Figure 5: Standard Medicare Prescription Drug Benefit, 2016

2015 UA Prescription Benefit

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  • CMS Prioritizes Customer Service to Our Beneficiaries and Our Partners
    As always, customer service is a priority at CMS to ensure beneficiaries and our partners are given accurate, timely information. With implementation of a brand new part of Medicare, CMS understands that people with Medicare, their families, doctors, and pharmacists will have questions about the new Medicare drug benefit. CMS' 1-800 MEDICARE Call Center has customer service representatives (CSRs) available to answer Medicare questions 24 hours a day, seven days a week with assistance in English and Spanish and many other languages as well. CMS' helpline and have served as critical tools for beneficiaries, caregivers, and enrollment assistance centers to sign up for the prescription drug benefit.

    Universal Rx is committed to improving both pharmacy benefits and overall medical conditions for all Clients’ plan members. A leader in pharmacy benefit management, Universal Rx has developed sophisticated and proprietary pharmacy data management tools to enhance overall benefits at the lowest possible cost. With our extensive experience in managing pharmacy benefits, Universal Rx captures and evaluates data on every prescription benefit encounter to provide a comprehensive illustration of drug utilization trends in the industry. Through optimal plan design, Universal Rx can support clients’ efforts to achieve all of its pharmacy benefit plan goals for plan members. Universal Rx uses pharmacy data management to provide sophisticated reporting mechanisms aimed at:

  • Universal Rx is committed to improving both pharmacy benefits and overall medical conditions for all Clients’ plan members. A leader in pharmacy benefit management, Universal Rx has developed sophisticated and proprietary pharmacy data management tools to enhance overall benefits at the lowest possible cost. With our extensive experience in managing pharmacy benefits, Universal Rx captures and evaluates data on every prescription benefit encounter to provide a comprehensive illustration of drug utilization trends in the industry. Through optimal plan design, Universal Rx can support clients’ efforts to achieve all of its pharmacy benefit plan goals for plan members. Universal Rx uses pharmacy data management to provide sophisticated reporting mechanisms aimed at:

    CMS Applauds and Supports the Outstanding Work of Pharmacists
    Pharmacists are the linchpin of the prescription drug benefit and all over the country they have been tremendous in implementing the new program. Traditionally, the start of a new year is one of the busiest times for pharmacists with new enrollments occurring in commercial and government plans in January. With the launch of the new Medicare prescription drug benefit, the task facing pharmacists was an additional challenge and CMS applauds and supports their tremendous efforts. Pharmacists are working hard to meet the demands of the new program, and CMS will continue to provide them and their software vendors and support associations with the tools they need to serve their customers.

    MEDICARE MANAGED CARE

    • The number of beneficiaries with drug coverage through Medicare managed care has risen to 17 percent. Most Medicare managed care plans offer prescription drugs. Drug coverage is one of the major attractions for beneficiaries to enroll in these plans.
    • Drug coverage under Medicare+Choice is unstable. Managed care plans are not required to offer a drug benefit, but can do so with any excess Medicare payments or by charging a premium. This results in wide variation across areas, since payments vary by area, and over time.

    • The value of Medicare managed care drug benefits is declining. Nearly three-fifths of plans are reporting that they will cap prescription drug benefits below $1,000 in the year 2000. The proportion of plans with $500 or lower benefit caps will increase by over 50 percent between 1998 and 2000. This is part of a troubling trend of plans to severely limit benefits through low caps.
    • Plans dropping out of Medicare limit access to drugs. Nearly 80,000 Medicare beneficiaries will lose access to Medicare managed care next year as plans withdraw from particular areas or Medicare altogether.


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  • » How Prescription Benefits Work

    Access to affordable prescription drugs is just as important as the ability to choose your own doctor. That's why all of our health insurance plans include a prescription drug benefit. These prescription drug benefits vary depending on the type of health plan you choose.

Taking the risk out of your prescription benefit

An exclusive report from Reuters claims that the “largest U.S. managers of private prescription drug benefits” have severed ties with “at least eight” pharmacies who are in close contact with drug manufacturers. This, according to the report, has raised concern about a system that purportedly games drug prices.