Prescription Health Insurance

In Japan, prices for every procedure and drug are negotiated every two years between the physicians and the government. The prices are fixed and the same regardless of where you go in Japan for treatment (Reid, 2008). In the United States, different healthcare plans offer a variety of coverage for medications but some prescriptions can be denied by the insurance company based on your type of insurance plan. Drug companies are very competitive in the United States and prices are expensive. Frequently, insurance companies might cover a similar or generic form of medication rather than the brand name medication and insurance co-pays differ depending on which drug is prescribed.

Within the formulary the drugs are divided into tiers. Co-payments are based on the tier that the drug is in and range from tier 1, the least expensive drugs, to tier 3 the most expensive drugs. Each insurance company plan is allowed to add or drop drugs from their formularies and move drugs from one tier level to another throughout the year. An insurance company can also drop a drug in the middle of the year, but must continue covering the drug for anyone taking it until the next reenrollment period, at which time a new plan will have to be chosen that covers that drug (Gustaitis, 2007). Although not used a lot there is a fourth tier that is for specialty drugs only. Some plans use a flat-rate or assign a percentage co-pay to the higher tier drugs (Gustaitis, 2007). Other characteristics of the insurance company plans that they have control over are requiring prior authorization for a drug, using step therapy, limiting the quantity, participating at certain pharmacies, and having preferred pharmacies (Gustaitis, 2007).

He is relieved to have access to the Medicare drug addition program. Although he feels strongly that the large pharmaceutical conglomerates of the world need to decrease the price of drugs. As a pharmaceutical company employee I informed him of the many programs available to help with the pharmaceutical cost of drugs. I do agree, the pharmaceutical companies need to continue working with those individuals in government, insurance companies and health care to provide access to affordable and novel compounds to all who need them. There are pharmacy and retailer prescription drug discount programs available. Discount drug cards are offered through chain pharmacies for a small monthly premium and provide discounts on a number of services, including prescription drugs. Individuals with a Part D plan may use a discount card, but the two drug programs operate independently of one another. Drug card discounts cannot be applied to Part

Cost has different perspectives depending on whom we are speaking about. Consumers refer to cost in reference to the price of healthcare, bills to insurance or payments to doctors directly. Nationally we refer to healthcare spending as a reflection of all healthcare spending that occurs in the nation and is normally measured in a percentage of the Gross domestic product or GDP. Provider costs are seen as the cost to pay staff, buying medical equipment and capital costs for buildings and the maintenance of the buildings infrastructure (Shi & Singh, 2005).

The passage of the Medicare Drug Price Negotiation Act will also inadvertently increase access to many types of medications for individuals who qualify for Medicare Part D. There is a clause within the bill that would establish rebates to be paid by pharmaceutical companies for low-income beneficiaries. These rebates, in addition to lowered costs, would considerably lessen the financial burden placed on low-income beneficiaries. This will allow more individuals greater access to expensive medications. As an example, each year, financial reasons hinder about 16% of diabetic Part D beneficiaries from filling at least one of their prescriptions (Williams, Steers, Ettner, Mangione, & Duru, 2013). This increase in access will help mitigate the occurrence of cost-related nonadherence to prescription medications, and other such consequences

: Insurance companies have the list of formularies that they agree to help cover but it is a tricky and a hassle to deal with. The patient must get a prescription of a similar drug first to make sure it works on them or even getting the doctor to prove that you need it. This is just to get coverage for an expensive drug. This can take weeks to do. It is a complicated list designed to give the patient the right drug for their conditions and that drug may not even be the first one that the doctor prescribes for them. It is a process to find out which one is right. When you fill a prescription of an approved drug of the formulary then you do not have to pay full price. Patients will have a copay through four different tiers. The first tier the patient pays a $20 copay on generic medications or a low cost medication, on the second tier, the patient pays a $40 copay for low cost brand names or a higher priced generic name drug. The third tier, the patient pays a $60 copay for brand name medication in which there is no generic, and the last and final tier which is number 4, the patient pays a $100 for the highest cost medication and/ or specialty drugs such as ones for chemotherapy. Some health care plan require the patient to pay full price for medication until they meet the deductible and then they can pay copays. Some formularies have coinsurance instead. The patient in these pays a percentage of

A person generally pays a premium for coverage in all such private and in some public

Part D decreases their out of pocket expenses for prescription drugs for a lot of people. Therefore, a great decrease is recognized by patients with extremely high annual expenses for prescription medication. Though, Part D cost patients with low income more then what they previously paid to its adoption when state Medicaid programs covered them. The legislation that established Part D forbids Medicare from negotiating lower prices with drug manufacturers. As a result of an increase in costs of prescription medications frequently passed to the benefit recipients (Mathews, 2006). The legislation are groups that influenced the final outcome of Medicare Part D.

When it comes to varies insurance companies such as Medicaid and Medicare insurance company pays very differently. Medicaid will pay for the patient medical billing and patient who has Medicare depending what they have if it’s Medicare plan A or B. There are very different and Medicare A will only covers inpatient care at a hospital, skilled nursing facilities, and hospice. For Medicare B will cover doctor’s visits, and any other health care providers services, outpatient care, durable medical equipment, home healthcare, and there are other services that it may cover. So what not covered by Medicare A and B they will have to pay out of pocket unless they have any other insurance that will pay the remaining. Healthcare providers can have a

On average I go to my primary doctor 3 times a year, visit an urgent care facility about 2 times a year, and am prescribed, on average, 3 prescriptions per year. However, in the event that I need emergency and urgent care services, outpatient or inpatient services, prescription drug coverage, preventative care services or to have imaging done, I am covered at no charge after the $500 deductible. Overall, anything could happen in the course of a year that costs more than $500 dollars and if it does happen, any other services after will be covered, as the out of pocket limit is $500; unless there is a fixed indemnity for a specific service.

One of the problems of Medicare itself is that it doesn't cover the costs of prescription drugs for its members; this has led to one of the major reasons that the program is in danger. A great deal of personal healthcare relies on the use of drugs, and since the program doesn't cover these costs, the individual must bear them. According to the AARP, in 1999 out-of-pocket costs for prescription drugs were estimated to be $450 per person each year (AARP). Obviously, members have joined the program to defray their medical costs, but these figures indicate that they still have large costs to pay. The other problem faced by the Medicare program is that it is also suffering from a lack of funds. According to Governor George W. Bush, the financial health of Medicare is in serious jeopardy and might face deficit as soon as 2010 (Bush). As a result of these major problems, one might wonder why the plan isn't scrapped for another program; well according to polls done by the Public Agenda, an Internet public policy site, American citizens are strongly in favor of Medicare, and would rather see the problems ironed out (Public Agenda). Therefore it is necessary to come up with a solution, so that the Medicare program remains intact.

So, make the best use of it, by surfing thoroughly to filter the best insurance firms. Shop around for the right level of insurance protection at the right price. Also, check the websites of the service providers to get the complete details of their myriad range of services. Before buying a green slip, read all the details of the contract properly. Check whether the numbers are same as given in the quotes. For assurance, read online reviews of the people who have purchased these policies.

And of course, compare policies from different insurance companies. Sometimes offer of a certain company may have deficiency of few hundreds of dollars each year from another company. You can compare by obtaining quotes from several or more insurance companies whether through online or via the local insurance agency. Also, ask for a quote on insurance for various types of cars as most companies offer different insurance rates for each.

One factor which affects your car insurance is the type of car. If you want to get cheap car insurance then you would definitely want to be driving around in a car which is either secondhand or not too expensive. Cars which you should not go for include muscle, sports and classical cars. These types of cars tend to have high expenses when they are manufactured therefore they will also cost a lot when they need to be repaired. An ideal car model should be one which has a low rate of car accidents.

Alternatively, you can hire a broker to help you in this process. Brokers are in a position to help in the online cover policies. These experts don’t work for a particular Company. They are in a better position to discern genuine and fake insurers.