Catastrophic Drug Coverage for New Brunswick. A proposal by the Multiple Sclerosis Society of Canada, Atlantic Division
|
|
- Archibald Hutchinson
- 8 years ago
- Views:
Transcription
1 Catastrophic Drug Coverage for New Brunswick A proposal by the Multiple Sclerosis Society of Canada, Atlantic Division July 2010
2 Proposal for a Catastrophic Drug Program in New Brunswick i Executive Summary The MS Society, Atlantic Division strongly urges the Government of New Brunswick to implement a universal program of catastrophic drug coverage as soon as possible. Implementing such a program would meet New Brunswickers expectations that medically necessary drugs are accessible without undue financial hardship, and will fulfil commitments made by the government since 2004 and as recently as June Currently 28 per cent of New Brunswickers lack insurance for these costs and the number of families currently paying more than five per cent of its net household income on prescription drugs is 68 per cent higher than the rest of Canada. A catastrophic drug program would mean that working families who need expensive drug treatments will be able to continue to be employed. In doing so, they will avoid resorting to social assistance programs simply to obtain coverage, thereby becoming dependent on the state for their incomes (in addition to their drugs) over their lifetimes. Families without insurance or with employer-sponsored health benefits who must pay thousands of dollars in co-payments will not have to make difficult choices between the necessities of life and drug treatments. Finally, workers who lose their jobs will not be vulnerable to unexpected and crippling costs. Because patients will be able to afford to take their medications as prescribed, New Brunswick s health system will be relieved of many unnecessary ER and physician visits. MS patients are particularly vulnerable to the high costs of drugs which are needed to treat the primary disease, to manage its symptoms and to treat other, unrelated conditions. Although Plan H of the New Brunswick Prescription Drug Program provides partial coverage for disease-modifying therapies, MS patients are required to pay a large part of these costs, in addition to covering the entire cost of their other drug treatments. These out-of-pocket expenses are often unmanageable. Because MS most often strikes in the prime of life, drugs which delay the progression of disease enable patients to continue to fulfil their roles as employees, parents and contributing members of society. The need for drug coverage should not determine when an MS patient leaves or rejoins the workforce, force patients to spend their family s savings, or exhaust their personal assets. These policies serve the interests of neither patients nor the Government of New Brunswick. New Brunswick is one of only two provinces in Canada that lacks a catastrophic drug coverage program. Other Atlantic provinces have made steps in this direction which, although far from ideal, provide at least some relief to their residents. The MS Society recommends a program which is based on the principles of universality, affordability, equity and public administration. We propose that no family pays more than five per cent of its net household income on prescription drugs, and that families below the Low Income Cut-Off are exempted from contributions. The range of drugs covered and the time period for review must be aligned with the practices of other provinces and the government of New Brunswick should set minimum standards of coverage by private insurance to ensure equity across the province. The cost to the government, estimated at between $20 and $40 million, would be offset in part by savings in social assistance payments, health care expenses, increased income taxes and improved economic productivity. Large expected savings from the patent expiries of major drug categories can be redirected to expand coverage. Moreover, the people of New Brunswick expect this support from each other and from their government. The MS Society offers its assistance to make catastrophic drug coverage a reality.
3 Proposal for a Catastrophic Drug Program in New Brunswick 1 Contents Executive Summary i 1. What is Catastrophic Drug Coverage? 1 2. Why Do New Brunswickers Need a Catastrophic Drug Plan? 2 3. Costs and Benefits of Drugs for MS Patients 5 4. Models of Catastrophic Drug Coverage 6 5. Proposed Catastrophic Drug Coverage Model for New Brunswick Costs and Sources of Funding Conclusions 13 Appendix 1 New Brunswick Prescription Drug Program: eligibility and costs What is Catastrophic Drug Coverage? The term catastrophic refers to costs of drugs that are high relative to families incomes. Today, it is not unusual for patients to have drug costs of more than $5,000 a year. Multiple drugs required to manage chronic diseases can reach thousands of dollars a year even though they each cost only a few dollars a day. Individual therapies for multiple sclerosis, arthritis or cancer can now cost between $20,000 and $130,000 a year. Many people who have private insurance must pay a contribution of 20 per cent or more and find these expenses difficult to manage. For people without any insurance coverage, the costs are devastating. Catastrophic drug costs are commonly defined as drug expenses amounting to more than a certain percentage of net family income. Three per cent is the level used by Revenue Canada for income tax deduction of medical expenses and was the threshold set by the Kirby Commission. 1 The present MS Society proposal recommends a five per cent limit, based on the lowest level used by the Newfoundland & Labrador Prescription Drug Program. 1 Standing Senate Committee on Social Affairs, Science and Technology, 2002
4 Proposal for a Catastrophic Drug Program in New Brunswick 2 2. Why Do New Brunswickers Need a Catastrophic Drug Plan? The people of New Brunswick need a system of catastrophic drug coverage because the costs of many drugs, including treatments for multiple sclerosis, have grown beyond the financial reach of individual families. Although funds were made available to the provinces to address this issue (among others) in the Health Accords of 2003 and 2004, New Brunswick is one of only two remaining provinces without a universal plan for high cost drugs. (The other province, Prince Edward Island, covers high cost drugs for many of its residents.) The lack of access to affordable prescription drug insurance for all New Brunswickers undermines the principles of universality and accessibility on which the Canada Health Act is based. Although the Act does not require provinces to cover drugs administered outside hospitals, these have increasingly become "medically necessary". Canadians expect their public systems of drug coverage to adhere to the same principles as the other medically necessary services defined under the Act. The issue of coverage for high cost drugs affects most New Brunswickers. Three-quarters of households in this province purchase prescription drugs, with an average annual expenditure of $ As new, highcost drugs are introduced every year, this situation will increase in importance over time. How many New Brunswickers are vulnerable to catastrophic drug costs? The proportion of New Brunswick families paying over five per cent of their net household income on prescription drugs is 68 per cent greater than for Canada as a whole, as shown in the table below. Table 1: Percentage of families with high drug costs relative to income Geography Spending category 2006 Canada Spending on prescription drugs greater than 3% of after tax income 8.0 Spending on prescription drugs greater than 5% of after tax income 3.8 Spending on prescription drugs greater than 3% of New after tax income 11.1 Brunswick Spending on prescription drugs greater than 5% of after tax income 6.4 Source: Statistics Canada Table Household spending on prescription drugs as a percentage of after-tax income, Canada and provinces, annual The root cause of this vulnerability is the lack of adequate prescription drug insurance. It is estimated that 28 per cent of New Brunswickers, or approximately 200,000 residents of the province, do not have any coverage. 3 2 Statistics Canada, 2008 figures 3 Applied Management Consultants. PRISM database, 2008
5 Proposal for a Catastrophic Drug Program in New Brunswick 3 Which New Brunswickers are at risk? The following groups of people in New Brunswick are most likely to face significant financial hardship due to high cost drugs. Group 1: Families with no insurance coverage One-third of working-age families and 18 per cent of senior families have no insurance Low-income workers who have no insurance through work are not eligible for NBPDP; most do not want to give up their family s assets in order to qualify for social assistance Persons diagnosed with a medical condition are uninsurable as individuals Group 2: Families with private insurance coverage Fifty-eight per cent of working-age families and 27 per cent of senior families have private insurance Three-quarters of insurance plans require a copayment most commonly 20 per cent for each prescription One in six private insurance plans has an annual or lifetime cap on claims which may be lower than the cost of many newer drugs Employees who are laid off lose their drug plans along with their jobs Group 3: Seniors and MS patients with provincial government coverage The NBPDP provides coverage for 47 per cent of NB senior families; 15 per cent of these families may have out-of-pocket costs greater than 5 per cent of their income Although Plan H provides some assistance to MS patients, the required contributions often exceed the accepted five per cent of net household income Source: Applied Management Consultants, Coverage of MS patients in New Brunswick Multiple sclerosis patients in New Brunswick are eligible for coverage of disease-modifying therapies under Plan H of the New Brunswick Prescription Drug Program (NBPDP). Individuals on this plan pay an annual registration fee of $50 and are required to pay a percentage of the drug cost for each prescription based on discretionary income. Families having discretionary income (including savings) of over $100,000 do not qualify. There are several important concerns with Plan H. 1. Liquid assets over $5,000 are included in the calculation of discretionary income, therefore families savings often must be spent before assistance is provided; 2. The degree of coverage is insufficient. Families with discretionary incomes over $17,000 but under $100,000 must pay between 35 and 76 per cent of the cost of drugs, which amounts to $7,000 to $15,200 a year for an average disease-modifying MS therapy. This is far in excess of the five per cent threshold defining catastrophic drugs costs; 3. Drugs needed by MS patients to manage symptoms of their disease (such as pain, spasticity and fatigue) or for other, unrelated diseases are not covered under Plan H.
6 Proposal for a Catastrophic Drug Program in New Brunswick 4 Case Study: Martha Jones Martha Jones (not her real name) is a Moncton widow whose daughter will be attending university this fall. Martha s income, from a disability pension, is less than $20,000 annually. Her daughter s part-time job yields $4,000 to $5,000 a year. Martha is eligible for drug coverage under her deceased husband s health benefits plan, which covers 80 per cent of drug expenses. One of these drugs, Copaxone, is a disease-modifying MS treatment which has enabled her to continue living in her home. Martha s monthly out-of-pocket drug expenses are $321 for Copaxone and approximately $80 for other drugs, for a total of $400, or 20 per cent of the family s before-tax income. This expense is proving unmanageable. As an MS patient, Martha qualifies for Plan H, however the small life insurance payout she received upon her husband s death disqualifies her from eligibility based on income. Martha has been advised to spend the insurance payout but she does not want to do so because the funds were intended to help provide for the family s future, including her daughter s education. In February, Martha and her neurologist decided she would stop taking Copaxone since it was becoming too expensive. Within ten days she was hospitalized and so resumed her treatments. She is using her credit cards to cover the costs and is short of money each month. Due to their disease, many MS patients fall into the categories of New Brunswickers who are vulnerable to unaffordable drug costs, as described above: once diagnosed, MS patients are uninsurable as individuals many are unable to work, and lose private insurance coverage with their jobs some must live on disability payments, which are lost if they return to work where they may be eligible for group coverage most are unable to afford co-payments (usually 20 per cent for private plans) which amount to thousands of dollars a year for disease-modifying therapies, or may be subjected to annual caps Often in these situations, MS patients are forced to resort to social assistance to cover the costs of needed medications. To become eligible for this support, they must first exhaust their personal assets. In doing so, they deprive themselves and their families of their homes, savings and investments in future education and retirement. Because the drugs required by one person are unaffordable, the entire family becomes dependent on government support for their lifetimes. Future trends The need for catastrophic drug coverage has become urgent as a wave of new and expensive targeted therapies is putting growing pressure on drug budgets across the country. Biotechnology and oncology drugs especially are growing two to three times as fast as overall drug costs 4 and this trend is expected to accelerate in the future. 4 IMS Health, 2008
7 Proposal for a Catastrophic Drug Program in New Brunswick 5 3. Costs and Benefits of Drugs for MS Patients The economic consequences of MS are significant, especially since the disease generally strikes earlier in life. Although the majority of individuals with MS are employed at the time of diagnosis, approximately half leave their jobs within a decade. 5 Productivity losses in Canadian studies were measured at $11,670 to $21,720 annually per patient, depending on disease severity. 6 Progressive disability in MS also has an associated economic burden to society in general. This includes the costs of inpatient admissions, ambulatory visits, informal care and short-term sick leave, all of which more than double as the disease progresses. 7 Disease-modifying drugs Disease-modifying drugs to treat multiple sclerosis cost between $15,800 and $31,000 a year. As the name suggests, this class of drugs can alter the course of this debilitating disease and has made an enormous difference in the lives of many MS patients. Drugs in this class have been proven to delay the onset of disability, allowing patients to return to a productive life as employees, parents, family members and contributors to society. The Dalhousie Multiple Sclerosis Research Unit (DMSRU) has a publicly funded program that provides disease-modifying drugs to all eligible MS patients in Nova Scotia free of charge. A study of DMSRU patients showed that this program was effective in slowing the progression of neurologic disability. The risk of reaching high levels of disability was reduced for the clinic population as a whole and was delayed by approximately four years. 8 Symptom-management drugs For approximately 80 per cent of MS patients, the disease progresses from an episodic disorder to a more progressive state. As disability progresses, patients experience increasing pain, spasticity and fatigue and withdraw from active life. Drugs are needed not only to slow the progression of disease but also to manage these symptoms. As mentioned earlier, many MS patients also need drugs to treat unrelated chronic conditions (such as diabetes). Multiple prescriptions each costing two to three dollars a day can easily add up to thousands of dollars a year. 5 Naci H et al. Economic Burden of Multiple Sclerosis. A Systematic Review of the Literature. Pharmacoeconomics 2010; 28 (5): Grima T et al. Cost and health related quality of life consequences of multiple sclerosis. Multiple Sclerosis (2000) 6, Naci H et al. Economic Burden of Multiple Sclerosis. A Systematic Review of the Literature. Pharmacoeconomics 2010; 28 (5): Veugelers PJ et al. Disease progression among multiple sclerosis patients before and during a disease-modifying drug program: a longitudinal population-based evaluation. Multiple Sclerosis 15(11) , 2009
8 Proposal for a Catastrophic Drug Program in New Brunswick 6 4. Models of Catastrophic Drug Coverage All provinces except New Brunswick and Prince Edward Island have implemented universal prescription drug programs that cover their residents for high drug costs relative to income. The other Atlantic Provinces were the latest to do so and, in general, their programs place a much higher financial burden on families compared with the other provinces. How do other Atlantic provinces provide catastrophic coverage? Many families in Atlantic Canada pay more than five per cent of net household income for drug coverage under the public drug programs. Newfoundland & Labrador The Assurance Plan of the Newfoundland & Labrador Prescription Drug Program (NLPDP) provides assistance for all families in the province for its list of covered drugs. The amount the family must pay is based on income, as shown in the table below. Families with net incomes $150,000 or greater are not covered. Table 2 NLPDP Assurance Plan income-based deductible Net Household Income Maximum % Income Paid for Eligible Drugs up to $39,999 5% $40,000 up to $74, % $75,000 up to $149,999 10% Nova Scotia Nova Scotia Family Pharmacare provides income-based coverage of eligible drugs, calculated on the basis of gross family income, less amounts for dependants. The calculation of the patient's contribution is based on the formula in the table below. Table 3 Calculation of patient contributions for Nova Scotia Family Pharmacare Type of Contribution Level Maximum Contribution Co-payment 20% of the prescription cost Income-based maximum copayment amount Deductible The remaining 80% of the prescription cost goes towards the income-based Income-based maximum deductible amount deductible. Total contributions Once the maximum deductible amount is reached, the patient pays only the 20% co-payment to an income-based total maximum amount. Once this maximum is reached, the government pays 100% of the costs of the prescription. Income-based total amount
9 Proposal for a Catastrophic Drug Program in New Brunswick 7 The three examples of out-of-pocket expenses in the table below were provided by the Nova Scotia government. Unlike other provinces, payments are calculated based on gross family income, so the percentage of net income paid would be greater than the figures shown here. Table 4 Examples of out-of-pocket expenses under Nova Scotia Family Pharmacare Family Income (gross) Number of family members Drug cost (annual) Out-of-pocket expense Percentage of gross income $25,000 4 $1,000 $ % $40,000 2 $5,050 $ % $81,000 4 $30,000 $14, % As mentioned in the previous section, the Dalhousie Multiple Sclerosis Research Unit (DMSRU) provides disease-modifying drugs free of charge to all eligible MS patients in the province in a separate program to Pharmacare. Prince Edward Island Prince Edward Island does not have a universal program, but has 31 different drug programs which cover various populations and specific drugs. Low income families with children are eligible for Family Health Benefits which include assistance with drug costs. The province's five High Cost Drug Programs provide income-based assistance for the costs of specific drugs and diseases for families with annual net incomes under $150,000. A sliding scale is applied to the net household income, adjusted for the number of dependent children. The amount of assistance ranges from zero to 100 per cent of the cost of drugs. Beneficiaries must pay the pharmacy dispensing fee. New Brunswick New Brunswick does not have a universal program for prescription drug coverage and has the smallest proportion of the population covered by its public drug programs compared to the other Atlantic Provinces. Appendix 1 shows the ten programs available under the New Brunswick Prescription Drug Program (NBPDP). General populations covered under the NBPDP are: seniors who are eligible to receive the Guaranteed Income Supplement (GIS), residents of nursing homes, and social assistance recipients (including temporary drug card-only benefits). In December 2009, the latter plan was extended to cover drug costs for social assistance recipients up to 12 months after they find a job. Other NBPDP plans cover specific drugs. Groups not covered under the NBPDP include: Seniors not eligible for GIS payments (persons over age 65 may purchase the provincial drug plan through Medavie Blue Cross for a premium of $105 per month); Working families of all income levels. MS patients are partially covered for the costs of their disease-modifying drugs under Plan H, as described in the previous section.
10 Proposal for a Catastrophic Drug Program in New Brunswick 8 How do the Atlantic programs compare regarding assistance with high drug costs? The following table shows a comparison of eligibility for coverage of high drug costs and of out-ofpocket expenses among the provincial plans in Atlantic Canada for families under age 65 having average and low incomes. The comparison is from the perspective of a working-age MS patient who incurs a $20,000 drug expense for disease-modifying drugs and/or drugs for symptom management. Prov. NL NS PE NB Table 5: Comparison of coverage and out-of-pocket expenses for high-cost drugs in Atlantic Canada Universal Eligibility? Yes Yes No No Drug Program Assurance Plan Family Pharmacare DMSRU (diseasemodifying) High Cost Drugs* Cost Burden of a $20,000 Annual Drug Expense Without Private Insurance Family with Average Income (net $50,600) $ % Net income Family with Low Income (net $22,700) % Net $ income $3, % $1, % $8, % $1, % $0 0% $0 0% $2, % None $20, % Plan H** no assets Plan H with $27,500 assets None approx. $30 approx. $30 0.1% 0.1% $9, % $ % $20, % $6, % $20, % $20,000 88% With Private Insurance Family with Average Income (net $50,600) $ % Net income $4, % Sources: NLPDP website; NS Family Pharmacare calculator (on website) with confirmation by telephone; PEI figures confirmed by drug plan assessors; NB figures from regulations to the Prescription Drug Payment Act. * Several High Cost Drugs Programs in PEI cover drugs required to treat specific diseases (MS, pulmonary hypertension, Remicade/Enbrel, diabetes, cancer). For drugs outside these categories (including symptommanagement drugs for MS patients) the average-income family is not eligible for assistance. The low-income family would be covered for all prescribed drugs included on the PEI formulary under Family Health Benefits because they have dependent children under age 18 and their income is below the established threshold. ** Plan H covers disease-modifying drugs to treat MS. It does not cover symptom-management drugs. Liquid assets over $5,000 are included in the calculation of the patient s contribution; average-income families with more than $27,500 in liquid assets would pay the full $20,000 drug cost. A $50 annual registration fee is also applied.
11 Proposal for a Catastrophic Drug Program in New Brunswick 9 Notes to table: Family is defined as two adults and two children (3 dependants). Average after-tax household income for New Brunswick families of two or more is $50,600 (Statistics Canada 2007). Low income is defined as $22,700 (net), based on the 2008 Statistics Canada Low-Income Cut-Off (LICO) for Canadian families living in rural areas. (Provincial LICO was unavailable.) Since Nova Scotia Family Pharmacare contributions are based on gross household income, net income was calculated using tax rates of 25% and 10%, respectively, for the average and low family incomes to estimate gross income ($67,500 and $25,200). Private insurance costs are based on a 20 per cent co-payment and no deductible amount.
12 Proposal for a Catastrophic Drug Program in New Brunswick Proposed Catastrophic Drug Coverage Model for New Brunswick The New Brunswick government has committed to providing universal coverage for catastrophic drug costs since ,10 Most recently (June 2010) the Minister of Social Services clarified that catastrophic coverage would be part of a universal drug coverage plan to be introduced by We recommend that the following criteria should apply to this program. Principles The catastrophic drug coverage program should be based on the following principles: Universal Affordable Equitable Publicly administered Features The proposed program would have the following features: Includes all residents of New Brunswick regardless of age, health status, employment status or income level Beneficiaries must not be required to pay more than five per cent of their net family income (adjusted for personal deductions and using the Low Income Cut Off as a threshold below which no contributions are required). The program must be equitable with coverage provided to other Canadians: It must cover an acceptable range of drugs and must approve new drugs within a similar review period. The government must set minimum standards for private insurers, based on the public program, for eligibility, affordability and comprehensiveness of their formularies. 9 Healthy Futures: Securing New Brunswick s Health Care System. The Provincial Health Plan Bruce Bartlett; Advocate pushes for catastrophic drug plan in N.B.; Telegraph-Journal, March 13th, Benjamin Shingler; Catastrophic drugs will be part of drug plan: Lamrock; Telegraph-Journal, June 18th, 2010
13 Proposal for a Catastrophic Drug Program in New Brunswick Costs and Sources of Funding An estimation of the costs of a universal catastrophic drug program must take into account the incremental tax dollars needed to provide additional coverage, balanced against costs saved or revenues gained by more efficient use of the health system and improved health outcomes. Estimating these amounts will require more detailed calculations than are possible here. The paragraphs below describe the categories of potential costs and savings that may be considered. Costs to New Brunswick of not having universal catastrophic drug coverage The lack of a catastrophic drug coverage program is resulting in costs to government departments, employers and families which may not be visible but are certainly significant. Higher utilization of medical services such as physician appointments, emergency room visits and hospitalizations have been demonstrated by numerous studies from Canada and the U.S. when patients cut back or forgo their medications due to unaffordability. 12,13,14 As was shown in the previous sections, treatment with disease-modifying drugs enables many MS patients to continue to fulfill their roles in society, including returning to work. The province benefits because economic productivity is increased, there is less reliance on social assistance and income taxes are collected. These outcomes also apply to other serious diseases for which high-cost drug therapies are used. Cost estimates of catastrophic drug coverage Other groups have estimated the costs to the government of implementing a universal program to cover high drug costs relative to income. Limiting families' contributions to five per cent of net household income would cost the New Brunswick government approximately $44 million annually, or $53 per resident. 15 (A second source pegged the cost of catastrophic drug coverage at approximately $20 million, but did not reveal the basis of its calculation. 16 ) Sources of funding There is an opportunity for New Brunswick to benefit from the impending "patent cliff" which will result, over the next few years, in the availability of cheaper generic versions of many drugs that presently account for the government's highest expenditures. Adopting the approaches of other provinces (notably Ontario) to reduce the allowable price of generic drugs will enable the government of New Brunswick to reallocate these cost savings toward extending NBPDP eligibility to residents who currently lack drug coverage. Another additional approach is to allow all uninsured residents to purchase the NBPDP plan, as seniors are allowed to do, for a reasonable premium and without discrimination due to age or health status. 12 Goldman DP et al.; Prescription Drug Cost Sharing. Associations With Medication and Medical Utilization and Spending and Health; JAMA. 2007;298: Tamblyn R et al. Adverse events associated with prescription drug cost-sharing among poor and elderly persons. JAMA Jan 24-31; 285(4): Ungar W et al. Effect of Cost-Sharing on Use of Asthma Medication in Children. Arch Pediatr Adolesc Med. 2008;162(2): Applied Management Consultants. Statistics presented to New Brunswick government representatives November This figure was confirmed by then-health Minister Mike Murphy as being close to the government s calculations. 16 Benjamin Shingler; Catastrophic drugs will be part of drug plan: Lamrock; Telegraph-Journal, June 18th, 2010.
14 Proposal for a Catastrophic Drug Program in New Brunswick 12 These residents would then be funding their own protection. Families who are unable to afford the premiums would be able to rely on the government's catastrophic drug program which would protect them only against costs greater than five per cent of net adjusted household income.
15 Proposal for a Catastrophic Drug Program in New Brunswick Conclusions In summary, the MS Society recommends the immediate implementation of a program of catastrophic drug coverage that is universal, affordable, equitable and publicly administered. No family should have to pay more than five per cent of its net income on prescription drugs. The program should cover an acceptable range of drugs and both the formulary and approval timelines should be benchmarked to the practices of other provinces. In addition, the government should set minimum standards for private insurers for eligibility, affordability and comprehensiveness of their formularies, based on those of the public program. A program of catastrophic drug coverage in New Brunswick would, at a reasonable cost, protect the over 200,000 residents of the province who are vulnerable to the potentially devastating consequences of high drug expenditures, allowing many to receive drug treatments that will allow them to return to productive lives as contributing members of society. Moreover, such a program would reinforce the principles of universality and accessibility that New Brunswickers expect from their health system.
16 Proposal for a Catastrophic Drug Program in New Brunswick 14 Appendix 1 New Brunswick Prescription Drug Program: eligibility and costs Beneficiary groups covered by provincial programs: A (Seniors) B (Cystic Fibrosis) E (Adults in Licensed Residential Facilities) F (Social Development) G (Special needs children and children in care of the Minister of Social Development) H (Multiple Sclerosis) R (Organ Transplant) T (Human Growth Hormone Deficiency) U (HIV/AIDS) V (Nursing Home Residents) The New Brunswick Prescription Drug Program Formulary lists the drugs which are eligible for coverage for each plan. NBPDP Plan Eligibility Costs Gaps Plan H (Multiple Sclerosis) Individuals diagnosed with Multiple Sclerosis and who have a prescription written by a neurologist for the drug Avonex, Rebif, Betaseron, Copaxone or Tysabri. Individuals on this plan pay an annual registration fee of $50 and are required to pay a percentage of the drug cost for each prescription ranging from zero to 100 per cent (co-pay). The copay amount will be determined during the application process and is based on discretionary income. No coverage for drugs to manage MS symptoms (pain, fatigue, spasticity). Copayments unacceptably high. Discretionary income includes family s savings. Plan A (Seniors) Persons 65 years of age or older who: Receive the Federal Guaranteed Income Supplement (GIS) OR Qualify based on an annual income as follows: - a single person with an annual income of $17,198 or less; - couple with both persons 65 years of age or older, with a Beneficiaries receiving the GIS are required to pay a co-payment of $9.05 for each prescription, up to a maximum of $250 in one calendar year. Beneficiaries who qualify based on their total annual income are required to pay a copayment of $15.00 per prescription with no yearly co-payment maximum. Seniors and working families with high drug costs relative to net household income.
17 Proposal for a Catastrophic Drug Program in New Brunswick 15 combined annual income of $26,955 or less; - couple with one person who is under 65 years of age, with a combined annual income of $32,390 or less. Plan E (Adults in Licensed Residential Facilities) Plan F (Social Development Clients) Plan V (Nursing Home Residents) Individuals who reside in a licensed adult residential facility. Eligibility for drug coverage through this plan is determined by the Department of Social Development. Individuals who hold a valid health card issued by the Department of Social Development. Eligibility for drug coverage through this plan is determined by the Department of Social Development. As of December 2009, coverage may be extended up to a year after the client has become employed. Individuals who reside in a registered nursing home. Eligibility for drug coverage through this plan is determined by the Department of Social Development. Individuals on this plan are required to pay a co-payment of $4.00 for each prescription up to a maximum of $250 per person in a fiscal year. Individuals on this plan are required to pay a co-payment of $4.00 for each prescription for adults (18 and over) and $2.00 for children (under 18 years) up to a maximum of $250 per family unit in a fiscal year. There are no copayments or fees associated with this plan.
18 The development of this proposal is supported by Pfizer Canada Inc. through an unrestricted educational grant.
Access to Prescription Drugs in New Brunswick
Access to Prescription Drugs in New Brunswick Discussion Paper Department of Health June 2015 Department of Health Published by: Department of Health Government of New Brunswick P. O. Box 5100 Fredericton,
More informationHealth. Government of New Brunswick Questions and Answers. Page 1 of 8
Page 1 of 8 Health Government of New Brunswick Questions and Answers 1) What is the New Brunswick Drug Plan? 2) The government s platform committed to a catastrophic drug plan. Is this the same thing?
More informationResponse to the New Brunswick Government Consultation on a Prescription Drug Plan for Uninsured New Brunswickers
Response to the New Brunswick Government Consultation on a Prescription Drug Plan for Uninsured New Brunswickers Brief submitted by The New Brunswick Nurses Union April 2012 Background The New Brunswick
More informationHow To Get A New Bronwell Drug Plan
Questions and Answers New Brunswick Drug Plan December 10, 2013 1) What is the New Brunswick Drug Plan? The New Brunswick Drug Plan is a prescription drug insurance plan that provides drug coverage for
More informationThe Burden of Out-of-Pocket Costs for Canadians with Diabetes
The Burden of Out-of-Pocket Costs for Canadians with Diabetes The Issue: Government coverage of diabetes medications, devices and supplies varies across jurisdictions, leaving some costs for these supports
More informationHealth Care Coverage and Costs in Retirement
Health Care Coverage and Costs in Retirement Health care coverage and costs should be an important consideration in your retirement planning. You need to have an idea of what coverage you will need and
More informationDrug Use Among Seniors on Public Drug Programs in Canada, 2002 to 2008
Drug Use Among Seniors on Public Drug Programs in Canada, 2002 to 2008 National Prescription Drug Utilization Information System Database Production of this report is made possible by financial contributions
More informationReport of the Advisory Committee on Health Benefits: An Insurance Plan for Prescription Drugs for Uninsured New Brunswickers
Report of the Advisory Committee on Health Benefits: An Insurance Plan for Prescription Drugs for Uninsured New Brunswickers Prepared for ESIC Board of Directors Final Report December 2012 Final Report
More informationNova Scotia Pharmacare Programs
Nova Scotia Pharmacare Programs The Nova Scotia Family Pharmacare Program Effective December 2012 The information in this booklet is subject to change and does not replace the Health Services and Insurance
More informationGuide to Canadian benefits Legislation
Guide to Canadian benefits Legislation 2014 PROVINCIAL ROADMAP PROVINCIAL ROADMAP to the Canadian Benefits Legislation Landscape BC-ALBERTA-SASK - 1 The federal government, ten provinces, and three territories
More informationCLOSING THE COVERAGE GAP. Pan-Canadian Pharmacare
CLOSING THE COVERAGE GAP Pan-Canadian Pharmacare Prescription drug coverage for all Canadians While the vast majority of Canadians have access to prescription drugs, some Canadians can t afford their medications.
More informationEquitable Choice. Ensuring affordability and accessibility to drug therapies
Equitable Choice Ensuring affordability and accessibility to drug therapies Equitable Choice - Ensuring affordability & accessibility to drug therapies Equitable Choice: Ensuring affordability and accessibility
More informationNumber 2 2005 DESIGNING HEALTH FINANCING SYSTEMS TO REDUCE CATASTROPHIC HEALTH EXPENDITURE
Number 2 2005 DESIGNING HEALTH FINANCING SYSTEMS TO REDUCE CATASTROPHIC HEALTH EXPENDITURE Every year, more than 150 million individuals in 44 million households face financial catastrophe as a direct
More informationCANCER DRUG ACCESS FOR CANADIANS
CANCER DRUG ACCESS FOR CANADIANS SEPTEMBER 2009 Cancer Drug Access for Canadians i Executive Summary Access to cancer drugs defined as the ability to obtain recommended cancer drug treatments in a timely
More informationHealth Insurance Reform at a Glance Implementation Timeline
Health Insurance Reform at a Glance Implementation Timeline 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access
More informationDRUG COVERAGE for low-income families
April 2015 DRUG COVERAGE for low-income families The Canadian reality and lessons from Switzerland and the Netherlands, by Nadeem Esmail and Bacchus Barua. Contents Foreword Dr. Brett Belchetz / i Executive
More informationPublic Health Care Insurance in Canada:
A Comparison of Provincial and Territorial Programs Provisions current to October 1 2010 A Comparison of Provincial and Territorial Programs i CANADA Supplementary group employee health benefit programs,
More informationNova Scotia Pharmacare Programs
Nova Scotia Pharmacare Programs The Nova Scotia Seniors Pharmacare Program Effective April 2013 The information in this booklet is subject to change and does not replace the Health Services and Insurance
More informationConsistent Results Across Most of The Board
Canadian Health Care Trend Survey Results 2015 Consistent Results Across Most of The Board Our 2015 Health Care Trend Survey demonstrates that drug, health and dental cost trend factors have remained consistent
More informationMedicare Benefits. As of 2012, approximately 50 million people were Medicare beneficiaries.
Medicare Benefits Medicare is the federal health insurance program for people age 65 and older, and those of all ages with certain disabilities, End-Stage Renal Disease (ESRD), or Lou Gehrig s disease
More informationStrengthening Community Health Centers. Provides funds to build new and expand existing community health centers. Effective Fiscal Year 2011.
Implementation Timeline Reflecting the Affordable Care Act 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access
More informationCANCER TREATMENT AND SUPPORT DRUGS
POSITION PAPER: CANCER TREATMENT AND SUPPORT DRUGS November 2010 Executive Summary The Canadian Cancer Society, Manitoba Division is advocating for three changes that together would significantly improve
More informationSOMETHING OLD, SOMETHING NEW: TEXAS TWO HIGH-RISK POOLS
July 19, 2010 Contact: Stacey Pogue, pogue@cppp.org SOMETHING OLD, SOMETHING NEW: TEXAS TWO HIGH-RISK POOLS Thanks to national health reform, Texas now has two separate high-risk pools that offer health
More informationCLHIA Submission to the New Brunswick Advisory Committee on Health Benefits Concerning Developing a Drug Plan for Uninsured New Brunswickers
CLHIA Submission to the New Brunswick Advisory Committee on Health Benefits Concerning Developing a Drug Plan for Uninsured New Brunswickers 1 Queen Street East Suite 1700 Toronto, Ontario M5C 2X9 1, rue
More informationCanadian Health Insurance. The Medical Expense Tax Credit. Life s brighter under the sun. June 2012. health plans
Canadian Health Insurance tax Guide June 2012 Life s brighter under the sun Sun Life Assurance Company of Canada, 2012. Individuals may not deduct hospital and medical expenses from their income, but they
More informationSenate-Passed Bill (Patient Protection and Affordable Care Act H.R. 3590)**
Prevention and Screening Services Cost-sharing Eliminates cost sharing requirements for requirements for all preventive services (including prevention and colorectal cancer screening) that have a screening
More informationWelcome to: Medicare and Social Security 101. Presented by: WGA s Retiree Solutions Team and WGA s Compliance Practice
Welcome to: Medicare and Social Security 101 Presented by: WGA s Retiree Solutions Team and WGA s Compliance Practice Introducing the webcast presenters: Alyssa Martin, Speaker Vice President Member of
More informationYour Retiree Health Care Travel Guide
SPECIAL EDITION for Individuals Not Yet Eligible for Medicare Your Retiree Health Care Travel Guide 2010 Enrollment for BorgWarner Pre-Medicare Health Care Coverage Welcome to 2010 Pre-Medicare enrollment!
More informationArticle from: The Actuary Magazine. October/November 2013 Volume 10, Issue 5
Article from: The Actuary Magazine October/November 2013 Volume 10, Issue 5 the increase in drug costs for private plans is about 5.2 percent per year, while the annual growth for governmentsponsored drug
More informationCan an administrative drug claims database be used to understand claimant drug utilization?
Can an administrative drug claims database be used to understand claimant drug utilization? By Elaine McKenzie, BSP, MBA, Consultant, TELUS Health Analytics Elaine McKenzie is a consultant who works with
More informationSection 2: INDIVIDUALS WHO CURRENTLY HAVE
Section 2: INDIVIDUALS WHO CURRENTLY HAVE COVERAGE OR AN OFFER OF COVERAGE FROM THEIR EMPLOYER Section 2 covers enrollment issues for individuals who have coverage or an offer of coverage whether through
More informationMultiple Sclerosis & Income Security. The need is now
Multiple Sclerosis & Income Security The need is now Multiple Sclerosis & Income Security Multiple Sclerosis and Income Security: The need is now Perhaps the most important action that the government can
More informationKansas Health Policy Forums
Forum Brief 2004 Kansas Health Policy Forums The Medicare Reform Act: What Are the Consequences for Kansas? Thursday, March 18, 2004 Noon 2:30 Lunch provided 212 SW Eighth Avenue, Topeka, KS Lower Level
More information2015 BRIEF BENEFITS SUMMARY FOR FULL-TIME EMPLOYEES
2015 BRIEF BENEFITS SUMMARY FOR FULL-TIME EMPLOYEES Health Insurance, Rx, and Vision We offer two choices for medical insurance. All plans include prescription drug and vision benefits. Dependent children
More informationMedicare and Medicaid: What You Need to Know
Medicare and Medicaid: What You Need to Know This program is sponsored by the Nevada Aging and Disability Services Division and is presented by the Access to Healthcare Network and Nevada Geriatric Education
More informationMedicare Part D & Ryan White HIV/AIDS Program As of November 2008
Medicare Part D & Ryan White HIV/AIDS Program As of November 2008 The below discussion can guide Ryan White HIV/AIDS programs in understanding implications of the Medicare Part D prescription drug benefit
More informationBasic Health Plan Offers a Chance to Provide Comprehensive Health Care Coverage for Low-Income Minnesotans
Basic Health Plan Offers a Chance to Provide Comprehensive Health Care Coverage for Low-Income Minnesotans The number of uninsured in Minnesota has been on the rise over the last decade, with one out of
More informationTimeline: Key Feature Implementations of the Affordable Care Act
Timeline: Key Feature Implementations of the Affordable Care Act The Affordable Care Act, signed on March 23, 2010, puts in place health insurance reforms that will roll out incrementally over the next
More informationChapter 8: Just in Case Additional Material
Chapter 8: Just in Case Additional Material Here I go into detail about Medicare, Medicare Advantage (MA) plans, and Medigap plans. What about Medicare? Medicare is a federal health insurance program for
More informationOffice of the Actuary
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop N3-01-21 Baltimore, Maryland 21244-1850 Office of the Actuary DATE: March 25, 2008 FROM:
More information4.0 Health Expenditure in the Provinces and Territories
4.0 Health Expenditure in the Provinces and Territories Health expenditure per capita varies among provinces/territories because of different age distributions. xii Population density and geography also
More informationCHAPTER 4. Eye Care in the Private Sector: Innovation at the Service of Patients
CHAPTER 4 Eye Care in the Private Sector: Innovation at the Service of Patients In Canada, it is professionals working essentially in private practices who provide patients with the eye and vision care
More informationPolicy in Focus SUMMARY. Maytree. Featured Research. Fix Employment Insurance to support the temporarily unemployed. Background and Context...
The Maytree Foundation Maytree Policy in Focus issue 2 Dec 07 Background and Context...2 Employment Insurance Doesn t Insure Many Canadians Featured Research...4 Towards a New Architecture Canada s Adult
More informationReview of Section 38 (Benefits), Workers Compensation Act
Legislative Review of Workers Compensation Review of Section 38 (Benefits), Workers Compensation Act Discussion Paper May 2015 Discussion Paper May 2015 Published by: Province of New Brunswick P.O. Box
More informationBENEFITS & COMPENSATION INTERNATIONAL TOTAL REMUNERATION AND PENSION INVESTMENT
BENEFITS & COMPENSATION INTERNATIONAL TOTAL REMUNERATION AND PENSION INVESTMENT Can the Retiree Health Benefits Situation in Canada be Saved? Ellen Whelan Ellen Whelan is a consultant in the Group Benefits
More informationRISK RESPONSIBILITY REALITY APPENDIX D AUTOMOBILE INSURANCE IN CANADA
The appendix includes relevant clauses drawn from the Compulsory Minimum Insurance Coverage for Private Passenger Vehicles as prepared by the Insurance Bureau of Canada (FACTS 2005 p. 12-15) used with
More informationINSIGHT on the Issues
INSIGHT on the Issues AARP Public Policy Institute Medicare Beneficiaries Out-of-Pocket for Health Care Claire Noel-Miller, PhD AARP Public Policy Institute Medicare beneficiaries spent a median of $3,138
More informationUpdated November 23, 2009
820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org Updated November 23, 2009 HOUSE HEALTH REFORM BILL EXPANDS COVERAGE AND LOWERS HEALTH
More informationNevada Employer s Guide to the Affordable Care Act. Nevada Division of Insurance
Nevada Employer s Guide to the Affordable Care Act Nevada Division of Insurance Nevada Employer s Guide to the Affordable Care Act State of Nevada Department of Business and Industry Division of Insurance
More informationThe Impact of Rising Health Care Costs on the Economy
The Impact of Rising Health Care Costs on the Economy EFFECTS ON WORKERS AND FAMILIES Employment-based health insurance is a critical element of jobs in the United States and can make the difference between
More informationKey Features of the Affordable Care Act, By Year
Page 1 of 10 Key Features of the Affordable Care Act, By Year On March 23, 2010, President Obama signed the Affordable Care Act. The law puts in place comprehensive health insurance reforms that will roll
More informationHealth Care Reform: Major Provisions and Bargaining Strategies for Retirees
Health Care Reform: Major Provisions and Bargaining Strategies for Retirees MEDICARE Summary of Benefit: Medicare is the federal government s healthcare program for the elderly and certain disabled individuals.
More informationHow Health Reform Will Help Children with Mental Health Needs
How Health Reform Will Help Children with Mental Health Needs The new health care reform law, called the Affordable Care Act (or ACA), will give children who have mental health needs better access to the
More informationHealth Insurance Risk-Sharing Plan (HIRSP)
Health Insurance Risk-Sharing Plan (HIRSP) Informational Paper 53 Wisconsin Legislative Fiscal Bureau January, 2013 Wisconsin Legislative Fiscal Bureau January, 2013 Health Insurance Risk-Sharing Plan
More informationSNHPI Safety Net Hospitals for Pharmaceutical Access
SNHPI Safety Net Hospitals for Pharmaceutical Access Why the 340B Program Will Continue to be Important and Necessary after Health Care Reform is Fully Implemented Since 1992, the 340B drug discount program
More informationEffective Jan. 1, 2015. STRS Ohio Health Care Program Guide
Effective Jan. 1, 2015 2015 STRS Ohio Health Care Program Guide 2 www.strsoh.org Welcome Thank you for your interest in the STRS Ohio Health Care Program. We understand that choosing a health care plan
More informationNew Medicare Prescription Drug Coverage: An Overview for Pharmacies in Oregon
New Medicare Prescription Drug Coverage: An Overview for Pharmacies in Oregon Note: All material in this manual is intended for people with Medicare who live in Oregon. It is not indicative of what classes
More informationSUBMISSION TO THE SENATE INQUIRY INTO OUT-OF- POCKET COSTS IN AUSTRALIAN HEALTHCARE. Prepared by National Policy Office
SUBMISSION TO THE SENATE INQUIRY INTO OUT-OF- POCKET COSTS IN AUSTRALIAN HEALTHCARE Prepared by National Policy Office May 2014 COTA Australia Authorised by: Ian Yates AM Chief Executive iyates@cota.org.au
More informationHR 3200, AMERICA S AFFORDABLE HEALTH CHOICES ACT FREQUENTLY ASKED QUESTIONS
HR 3200, AMERICA S AFFORDABLE HEALTH CHOICES ACT HOW WILL THIS AFFECT ME? FREQUENTLY ASKED QUESTIONS 1. Why do we have to wait until 2013 for it to start? Some of the reforms in the bill start earlier
More informationSummary of the Major Provisions in the Patient Protection and Affordable Health Care Act
Summary of the Major Provisions in the Patient Protection and Affordable Care Act Updated 10/22/10 On March 23, 2010, President Barack Obama signed into law comprehensive health care reform legislation,
More informationStable and Secure Health Care for America: The Benefits of Health Insurance Reform: Table of Contents
Stable and Secure Health Care for America: The Benefits of Health Insurance Reform: Table of Contents HEALTH INSURANCE CONSUMER PROTECTIONS... 1 STABLE AND SECURE HEALTH CARE FOR AMERICA... 2 HEALTH INSURANCE
More informationmedicaid and the uninsured June 2011 Health Coverage for the Unemployed By Karyn Schwartz and Sonya Streeter
I S S U E kaiser commission on medicaid and the uninsured June 2011 P A P E R Health Coverage for the Unemployed By Karyn Schwartz and Sonya Streeter In May 2011, 13.9 million people in the U.S. were unemployed,
More informationNear-Elderly Adults, Ages 55-64: Health Insurance Coverage, Cost, and Access
Near-Elderly Adults, Ages 55-64: Health Insurance Coverage, Cost, and Access Estimates From the Medical Expenditure Panel Survey, Center for Financing, Access, and Cost Trends, Agency for Healthcare Research
More informationMaryland Medicaid Program
Maryland Medicaid Program Maryland s Pharmacy Discount Waiver Tuesday, November 19, 2002 Debbie I. Chang Deputy Secretary for Health Care Financing Maryland Department of Health and Mental Hygiene Overview
More informationAlberta Government Health Insurance Plan offers Limited Coverage.
Alberta Government Health Insurance Plan offers Limited Coverage. Alberta government provides supplementary health coverage via Blue Cross to individuals in low-income; assured-income or other programs
More informationTHE A,B,C,D S OF MEDICARE
THE A,B,C,D S OF MEDICARE An important resource for understanding your healthcare in retirement What you need to know for 2014 How Medicare works What Medicare covers How much Medicare costs INTRODUCTION
More informationGlobal Health Care Update
Global Health Care Update September/October 2012 This bimonthly Update summarizes recent legislative developments and trends related to health care and highlights recently passed and pending legislation
More informationMedicare Part D Prescription Drug Coverage
Medicare Part D Prescription Drug Coverage Part 3 Version 7.1 August 1, 2013 Terms and Conditions This training program is protected under United States Copyright laws, 17 U.S.C.A. 101, et seq. and international
More informationPolicy Options to Improve the Performance of Low Income Subsidy Programs for Medicare Beneficiaries
Policy Options to Improve the Performance of Low Income Subsidy Programs for Medicare Beneficiaries January 2012 Stephen Zuckerman, Baoping Shang, Timothy Waidmann Introduction One of the principal goals
More informationMedicare Part D Prescription Drug Coverage
Medicare Part D Prescription Drug Coverage Part 3 Version 9.0 June 22, 2015 Terms and Conditions This training program is protected under United States Copyright laws, 17 U.S.C.A. 101, et seq. and international
More informationSPECIAL COVERAGES. Seniors with Special Support coverage will pay the lesser of the Special Support co-payment or the $20 per prescription.
SPECIAL COVERAGES A) SENIORS DRUG PLAN As of July 1, 2015, Saskatchewan residents who are 65 years of age and older with a reported income (Line 236) that is $65,515 or less for 2013 will be eligible for
More informationHow To Improve Health Care For All
TIMELINE FOR IMPLEMENTATION OF THE AFFORDABLE CARE ACT 2010: NEW CONSUMER PROTECTIONS Eliminated pre-existing coverage exclusions for children: under age 19. Prohibited insurers from dropping coverage:
More informationThe Patient Protection and Affordable Care Act. Implementation Timeline
The Patient Protection and Affordable Care Act Implementation Timeline 2009 Credit to Encourage Investment in New Therapies: A two year temporary credit subject to an overall cap of $1 billion to encourage
More informationBARACK OBAMA S PLAN FOR A HEALTHY AMERICA:
BARACK OBAMA S PLAN FOR A HEALTHY AMERICA: Lowering health care costs and ensuring affordable, high-quality health care for all The U.S. spends $2 trillion on health care every year, and offers the best
More informationPrescription drug costs continue to rise at
Prescription Drugs Developing an Effective Generic Prescription Drug Program by John D. Jones Pharmacy benefit managers (PBMs) use a variety of pricing strategies. When employers have a thorough knowledge
More informationNAVIGATOR RESOURCE GUIDE ON PRIVATE HEALTH INSURANCE COVERAGE & THE HEALTH INSURANCE MARKETPLACE
NAVIGATOR RESOURCE GUIDE ON PRIVATE HEALTH INSURANCE COVERAGE & THE HEALTH INSURANCE MARKETPLACE The Center on Health Insurance Reforms Georgetown University Health Policy Institute Acknowledgements This
More informationDoes Private Insurance Protect Canadians from the Cost of Cancer Drugs?
Does Private Insurance Protect Canadians from the Cost of Cancer Drugs? by CHRIS BONNETT Private health insurance, the largest part being prescription drug coverage, has become the security blanket for
More informationEffective Jan. 1, 2016. STRS Ohio Health Care Program Guide
Effective Jan. 1, 2016 2016 STRS Ohio Health Care Program Guide 2 www.strsoh.org Welcome Thank you for your interest in the STRS Ohio Health Care Program. We understand choosing a health care plan is an
More informationPharmaCare is BC s public drug insurance program that assists BC residents in paying for eligible prescription drugs and designated medical supplies.
PHARMANET AND PHARMACARE DATA DICTIONARY Date Range: September 1, 1995 to present date, data is provided by calendar year Data Source: BC Ministry of Health Description The PharmaNet system is an online,
More informationKaiser Low-Income Coverage and Access Survey
Kaiser Low-Income Coverage and Access Survey Spotlight on Uninsured Parents: December 2007 How a Lack of Coverage Affects Parents and Their Families How Trends in the Health Care System Affect Low-Income
More informationCanadian Publicly Funded Prescription Drug Plans, Expenditures and an Overview of Patient Impacts
Canadian Publicly Funded Prescription Drug Plans, Expenditures and an Overview of Patient Impacts Prepared for Alberta Health Fiona M. Clement PhD; Lesley J.J. Soril MSc; Herbert Emery PhD; David J.T.
More informationCoinsurance A percentage of a health care provider's charge for which the patient is financially responsible under the terms of the policy.
Glossary of Health Insurance Terms On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. When making decisions about health coverage, consumers should
More informationPlanning for health care in retirement
FOR INVESTORS Planning for health care in retirement A guide to covering your medical expenses 1 Not FDIC Insured May Lose Value No Bank Guarantee You can stay on top of health care expenses The confidence
More informationTRENDS AND ISSUES EARLY RETIREE HEALTH INSURANCE ISSUES. By Marilyn Moon, American Institutes for Research and TIAA-CREF Institute Fellow
EARLY RETIREE HEALTH INSURANCE ISSUES By Marilyn Moon, American Institutes for Research and TIAA-CREF Institute Fellow March 2007 EXECUTIVE SUMMARY Individuals considering early retirement, i.e., retirement
More informationThe Impact of Prescription Drug Prices on Seniors
The Impact of Prescription Drug Prices on Seniors Over the years medicine has changed, particularly with respect to prescription drugs: more drugs are available, they are more frequently prescribed, and
More informationWhite Paper. Medicare Part D Improves the Economic Well-Being of Low Income Seniors
White Paper Medicare Part D Improves the Economic Well-Being of Low Income Seniors Kathleen Foley, PhD Barbara H. Johnson, MA February 2012 Table of Contents Executive Summary....................... 1
More informationCopayment: The amount you must pay for each medical visit to a participating doctor or other healthcare provider, usually at this time service.
Basic Terms How to calculate Out of Pocket Costs on a Hospital Stay: If you have a $2000 deductible and 30% coinsurance health insurance plan. If you have a $10,000 emergency room or hospital stay your
More informationFINAL REPORT AND RECOMMENDATIONS. Johns Hopkins University Benefits Advisory Committee
FINAL REPORT AND RECOMMENDATIONS Johns Hopkins University Benefits Advisory Committee 2012 The Faculty and Staff Benefits Advisory Committee (BAC) was jointly appointed by Professor Sarah Woodson, Chair
More informationHealth Insurance Buyers Guide. What You Need to Know to Get Started
Health Insurance Buyers Guide What You Need to Know to Get Started Time to Enroll The Affordable Care Act has changed the way that many people get health insurance. You may have more options and more ways
More informationBayCrest Insurance Services, 1275 S. Winchester Blvd., B, San Jose, CA 95128 Allan S. Eckmann. Medicare 2014
BayCrest Insurance Services, 1275 S. Winchester Blvd., B, San Jose, CA 95128 Allan S. Eckmann What is Medicare? Medicare 2014 Medicare is a Health Insurance Program for: * People age 65 or older * People
More informationAn Internist s Practical Guide to Understanding Health System Reform
An Internist s Practical Guide to Understanding Health System Reform Prepared by: ACP s Division of Governmental Affairs and Public Policy Updated October 2013 How to cite this guide: American College
More informationGuide to Medicare MEDICARE BASICS. Presented by
Guide to Medicare MEDICARE BASICS Presented by 14 Medicare Basics What Is Medicare? Medicare is health insurance for the following: People 65 or older People under 65 with certain disabilities People of
More information407-767-8554 Fax 407-767-9121
Florida Consumers Notice of Rights Health Insurance, F.S.C.A.I, F.S.C.A.I., FL 32832, FL 32703 Introduction The Office of the Insurance Consumer Advocate has created this guide to inform consumers of some
More informationOTTAWA 1800-160 Elgin St. Tel: (613) 230-2200 Ottawa, Ontario, Canada Fax: (613) 230-3793 K2P 2P7
What Canadians Say: The Way Forward Survey Report December 2013 Proprietary Warning The information contained herein is proprietary to the Canadian Hospice Palliative Care Association (CHPCA) and may not
More informationMedicare Economics. Part A (Hospital Insurance) Funding
Medicare Economics Medicare expenditures are a substantial part of the federal budget $556 billion, or 15 percent in 2012. They also comprise 3.7 percent of the country s gross domestic product (GDP),
More informationCommittee on Ways and Means Subcommittee on Health U.S. House of Representatives. Hearing on Examining Traditional Medicare s Benefit Design
Committee on Ways and Means Subcommittee on Health U.S. House of Representatives Hearing on Examining Traditional Medicare s Benefit Design February 26, 2013 Statement of Cori E. Uccello, MAAA, FSA, MPP
More informationThis glossary provides simple and straightforward definitions of key terms that are part of the health reform law.
This glossary provides simple and straightforward definitions of key terms that are part of the health reform law. A Affordable Care Act Also known as the ACA. A law that creates new options for people
More informationyour Benefits in Brief
your Benefits in Brief Salaried and Non-Union Non-Exempt Employees of Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals Northern California Kaiser Permanente is committed to providing
More informationFocus on Need: A Vision for Student Finance & the Student Movement February 17, 2015 STUDENTSNS.CA 1649 BARRINGTON ST., HALIFAX, NS B3J 1Z9
Focus on Need: A Vision for Student Finance & the Student Movement February 17, 2015 STUDENTSNS.CA 1649 BARRINGTON ST., HALIFAX, NS B3J 1Z9 FOCUS ON NEED: A Vision for Student Finance & the Student Movement
More information