Medicare Part D Donut Hole Closing Sooner!

Did you know? The Bipartisan Budget Act of 2018 moved up the date for closing the so-called donut hole for brand name drugs to 2019. It was previously 2020. For 2019 and every year after, the beneficiary cost sharing for brand name drugs after the initial coverage limit is 25% — the same as after the deductible and before the initial coverage limit. In 2020, the beneficiary cost sharing for generic drugs will also be 25%. Ask your Total Benefit Solutions Account Manager for more information at (215)355-2121. Total Benefit Solutions Inc. is your Medicare health insurance specialist! We work for your benefit!

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Four Stages of Medicare Part D

  It’s easy to see why Many people are confused by the Medicare part D plan coverage deductibles, limits and the donut hole. We have provided this graphic for you, our clients and friends to make it a little easier to see in a pie chart. Click the link below to download this graphic bulletin. 2018 Four Stages Of Medicare Part D   Want to compare part D plans in your area quickly? Click here   Have more questions? Call us today at (215)355-2121.

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Medicare Part D Creditable Coverage Notice Due Soon

Medicare Part D Creditable Coverage Notice The Medicare Modernization Act (MMA) requires employers whose policies include prescription drug coverage to provide a written disclosure notice to all Medicare eligible policyholders of whether such coverage is creditable. Creditable coverage means that the coverage is expected to pay, on average, as much as the standard Medicare prescription drug coverage.  This disclosure must be provided prior to October 15th, 2015 (and at various times as stated in the regulations) to: Medicare eligible active working individuals and their dependents (including a Medicare eligible individual when he or she joins the plan); Medicare eligible COBRA individuals and their dependents; Medicare eligible disabled individuals covered under… Read More

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Aetna & Coventry Formulary Changes

  Changes to your drug lists – starting July 1, 2015 Regularly, Aetna Pharmacy and Coventry Prescription Management Services, Inc. update drug lists based on the latest medical findings, information from the Food and Drug Administration (FDA), drug makers and cost arrangements, which include manufacturer rebates. Members are being notified They sending letters to clients about drug list changes for 2015. Click to read the 2015 Aetna Drug Changes Letter or 2015 Coventry Drug List Changes Letter. Impacted members with Aetna or Coventry pharmacy benefits will also receive a notification. Understanding the preferred drugs benefit They call drugs “preferred” because the members’ copay may be lower than the copay for non-preferred drugs. Members typically pay lower… Read More

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Medicare: Video-Parts of Medicare

  CMSHHSgov has uploaded Medicare & You: Different Parts Of Medicare :     As always, if you have any questions about Medicare health plans, please contact your Total Benefit Solutions account manager at (800)924-6718 or (215)355-2121.  

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Medicare Part D: Reminder to Distribute Creditable Coverage Notice

 Medicare Part D: Reminder to Distribute Creditable Coverage Notice    Employers who sponsor a group health plan with prescription drug benefits are required to notify their Medicare-eligible participants and beneficiaries as   to whether the drug coverage provided under the plan is “creditable” or “non-creditable.” This notification must be provided prior to October 15th each year. Please click the link below to read the detailed bulletin. Medicare Part D Reminder-091914R    

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