We know firsthand about the importance of your overall health and its impact on health insurance coverage options and costs. One thing we can all do to contribute to community well-being is to keep our Connecticut shoreline a clean place to enjoy recreation, exercise and uphold our mental health by being outside and with others. To that end, our cities and towns have extensive programs in place to keep waste out of the Long Island Sound by recycling not just glass and plastic, but many of the household goods we throw out in abundance. Of course, donating or freecycling reusable items such as clothing and furniture is best. But when that’s not an option, we’ve prepared a handy chart highlighting some of our local recycling centers and events. Here’s to clean waters and trash-free parks! Take a look here.
IMPORTANT MEDICAID UPDATE
During the pandemic, Connecticut extended health coverage for most Medicaid members enrolled on or after March 18, 2020, even if they no longer qualified, a process the federal government calls Continuous Enrollment. As of March 31, 2023, Connecticut began “Unwinding” Continuous Enrollment. That is, they resumed the process of reviewing households for eligibility.
HUSKY Health renewal forms are being distributed (to ~45,000 households per month) on a staggered basis over 12 months based on how long eligibility has been extended. Notifications are sent from the Department of Social Services 45 days prior to renewal time — first electronically and, if no response is received, pre-filled forms are mailed.
If you are concerned about your eligibility or need assistance understanding your HUSKY Health renewal, please speak with Curtis or Mark. For more information about the unwinding process and your benefits, please click here.
Looking Ahead: Updates to 2024 Medicare Advantage Program and Part D Payment Policies
In an effort to ensure that Medicare Advantage and Part D drug programs remain strong, fair and viable, the Centers for Medicare & Medicaid Services (CMS) has ruled on commonsense updates for next year. Some abbreviated highlights:
Medicare Advantage
Guidelines are clarified to ensure equal access to medically necessary care as with Traditional Medicare.
When coverage criteria are not fully established, organizations may create internal coverage criteria based on current evidence in widely used treatment guidelines or clinical literature made publicly available.
To promote more transparent, clinically-based decisions, circumstances are explicitly stated under which plans may apply internal coverage criteria when making medical necessity decisions.
Part D
Cost-sharing will be eliminated for beneficiaries in the catastrophic phase of coverage.
The Low-Income Subsidy program (LIS) will be expanded.
Plans must not apply the deductible to any Part D-covered insulin product and must charge no more than $35 per month’s supply in the initial coverage phase and the coverage gap phase.
The annual growth in the Base Beneficiary Premium will be capped at 6 percent.
We will continue to provide updates as rulings change that could impact your existing overage or future Medicare decisions.
Source: cms.gov
Inflation Reduction Act: Extending Relief for Marketplace Insurance Premiums
Our non-Medicare clients and friends may also benefit from the Inflation Reduction Act as it extends—through 2025—the financial help for premiums on Healthcare.gov and state-based Marketplaces (such as Access Health CT). These supports were initially made available through the American Rescue Plan of 2021 and would have expired at the end of 2022. On average, consumers are saving over $800.*
If you need help understanding your Marketplace health plan options, benefits and associated costs, please speak with Curtis or Mark.
*Source: CMS.gov
Inflation Reduction Act: Key Dates for Medication Price Reductions
Provisions of the Inflation Reduction Act of 2022 will favorably impact prescription drug prices and other healthcare costs for Medicare participants. While it will take several years to realize the full benefit of the law (including the $2,000 cap on total out-of-pocket drug costs in 2025) there are a number of immediate changes in 2023 that will relieve seniors of some of the burden of Part D costs:
- Covered insulin copays are capped at $35 for a 30-day supply.
- All vaccines approved by the CDC Advisory Committee are fully covered, most notably the shingles vaccine.
- Drugmakers who raise their prices more than the rate of general inflation will have to pay Medicare a rebate for the amount of their price increases above the rate of inflation.
- By September 1, the Centers for Medicare & Medicaid Services (CMS) will publish the first 10 Medicare Part D drugs selected for the Medicare Drug Price Negotiation Program.
For more details on the Inflation Reduction Act Medicare drug prices negotiation calendar read here.
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