Health Insurance

Broward County Launches Prescription Drug Discount Card Program

Broward County has launched a discount card program to help consumers cope with the high price of prescription drugs. The County is making free prescription drug discount cards available under a program sponsored by the National Association of Counties (NACo).
The cards may be used by all County residents, regardless of age, income, or existing health coverage, and at any participating retail pharmacy. A national network of more than 57,000 participating retail pharmacies also will honor the NACo prescription discount card, including most chain pharmacies and many independents. Cards can be picked up free of charge at many Broward County government facilities, including parks, libraries, transit facilities, the downtown Governmental Center and the County’s four Family Success Centers.
There is no enrollment form, no membership fee and no restrictions or limits on frequency of use. Cardholders and their family members may use the card any time their prescriptions are not covered by insurance. Unlike many other card programs, there is no enrollment cost or membership fee. The cardholder pays the negotiated discount price or the pharmacy’s retail price, whichever is lower. The average discount is 20 percent. Cardholders are eligible for higher discounts on a three-month supply of some medications through mail service. Cardholders also can save on pet prescriptions at participating retail pharmacies.
The program has a safety feature that alerts pharmacists when one drug may conflict with another medication the cardholder is taking, if the prescriptions were obtained with the NACo discount card.
The NACo discount card program remains a useful option now that Medicare Part D has been implemented. For example, the card can be used when a Medicare Part D plan doesn’t cover a drug. The program is administered by Caremark Rx, Inc., a leading pharmaceutical services company with broad experience in managing drug discount card programs for sponsoring clients. The program is available at no cost to Broward County taxpayers.

Why Devote a Month to Disability Insurance Awareness?

Many people have bought life insurance after giving serious thought to how their death might impact their families' living standards. Few, though, give the same level of consideration to disability insurance. Ironically, the typical worker faces a much higher risk of extended disability than of premature death. But for a variety of reasons, disability insurance remains one of the most overlooked and misunderstood forms of insurance.
Though disability is behind nearly half of all mortgage foreclosures and a significant number of personal bankruptcies, insuring against it has not been a high priority for most workers because many assume they're already covered through Social Security, state-mandated workers compensation or employer-provided group plans. However, there are numerous holes in this safety net of coverage.
Only about 39% of the 2.1 million workers who applied for Social Security Disability Insurance benefits in 2005 were approved. And those who were approved get an average benefit last year of just $938 monthly – hardly enough to replace the average worker's income. Workers comp covers only work-related disabilities, while 90% of disabling accidents and illnesses aren't work related. And what about coverage through work? It’s a great employee benefit, but it’s not available to many workers. Only 36% of all full-time employees have access to long-term disability insurance through their employers.
So what’s a worker to do? Explore his or her or options. If your employer offers disability coverage, take the time to find out if the coverage would be sufficient to meet your income replacement needs in the event of a disabling illness or accident. If it’s insufficient, your employer may offer you the option to increase your disability benefit, often through a voluntary payroll deduction. Another option is to purchase coverage on your own. One of the big benefits of individual coverage is that it’s 100% portable, meaning that it will follow you no matter how many times you changes jobs.
You may not realize it, but your home, your car and your jewelry are NOT your most valuable assets. Your ability to earn an income is your most valuable asset. Without it, you wouldn’t be able to make your monthly mortgage or car loan payments.
May is Disability Insurance Awareness Month (DIAM), the perfect time for a disability insurance “reality check.” Take this opportunity to make sure you’d be ok financially in the event of a disability that keeps you out of work for an extended period of time.

Insurer unveils advance peek at doctors' bills

Ever wonder how much your insurer pays your doctor for the services you receive? If your insurer is Aetna Inc., now you can find out.

South Florida is one of a dozen markets in the United States where Aetna began this week allowing members to have access to pricing information before they go to a doctor's office. Previously, they learned what the insurer paid only when they received an explanation of benefits report weeks after treatment.

The information helps consumers doctor shop because rates can vary. For example, Aetna pays West Palm Beach orthopedic surgeon Pierre Girars $1,713 for a hip replacement. But it pays another West Palm Beach orthopedic surgeon, Milan DiGiulio, $1,456 for the same procedure. Doctors get paid differently because they negotiate with insurers separately.

Although most large U.S. health insurers disclose some cost and quality data on hospitals and doctors, Aetna is the first to provide the doctor-specific pricing information to its members via the company's password-protected Web site (Aetnanavigator.com). Insurers have closely guarded payment data in the past, citing competitive pressures. Aetna is the nation's second-largest health insurer with more than 15 million members.

Aetna expects the pricing information to be most useful to the small but growing number of customers who have health savings accounts tied to a high-deductible insurance plan that require consumers to pay for most of their routine care out-of-pocket. The decision to release the data is part of Aetna's larger effort to make consumers better health-care shoppers.
But the company said even those customers in its traditional HMOs or PPOs will benefit because it will help them appreciate the true cost of their health care.

"Some people still think the cost of their health care is their $10 or $15 co-payment," Dr. Charles Cutler, Aetna's national medical director, said Tuesday. "This will help raise the level of awareness about the difference in costs and support the whole consumerism approach where people make decisions about health care the same way they act in other domains."
Aetna's member Web site also discloses whether the doctors met certain Aetna quality and efficiency standards, but it provides no specifics.

During the past decade, the federal government, most states and private health insurers have been giving consumers a growing amount of cost and quality data to compare doctors and hospitals. But some health analysts and doctors question whether consumers even look at it.
"I think its totally meaningless," Dr. Steven Rosenberg said of the Aetna data. He said patients will continue to select doctors based on proximity to where they live and recommendations from family and friends.

Aetna pays Rosenberg, a West Palm Beach dermatologist, $80.79 for a skin biopsy and $29.37 for each additional biopsy. Prices may vary because some doctors use nurse practitioners and physician assistants, which can keep their costs lower because they allow their practices to see more patients, Rosenberg said.

Doctors across the region will be interested in looking at the pricing data so they can see whether they are getting a fair deal. "We all want to know who is getting paid for what to make sure we are not being underpaid compared to other doctors," Rosenberg said.

Dianne Howard, risk management director for the Palm Beach County School District, applauds Aetna's effort to give consumers more data to make decisions. "This is part of the whole transparency movement in health care," she said.

Most school district employees get their health benefits through United Healthcare. Nonetheless, the data showing what doctors get paid would be enlightening to employees used to paying a small co-payment for their care, she said.

Aetna tested its new doctor-pricing data in Cincinnati last year. In that market, about 1,000 consumers each month looked at the database, Aetna officials said. In addition to South Florida, the program is being rolled out in other markets, including Ohio, Connecticut and the Washington, D.C., area.

Some health analysts predict that, in a few years, most consumers will be getting their health insurance through health savings account/high deductible plans and they'll want to shop for health care the same way they do for a new car. "Employers will demand to have this type of information for their workers," said a Palm Beach-based insurance broker. He predicts other insurers will release similar data. "You can't negotiate if you don't know what the price is."

Learn About Fake, Counterfeit Drugs

More than six million consumers have logged on to BuySafeDrugs.info over the last year to learn about the risks associated with fake and counterfeit medicines. The Web site, sponsored by the Pharmaceutical Research Manufacturers of America (PhRMA), was launched June 21, 2005, and is the first online clearinghouse of information on the potential dangers of buying medicines outside of the secure U.S. drug delivery system.

"When we launched the site, our goal was to educate and inform patients about the growing problem of fake, substandard and counterfeit drugs imported into the United States. Since then, BuySafeDrugs.info and the number of people visiting it have grown tremendously. This demonstrates the need to provide patients with reliable information on how to identify potential problems so they are armed to make smart decisions about where to get their medicines," said Ken Johnson, senior vice president of PhRMA.

In the year since the Web site's launch, numerous federal and international authorities have weighed in on the dangers of illegal importation and counterfeiting, including the Food and Drug Administration (FDA), Drug Enforcement Agency (DEA) and the World Health Organization (WHO). In December, an FDA operation found that nearly half of the imported drugs they intercepted from four selected countries were shipped to fill orders that consumers believed they were placing with "Canadian" pharmacies. A number of these products were found to be counterfeit. On June 4, NBC News's "Dateline," aired a stunning expose into the growing international problem of counterfeit prescription drugs.

The Center for Medicines in the Public Interest predicts that counterfeit drug sales will reach $75 billion globally in 2010, an increase of more than 90 percent from last year. According to WHO, the consequences of accidentally taking counterfeit medicines can be serious, leading to therapeutic failure or drug resistance, and in some cases, even death.

"When people can't afford their prescriptions, they should not be directed to foreign countries where unsafe and counterfeit drugs have been found," said Johnson. "This site not only educates consumers about the potential dangers associated with imported medicines, but also puts them in touch with resources that can help them safely save on their prescription drugs."

More than 475 assistance programs are available now to help through the Partnership for Prescription Assistance (http://www.pparx.org or 1-888-4PPA- NOW). To date, the PPA has matched nearly 2.5 million patients to programs that can provide free or nearly free medications.

The new Medicare prescription drug program is also offering a safe, legal alternative to beneficiaries looking to save on their medicines. A recent AARP study found many seniors will save more through Medicare's new drug program than through illegal importation schemes. The typical senior who previously lacked drug coverage will save $1,100 annually on their prescription drugs through the new Medicare plan, according to this study.

The Pharmaceutical Research and Manufacturers of America (PhRMA) represents the country's leading pharmaceutical research and biotechnology companies, which are devoted to inventing medicines that allow patients to live longer, healthier, and more productive lives. PhRMA companies are leading the way in the search for new cures. PhRMA members alone invested an estimated $39.4 billion in 2005 in discovering and developing new medicines. Industry- wide research and investment reached a record $51.3 billion in 2005.

For information on the danger of imported drugs, visit: http://www.buysafedrugs.info

PhRMA Internet Address: http://www.phrma.org

For information on how innovative medicines save lives, visit: http://www.innovation.org

For information on the Partnership for Prescription Assistance, visit: http://www.pparx.org