Part D Senior Savings Model: What is it?
If you are on Medicare, how much will you pay for insulin? The answer is in the graph below (via MedPAC’s Payment Basics) Seem confusing? Well it is. Medicare Part D beneficiaries have a deductible, then the standard coverage phase with 25% cost sharing, then a coverage gap where beneficiaries pay 25% of cost (manufacturers cover 70% of the cost for branded drugs in this coverage gap), and then a catastrophic phase where beneficiaries pay 5%. Wouldn’t it be easier if there were simple copayments like many commercial plans? That is what CMS has been trying out in their Part D Senior Savings Model. The model includes fixed copayments for certain enhanced Part D plans. CMS writes:
As described by former CMS administrator Seema Verma in the Health Affairs blog:
Sharon Jhawar, Chief Pharmacy Officer at the SCAN Health Plan argues that the Senior Savings Model is working, should be made permanent, and should be expanded to both other diabetes medications and medications used to treat other common chronic conditions. Previous research shows that cost is a barrier to medication adherence, and she writes:
For more information, read the CMS Senior Savings Program Fact Sheet and visit their website. Via Dental Tips http://www.rssmix.com/via Blogger http://jeanxrussell.blogspot.com/2021/10/part-d-senior-savings-model-what-is-it.html October 23, 2021 at 12:45PM
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