October 23, 2023 • 25 mins
In this episode of The Community Check-In, Renee Sabin-Haggerty, Clinical Pharmacist and Director of Medicare Part D Strategy & Operations at Excellus BlueCross BlueShield gives valuable tips on how people with Medicare can save money on their prescription medications and stay healthy. Renee discusses the ways to cut prescription costs, government programs that can help, recent law changes and tips for managing diabetes. This episode is full of helpful advice to help Medicare members make smart decisions about their health and finances as they get older.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Welcome to excel Us Blue Cross BlueShields Community check In. Each week we
cover a specific topic featuring excel UsBlue Cross Blue Shield experts. You'll get
to know our team as we discussthe latest in healthcare, health education,
and community health. Find us atexcel USBCBS dot com and follow on Instagram
(00:26):
and Facebook. I'm Joelamonico and welcometo this week's check in. Healthy aging
is a goal that everyone aspires to, myself included. Now, there's a
lot of factors that contribute to maintaininggood health as we get older. Nutritious
diets, making sure you're moving properexercise, going to see your doctor regularly
for physical exams and tests, gettingvaccines when they're recommended for most people.
(00:51):
Prescription medications also play an important rolein staying healthy, but as we age,
many of us find that we takemore prescription medication to maintain our health,
and prescription medications they can be lifesavers. They also help seniors manage
chronic illnesses like hypertension and diabetes.But we all know that the costs continue
to go up. How do youbalance all of that? Today, we
(01:12):
have an expert with us. Wehave Renee Saban Haggerty, who is a
clinical pharmacist with over thirty years experience, and she manages the Medicare Part D
drug benefit program for Excellus Blue Cross, Blue Shield, and she's here to
share some tips with us to helpMedicare members simplify as well as economize on
their prescription medication. Renee, Welcometo the community check in. Why,
(01:34):
thank you, Joe, glad tobe here. All right, We're going
to start from the bottom and workour way up the bottom, meaning the
bottom line paying for prescription drugs.Let's talk about some of the ways that
Medicare members can save money on theirneeded and really very necessary prescription drugs.
Yeah, Joe, I mean it'sit's always a really tricky thing, truth
(01:57):
be told. If we're trying tosave money, it doesn't matter whether we're
buying groceries, were standing at thegas pump, or we're out there paying
for our utilities. We're always lookingto get a good value for our dollar.
So a couple things to think about. Most Medicare plans do have different
types of network setups, and oftentimesthe best way to get the lowest pay
(02:21):
the least amount would be to usea preferred pharmacy, so there may be
preferred pharmacies versus standard pharmacies, andyou could save money by using that preferred
those preferred pharmacies of which you canlook up using online directories. There is
also paper directories and of course contactingcustomer service which is always there to help.
(02:47):
Another item which is really critical andexcellent to help folks actually adhere to
their medication regimen is to fill ninetydays of ninety days applies of medicines when
available. So when you're taking amaintenance drug for as you mentioned before,
blood pressure, cholesterol doesn't really matterwhat it is if it's something that you
(03:10):
take every day. When you filla ninety day supply, it's been proven
that about twenty three percent of thatfolks are twenty three percent more adherent to
their drugs, meaning they're more likelyto take them if they have a larger
supply on hand, and in addition, they can likely save money by doing
a ninety day supply versus thirty days. And then lastly, you know there
(03:32):
are folks that take specialty drugs.Specialty drugs generally or higher and cost a
little bit more complex and generally requirespecial storage or handling. There are often
instances we're using a specialty pharmacy versusjust a traditional pharmacy can save folks money
(03:53):
but also increase the level of carethat they get to manage those very special
conditions like psoriasis or Crone's disease,or any one of a number of things.
And then, lastly, for convenienceand cost savings, using a pharmacy
to get vaccines, it just tendsto be the easiest way, certainly in
(04:15):
the state of New York, toget your vaccines, and pharmacists are duly
licensed to provide almost all adult preventativevaccines. It's one of the ways that
medicine and medications have been brought rightto the population that needs them the most.
If you say, get your medicationin a supermarket, as an example,
you're probably going to be there.What better way for you to get
(04:38):
those needed vaccines with that point ofcontact that you're also familiar with. I'll
also throw in making sure you haveautomatic refills set up or text alerts when
you need more things as a wayto not only save dollars, but also
to make sure that you always havethat medication on hand and you're getting that
needed medication and it's super convenient foryou. Absolutely, those are excellent points
(05:03):
stow using those services are great.The one key I would just mention is
if you're using autofil, to justbe thoughtful about what prescriptions you're picking up.
Don't go to the pharmacy and blindlypick up your prescriptions. Make sure
you review the ones that are thereto make sure your doctor hasn't discontinued something
(05:24):
or changed to dose or any oneof a number of things. But your
spot on really helpful. Pay attentionand utilize the resources of your pharmacy and
pharmacists. They're there and they arehappy to help you. But as we
mentioned on the onset, as weage in many instances, we need different
medications, more medications. With moremedications comes increased cost. Many seniors or
(05:48):
many people who are on the Medicareprograms live on fixed incomes or don't have
the ability perhaps to do all thatout of pocket. What programs are currently
available that you can remind people ofthat provides support to help offsetting the cost
of prescription medications. Sure, so, there's really two different mechanisms that a
(06:11):
person can seek up. One isto potentially look into the New York State
EPIC program. That program is theElderly Pharmaceutical Insurance Coverage Program and it basically
provides wrap around coverage for a partD, So when someone has Medicare D
pharmacy coverage, this oftentimes will easethe burden of the COPE for the member,
(06:39):
lower the kope for the member,and it really depends on what plan
they're own rolled in. So todetermine who's eligible, the best way to
go about doing that is to goto health dot New York dot gov and
search for the word EPIC. Thatwill pull up all the information and all
of the financial thresholds for the thatmay qualify for those programs. And then
(07:03):
the second thing is actually federally available, which is to go to SSA dot
gov, and this is where we'relooking for extra help associated with prescription drug
costs, and the same story istrue there where it gives you the different
levels for eligibility, et cetera.I think it's a very little known fact
(07:26):
that these services are out there,and just even just some cursory investigation,
people oftentimes find out that they areeligible can make a huge difference to their
bottom line. Lastly, I wouldsay that pharmacists are very very clever when
it comes to help easing the burdenrights of prescription drug costs. So,
(07:48):
you know, being a pharmacist myself, I suggest speaking with one. But
the second you know option of course, is to reach out to customer service
who are there to also help easethat and it excels that would be at
excel USBCBS dot com. Renee SabanHaggerty is a clinical pharmacist. She manages
the Medicare Part D drug benefit programfor Excell's Blue Cross Blue Shield and on
(08:11):
this community check in, we're helpingMedicare members simplify as well as economize on
their prescription medication. We have heardin the news about hopefully or potential moves
toward making some prescription medications more affordable, legislation that's potentially being looked at to
help with the costs for seniors.Let's take sort of just an helicopter view
(08:37):
of some of the things that's goingon right now. I know it's not
going to change things tomorrow, butperhaps in the near future there could be
some release or some consistency in pricingfor some of these medications. Absolutely.
In August of twenty twenty two,a bell was passed into law, and
as part of that law, basicallystarting in twenty twenty three, really really
(09:00):
excellent things happen. Number One,adult vaccines that are recommended by ASIP,
which is a governing body that basicallyvet's out what's appropriate for immunizations across everyone.
Basically what happened there is it wasdetermined that there'd be a zero dollar
cope associated with part dy vaccines thathave been recommended by this body, which
(09:26):
is wonderful because it's really pretty muchall the vaccines that most individuals would need
living in the United States, Sothe popular vaccines such as shing rex or
otherwise the shingles vaccine, and theneven more currently in the news, all
the rage around RSV vaccines, youprobably heard a lot about that, and
(09:50):
those are also covered at zero dollarcope and that was effective January of twenty
twenty three. At the same time, insul when was capped at thirty five
dollars for a month's supply. Therefore, no matter what drug plan you're involved
in, if it's a Medicare partydrug plan, a plan can charge you
(10:11):
no more than thirty five dollars fora month supply of insulin. That's huge,
absolutely huge. And lastly, inJuly, those members that actually get
their insulin under Part B, whichare pump users, get their's caped at
thirty five dollars. So that goesfrom a twenty percent cost here which has
been the case for years and yearsand years, to now being a thirty
(10:35):
five dollars cap just like if youwere to obtain it on the Part D
side. So this is really excellentfor those that are insulin dependent. It's
a huge it's a huge deal,and there's more to come in twenty twenty
four and twenty twenty five. Thatmakes a big difference, especially for insulin
users. As an example, we'veheard the stories of people who have had
to take less doses than they areasked to do or or directed to do
(10:58):
by doctors, skip doses because theycan't afford that. In fact, with
one point four million people in theUS diagnosed with diabetes every year, those
patients, especially newly diagnosed patients,who are now going to have to start
a maintenance drug and beyond that,potentially for the rest of their lives,
they're going to be not only overwhelmedwith questions and also they could have been
(11:20):
overwhelmed with cost prior to this legislationcoming through. Let's talk to those Medicare
members and who are managing diabetes.Now they've got some help, but cost
is only part of it. Ifthey're not taking the drug correctly and they're
not you know, they're not doingexactly what their doctor tells them to do.
Yeah. Absolutely so diabetes, givenhow complex it is, it can
(11:43):
affect things what we would call amacro level, which means big organs like
your heart, your cardiovascular disease,but can also it can also affect small
vessels like the blood vessels in youreyes, and can affect your eyesight.
So it really has far reaching implicationsif it goes unmanaged. So the point
(12:05):
that you make about being able toafford something does also set people up for
success. If they're able to affordtheir drugs, then therefore, hopefully they
can prevent these things from occurring.Also, obviously exercise, healthy eating,
just simple movement, standing, doingthings that just seems so simple they make
(12:31):
a huge difference. And regular checkupsof course, exactly. And you know,
having the access to all of that'syou know, it's not just about
the medication, it's the access toall of the support that's necessary. And
for diabetes, since we're talking aboutthat, let's let's stay with it.
It's not just the insulin, it'snot just the medication. There are layers
(12:52):
to how someone who manages this chroniccondition needs, They need supplies, they
need other things to go along withit. What is and typically is covered
by Medicare when it comes to thoseancillary things that go along with medic the
medicine that that patient needs to take. Yeah, you raise an excellent point.
(13:16):
Most individuals, depending on whether they'reon insulin or not on insulin,
are going to be testing their bloodsugar and they're going to generally do this
in one of two ways. Theyare going to use what's been available for
a million years a glue cometer,which is basically testing blood sugar at a
given moment in time. And withthat means you need supplies to be able
(13:39):
to use that machine, and thosesupplies can be costly as well, so
in the Medicare space. In originalmedicare, the costs that a member pays
for a person piece where is twentypercent of the total costs, which,
depending on how frequently you test,that can certainly drive costs up. Not
all benefits are that way though,so it's important to understand your benefit,
(14:03):
which for medicure members, they canfind out everything they need to know about
costs for diabetes in their explanation ofcoverage which comes out excuse me, their
evidence of coverage which comes out everyyear, explains everything. And the second
piece is what's becoming more common andyou hear about a lot more certainly through
(14:24):
advertising, is continuous blood glucose monitoring, where instead of just taking a snapshot
in time as to what someone's bloodsugar is, it is doing as it
sounds, it's constantly looking at thelevel of blood suger, which may help
folks that have more difficulty managing theirdiabetes keep it under better control. And
(14:46):
similar rules supply in terms of coverage. So it seems like in this space
there is a lot of support thatis available, supplies testing knowledge both in
person and online to help those whoare managing diabetes stay helpful, stay healthy,
and they're very helpful in able toyou know, having people do that.
(15:07):
Other benefits that we should be awareof and how that plays into the
medicare space. Yeah, I mean, one of the other things that I
would really think about is to really, as I said before, investigate what
you have as a benefit. Oftentimesthere is care management where somebody can have
one on one support from a nurseor somebody that's educated in diabetes to provide
(15:33):
that kind of hands on approach,because it can be a very intimidating and
scary diagnosis to get. So tobe able to look into all that and
be able to work with somebody thatreally understand is going to be super important.
I would say. Obviously testing asappropriate and based on what the doctors
(15:54):
recommended is key. And obviously takingany doing and a lab work that's required
by the provider to make sure thatthings are going that they're on track basically
not just on a daily basis,but you know, looking at the big
the big picture, those are myrecommendations. And to know that when you
(16:17):
are on a Medicare plan and youhave achieved the right coverage for you and
for your current conditions and your ongoingconditions, you know, if you've especially
if it's like let's say your firsttime, like you're brand new to it,
you've come off an employer plan,now you're onto a Medicare plan,
to know that the benefits are there, to know that you're not getting anything
(16:37):
less than what you may be usedto. You're getting a robust plan that's
going to suit your needs. You'veworked with someone from the right team who
is who has gotten you that rightcoverage to know that you're going to be
able to manage your chronic conditions.And we've talked a lot about diabetes,
but hypertension and high cholesterol and thingsof that nature, they all require ongoing
(16:59):
care and that team is going tobe there with the right resources to help
you get that on an ongoing basis. We are very fortunate to have Renee
Saban Haggerty with us today. She'sa clinical pharmacist managing the Medicare Part D
drug benefit program for Excell's Blue CrossBlue Shield. She helps Medicare members simplify
as well as economize on their prescriptionmedications. And we've talked a lot about
(17:21):
diabetes management. That's just one smallpart of how this care package works.
You mentioned vaccines. I want tocircle back around to it because as a
person of a certain age, Iget suggested every time I go to the
pharmacy, Hey, have you gotthe single shot yet? D n each
your flu shot yet? Have yougot the RSV shot, Yet seems to
be a lot of that. Rememberingand getting vaccines when we were kids.
(17:44):
I mean that was easy. Momsand dads took care of it. But
of course adults we need them too, And what should medicare members understand about
what the vaccine coverage is like wewant to expand on that, sure,
So I think I touched on thisa little bit earlier today where we talked
about the fact that based on thenew law that came about, most vaccines
that are covered under Part D thatare recommended by ACEIP are not going to
(18:08):
be zero dollars. And in NewYork State, again, the majority of
adult preventative vaccines can be attained ina pharmacy. It's as simple as going
in and having a conversation with thepharmacists about what are appropriate. And they
might say, oh, you're thisage, you need pneumonia shot, or
you're this age, I recommend RSV, or if you're over the age of
(18:30):
fifty, I recommendtion GRICKS. Youknow, it can be any one of
a number of recommendations, and someof these are more than one shot series.
So it's always also having the conversation. Okay, well, if I
give you this first dose, areyou going to be around for the second
dose? Right? That's really importantand it's you know, people can be
(18:52):
snowbirds and it's planning, right,So there are some intricacies there, But
in Part B, again it's beenaround a long, long long time,
flu, pneumonia and COVID nineteen arealways covered at zero costs, and they're
covered under the Part BE benefit.And again, vaccines they're safe and convenient
(19:14):
now that you don't have to makean appointment with a doctor's office in order
to get them when you need them, or to get those recommendations. Of
course, have a conversation with yourprimary care physician if you do have questions,
or with a pharmacist to know whatmight be right for you. Do
your due diligence, but that ifit are recommended, you know, as
we talked about, doctor's offices havethem, but just to reiterate in New
(19:37):
York State, they are available atother places and you don't necessarily even need
an appointment to get one. Absolutely, yeah, I mean yeah, I
absolutely nailed it there for sure.Joe. All right, great reminders,
and of course I do I haveto I do need to get my shingle
shot. I do have to keepreminding myself, Yes, when you go
and start your single series, you'reover fifty, all right, great reminders
(19:59):
for all of us, including myself. Rene. So we have a few
more minutes to spend with you hereon this community check in. What do
you really want our listeners to tokind of take away from all this discussion
we've done, really just a cursoryoverview of what benefits are available and how
to take advantage of those, maximizecoverage and minimize out of pocket expense.
(20:22):
Sure, I mean, I reallythink that it's much simpler than it seems.
Right. If you want to havea good quality of life, you
need to keep in touch with yourdoctor, keep your check keep your checkups,
take your medicines when they've been prescribed, and hopefully some of these cost
saving tips are going to make iteasier to do so. But don't be
(20:45):
afraid to have a dialogue with yourdoctor. Say, you know, Doc,
like, I'm on this drug,is there anything else that I could
take that's in the same family,And we'll do the trick but cost less.
I'm having trouble affording something. Honestyis best not taking something and not
(21:07):
telling your doctor isn't helping anyone.So I advise, you know, just
lay it out on the table,keep you know, keep getting your vaccines,
and keep moving, always keep moving. I mean, I couldn't recommend
anything more than that, because justsmall movement makes a big difference. So
it excels. Yeah, go ahead, isn't it. It's the least expensive
(21:30):
thing and the most accessible thing thatalmost anyone can do to help with ongoing
conditions of any variety is getting upand just taking a step or hopefully several
steps, maybe thousands of them aday if you can get them in.
Yeah, and if the step isn'teasy, just stand, just stand and
sit, bick down and stand backup. Yeah it does, I mean,
(21:52):
it really does get everything moving.So and again, have the conversations
with your doctor, have conversations withMedicare professionals like excell As, Blue Cross,
Blue Shield members can do. Havethose, you know, because prescription
drugs are a big part. Andthis is a discussion for another day about
how prescription drugs pay into overall costsand how that works into finding the right
(22:14):
plan. But there are always optionsand alternatives. As we mentioned earlier in
the show, there are assistance programsthat are available through the state, through
the federal government. Even some prescriptiondrug manufacturers will offer some additional assistance if
necessary, have the conversations, havea good understanding about what it is that
you need to stay as healthy aspossible, and then find the right pathway
(22:40):
using all of the resources that areavailable to you. So as we as
we wrap up in our final coupleminutes renee, why don't we let people
know where they can go to findinformation because there is really a wealth of
it and we want to direct themto the right place to get the most
the best information for them. Asa good starting point to have those conversations,
(23:02):
you bet the easiest thing to dowould be to go to medicure dot
excel us bc BS dot com orcall us at eight eight eight four three
five three nine four zero. Wealso have a presence on Facebook and Instagram
where we often share wellness tips andprogram information. As a reminder, if
(23:25):
you're a member, the app thatis available for your phone is really super
helpful, and of course our numbersare always on the back of your identification
card and we look forward to hearingfrom you any in any way we can
help you we will, so thatis Medicare dot excel, us, BCBS
dot com or toll free. It'seight eight eight four three five three nine
(23:51):
four zero. Follow on Facebook andInstagram because work, we're on our phones
pretty much anyway, so why notget the information sent directly to you?
And because there is an app foreverything. If you are a member within
the community and you would like tohave all that information warehoused right there in
one tap, you can find theapp in your app store. Renee,
(24:11):
thank you so very much for spendingsome time with us. Renee Saban Haggerty
our guest today on the Community checkIn. You say clinical pharmacist. She
manages Medicare Part D drug benefit programfor Excellus Blue Cross Blue Shield, and
she's been helping Medicare members simplify aswell as economize their prescription medications for the
better part of three decades. Thanksfor sharing some of your expertise with us
this week, Joe is a pleasureAs a ways, Thanks for joining us
(24:36):
on Community check In, a presentationof Excel's Blue Cross, Blue Shield and
iHeartRadio. Podcasts of Community check Inare available on the iHeartRadio app or wherever
you find your favorite audio content.For more ways to stay safe, healthy,
and educated, visit excel usbcbs dotcom and follow on Instagram and Facebook
Welcome to excel Us Blue Cross BlueShields Community check In. Each week we
cover a specific topic featuring excel UsBlue Cross Blue Shield experts. You'll get
to know our team as we discussthe latest in healthcare, health education,
and community health. Find us atexcel USBCBS dot com and follow on Instagram
(00:26):
and Facebook. I'm Joelamonico and welcometo this week's check in. Healthy aging
is a goal that everyone aspires to, myself included. Now, there's a
lot of factors that contribute to maintaininggood health as we get older. Nutritious
diets, making sure you're moving properexercise, going to see your doctor regularly
for physical exams and tests, gettingvaccines when they're recommended for most people.
(00:51):
Prescription medications also play an important rolein staying healthy, but as we age,
many of us find that we takemore prescription medication to maintain our health,
and prescription medications they can be lifesavers. They also help seniors manage
chronic illnesses like hypertension and diabetes.But we all know that the costs continue
to go up. How do youbalance all of that? Today, we
(01:12):
have an expert with us. Wehave Renee Saban Haggerty, who is a
clinical pharmacist with over thirty years experience, and she manages the Medicare Part D
drug benefit program for Excellus Blue Cross, Blue Shield, and she's here to
share some tips with us to helpMedicare members simplify as well as economize on
their prescription medication. Renee, Welcometo the community check in. Why,
(01:34):
thank you, Joe, glad tobe here. All right, We're going
to start from the bottom and workour way up the bottom, meaning the
bottom line paying for prescription drugs.Let's talk about some of the ways that
Medicare members can save money on theirneeded and really very necessary prescription drugs.
Yeah, Joe, I mean it'sit's always a really tricky thing, truth
(01:57):
be told. If we're trying tosave money, it doesn't matter whether we're
buying groceries, were standing at thegas pump, or we're out there paying
for our utilities. We're always lookingto get a good value for our dollar.
So a couple things to think about. Most Medicare plans do have different
types of network setups, and oftentimesthe best way to get the lowest pay
(02:21):
the least amount would be to usea preferred pharmacy, so there may be
preferred pharmacies versus standard pharmacies, andyou could save money by using that preferred
those preferred pharmacies of which you canlook up using online directories. There is
also paper directories and of course contactingcustomer service which is always there to help.
(02:47):
Another item which is really critical andexcellent to help folks actually adhere to
their medication regimen is to fill ninetydays of ninety days applies of medicines when
available. So when you're taking amaintenance drug for as you mentioned before,
blood pressure, cholesterol doesn't really matterwhat it is if it's something that you
(03:10):
take every day. When you filla ninety day supply, it's been proven
that about twenty three percent of thatfolks are twenty three percent more adherent to
their drugs, meaning they're more likelyto take them if they have a larger
supply on hand, and in addition, they can likely save money by doing
a ninety day supply versus thirty days. And then lastly, you know there
(03:32):
are folks that take specialty drugs.Specialty drugs generally or higher and cost a
little bit more complex and generally requirespecial storage or handling. There are often
instances we're using a specialty pharmacy versusjust a traditional pharmacy can save folks money
(03:53):
but also increase the level of carethat they get to manage those very special
conditions like psoriasis or Crone's disease,or any one of a number of things.
And then, lastly, for convenienceand cost savings, using a pharmacy
to get vaccines, it just tendsto be the easiest way, certainly in
(04:15):
the state of New York, toget your vaccines, and pharmacists are duly
licensed to provide almost all adult preventativevaccines. It's one of the ways that
medicine and medications have been brought rightto the population that needs them the most.
If you say, get your medicationin a supermarket, as an example,
you're probably going to be there.What better way for you to get
(04:38):
those needed vaccines with that point ofcontact that you're also familiar with. I'll
also throw in making sure you haveautomatic refills set up or text alerts when
you need more things as a wayto not only save dollars, but also
to make sure that you always havethat medication on hand and you're getting that
needed medication and it's super convenient foryou. Absolutely, those are excellent points
(05:03):
stow using those services are great.The one key I would just mention is
if you're using autofil, to justbe thoughtful about what prescriptions you're picking up.
Don't go to the pharmacy and blindlypick up your prescriptions. Make sure
you review the ones that are thereto make sure your doctor hasn't discontinued something
(05:24):
or changed to dose or any oneof a number of things. But your
spot on really helpful. Pay attentionand utilize the resources of your pharmacy and
pharmacists. They're there and they arehappy to help you. But as we
mentioned on the onset, as weage in many instances, we need different
medications, more medications. With moremedications comes increased cost. Many seniors or
(05:48):
many people who are on the Medicareprograms live on fixed incomes or don't have
the ability perhaps to do all thatout of pocket. What programs are currently
available that you can remind people ofthat provides support to help offsetting the cost
of prescription medications. Sure, so, there's really two different mechanisms that a
(06:11):
person can seek up. One isto potentially look into the New York State
EPIC program. That program is theElderly Pharmaceutical Insurance Coverage Program and it basically
provides wrap around coverage for a partD, So when someone has Medicare D
pharmacy coverage, this oftentimes will easethe burden of the COPE for the member,
(06:39):
lower the kope for the member,and it really depends on what plan
they're own rolled in. So todetermine who's eligible, the best way to
go about doing that is to goto health dot New York dot gov and
search for the word EPIC. Thatwill pull up all the information and all
of the financial thresholds for the thatmay qualify for those programs. And then
(07:03):
the second thing is actually federally available, which is to go to SSA dot
gov, and this is where we'relooking for extra help associated with prescription drug
costs, and the same story istrue there where it gives you the different
levels for eligibility, et cetera.I think it's a very little known fact
(07:26):
that these services are out there,and just even just some cursory investigation,
people oftentimes find out that they areeligible can make a huge difference to their
bottom line. Lastly, I wouldsay that pharmacists are very very clever when
it comes to help easing the burdenrights of prescription drug costs. So,
(07:48):
you know, being a pharmacist myself, I suggest speaking with one. But
the second you know option of course, is to reach out to customer service
who are there to also help easethat and it excels that would be at
excel USBCBS dot com. Renee SabanHaggerty is a clinical pharmacist. She manages
the Medicare Part D drug benefit programfor Excell's Blue Cross Blue Shield and on
(08:11):
this community check in, we're helpingMedicare members simplify as well as economize on
their prescription medication. We have heardin the news about hopefully or potential moves
toward making some prescription medications more affordable, legislation that's potentially being looked at to
help with the costs for seniors.Let's take sort of just an helicopter view
(08:37):
of some of the things that's goingon right now. I know it's not
going to change things tomorrow, butperhaps in the near future there could be
some release or some consistency in pricingfor some of these medications. Absolutely.
In August of twenty twenty two,a bell was passed into law, and
as part of that law, basicallystarting in twenty twenty three, really really
(09:00):
excellent things happen. Number One,adult vaccines that are recommended by ASIP,
which is a governing body that basicallyvet's out what's appropriate for immunizations across everyone.
Basically what happened there is it wasdetermined that there'd be a zero dollar
cope associated with part dy vaccines thathave been recommended by this body, which
(09:26):
is wonderful because it's really pretty muchall the vaccines that most individuals would need
living in the United States, Sothe popular vaccines such as shing rex or
otherwise the shingles vaccine, and theneven more currently in the news, all
the rage around RSV vaccines, youprobably heard a lot about that, and
(09:50):
those are also covered at zero dollarcope and that was effective January of twenty
twenty three. At the same time, insul when was capped at thirty five
dollars for a month's supply. Therefore, no matter what drug plan you're involved
in, if it's a Medicare partydrug plan, a plan can charge you
(10:11):
no more than thirty five dollars fora month supply of insulin. That's huge,
absolutely huge. And lastly, inJuly, those members that actually get
their insulin under Part B, whichare pump users, get their's caped at
thirty five dollars. So that goesfrom a twenty percent cost here which has
been the case for years and yearsand years, to now being a thirty
(10:35):
five dollars cap just like if youwere to obtain it on the Part D
side. So this is really excellentfor those that are insulin dependent. It's
a huge it's a huge deal,and there's more to come in twenty twenty
four and twenty twenty five. Thatmakes a big difference, especially for insulin
users. As an example, we'veheard the stories of people who have had
to take less doses than they areasked to do or or directed to do
(10:58):
by doctors, skip doses because theycan't afford that. In fact, with
one point four million people in theUS diagnosed with diabetes every year, those
patients, especially newly diagnosed patients,who are now going to have to start
a maintenance drug and beyond that,potentially for the rest of their lives,
they're going to be not only overwhelmedwith questions and also they could have been
(11:20):
overwhelmed with cost prior to this legislationcoming through. Let's talk to those Medicare
members and who are managing diabetes.Now they've got some help, but cost
is only part of it. Ifthey're not taking the drug correctly and they're
not you know, they're not doingexactly what their doctor tells them to do.
Yeah. Absolutely so diabetes, givenhow complex it is, it can
(11:43):
affect things what we would call amacro level, which means big organs like
your heart, your cardiovascular disease,but can also it can also affect small
vessels like the blood vessels in youreyes, and can affect your eyesight.
So it really has far reaching implicationsif it goes unmanaged. So the point
(12:05):
that you make about being able toafford something does also set people up for
success. If they're able to affordtheir drugs, then therefore, hopefully they
can prevent these things from occurring.Also, obviously exercise, healthy eating,
just simple movement, standing, doingthings that just seems so simple they make
(12:31):
a huge difference. And regular checkupsof course, exactly. And you know,
having the access to all of that'syou know, it's not just about
the medication, it's the access toall of the support that's necessary. And
for diabetes, since we're talking aboutthat, let's let's stay with it.
It's not just the insulin, it'snot just the medication. There are layers
(12:52):
to how someone who manages this chroniccondition needs, They need supplies, they
need other things to go along withit. What is and typically is covered
by Medicare when it comes to thoseancillary things that go along with medic the
medicine that that patient needs to take. Yeah, you raise an excellent point.
(13:16):
Most individuals, depending on whether they'reon insulin or not on insulin,
are going to be testing their bloodsugar and they're going to generally do this
in one of two ways. Theyare going to use what's been available for
a million years a glue cometer,which is basically testing blood sugar at a
given moment in time. And withthat means you need supplies to be able
(13:39):
to use that machine, and thosesupplies can be costly as well, so
in the Medicare space. In originalmedicare, the costs that a member pays
for a person piece where is twentypercent of the total costs, which,
depending on how frequently you test,that can certainly drive costs up. Not
all benefits are that way though,so it's important to understand your benefit,
(14:03):
which for medicure members, they canfind out everything they need to know about
costs for diabetes in their explanation ofcoverage which comes out excuse me, their
evidence of coverage which comes out everyyear, explains everything. And the second
piece is what's becoming more common andyou hear about a lot more certainly through
(14:24):
advertising, is continuous blood glucose monitoring, where instead of just taking a snapshot
in time as to what someone's bloodsugar is, it is doing as it
sounds, it's constantly looking at thelevel of blood suger, which may help
folks that have more difficulty managing theirdiabetes keep it under better control. And
(14:46):
similar rules supply in terms of coverage. So it seems like in this space
there is a lot of support thatis available, supplies testing knowledge both in
person and online to help those whoare managing diabetes stay helpful, stay healthy,
and they're very helpful in able toyou know, having people do that.
(15:07):
Other benefits that we should be awareof and how that plays into the
medicare space. Yeah, I mean, one of the other things that I
would really think about is to really, as I said before, investigate what
you have as a benefit. Oftentimesthere is care management where somebody can have
one on one support from a nurseor somebody that's educated in diabetes to provide
(15:33):
that kind of hands on approach,because it can be a very intimidating and
scary diagnosis to get. So tobe able to look into all that and
be able to work with somebody thatreally understand is going to be super important.
I would say. Obviously testing asappropriate and based on what the doctors
(15:54):
recommended is key. And obviously takingany doing and a lab work that's required
by the provider to make sure thatthings are going that they're on track basically
not just on a daily basis,but you know, looking at the big
the big picture, those are myrecommendations. And to know that when you
(16:17):
are on a Medicare plan and youhave achieved the right coverage for you and
for your current conditions and your ongoingconditions, you know, if you've especially
if it's like let's say your firsttime, like you're brand new to it,
you've come off an employer plan,now you're onto a Medicare plan,
to know that the benefits are there, to know that you're not getting anything
(16:37):
less than what you may be usedto. You're getting a robust plan that's
going to suit your needs. You'veworked with someone from the right team who
is who has gotten you that rightcoverage to know that you're going to be
able to manage your chronic conditions.And we've talked a lot about diabetes,
but hypertension and high cholesterol and thingsof that nature, they all require ongoing
(16:59):
care and that team is going tobe there with the right resources to help
you get that on an ongoing basis. We are very fortunate to have Renee
Saban Haggerty with us today. She'sa clinical pharmacist managing the Medicare Part D
drug benefit program for Excell's Blue CrossBlue Shield. She helps Medicare members simplify
as well as economize on their prescriptionmedications. And we've talked a lot about
(17:21):
diabetes management. That's just one smallpart of how this care package works.
You mentioned vaccines. I want tocircle back around to it because as a
person of a certain age, Iget suggested every time I go to the
pharmacy, Hey, have you gotthe single shot yet? D n each
your flu shot yet? Have yougot the RSV shot, Yet seems to
be a lot of that. Rememberingand getting vaccines when we were kids.
(17:44):
I mean that was easy. Momsand dads took care of it. But
of course adults we need them too, And what should medicare members understand about
what the vaccine coverage is like wewant to expand on that, sure,
So I think I touched on thisa little bit earlier today where we talked
about the fact that based on thenew law that came about, most vaccines
that are covered under Part D thatare recommended by ACEIP are not going to
(18:08):
be zero dollars. And in NewYork State, again, the majority of
adult preventative vaccines can be attained ina pharmacy. It's as simple as going
in and having a conversation with thepharmacists about what are appropriate. And they
might say, oh, you're thisage, you need pneumonia shot, or
you're this age, I recommend RSV, or if you're over the age of
(18:30):
fifty, I recommendtion GRICKS. Youknow, it can be any one of
a number of recommendations, and someof these are more than one shot series.
So it's always also having the conversation. Okay, well, if I
give you this first dose, areyou going to be around for the second
dose? Right? That's really importantand it's you know, people can be
(18:52):
snowbirds and it's planning, right,So there are some intricacies there, But
in Part B, again it's beenaround a long, long long time,
flu, pneumonia and COVID nineteen arealways covered at zero costs, and they're
covered under the Part BE benefit.And again, vaccines they're safe and convenient
(19:14):
now that you don't have to makean appointment with a doctor's office in order
to get them when you need them, or to get those recommendations. Of
course, have a conversation with yourprimary care physician if you do have questions,
or with a pharmacist to know whatmight be right for you. Do
your due diligence, but that ifit are recommended, you know, as
we talked about, doctor's offices havethem, but just to reiterate in New
(19:37):
York State, they are available atother places and you don't necessarily even need
an appointment to get one. Absolutely, yeah, I mean yeah, I
absolutely nailed it there for sure.Joe. All right, great reminders,
and of course I do I haveto I do need to get my shingle
shot. I do have to keepreminding myself, Yes, when you go
and start your single series, you'reover fifty, all right, great reminders
(19:59):
for all of us, including myself. Rene. So we have a few
more minutes to spend with you hereon this community check in. What do
you really want our listeners to tokind of take away from all this discussion
we've done, really just a cursoryoverview of what benefits are available and how
to take advantage of those, maximizecoverage and minimize out of pocket expense.
(20:22):
Sure, I mean, I reallythink that it's much simpler than it seems.
Right. If you want to havea good quality of life, you
need to keep in touch with yourdoctor, keep your check keep your checkups,
take your medicines when they've been prescribed, and hopefully some of these cost
saving tips are going to make iteasier to do so. But don't be
(20:45):
afraid to have a dialogue with yourdoctor. Say, you know, Doc,
like, I'm on this drug,is there anything else that I could
take that's in the same family,And we'll do the trick but cost less.
I'm having trouble affording something. Honestyis best not taking something and not
(21:07):
telling your doctor isn't helping anyone.So I advise, you know, just
lay it out on the table,keep you know, keep getting your vaccines,
and keep moving, always keep moving. I mean, I couldn't recommend
anything more than that, because justsmall movement makes a big difference. So
it excels. Yeah, go ahead, isn't it. It's the least expensive
(21:30):
thing and the most accessible thing thatalmost anyone can do to help with ongoing
conditions of any variety is getting upand just taking a step or hopefully several
steps, maybe thousands of them aday if you can get them in.
Yeah, and if the step isn'teasy, just stand, just stand and
sit, bick down and stand backup. Yeah it does, I mean,
(21:52):
it really does get everything moving.So and again, have the conversations
with your doctor, have conversations withMedicare professionals like excell As, Blue Cross,
Blue Shield members can do. Havethose, you know, because prescription
drugs are a big part. Andthis is a discussion for another day about
how prescription drugs pay into overall costsand how that works into finding the right
(22:14):
plan. But there are always optionsand alternatives. As we mentioned earlier in
the show, there are assistance programsthat are available through the state, through
the federal government. Even some prescriptiondrug manufacturers will offer some additional assistance if
necessary, have the conversations, havea good understanding about what it is that
you need to stay as healthy aspossible, and then find the right pathway
(22:40):
using all of the resources that areavailable to you. So as we as
we wrap up in our final coupleminutes renee, why don't we let people
know where they can go to findinformation because there is really a wealth of
it and we want to direct themto the right place to get the most
the best information for them. Asa good starting point to have those conversations,
(23:02):
you bet the easiest thing to dowould be to go to medicure dot
excel us bc BS dot com orcall us at eight eight eight four three
five three nine four zero. Wealso have a presence on Facebook and Instagram
where we often share wellness tips andprogram information. As a reminder, if
(23:25):
you're a member, the app thatis available for your phone is really super
helpful, and of course our numbersare always on the back of your identification
card and we look forward to hearingfrom you any in any way we can
help you we will, so thatis Medicare dot excel, us, BCBS
dot com or toll free. It'seight eight eight four three five three nine
(23:51):
four zero. Follow on Facebook andInstagram because work, we're on our phones
pretty much anyway, so why notget the information sent directly to you?
And because there is an app foreverything. If you are a member within
the community and you would like tohave all that information warehoused right there in
one tap, you can find theapp in your app store. Renee,
(24:11):
thank you so very much for spendingsome time with us. Renee Saban Haggerty
our guest today on the Community checkIn. You say clinical pharmacist. She
manages Medicare Part D drug benefit programfor Excellus Blue Cross Blue Shield, and
she's been helping Medicare members simplify aswell as economize their prescription medications for the
better part of three decades. Thanksfor sharing some of your expertise with us
this week, Joe is a pleasureAs a ways, Thanks for joining us
(24:36):
on Community check In, a presentationof Excel's Blue Cross, Blue Shield and
iHeartRadio. Podcasts of Community check Inare available on the iHeartRadio app or wherever
you find your favorite audio content.For more ways to stay safe, healthy,
and educated, visit excel usbcbs dotcom and follow on Instagram and Facebook
Popular Podcasts
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com