{"id":7902,"date":"2022-12-28T15:33:33","date_gmt":"2022-12-28T15:33:33","guid":{"rendered":"http:\/\/hnetalk.com\/provider\/?p=7902"},"modified":"2022-12-28T15:34:08","modified_gmt":"2022-12-28T15:34:08","slug":"inflation-reduction-act-1-23","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/inflation-reduction-act-1-23\/","title":{"rendered":"Inflation Reduction Act"},"content":{"rendered":"<p>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.<\/p>\n<p><em><strong>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.<\/strong> <\/em>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.<\/p>\n<p>Here is what you need to know about the coverage:<\/p>\n<ul>\n<li>All insulin, not just Select, will cap at $35 during the deductible, initial coverage, coverage gap, and catastrophic stages.<\/li>\n<li>Any formulary exceptions that are approved are capped at $35.<\/li>\n<li>This applies to all Medicare Advantage Plans, including LIS Plans and Employer Group Waiver Plans.<\/li>\n<li>Program does not include insulin supplies such as BD pen needles, syringes.<\/li>\n<li>Includes all out-of-network pharmacies.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>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.<\/p>\n<p>For more information, you may call your Provider Relations Representative at (800) 842-4464, ext. 5000, or send an email to <a href=\"mailto:providerrelations@hne.com\" target=\"_blank\" rel=\"noopener\">providerrelations@hne.com<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>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 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[162,161],"class_list":["post-7902","post","type-post","status-publish","format-standard","hentry","category-provider-newsletter","tag-inflation-reduction-act","tag-insulin"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-23s","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/7902","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=7902"}],"version-history":[{"count":1,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/7902\/revisions"}],"predecessor-version":[{"id":7903,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/7902\/revisions\/7903"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=7902"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=7902"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=7902"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}