest price of products in the group. Patients then pay the difference between the allowance and the drug's actual cost.

Meantime, market research firm Kline & Co reports that managed care organizations and pharmacy benefit managers are considering the possibility of extending coverage to certain classes of over-the-counter drugs, particularly those recently switched from prescription status. However, while this development offers opportunities for partnerships between drugmakers and MCOs, many insurers do not want to be seen endorsing specific brands or companies, comments the report."

Well, I can see a need to formulate a mailer that asks "Are you getting screwed by CMS with your new Part D plan? Call me at xxx-xxxx."

This is going to be a hot issue during the OEP. I think I will look up all the plans that use reference-based pricing and target them for switching "like to like" plans!

According to these articles, someone getting hit with this added charge could end up paying more than full price for the drug! This appears most likely for a situation with a big premium and a high cost drug, but a low cost generic. In that case, the beneficiary would be best off not to use the PDP card and just pay the cost OOP.... what a mess.

Anyone else smell a rat here? It appears that Kerry Weems has conducted a slash and burn campaign when he left. It hasn't just been us agents that have been injured...
All this happened on the watch by the same people that brought you Christopher Cox and the CDS shenanigans, not to mention Fanny Mae and Freddy Mac, Henry Paulson and the toxic loan retraction, .... I could go on.
 
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