Monday, June 21, 2010

Medicare Rx Plans Does AARP Offer?

What Medicare Rx Plans Does AARP Offer?

Three prescription drug plans will be offered in 2007. They are AARP Medicare Rx Plan, AARP Medicare Rx Plan - Enhanced, and AARP Medicare Rx Plan - Saver. Each plan may have one or more of the four tiers (co-pay/co-insurance coverage levels) offered for you to choose from.

Description of Tiers and Co-Pay

    * Tier 1 - This has the lowest co-pay and includes most generic drugs.
    * Tier 2 - This has the medium co-pay and includes preferred brand name drugs.
    * Tier 3 - This has higher co-pay and includes non-preferred drugs.
    * Specialty Tier - This is the highest cost co-insurance.

Each of the three plan options is unique. Listed below are the items covered by each plan.

AARP Medicare Rx Plan

    * Includes 100% of the drugs covered by Medicare Part D
    * Mid-priced premium
    * Flat and simple co-pays
    * No deductible
    * Over 60,000 participating network pharmacies

AARP Medicare Rx Plan - Enhanced

    * Includes 100% of the drugs covered by Medicare Part D
    * Tier 1 generic drug coverage (w/in coverage gap)
    * Bonus drug list (drugs not covered by Medicare Part D)
    * Flat and simple co-pays
    * No deductible
    * Over 60,000 participating network pharmacies

AARP Medicare Rx Plan - Saver

    * Low monthly premiums
    * Low co-pays
    * Annual deductible ($265)
    * Includes 100% of the drugs covered by Medicare Part D

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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download