Aetna Medicare gets new Pharmacy Benefits Manager

New Pharmacy Benefits Manager (PBM) for Coventry, Altius, HAPA and First Health Part D members In 2016, members of Coventry, Altius, HAPA and First Health Part D plans have a new Pharmacy Benefits Manager (PBM). A PBM manages their prescription drug benefits on behalf of our plan. In 2015, the PBM was Express Scripts (ESI). In 2016, the PBM is CVSHealth. …

NY Medicare Advantage plan closes

Effective Jan. 1, 2016, Touchstone Health HMO, Inc. in New York will no longer be offering coverage of Medicare Advantage benefits in the following service areas: Bronx, Queens, Kings, Richmond, New York, Westchester, and Orange counties. Approximately 10,000 Touchstone Health HMO enrollees have the opportunity to return to Original Medicare and could be in the market for a new Medicare Supplement …

Changes to Medicare 2016

The headline this year may be that Medicare will pay for end-of-life counseling.  “So far, the 2016 change getting the most attention is that Medicare will pay clinicians to counsel patients about options for care at the end of life. The voluntary counseling would have been authorized earlier by President Barack Obama’s health care law but for the outcry fanned by …

Medicare Copays announced for 2016

2016 MEDICARE PART A   Part A is Hospital Insurance and covers costs associated with confinement in a hospital or skilled nursing facility.   WHEN YOU ARE HOSPITALIZED FOR: MEDICARE COVERS   YOU PAY   1-60 DAYS   Most confinement costs after the required Medicare deductible $1,288 DEDUCTIBLE     61-90 DAYS   All eligible expenses after patient pays a …

Medicare Premiums to rise, but no cost of living increase this year!

New Medicare Beneficiaries, and high earners, are going to get hit with substantially higher premiums.  Those currently on Medicare that are not high-earners will continue to pay $104.90 this coming year.  New Medicare Beneficiaries will pay $159 in 2016. From the Wall Street Journal “The rise in premiums seems increasingly likely because the Social Security Administration is expected to announce …