Medicare Part D – Citizens Report https://citizensreport.org a digital channel commited to health & medical rights. Wed, 17 Jan 2024 09:06:12 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.24 https://citizensreport.org/wp-content/uploads/2016/12/cropped-cr-icon-1-32x32.png Medicare Part D – Citizens Report https://citizensreport.org 32 32 The Different Parts Of Medicare Open Enrollment https://citizensreport.org/2015/10/29/medicare-open-enrollment/ https://citizensreport.org/2015/10/29/medicare-open-enrollment/#respond Thu, 29 Oct 2015 18:14:07 +0000 http://www.citizensreport.org/?p=9180 The annual open enrollment period for Medicare allows Americans to revise their insurance plans during Oct. 15 to Dec. 7. Medicare plans have a variety of different parts. It’s important to know the basics of each one. Participating In Open Enrollment Each year, the terms and costs of Medicare plans chance drastically. Millions of beneficiaries […]

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Learning About The Different Parts Of Medicare Open Enrollment

Medicare beneficiaries should be aware that open enrollment season, a three-month period that offers options to change or add to existing health care plans, has finally begun.

The annual open enrollment period for Medicare allows Americans to revise their insurance plans during Oct. 15 to Dec. 7.

Medicare plans have a variety of different parts. It’s important to know the basics of each one.

Participating In Open Enrollment

Open enrollment begins in October and ends in December.
Image: Cusd

Each year, the terms and costs of Medicare plans chance drastically. Millions of beneficiaries could save large amounts of money with better plans that offer more coverage in the new year.

If one in five people choose to select a new Medicare plan, there would be a significant shift. Because Medicare is difficult to understand, most people don’t bother with changing plans.

For existing patients, the current plan will automatically renew… even if it’s not the best fit.

An Alphabet Of Plans

Medicare is broken up into different parts identified by a letter.
Image: Boomer Benefits

Original Medicare, or Part A, includes hospital insurance. Part B is for doctors, outpatient expenses and medical equipment. Medicare Advantage plans include both Parts A and B.
Medicare Advantage plans fall under Part C, whereas Medicare prescription drug plans are classified as Part D.
The free annual guide Medicare & You 2016 will help to clear up the difference kinds of coverage for each part. For people with private insurance, the Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents will also provide important information. Being familiar with the documents is an instrumental part of selecting a plan.

Making A Decision

The plans are split into a few basic choices. The Original Medicare beneficiaries may also purchase a Medigap policy. These supplemental policies fill the holes in the Original Medicare plans.

Because Original Medicare only covers 80 percent health expenses, patients will have to pay for the rest out of pocket. This can be very expensive for patients with serious conditions that require hospitalization, surgery or other costly treatments.

During open enrollment, beneficiaries can add Medigap “letter” plans. The coverage for each letter plan is identical, meaning that all A plans are the same, all B plans, and so on. The only difference is the premiums.

If you’ve already passed the beginning eligibility period for Medicare, the plans may be pricier because guaranteed issue rights to Medigap have expired. Private insurers no longer have to sell beneficiaries a plan regardless of health status or age. It’s possible that beneficiaries could be forced to pay higher premiums or deal with coverage limitations based on pre-existing medical conditions.

Original Medicare beneficiaries may also purchase a Medicare Advantage plan or change their current Advantage plan. For this specific plan, patients cannot be forced to pay higher premiums or face rejections because of current medical problems.

The only catch is that if you choose to switch to Medigap, you can’t keep a Medicare Advantage plan. The two plans can never overlap, so patients should be sure about making the switch because they will lose their guaranteed issue rights.

While 70 percent of patients have Original Medicare plans, and 30 percent are covered by Medicare Advantage, all beneficiaries can alter their Part D prescription plan during open enrollment.

Take the time to understand the different options during Medicare enrollment to receive better coverage for a cheaper price.

 

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A Bill To Regulate Prescription Drug Price https://citizensreport.org/2015/09/21/a-bill-to-regulate-prescription-drug-price/ https://citizensreport.org/2015/09/21/a-bill-to-regulate-prescription-drug-price/#respond Mon, 21 Sep 2015 19:28:58 +0000 http://www.citizensreport.org/?p=7910 “Feel the Bern,” the slogan of democratic presidential candidate and Vermont Sen. Bernie Sanders, is popularly exchanged among adolescents who favor his platform. Sanders is known for his opinions on income inequality, universal healthcare, parental leave, climate change, and LGBT rights. The politician’s most recent endeavor, a bill to reduce prescription drug prices, addresses the issue of medicine affordability in an increasingly […]

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The Bernie Sanders Bill To Reduce Drug Prices

Presidential candidate Bernie Sanders has created a bill to regulate drug prices, including Medicare Part D negotiation, drug importation from Canada, Medicaid and Medicare rebates, the prohibition of pay-for-delay deals, penalties for fraud convictions and drug pricing cost and transparency.

“Feel the Bern,” the slogan of democratic presidential candidate and Vermont Sen. Bernie Sanders, is popularly exchanged among adolescents who favor his platform.

Sanders is known for his opinions on income inequality, universal healthcare, parental leave, climate change, and LGBT rights. The politician’s most recent endeavor, a bill to reduce prescription drug prices, addresses the issue of medicine affordability in an increasingly concentrated and competitive market.

All About The Bill

Bernie Sanders is the face, the creator and the biggest advocate of the bill.
Image: NY Post

The bill is titled the Prescription Drug Affordability Act of 2015. If the bill passes, network negotiations and price changes will begin on Jan. 1, 2016.

Focused on making changes to the prescription drug market, the bill includes nine major areas of focus, including:

    • “Negotiation of lower covered part D drug prices on behalf of Medicare beneficiaries.”
    • “Acceleration of the closing of the Medicare Part D donut hole.”
    • “Prescription drug importation.”
    • “Sense of the Senate regarding trade agreements.”
    • “Requiring drug manufacturers to provide drug rebates for drugs dispensed to low-income individuals.”
    • “Applying the medicaid additional rebate requirement to generic drugs.”
    • “Preserving access to affordable generics.”
    • “Conditions on award of drug exclusivity.”
    • “Drug manufacturer reporting.”

Backing The Bill

Although Republicans notoriously disagree with allowing the federal government to gain a tight legislative grasp on the country, members of the political party have approved some portions of the bill.
Image: The American Nurse

Sanders frequently receives emails from individuals who can’t afford their medication. A 2014 Commonwealth Fund survey found that about 20 percent of U.S. adults didn’t file a prescription because it was unaffordable.

“Well, obviously, they will get sicker and in some cases, they will die,” Sanders said. “This is an unacceptable situation we must fix.”

Pharmaceutical companies allocate the majority of the budget to sales and marketing, leaving little funding for research and development. Sanders believes transparency is necessary to create pricing that has allows the company to make a fair profit at a fair price to consumers.

The bill is aimed at keeping generic drug prices as low as possible, using evidence from other countries to illustrate how serious the pricing problem is in the United States.

“It is unacceptable that Americans pay, by far, the highest prices in the world for prescription drugs,” Sanders said in a statement. “For years, generic drugs have made it possible for people to buy the medicine they need at lower prices. We need to make certain that generics remain affordable.”

In addition, he wants to outlaw the practice of allowing one company to pay another company to keep generics off the market, which stifles competition.

Robert Moffit, a senior fellow, opposes the bill. He asserts that federal regulation of prescription drugs would lower access.

“When the government fixes prices, the government excludes the companies that do not or cannot accept the fixed government prices from participating in Medicare,” Moffit wrote. “That means that all seniors would not get Medicare access to the drugs of those companies.”

Legislators expect to be faced with opposition from Republicans on certain key points. However, the importation of Canadian prescription drugs is supported by both parties.

“In 2013, the U.S. spent nearly 40 percent more on prescriptions per person than Canada, the next- highest OECD spender, twice as much as the average major industrialized country, and nearly five times as much as Denmark,” according to the bill.

It doesn’t make sense for a politician to advocate for free trade and market competition but not support that measure, Moffit said.

“The greed of the pharmaceutical industry is killing Americans,” he said.

 

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