5/19/2023 0 Comments Xarelto copay card![]() The share of people who chose bronze plans grew from 23 percent in 2017 to 29 percent this year, says Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation. A smaller percentage of bronze plans offer limited visits at no cost or low cost before the deductible is met. Only 38 percent of bronze plans offer any primary care coverage before the deductible, and generally patients still have to pay a copayment or coinsurance amount. Beyond that, many marketplace plans cover some services before you reach your deductible - such as some primary care visits or generic drugs.Ī small number of plans offer a limited number of no-cost or low-cost visits first, and then people using more services either have to pay the full charge for each visit or must share at least part of the cost until the deductible is met.īronze plans for 2018 are much stingier than silver plans in how much they'll contribute to payments for primary care before people their deductible - the median deductible in 2018 plans is $6,400. Under the Affordable Care Act, marketplace plans are required to cover many preventive services, including an annual checkup, without charging consumers anything out-of-pocket. Is that typical now? It makes me think twice about going. This year, it doesn't cover any appointments before the deductible, and I had to pay $80 out-of-pocket when I went to the doctor. Last year, my marketplace plan covered five primary care visits at no charge before I paid down my $2,200 deductible. There's also a hitch for any patient using the coupons, Ross points out: The discounts often have annual maximums that leave patients on the hook for the entire copayment after a certain number of months. If patients choose to use the coupons to buy a higher-cost drug over a generic or other cheaper alternative, the cost to Medicare and other federal health programs is likely to be more than what they would otherwise pay. Under the federal anti-kickback law, it's illegal for drug manufacturers to offer any type of payment that might persuade a patient to purchase something that federal health care programs like Medicare and Medicaid might pay for. The explanation may offer you little comfort. Why can't I use a $5 drug copay coupon from the manufacturer? If I had commercial insurance, I could. My doctor wants me to take Repatha for my high cholesterol, but my Medicare drug plan copayment for it is $618 a month. We have answers to these health care questions that may have been worrying or frustrating you, too: One reader suspects a double standard - how come people with private health insurance are allowed to use a manufacturer's discount coupon for medicine, but Medicare patients can't? Another consumer wonders what ever happened to cost-free primary care appointments. But health care analysts say the coupons may also discourage patients from considering appropriate lower-cost alternatives, including generic drugs. Patients with private insurance like the drug coupons because they can help make specialty medicines more affordable.
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