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I don’t post much about these things but many of you know that I am an Insurance broker and for the past 10+ years have specialized in Medicare. I also am a volunteer counselor with a veterans advocacy group counseling veterans and their family in maters of health insurance and long term care, both VA and none VA. Enough about me the purpose of this post is to raise awareness to 2 very significant changes to medicare coverage for 2021.
The first Change is regarding Insulin – in the past with the exception of a few special need plans folks would pay for insulin as a tier 3 drug which meant that they would pay about $45 for a 30 day supply until they reached the GAP (Doughnut hole) and then after that they would pay 25% of the cost of the insulin. That meant by June most insulin dependent folks would see the price of their insulin go up to between $125 to $150 per 90 supply. As a result of this many would either cut down on their required dose or stop taking it all together. The end result was these diabetics would develop complication and many of them would die because of this. One of the complication of this is ESRD (End Stage Renal Disease), kidney failure. (Carol Reed was a diabetic and felt insulin was to expensive and therefore did not take it).
The Medicare has created a special program where some insurance companies can offer insulin for $35 both before and during the GAP. Not all companies are participating at this time but some of the bigger ones are. In Arizona United Health Care and Humana are offering it.
The second BIG change is for folks with ESRD – in the past these folks were not allowed to sign up for any type of Medicare insurance other than original Medicare and therefor had to buy a separate drug plan and were forced to pay 20% for all out patent services including dialysis. There is no max out of pockets. Now starting in 2021 they can sign up for a Medicare Advantage Plan. This means that going forward they will usually pay far less then the 20% for there out patent services and all Medicare Advantage Plans have a maximum out of pocket. Most also include a drug plan. Medicare advantage plans can be had for little or no cost. (Carol Reed died from ESRD).
I am putting this out there so that if you or anyone you know is effected by these two significant changes please tell them to get a hold of a broker learn more.
The first Change is regarding Insulin – in the past with the exception of a few special need plans folks would pay for insulin as a tier 3 drug which meant that they would pay about $45 for a 30 day supply until they reached the GAP (Doughnut hole) and then after that they would pay 25% of the cost of the insulin. That meant by June most insulin dependent folks would see the price of their insulin go up to between $125 to $150 per 90 supply. As a result of this many would either cut down on their required dose or stop taking it all together. The end result was these diabetics would develop complication and many of them would die because of this. One of the complication of this is ESRD (End Stage Renal Disease), kidney failure. (Carol Reed was a diabetic and felt insulin was to expensive and therefore did not take it).
The Medicare has created a special program where some insurance companies can offer insulin for $35 both before and during the GAP. Not all companies are participating at this time but some of the bigger ones are. In Arizona United Health Care and Humana are offering it.
The second BIG change is for folks with ESRD – in the past these folks were not allowed to sign up for any type of Medicare insurance other than original Medicare and therefor had to buy a separate drug plan and were forced to pay 20% for all out patent services including dialysis. There is no max out of pockets. Now starting in 2021 they can sign up for a Medicare Advantage Plan. This means that going forward they will usually pay far less then the 20% for there out patent services and all Medicare Advantage Plans have a maximum out of pocket. Most also include a drug plan. Medicare advantage plans can be had for little or no cost. (Carol Reed died from ESRD).
I am putting this out there so that if you or anyone you know is effected by these two significant changes please tell them to get a hold of a broker learn more.
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