A Few MEDICARE UPDATES

I hope all is well in your world!

We’ve posted some articles about Medicare and their policies concerning this new outbreak. Now, we have a few updates to add to those posts, as every day seems to bring a new bill or procedure. The words highlighted in blue lead you to links for further reading.

There’s not much to add, but they are improvements, therefore, worth mentioning. As changes occur, we will update accordingly.

TELEHEALTH- has now become available nationwide and available on more devices, such as smartphones. Also, HHS Office of Inspector General is providing flexibility for providers to reduce or waive cost sharing for Telehealth visits during the COVID-19 public health emergency, which means that some will not have to pay their normal coinsurance or deductible.

Check with your provider to verify their costs.

While Medicare beneficiaries are subject to their normal coinsurance and deductible in most cases, some providers are waiving these costs. Check with your doctor to verify.

Typically Medicare Part D plans place limits on the amount of medication people can receive at one time, and limits on the frequency with which patients can refill their medications. CMS has stated that in cases of national disaster or emergency declarations or public health declarations, it expects Part D plans to lift their “refill-too-soon” edits until the termination of the emergency declaration.

In light of the coronavirus pandemic, Part D plans (both stand-alone drug plans and Medicare Advantage drug plans) may be (but are not required to) relax certain requirements with regard to limits on extended day supply and “refill-too-soon” restrictions. Because refill rules vary across Part D plans, Part D enrollees would need to contact their pharmacist or plan to determine if they can get an extended supply.

According to CMS, for drugs covered under Part B, Medicare and its contractors make decisions locally and on a case-by-case basis as to whether to provide and pay for a greater-than-30 day supply of drugs.

If you have any questions, please feel free to contact us. We wish you all happy & healthy days!

All the best,

Randall J. Lawson

Owner/Agent

The HgO Group

803-851.0219 office

randy@thehgogroup.com

thehgogroup.com

National Producer Number #9276045