* Limit on Medicare drug copays
: Medicare's "Part D" prescription drug benefit currently has no limit on out-of-pocket costs paid by patients, which means beneficiaries taking very expensive medications may wind up with copays
rivaling a mortgage payment.
Ireland-based Jazz Pharmaceuticals, Denmark-based Lundbeck and United States-based Alexion Pharmaceuticals have agreed to pay a total of USD122.6m to resolve allegations of paying kickbacks through copay
assistance foundations, it was reported on Friday.
Holy Name Medical Center, Hackensack Meridian Health, RWJBarnabas Health and Atlantic Health have announced that they will also waive copays
for furloughed federal employees.
Enrolled beneficiaries can take advantage of a $0 deductible on all covered drugs in most states and $0 copays
for 90-day supplies of Tier 1 drugs nationwide when filled through the CVS Caremark mail-service pharmacy.
If one were to bypass them by writing "no copay
" on a bill, an insurance company likely would either bill the patient for the uncollected amount or send the doctor a letter saying he or she is in violation of a contract.
Consumer advocates worried that the NAIC should not detail a "fallback position" to copays
or it would undercut the message that no cost sharing should be the stance.
In addition to a medicare supplement comparison tool Vertex Insurance has also introduced a program with plans that help to offset the copays
that medicare advantage plans typically do not cover.
The new guidelines require no copays
, coinsurance or deductibles.
A review of 132 publications found that for each 10% increase in patient cost sharing (eg, copays
, coinsurance, coverage caps), prescription drug spending fell by 2% to 6%, depending on the drug class and patient's condition.
and deductibles is essential in today's tight healthcare environment.
The study bolsters the idea of "value-based insurance" in which insurers lower copays
and other costs to patients as a way to promote the use of tests and drugs that are proven to be cost effective in the long run.
Thirty years later, Gruber compares the HIE results--including the fact that higher copays
generally lead to lower levels of utilization, although apparently without compromising patient health status--against newer, similar studies.