Prescription medication coverage: You may find you need to start using different prescriptions that your current plan doesn’t cover. Switching to a different Medicare prescription drug plan (Part D) or a Medicare Advantage plan that includes prescription drug coverage may be beneficial. ...
Using Medicare data, researchers examined trends in Part D plans excluding compounds from coverage or applying one of two utilization restrictions: "prior authorization," which requires plan members to get approval before filing a prescription; or "step therapy," which requires plan members to try a...
Older Americans that entered Medicare after the introduction of the Affordable Care Act (ACA) were found to have less hospitalizations, a reduction in medication use for chronic disease, and less out-of-pocket costs, compared to those that were on Medicare prior to ACA. Nursing home care was ...
The Centers for Medicare and Medicaid Services (CMS), the agency that runs the health plan for people age 65 and older, currently covers the medication only for patients enrolled in clinical trials. The agency said it will broaden coverage if Leqembi - ...
Of concern to health economists, said Dr. Bach, is that, at least in some cases, the cost of oncology drugs appears to be rising faster than the health benefits associated with them. Several experts have suggested a pattern of "diminishing returns," for example, in the treatment of metastat...
Part D plans excluding compounds from coverage or applying one of two utilization restrictions: "prior authorization," which requires plan members to get approval before filing a prescription; or "step therapy," which requires plan members to try a different medication before using the prescribed ...