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Medicare Prescription Payment Plan

somarco

GA Medicare Expert
5000 Post Club
36,929
Atlanta
For the first time, beginning in 2025, the prescription drug law, known as the Inflation Reduction Act, requires all Medicare prescription drug plans (Medicare Part D plans) — including both standalone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage — to offer enrollees the option to pay out-of-pocket prescription drug costs in the form of capped monthly payments instead of all at once at the pharmacy.



Above information posted for agents who are not too busy selling and are willing to take a few minutes for education that could help them better serve their clients and prospects . . .
 
This is a recipe for disaster.....insurance companies becoming debt collectors for out of pocket Rx costs. What could go wrong lol

I don't disagree.

The first thing that stopped me in my (reading) tracks was the reference to "plan sponsors" (presumably PDP carriers although it possibly entangles the pharmacy as well) shouldering the responsibility for "stretching out" the MOOP rather than requiring the insured to pay up front.

This alone can create not only a funding issue but bookkeeping nightmare as well.
 
I don't disagree.

The first thing that stopped me in my (reading) tracks was the reference to "plan sponsors" (presumably PDP carriers although it possibly entangles the pharmacy as well) shouldering the responsibility for "stretching out" the MOOP rather than requiring the insured to pay up front.

This alone can create not only a funding issue but bookkeeping nightmare as well.
Yeah. Loads of issues as I see it.....this is one of those government "this looks like it might work on paper (and be a vote winner)" But has clearly not been thought out.....
 
I don't disagree.

The first thing that stopped me in my (reading) tracks was the reference to "plan sponsors" (presumably PDP carriers although it possibly entangles the pharmacy as well) shouldering the responsibility for "stretching out" the MOOP rather than requiring the insured to pay up front.

This alone can create not only a funding issue but bookkeeping nightmare as well.

And when the "plan sponsor" is overpaid, I'm sure the Medicare beneficiary will be happy to wait 6-8 weeks for a refund, or longer. And who are they calling when it's taking forever? The agent of course.

(I haven't read the material yet so I don't know if this is addressed)
 
Trust y'all to see this as a bad thing..
Imagine the calls from clients calling because xyz insurance company keeps calling them, harassing them etc etc, because they missed their Rx payment....... "I ain't paying them nothing they can go......".

They will love it because they get it "free" at the pharmacy.....they will hate the bill that comes after it.

It also places a lot of responsibility on the carrier to fund someone's meds for a year in the promise that they get paid back......we all know how this will end :)
 

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