1 / 19

Minnesota Rural Health Association presents “Pharmaceutical Options for Seniors”

Minnesota Rural Health Association presents “Pharmaceutical Options for Seniors”. Robin Weis MN River Area Agency on Aging 2/9/07. Senior LinkAge Line ® (SLL). Statewide information and assistance phone line 1-800-333-2433

genica
Download Presentation

Minnesota Rural Health Association presents “Pharmaceutical Options for Seniors”

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Minnesota Rural Health Association presents“Pharmaceutical Options for Seniors” Robin Weis MN River Area Agency on Aging 2/9/07

  2. Senior LinkAge Line® (SLL) • Statewide information and assistance phone line • 1-800-333-2433 • 7 Call Centers in MN- Slayton, Rochester, Metro, St. Cloud, Duluth, Fergus Falls, Warren • Monday-Friday, 8 a.m. to 4:30 p.m. • Resources online at www.minnesotahelp.info • Call specialists are certified health insurance counselors thru the MN Board on Aging and Certified Information and Referral Specialists thru the Alliance of Information and Referral Systems (at a minimum) • Senior Outreach Specialists and trained volunteers provide in-person assistance

  3. SLL- Who we Serve • Seniors (60 and older) • Medicare Beneficiaries of all ages • Caregivers • Grandparents raising grandchildren • People of all ages needing prescription assistance • Professionals working with these populations

  4. Options Based on Individual Circumstances • Medicare • Medicare Part D • Medical Assistance • Medicare Supplemental Polices • Health Plans and Advantage Plans • Employer/Retiree Plans • Veteran Benefits • RxConnect™ • Foundations

  5. Medicare’s Rx Coverage • Medicare Part A and B continues to cover prescription drugs that were covered prior to Medicare Part D • Medicare approved hospital stay • Medicare approved nursing home stay • Medications that can’t be self- administered • Most prescriptions are NOT covered by Medicare Part A and B.

  6. Medicare Part D’s Rx Coverage • Multiple options with varying premiums, deductibles, coverage gap and cost sharing. • Stand alone plans or Medicare Advantage/Health Plans • Formulary • Pharmacy Networks- Mail order an option with some companies • Enrollment periods • Creditable Coverage

  7. Medical Assistance Rx Coverage • Drastically changed since Medicare Part D • Medicare Part D covered meds are no longer covered under Medical Assistance • Can change plans monthly if enrolled in a MN Health Care Program • MSHO/MnDHO- Medicare A, B and D • Wellpoint- Point of Sale Option

  8. Medicare Supplemental Polices • Prescription coverage not available for purchase after 1/1/06 • 80% or 50% coverage still available on plans in place prior to 12/31/05 • Should compare current policy with Medicare Part D options • 50% coverage under supplemental plans is not creditable coverage

  9. Health Plans and Advantage Plans • Medicare Cost Plans • Medicare Advantage Plans • Medicare Advantage HMO Plans • Medicare Advantage Private Fee-for-Services (PFFS) plans • Medicare Advantage Preferred Provider Organization (PPO) Plans • Medicare Advantage Special Needs Plans (SNP’s) • Medicare Medical Savings Account Plans

  10. Medicare Cost Plans • Some provide drug coverage for their members only • Members may opt out of drug coverage and buy a stand alone Medicare Part D plan

  11. Medicare Advantage (MA) Plans • Many Medicare Advantage Plans provide prescription drug coverage • If drug coverage is offered, enrollees must get drug coverage from their plan. • In most plans if they enroll in a stand-alone plan, they will be dis-enrolled from their health care coverage.

  12. Medicare Medical Savings Account (MSA) Plans • Will begin to see options in MN in 2007 • MSA plans do not have drug coverage • Enrollees have the option of enrolling in a stand-alone Medicare Part D plan

  13. Employer/Retiree Plans • Must refer to the coverage handbook to see how drugs are covered • Each plan varies • Consider premium costs paid by the senior

  14. Veteran Benefits • Encourage to contact the county Veteran Service Officer if not currently receiving drug coverage thru VA • VA guidelines change frequently

  15. RxConnect™- objective, neutral service that discusses all pharmaceutical options • Using web sites to compare various prices • Mail order • Review benefits available through a health plan,Medicare supplement plan or HMO • Enrolling in publicly funded programs • Negotiating with a local pharmacist • Getting help from the drug companies • Medicare Prescription Drug coverage • Prescription savings discount cards

  16. Discount Card Example • TogetherRx Access • Can not have current drug coverage • Can not be a Medicare beneficiary • Uses local pharmacy • Free, little paperwork required • Discount available on over 300 brand names and some generics • Most receive 25-40% off of brand-name drugs

  17. Help from Drug Companies • Most require no current drug coverage, however some helping in Medicare Part D coverage gap • Guidelines and applications often change • Income guidelines and sometimes asset guidelines • Physician participation • Renewals required frequently • www.needymeds.com or www.rxassist.org

  18. Foundations • Vary by foundation • Examples • www.healthwellfoundation.org • www.patientaccessnetwork.org

  19. Contact Information Robin Weis 507-836-8547, ext. 112 srlinkage@swrdc.org

More Related