Inflation Reduction Act
Posted on December 28, 2022
As communicated back in November 2022 with 2023 product updates, Health New England participates in the Part D Senior Savings Model Program for our Medicare Advantage members.
With this program, our members will not pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier the insulin is on even if the member has not paid their deductible. In accordance with the Inflation Reduction Act of 2022, this plan provides additional coverage for all insulin drugs that are not Select Insulin drugs covered under the Part D Senior Savings Model.
Here is what you need to know about the coverage:
- All insulin, not just Select, will cap at $35 during the deductible, initial coverage, coverage gap, and catastrophic stages.
- Any formulary exceptions that are approved are capped at $35.
- This applies to all Medicare Advantage Plans, including LIS Plans and Employer Group Waiver Plans.
- Program does not include insulin supplies such as BD pen needles, syringes.
- Includes all out-of-network pharmacies.
Our formularies indicate this change. We notified all applicable members and included this change in our Annual Notice of Change (ANOC) back in October when the Medicare enrollment period began.
For more information, you may call your Provider Relations Representative at (800) 842-4464, ext. 5000, or send an email to providerrelations@hne.com.
