Campaign begins for Medicare drug coverage
Competition Is heating up among insurers, pharmacy benefit managers (PBMs) and health plans as they ready major marketing campaigns to attract and enroll thousands of seniors in Part D Medicare prescription drug plans (PDPs). Insurers are offering hundreds of stand-alone and Medicare Advantage prescription drug plans (MA-PDs) in every region of the country, many promoting lower costs as a way to build market share.
Competition Is heating up among insurers, pharmacy benefit managers (PBMs) and health plans as they ready major marketing campaigns to attract and enroll thousands of seniors in Part D Medicare prescription drug plans (PDPs). Insurers are offering hundreds of stand-alone and Medicare Advantage prescription drug plans (MA-PDs) in every region of the country, many promoting lower costs as a way to build market share.
The official Part D marketing period begins Oct. 1, with enrollment starting Nov. 15. The Centers for Medicare and Medicaid Services (CMS) has dubbed this the "beneficiary decision" phase (October 2005 to December 2005) when all seniors can enroll in a drug plan. Even MA plan members who have been receiving drug coverage through their plans will have to re-enroll in a MA-PD plan or a stand-alone Part D plan by May 2006 or face penalties if they want to sign up for drug coverage later on.
POSITIVE PROMOTION
This will change after Oct. 1, as MA plans begin promoting their options on the basis of:
The low-cost bids from PDPs and MA-PDs is encouraging optimism among Medicare officials that many seniors will sign up for Part D. Enrollment was disappointing for Medicare drug discount cards, as well as an interim pilot offering coverage for oral cancer drugs. CMS is working hard to simplify plan selection and enrollment processes, but it most likely will take at least three years for Part D to prove its value.
Jill Wechsler, a veteran reporter, has been covering Capitol Hill since 1994.
David Calabrese of OptumRx Talks New Role, Market Insulin Prices and Other Topics 'On His Mind'
April 13th 2023In this month’s episode of the "What's On Your Mind podcast," Peter Wehrwein, managing editor of MHE connects with the now Chief Clinical Officer of OptumRx Integrated Pharmacies, David Calabrese. In this conversation, David touches on his transition in January as OptumRx’s former chief pharmacy officer and market president of health plans and PBMs to his new role as Chief Clinical Officer where he now focuses more on things such as specialty pharmacy to home delivery — with an overall goal of creating whole-patient care. Throughout the conversation, Calabrese also touched on the market’s hot topic of insulin prices and behavioral health services within the OptumRx community, among other topics.
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Briana Contreras, editor of Managed Healthcare Executive, spoke with Nancy Lurker, CEO and president of EyePoint Pharmaceuticals. Nancy shared a bit about EyePoint and how the organization’s innovative therapies are addressing patient needs through eye care, and most importantly, she addressed C-Suite positions like the CEO role. Nancy shared advice for those seeking to reach the CEO level, especially toward women in healthcare and other roles, and what it takes to run a biopharma company.
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