There is some good news to share as you meet with Medicare clients this AEP. In addition to having a wide range of plans to show them, there are some new ways to help them save money and manage their benefits. Here’s a closer look at three great MAPD enhancements for 2021.
Affordable Insulin
Prescription costs are a major concern for many seniors. A Morning Consult survey found that 24% of seniors with at least one chronic condition say they have stopped taking a prescription due to the cost. This is an ongoing problem in the U.S., but the introduction of the Senior Savings Model may help.
Plans that participate in this program will offer a broad set of insulins on the plan’s formulary at a maximum copay of $35 for a month’s supply. This price cap will apply throughout the entire year, whether the beneficiary is in the deductible, initial coverage or coverage gap phase of their Part D prescription drug benefits.
CMS says that one in three Medicare beneficiaries has diabetes, and more than 3.3 million Medicare beneficiaries use one of the common forms of insulin. Medicare beneficiaries who take insulin and enroll in a participating plan are expected to save an average of $446 per year in out-of-pocket costs.
The Senior Savings Model is a voluntary program, and not all plans will be participating.
Coverage for the COVID-19 Vaccine
Work is being done to create a vaccine for COVID-19 as fast as possible. This vaccine may be ready by 2021, and a new announcement from CMS confirms that it will be covered by Medicare.
Before a new treatment can be approved for Medicare coverage, it must typically go through a specific approval process. However, CMS has announced that measures have been taken to remove regulatory barriers and ensure that the vaccine is covered. When it is available, the COVID-19 vaccine will be provided at no charge to beneficiaries.
Blue Button 2.0
CMS has rolled out Blue Button 2.0, an application programming interface (API) that has four years of data from Medicare Part A, B and D.
The original Blue Button gave beneficiaries access to their health information so it could be downloaded and saved to a file. Data from Blue Button 2.0 can also be shared with authorized applications, services and research programs. The program is designed to give beneficiaries more control over their information and make it easier to share with providers.
Medicare beneficiaries can control who has access to the data through their account at MyMedicare.gov. To keep the information secure, CMS suggests that beneficiaries use encryption if they download the information and save it or send it via email. Paper copies and login information should also be kept secure.
Please be sure to share these MAPD enhancements with your clients and subscribe to the WAP Blog to keep informed of the latest Medicare news!