#Drug Insurance

[insurance-professionals-arizona]

Understanding Commercial Prescription Drug Insurance | Insurance Professionals of Arizona

Commercial Prescription Drug Insurance is a part of commercial health insurance. This article will guide you on how to protect yourself and your family from large prescription drug bills.One area of healthcare that can be the most expensive for consumers, but which we don’t really think about, is the price of prescription drugs.In fact, according to a 2018 Consumer Reports survey of 1,200 adults taking prescription drugs, many Americans report that in order to afford their prescriptions, they have to cut back in other areas of the budget, like groceries.

[lookingforcactus]

A big cost and concern for many seniors in the U.S. is the price of prescription drugs and other healthcare expenses—and this year, thanks to The Inflation Reduction Act, their costs may go down dramatically, especially for patients fighting cancer or heart disease.

I learned about the new benefits because my ‘Medicare birthday’ is coming up in a couple months when I turn 65. I was shocked that there were so many positive changes being made, which I never heard about on the news.

Thousands of Americans on Medicare have been paying more than $14,000 a year for blood cancer drugs, more than $10,000 a year for ovarian cancer drugs, and more than $9,000 a year for breast cancer drugs, for instance.

That all changed beginning in 2023, after the Biden administration capped out-of-pocket prescriptions at $3,500—no matter what drugs were needed. And this year, in 2024, the cap for all Medicare out-of-pocket prescriptions went down to a maximum of $2,000.

“The American people won, and Big Pharma lost,” said President Biden in September 2022, after the legislation passed. “It’s going to be a godsend to many families.”

Another crucial medical necessity, the shingles vaccine, which many seniors skip because of the cost, is now free. Shingles is a painful rash with blisters, that can be followed by chronic pain, and other complications, for which there is no cure

In 2022, more than 2 million seniors paid between $100 and $200 for that vaccine, but starting last year, Medicare prescription drug plans dropped the cost for shots down to zero.

Another victory for consumers over Big Pharma affects anyone of any age who struggles with diabetes. The cost of life-saving insulin was capped at $35 a month [for people on Medicare].

Medicare is also lowering the costs of the premium for Part B—which covers outpatient visits to your doctors. 15 million Americans will save an average of $800 per year on health insurance costs, according to the US Department of Health and Human Services.

Last year, for the first time in history, Medicare began using the leverage power of its large patient pool to negotiate fair prices for drugs. Medicare is no longer accepting whatever drug prices that pharmaceutical companies demand.

Negotiations began on ten of the most widely used and expensive drugs.

Among the ten drugs selected for Medicare drug price negotiation were Eliquis, used by 3.7 million Americans and Jardiance and Xarelto, each used by over a million people. The ten drugs account for the highest total spending in Medicare Part D prescription plans...

How are all these cost-savings being paid for?

The government is able to pay for these benefits by making sure the biggest corporations in America are paying their fair share of federal taxes.

In 2020, for instance, dozens of American companies on the Fortune 500 list who made $40 billion in profit paid zero in federal taxes.

Starting in 2023, U.S. corporations are required to pay a minimum corporate tax of 15 percent. The Inflation Reduction Act created the CAMT, which imposed the 15% minimum tax on the adjusted financial statement income of any corporation with average income that exceeds $1 billion.

For years, Americans have decried the rising costs of health care—but in the last three years, there are plenty of positive developments.

-via Good News Network, February 25, 2024

[dontmean2bepoliticalbut]

HOW CHRISTIANITY SUPPORTS MULTIRACIAL, MULTICULTURAL DEMOCRACY

'The Bible doesn't mention abortion or gay marriage, but it goes on and on about forgiving debt, liberating the poor, and healing the sick' — This pastor perfectly explained how the values expressed in Christianity can support a multiracial, multicultural democracy instead of right-wing extremism (via jamestalarico on TikTok)

#christianity #religion #democracy

[bigmammallama5]

I call monthly to fill my ADHD meds and because it is so controlled I'm legally not allowed to get extra (context: I am currently on the branded because I've met my deductible for the year (surgery) and the generic isn't in my pharmacy).

The pharmacy places a refill for the generic. The generic is still widely out of stock and won't get in for weeks. I call to ask if they can switch it to branded, they have done so in the past. I cannot, it is so controlled I have to get a new prescription. I get a new order and for the next three months I'm okay. I forget the headache and then it's time for a new set of three months and I hope my provider has sent in the branded request. The pharmacy places a refill for the generic. The generic is still widely out of stock and won't get in for weeks.

[longreads]

Unknown Costs

“Addicts and alcoholics cannot prove their need for treatment by requesting it. They’ve gotta bleed and pee for it. And even that might not be enough.”

A powerful new Longreads essay on addiction recovery is out today. Take some time to read it here. 

[reasonsforhope]

"Sanofi on Thursday said it’s planning to cut the U.S. price of its most popular insulin drug by 78% and cap monthly out-of-pocket costs at $35 for people who have private insurance starting next year. 

In addition to its widely prescribed Lantus, the French drugmaker will reduce the list price of its short-acting insulin Apidra by 70%. Sanofi already offers a $35 monthly cap on insulin for uninsured diabetes patients.

The company is the last major insulin manufacturer to try to head off government efforts to cap monthly costs by announcing its own steep price cuts for the lifesaving hormone. 

Eli Lilly and Novo Nordisk made similar sweeping cuts earlier this month after years of political pressure and public outrage over the high costs of diabetes care. The three companies control over 90% of the global insulin market. 

... The change takes effect Jan. 1.

President Joe Biden’s Inflation Reduction Act capped monthly insulin costs for Medicare beneficiaries at $35, but it did not provide protection to diabetes patients who are covered by private insurance.

Sen. Bernie Sanders, a Vermont independent and the chairman of the Senate Health, Education, Labor and Pensions Committee, introduced a bill earlier this month that would cap the list price of insulin at $20 per vial.

Both the president and Sanders on Tuesday directly called on Sanofi to slash its prices after Novo Nordisk announced its own cuts that day.

Roughly 37 million people in the U.S., or 11.3% of the country’s population, have diabetes, according to the Centers for Disease Control and Prevention. Approximately 8.4 million [U.S.] diabetes patients rely on insulin, the American Diabetes Association said."

-via CNBC, 3/16/23

[omg-snakes]

Do you know if there are ways to know if a snake from a pet shop has been properly taken care of or not? Asking since i've been visiting some and i saw one with a boa that had some kind of sinking or deformity on his tail, so i'm kinda wary now.

Hello, friend! I'm sorry to tell you that there is not.

I've worked in multiple areas of the pet industry and I've met the full gamut of types of shop owners, and while I don't consider all of them wicked people, some certainly are. Even the best of them have a bottom line to consider. This means that they won't divulge where their animals are coming from so that you can look into a breeder before making a choice, and they're likely buying animals from backyard breeders or bulk importers. This also means that it's unlikely that the animals they're selling will have established health histories.

Having worked at one of if not The biggest reptile chain in Northern California, I saw some horrors that scarred me for life. Among the lesser sins that took place there:

Folks who bred reptiles but didn't have incubators set up could bring their eggs in for incubation services, the price of which was half of the clutch, and the store owner would then sell the resulting babies as "born on-site," which was technically true! But we didn't know the parentage or health potential of any of these animals. We didn't sell incubators in the store for this specific reason.

Surrenders came in regularly from owners who didn't have the time or resources to care for their pets any longer. They went on the sales floor with a price tag the second the previous owner walked out the door. No veterinary care, no health evaluation, no observation period, nothing. If they looked okay they were priced at regular retail price and we were explicitly told to never admit that they had been surrendered. 100% profit.

Any animal that was injured or sickly, no matter where it came from or how it got injured, was tagged as a "surrender" that we would claim was dropped off by a bad former owner and we'd had them cleared by a vet so that we could rehome them. This was a lie. None of them ever got veterinary care, ever.

Enclosures were cleaned regularly but were never properly sterilized between animals. We sold veterinary-grade cleaner in the store but we were not allowed to use it because it was too expensive. We used diluted Lysol!

Again, this is a large reptile chain with multiple stores and mostly positive online reviews* and I wouldn't trust them with a pet rock, let alone anything breathing.

You're much better off getting a snake from a reputable breeder, or at least someone who can answer reasonable questions about feeding, parentage, genetics, any possible health issues, etc.

*the owner actually reported negative reviews and would have employees write good ones while I was there.

[hijinxinprogress]

Coffee addict Never sleeps Tim drake ❌ 

Solving cases in his sleep off 87 energy drinks Tim Drake ✅

The coffee addict never sleeps perpetually tired Tim Drake thing is a widely accepted headcanon however that was elementary school tim but after he stayed up for a week straight subsisting entirely on coffee to decipher the bat weekly patrol schedule and how it aligns with rogue attacks/Arkham breakouts, he crashed then when he woke up it was fucking wednesday so he missed his chance to commemorate his discovery with pictures of Robin and he decided that shit would never happen again and made himself an ‘efficient’ sleep schedule so he could run around doing fuck shit, add to his robin shrine, and stay on honor roll bc he was even more pissed to see the gotham gazette had pictures of Robin with an on site interview credited to Vicki Vale (listen bowl cut tim had a one sided beef with vicki vale that included tim judging who gets better pics of the bats but she isn’t even aware that she’s competing with a whole ass child 😭 he’s sitting at the table with a mug of orange juice and looks at the newspaper snorts and goes ‘fucking amateur I could do better’) 

Regularly unsupervised tiny businessman in training Tim ‘Ten hours of uninterrupted sleep?? That’s so inefficient not to mention fucking stupid’ Drake is so pissed he missed getting shots of Robin dropkicking a rogue from 6 six stories up (for absolutely no reason dick just thinks it’s fun) that he just takes at least 3 hour naps every eight hours 😭 he refuses to spend almost half a day sleeping ‘for no reason when he could be doing something productive’ 

And he still does this as a bat but it’s just easier to tell if he didn’t take his nap bc he has less than zero impulse control and he’s just fucking done with everything like the gcpd is terrified bc tim’s saying shit like ‘This guys a fucking moron, I could’ve done this in half the time without killing anyone fucking loser doesn’t he know if you keep them alive you can prolong the torture?’ and ‘you’re like all hysterical and for what 🤨 ‘you blew up 83% of Bristol waah’ stfu and fucking rebuild it?? It’s only rich mfs that live there, it’s just a matter of them opening their fucking wallets’ once a new recruit made the mistake of asking if robin had adult supervision regularly and Tim responded with ‘well if you’re gonna snitch to cps like a little bitch then yeah’ and that cop did snitch so tim fucking doxxed him

Yj has just accepted that sometimes they will find tim in an air vent, on the roof, in one of their closets, or something just fucking knocked out then an alarm will go off and he’ll just get up like nothing happened but for the first couple of months they were probably concerned bc ‘I’ve never seen you sleep?? wtf are you on man’ and Tim’s confused bc ‘I slept next to you this morning wdym??’ and that’s how yj discovers tim sleeps with his eyes open

But one of the worst things about Tim’s ‘time efficient sleep schedule’ nonsense is that it fucking works he’s one of the most well rested and coherent bats even after back to back Arkham breakouts however the absolute worst thing about his sleep schedule is the likelihood of going into the cave and seeing tim staring in a daze but wide eyed yet somehow never blinking at the batcomputer with 57 tabs open on top of being unresponsive and thinking he has a fucking concussion or he’s been replaced but he’s just doing case work while muttering nonsense in his fucking sleep for some reason

[whatiswhump]

Daily injections, whumpee wished they didn’t flinch. They know they shouldn’t be scared of them, they’ve had much worse.

But each time the skin has to be swabbed with alcohol and that smell fills their nostrils, whumpee freezes up.

[insurance-professionals-arizona]

Understanding Commercial Prescription Drug Insurance | Insurance Professionals of Arizona

One area of healthcare that can be the most expensive for consumers, but which we don’t really think about, is the price of prescription drugs.

Last year when my father-in-law was diagnosed with a form of leukemia. The type of leukemia that he had is very treatable with daily medication, which was great news.

Then he found out that his prescription for his illness would cost $5000 per month. No matter how bad you need medicine, few of us can afford a $60,000 yearly price tag for our prescriptions.

In fact, according to a 2018 Consumer Reports survey of 1,200 adults taking prescription drugs, many Americans report that in order to afford their prescriptions, they have to cut back in other areas of the budget, like groceries.

Some people even decide to delay their retirement plans because of the cost of the prescriptions.

The Consumer Report survey found that many others change the use and amounts of their prescriptions to save money. The report found that:

30% did not fill a prescription

20% switched to a supplement, over-the-counter medication, or an alternative treatment

18% took expired medication

16% did not take the drug as scheduled

15% cut pills in half without a doctor’s approval

You never want to be in a position where you have to compromise your health because of your budget concerns. The best way to prepare for these kinds of unexpected bills related to prescription drug costs is to have a commercial prescription drug insurance policy.

Because commercial prescription drug insurance is often combined within your health insurance policy we will address everything you need to know about health insurance in general before talking specially about prescription drug coverage.

In this article, we will talk help you understand the components of commercial health insurance and the options that are available to you, as well as discuss the role of the prescription drug insurance portion of that policy and how to protect yourself and your family from large healthcare costs and prescription drug bills.

WHAT IS COMMERCIAL HEALTH INSURANCE?

Private insurance companies offer commercial health insurance policies that offset the out-of-pocket costs that consumers have to pay for healthcare services, which include hospital costs and doctor visits, treatment, tests and labs, and in many cases, prescription drugs as well.

Policyholders pay a monthly premium that funds these policies.

After a consumer pays a premium they will pay an agreed portion of their healthcare costs and the insurance company will provide coverage for the rest.

Often employers will offer group health insurance policies as a benefit to their employees. Employers often cover part of the premium’s cost for their employees. Nearly 50% of Americans get their health insurance through an employer.

However, you can also purchase health insurance as an individual if you do not receive a health insurance benefit through your employer or you do not qualify for government insurance benefits.

Insurance carriers are regulated by federal and state laws and requirements. This means that commercial health insurance providers and policies will vary by state.

Some providers will only work in certain states, and keep in mind that the policies offered by national companies tend to vary by state to meet to each state’s particular requirements.

HOW DOES COMMERCIAL HEALTH INSURANCE WORK?

When you buy a commercial health insurance policy, the idea is to protect yourself from exorbitant or catastrophic health costs. You want to choose a plan which covers the services you need and has a monthly premium you can afford.

Keep in mind that in addition to your monthly premium, many plans also have a deductible.

This is the amount of money your have to pay first towards you healthcare costs in that calendar year before the insurance will pay its share.

When choosing a plan, consider both the premium and the deductible amounts.

A lower premium is typically offset by a higher yearly deductible, and vice versa. The amount of your annual deductible will usually be listed on your insurance card.

The exact healthcare services and costs covered by your commercial health insurance will vary depending on the policy you choose, but in general, commercial health insurance pays for a significant portion of the covered person’s medical expenses.

Most qualifying expenses include routine doctor visits and medical care, inpatient hospital stays, emergency services, mental and behavioral health, substance abuse treatment, and preventive care.

Preventive care is performed regularly to detect or prevent health issues early, so they can be avoided or treated before they become more serious. Most commercial health insurance policies cover these preventive services at no cost to the patient.

Preventive care is performed regularly to detect or prevent health issues early, so they can be avoided or treated before they become more serious. Most commercial health insurance policies cover these preventive services at no cost to the patient.

Elective procedures that are not deemed “medically necessary” by the carrier or a physician, generally are not covered.

When you have a commercial healthcare insurance policy and you see a doctor, the office will submit a claim for the care provided to the insurance company.

The insurance company will directly reimburse the doctor for their work and pay the covered amount of the bill. If a balance remains after the insurance company has paid its portion, you will be billed for it.

Most insurance carriers have contracts with specific providers, so the insurance policy will generally cover a larger portion of the overall cost if you visit a doctor who is within your insurance provider’s network.

WHAT IS COMMERCIAL PRESCRIPTION DRUG INSURANCE?

Commercial prescription drug insurance is a policy that is designed to cover part of the cost of medications prescribed by a doctor, and which are filled by a pharmacy.

Most commercial health insurance plans already include commercial prescription drug insurance as part of the policy.

However, there are plans which just cover prescriptions that can be purchased separately if your policy does not provide prescription coverage. These stand-alone prescription drug policies are offered by large commercial health insurance providers.

Just as with health insurance plans, the policyholder will pay a monthly premium for their commercial prescription drug insurance. Additionally, most plans also have an annual deductible, and a co-pay is charged based on the type of drug prescribed.

Insurance providers prefer to have prescriptions filled with generic drugs, which cost the least if they are available. When you opt for a prescription at a lower tier, your co-pay will be smaller. Name-brand drugs typically cost more, especially if a generic version is available.

HOW CAN I MAKE SURE I HAVE THE RIGHT COMMERCIAL PRESCRIPTION DRUG COVERAGE?

As you can see, there are lots of ways to meet your personal healthcare insurance needs. Not every policy will work for every consumer or every family. Your personal healthcare needs and conditions will play a factor in your decisions about your coverage.

Buying policies vary greatly in terms of premium price, deductible, and co-payments. A careful evaluation of all your options in terms of your personal situation is the best way to make sure you have the right commercial healthcare and prescription drug coverage.

At Insurance Professionals of Arizona, we have decades of experience in health insurance and we can assess your personal needs to get you the best policy at the best price. This is our specialty.

There is an old saying that you don’t need insurance until you need it. Don’t wait to get the healthcare insurance and prescription drug insurance you need until after you receive a challenging diagnosis.

At IPA, we want you to be prepared for anything so that you can have the peace of mind and financial security you need to fully enjoy your life.

We’re here to help. Contact us today or fill out an interest form here on the website and we will get in touch with you. Let our expert brokers help you get properly protected today. Call us Today (480-981-6338)

[pngblog]

I hope your headache gets better! 🩷 If it's not much trouble could I suggest the Lykoi cat breed?

[millerflintstone]

This month into next month is going to be busy for me at work. The main executive at the state office has been sending me some urgent report requests which I've been handling.

She sent one at 4:40 ish EDT yesterday. When I went to check to see if she was still online, I saw that she wasn't. I was working on something else for her so I figured I'd just reply in the morning that I got it and would work on it next.

My boss sent me a Teams message seeing if I could take a call (I love that, btw. I hate random Teams calls with no warnings). Seems that the exec texted her asking if I had gotten her urgent email and wanted my phone number.

I am SO HAPPY my boss didn't just give her my cell. The only number on my signature is my Teams phone, which would've been fine. I let my boss know that the exec didn't mark it as urgent, so I had no idea it was another urgent one. I let my boss know what I mentioned above and she understood. My boss said she'd reply to her text letting her know I was aware and would reply to the email, which i did.

My boss was exasperated. "Boy, I tell ya, she is all over the place today!" but she stopped herself. It was enough venting to let me know she wasn't happy about the situation but she remained professional.

This is a way different experience than when the head of one department just gave my cell number to a vendor who tried to get me to join a meeting after I logged off for work. That story is here (x) and happened during my two weeks for leaving the hell TX job.

The gist of the video is that the department head wanted manual corrections to things that should not have been manually corrected and was not part of my job. My boss at the time tried to back me up and the department head/ director looped in the CEO, CFO and some other c suite person. So glad I'm not there anymore

[doulayogimama]

My SIL has been raving about a RX drug for nausea during pregnancy since I was pregnant with Sky. My doctors at the time told me no. I was too stupid to push them, thinking they knew best.

Dumb, sadistic fucks. My SIL found her old bottle from her pregnancy last year. You can take up to 3-4 per day. I took 1 today and my life feels forever changed. If I could truly have an experience where I only get sick every few days instead of 12x per day… that would be a miracle. I can’t even imagine the miracle of not getting sick at all but I guess it’s possible.

I was down all day yesterday. I couldn’t stand for more than 10 minutes, took my first pregnancy nap (I don’t nap). Today I felt the same so my SIL went to rummage through her stuff. It’s been 4+ hours since I took 1 pill and I still feel 90% better than yesterday. I got to be outside with the kids and play a bit with them as they ran around the yard in bathing suits.

This is AMAZING. Thank you, drugs. 🫶🏽

[thoughtportal]

undefined

price gouging medication that was paid for by tax payers

[justinspoliticalcorner]

John Whitehouse at MMFA:

Project 2025 is a comprehensive transition plan organized by right-wing think tank The Heritage Foundation to guide the next GOP presidential administration. Its lengthy guidebook, Mandate For Leadership, lays out a legislative proposal that would upend Medicare as we know it, pushing seniors onto privately run Medicare Advantage plans instead of traditional Medicare.  This proposal comes even as Medicare Advantage plans have struggled, plagued by falling stock prices, overpayment, and treatment delays. Meanwhile, Project 2025 also calls for undoing prescription drug reforms included in the Inflation Reduction Act.

The difference between traditional Medicare and Medicare Advantage

As long as Medicare and Social Security have existed, there have been right-wing pushes for privatization.  A private component — Part C of Medicare, now known as Medicare Advantage — was created as part of the Balanced Budget Act of 1997. Contemporaneous reporting shows that Democrats and the AARP disapproved of the effort to partially privatize Medicare because of the high user costs that would be associated with it. The reason for those high costs is that Medicare Advantage allows private insurance companies to make a profit providing Medicare benefits to seniors.  AARP explains that regular Medicare has three parts: “Part A (hospital care), Part B (doctor visits, lab tests and other outpatient services) and Part D (prescription drugs).” Part C is Medicare Advantage, which is “essentially” like “joining a private insurance plan like you probably had through your employer.” [...]

Project 2025 wants to make Medicare Advantage the default option for all seniors

Given all of these serious issues, it's alarming that Project 2025's proposal is to make Medicare Advantage the “default” selection for all seniors. Project 2025 calls for encouraging “more direct competition between Medicare Advantage and private plans" and says “critical reforms are still needed to strengthen and improve the program,” claiming that it provides a “richer set of benefits than traditional Medicare provides and at a reasonable cost.” [...]

Project 2025 also wants to roll back the federal government’s ability to negotiate lower drug prices

The Medicare section of Project 2025’s policy book also calls for rolling back reforms included in the Inflation Reduction Act of 2022 to negotiate lower prescription drug prices.

Project 2025’s plans to upend Medicare as we know it should set off alarms.

[anonymusbosch]

LOVE mass production of common and vital drugs. penicillin my beloved. ibuprofen my dearest. literally the way i would not be here without you