#costshare – Total Benefit Solutions Inc

Prescription Drug Provisions in the Inflation Reduction Act

September 21, 2022August 17, 2022Cayla Widdop

For the first time, requires the federal government to negotiate prices for some top-selling drugs covered under Medicare Requires drug companies to pay rebates if prices rise faster than inflation for drugs used by Medicare beneficiaries Eliminates 5% coinsurance for catastrophic coverage in Medicare Part D in 2024, adds a $2,000 cap on Part D out-of-pocket spending in 2025, and limits annual increases in Part D premiums for 2024-2030 Limits monthly cost sharing for insulin products to $35 for people with Medicare Expands eligibility for Medicare Part D Low-Income Subsidy full benefits Eliminates cost sharing for adult vaccines covered under Medicare Part D and improves access to adult vaccines under… Read More

Further Guidance Issued on Contraceptive Coverage

September 12, 2022August 15, 2022Cayla Widdop

On July 28, 2022, the Departments of Labor, Health and Human Services and the Treasury (collectively, “the Departments”) issued FAQ Part to clarify protections for contraceptive coverage under the Affordable Care Act (the “ACA”). In January 2022, the Departments had issued guidance on the ACA Preventive Care Mandate, including contraception. The Departments issued FAQ Part 54: In response to reports that individuals continue to experience difficulty accessing contraceptive coverage without cost sharing; To clarify application of the contraceptive coverage requirements to fertility awareness-based methods and to emergency contraceptive; and To address federal preemption of state law. Employers sponsoring non-grandfathered group health plans should review the various preventive care requirements effective… Read More

Medicare Advantage (MA) Quick Facts

August 30, 2022August 3, 2022Cayla Widdop

What is it? A Medicare Advantage Plan is a type of Medicare health plan offered by a private company, such as Independence Blue Cross, that contracts with Medicare to provide all Part A and Part B benefits. If enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Plan types offered: Medicare Advantage Plans include Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO), for example. Independence offers Keystone 65 HMO as well as Personal Choice 65 PPO. Medical Coverage: If enrolled in a HMO, members must choose a PCP (which also will coordinate referrals) and must stay In-Network. PPO… Read More

5 Affordable Self-Employed Health Insurance Options When You’re on a Budget

September 17, 2018Cayla Widdop

5 Affordable Self-Employed Health Insurance Options When You’re on a Budget When you are self-employed, finding affordable health insurance options isn’t easy. There are more types of insurance policies now more than ever; However not all of those choices are affordable. So, how can you find good coverage when you’re on a budget? Continue reading below for some great options to make sure you get the benefits you need at a price you can afford! 1. Telemedicine Services and Secure Doctor Consultations A budget-friendly health insurance alternative that’s gaining popularity are Telemedicine Services. Telemedicine services are just like they sound, it’s a medical service that allows you to speak to… Read More