RE: Medicare Managed Care Plans and Immunosuppressant Coverage in 2011

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I was under the impression patients could not have a supplement with an MA plan? Sara Danner| Transplant Financial Coordinator | Memorial Medical Center | Springfield, ILPhone: | Fax: | E-mail:danner.sara@... CHOOSE GREAT. CHOOSE MEMORIAL. From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of lmk_276@...Sent: Wednesday, December 01, 2010 11:27 AMTo: TxFinancialCoordinators Subject: Re: Medicare Managed Care Plans and Immunosuppressant Coverage in 2011 We have plenty of patients who have Medicare Advantage plans that are already structured like this. They have to follow Medicare guidelines and pay like Medicare B would pay for immunosuppressive medications. Medicare B covers at 80% andthe patient is responsible for the remainder (unless they have a supplement plan). However, most of the Medicare Advantage plans also have a stop loss that includes coinsurances for part B meds. Once that amount is met, then the plan pays at 100% includingimmunos. Is there a stop loss w/ these plans? Leah KnowlesCMCCharlotte NCSubject: Medicare Managed Care Plans and Immunosuppressant Coverage in 2011 [1 Attachment]To: txfinancialcoordinators Date: Wednesday, December 1, 2010, 12:16 PM Hello everyone Recently here at my organization we learned of upcoming changes in 2011 with the Blue Cross Blue Shield Medicare Managed Care Plans Keystone 65 and Personal Choice 65 and reimbursement for immunosuppressant medications. In 2011 transplant recipients with the above-mentioned plans will become responsible for the 20% coinsurance of their immunosuppressant medications. This is going to have a huge impact on the Pennsylvania transplant patient community andI was wondering if anything similiar to what I have described has happened with the Medicare Managed Care products in your state and if so how did you center handle it. I have enclosed the benefits information from the 2011 Evidence of Coverage for Keystone 65 Rx HMO This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message.Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.