Tag Archives: catastrophic coverage

Consumers Direct Insurance Services of New Mexico Releases Dates and Times for its Medicare Seminar Series

Albuquerque, New Mexico (PRWEB) October 08, 2014

Late enrollment penalties, donut holes, calendar year maximums, catastrophic coverage – oh my. Medicare sure sounds frightening but don’t fret. With a little knowledge you’ll find it’s not nearly as scary as you may think.

Consumers Direct Insurance Services (CDIS), Inc., an Independent, Authorized Senior General Agent for Blue Cross and Blue Shield of New Mexico is gearing up for Medicare’s 2014 Annual Enrollment Period (AEP), which runs from October 15th through December 7th, with the release of its Medicare Seminar Series*.

CDIS’ Medicare Seminar Series, is a grassroots initiative that places experienced local insurance agents in a controlled learning environment for Medicare beneficiaries to gather essential plan benefit information while also providing a forum for answers to their questions.

“Consumers Direct Insurance Services of New Mexico is excited about its upcoming Medicare Seminar Series, because it gives us an opportunity to engage the local public and present all of the new plan options from Blue Cross and Blue Shield of New Mexico,” said Scott Loochtan, President of Consumers Direct Insurance Services, Inc. “Trying to decipher all of this material on your own can be daunting and that is why we offer this complimentary service to make the process much easier.”

The Medicare Annual Enrollment Period (AEP) is the one time of year that Medicare beneficiaries enrolled in either a standalone Medicare Part D prescription drug plan (PDP) or Medicare Advantage (MA) plan can make a change for the next year.

“The AEP is the insurance agent’s tax season,” noted Loochtan. “Medicare beneficiaries all over the country have been eagerly awaiting this time of year to review and analyze their plans so that they can secure the best options to meet their needs in the upcoming year.”

CDIS’ insurance agents go through a stringent Medicare Part D Prescription Drug Plan (PDP) and Medicare Part C, also known as Medicare Advantage (MA), continuing education and certification process each year in order to assist current and potential clients. This certification allows them to provide full service Medicare solutions while making themselves available in a variety of ways through technology, over the phone or in person appointments.

To register for one of CDIS of New Mexico’s Medicare Seminars please visit http://www.CDISofNM.com/seminars or call directly at 888.257.6640. There is limited seating for each seminar.

About Consumers Direct Insurance Services, Inc. (CDIS)

Consumers Direct Insurance Services, Inc., (CDIS), is an Independent, Authorized Senior General Agent for Blue Cross and Blue Shield of New Mexico, Oklahoma and Texas that were founded in an effort to bridge the gap between education and insurance. Headquartered in Riverwoods, IL, the company has an executive team with over 100 years’ experience that has been providing world-class healthcare guidance to over 20,000 active clients. For more information, please visit our state specific websites at http://www.CDISofNM.com, http://www.CDISofOK.com and http://www.CDISofTX.com.

*Not connected with or endorsed by the U.S. Government or the Federal Medicare program.

New Milliman Study: Hepatitis C Drugs Could Increase Medicare Part D Spending by $2.9 to $5.8 Billion in 2015

Washington D.C. (PRWEB) July 29, 2014

New high priced hepatitis C drugs will increase federal spending in Medicare Part D by a projected $ 2.9 to $ 5.8 billion next year, according to a new report by the actuarial firm Milliman released today by the Pharmaceutical Care Management Association (PCMA). Milliman projects that average Part D premiums could increase by as much as 8.6 percent in 2015 as a result of high-priced hepatitis C drugs, including Sovaldi and Olysio.

The study finds that the majority of new Federal spending will come from increased federal reinsurance subsidies. Medicare payments for Part D catastrophic coverage have grown considerably faster than other components of Part D spending. According to the Medicare Payment Advisory Commission, between 2007 and 2012, payments have increased at an average annual rate of 14 percent while nearly doubling from $ 8 billion to $ 15.6 billion.

Milliman bases its cost projections on the assumption that 15 percent to 30 percent of the Medicare Part D population estimated to be infected with hepatitis C will receive an $ 84,000 course of treatment in 2015.

“While most payers cover about 75 percent of an enrollee’s prescription drug costs, Medicare Part D covers 95 percent at high spending levels,” said PCMA President and CEO Mark Merritt. “The study shows taxpayers will bear the lion’s share of the increased drug costs for Medicare Part D beneficiaries taking hepatitis C drugs.”

Click here to read the new report.

Major findings from the report include:

    New hepatitis C drugs, including Sovaldi and Olysio, will increase 2015 federal spending on Medicare Part D by $ 2.9 to $ 5.8 billion for beneficiaries enrolled in Medicare Prescription Drug Plans (PDPs), an increase of $ 100 to $ 200 per beneficiary per year.

    Average monthly premiums for Medicare PDPs are projected to increase 4.3 percent to 8.6 percent next year as a result of new hepatitis C drugs, an increase of $ 17 to $ 33 per beneficiary per year.

Milliman’s analysis measured the impact of these new drugs on the Medicare Part D program; the study did not include the effect of the drug therapy on other medical costs.

Related Medicare Enroll Press Releases

Obamacare Catastrophic Plans Extended to Noncompliant Cancellations

obamacare catastrophic plansIn November, millions of Americans received cancellation notices from their insurance companies, saying their current plans were not in compliance with the provisions mandated by the Affordable Care Act. Now, just days before the enrollment deadline for a January 1, 2014 effective date, the White House has included the people affected by these cancellations as eligible for exemption from the individual mandate.

Alternatively, the administration also extended catastrophic plan eligibility to the Americans whose policies were cancelled by their insurance companies for noncompliance. These plans were originally only available to young adults between the ages of 18 and 29. Obamacare catastrophic plans do not cover many of the benefits included in other plans sold through the health insurance exchanges.

Change Not Well Received by Opponents

Many people against the Affordable Care Act, including Republicans, said the most recent change allowing more people to enroll in Obamacare catastrophic plans would further destabilize the insurance industry. It would also cause confusion for consumers, particularly those who think they can now sign up for catastrophic coverage but are not eligible because they did not have their plans cancelled.

In addition, opponents who have battled against the individual mandate for months believe this most recent change is a precursor to doing away with the individual mandate altogether. It also signals the inevitable failure of the ACA, according to Republicans, as more people have lost their insurance under Obamacare than have gained it.

Obamacare Catastrophic Coverage Not Selling Well

Even before the administration extended Obamacare catastrophic coverage to the millions of people whose policies were cancelled, the slimmed-down version of health coverage was not selling well. Just one percent of the enrollees in California had signed up for a catastrophic plan in the first two months of open enrollment. In Connecticut, the percentage was higher at two percent, but in Washington State, only 0.4 percent of residents have selected catastrophic coverage.

Exchange officials say they did not expect high demand for Obamacare catastrophic plans because residents cannot use federal subsidies to buy them. Consumers who are eligible to receive federal premium assistance are financially better off to purchase a Bronze or Silver level plan that has lower out-of-pocket costs than a catastrophic plan.

Officials also believe consumers are starting to become more aware about their health insurance as a result of the ACA. They are carefully weighing premium amounts against deductibles, copays and coinsurance to make the right decision for them in terms of what type of coverage they need. Many of the plans that were cancelled, though, were very similar to the catastrophic plans sold through the health insurance exchanges. It is possible there will be a slight increase in catastrophic enrollments following the administration’s expansion of eligibility for these plans.

What Does a Catastrophic Plan Cover?

All Obamacare catastrophic plans are required to cover the 10 essential health benefits as mandated by the ACA, including doctor and hospital visits. However, under a catastrophic plan, these costs of these services are applied to the deductible before the insurance company begins contributing toward the bills. Since catastrophic plans have extremely high deductibles, many people won’t see any cost-sharing unless they experience a severe injury or illness.

Of course, catastrophic plans are usually cheaper than other types of insurance because of these high deductibles. This is why they might be an attractive option for young adults who rarely get sick or visit the doctor. Still, research has shown that with subsidies, a Bronze level plan through an exchange might actually be cheaper than a catastrophic plan without subsidies. By choosing a Bronze plan, a consumer would be getting more comprehensive coverage at a lower price.

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