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Post by MnkdWASmyRtrmntPlan on Jan 5, 2018 21:31:01 GMT -5
Regarding MNHoldum's Formulary update for January 2018 'http://mnkd.proboards.com/post/134635/thread I seem to remember Mike saying recently that there would be a big increase in Medicare coverage in January. Anyone else remember that? Could it be coming a little later in the month? I hope!  |
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Post by cjm18 on Jan 5, 2018 23:14:12 GMT -5
And virtually no changes overall since September. Label change doing wonders.
I don’t remember mike saying anything optimistic about medicare but he did say there was a big carrier going to be announced. And one called to wish congratulations on the label change.
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Post by sportsrancho on Jan 6, 2018 5:47:11 GMT -5
And virtually no changes overall since September. Label change doing wonders. I don’t remember mike saying anything optimistic about medicare but he did say there was a big carrier going to be announced. And one called to wish congratulations on the label change. That’s what I remember. |
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Post by agedhippie on Jan 6, 2018 8:18:15 GMT -5
And virtually no changes overall since September. Label change doing wonders. I don’t remember mike saying anything optimistic about medicare but he did say there was a big carrier going to be announced. And one called to wish congratulations on the label change. That’s what I remember. If a drug is approved by Medicare for reimbursement does that mean that PBMs selling Medicare plans can cover the drug, or must cover the drug? Or are prescriptions handled some other way (I haven't quite reached Medicare age yet but getting close). |
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Post by sportsrancho on Jan 6, 2018 8:28:47 GMT -5
If a drug is approved by Medicare for reimbursement does that mean that PBMs selling Medicare plans can cover the drug, or must cover the drug? Or are prescriptions handled some other way (I haven't quite reached Medicare age yet but getting close). I was just talking to someone about this yesterday. Medicare covers hospitalization and doctors, you have to sign up for another plan like AARP or secure horizon to get drugs. I believe that’s how it works, but would love to hear from someone on Medicare if this is actually the case. |
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Post by timri on Jan 6, 2018 8:46:12 GMT -5
If a drug is approved by Medicare for reimbursement does that mean that PBMs selling Medicare plans can cover the drug, or must cover the drug? Or are prescriptions handled some other way (I haven't quite reached Medicare age yet but getting close). I was just talking to someone about this yesterday. Medicare covers hospitalization and doctors, you have to sign up for another plan like AARP or secure horizon to get drugs. I believe that’s how it works, but would love to hear from someone on Medicare if this is actually the case. Original Medicare Parts A and B doesn't include prescription drug coverage. And you don't automatically get prescription drug coverage when you sign up for Medicare. Some Medicare Advantage plans include prescription drug coverage. But you can also get Part D drug coveragein a standalone Medicare prescription drug plan. www.aarpmedicareplans.com/health-plans/prescription-drug-plans.html |
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Post by sportsrancho on Jan 6, 2018 8:51:05 GMT -5
I was just talking to someone about this yesterday. Medicare covers hospitalization and doctors, you have to sign up for another plan like AARP or secure horizon to get drugs. I believe that’s how it works, but would love to hear from someone on Medicare if this is actually the case. Original Medicare Parts A and B doesn't include prescription drug coverage. And you don't automatically get prescription drug coverage when you sign up for Medicare. Some Medicare Advantage plans include prescription drug coverage. But you can also get Part D drug coveragein a standalone Medicare prescription drug plan. www.aarpmedicareplans.com/health-plans/prescription-drug-plans.html Thanks timri:-) |
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Post by slugworth008 on Jan 6, 2018 16:40:06 GMT -5
I was just talking to someone about this yesterday. Medicare covers hospitalization and doctors, you have to sign up for another plan like AARP or secure horizon to get drugs. I believe that’s how it works, but would love to hear from someone on Medicare if this is actually the case. Original Medicare Parts A and B doesn't include prescription drug coverage. And you don't automatically get prescription drug coverage when you sign up for Medicare. Some Medicare Advantage plans include prescription drug coverage. But you can also get Part D drug coveragein a standalone Medicare prescription drug plan. www.aarpmedicareplans.com/health-plans/prescription-drug-plans.html That is correct, however most, if not all, Med-advantage plans DO have prescription drug coverage. |
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Post by MnkdWASmyRtrmntPlan on Jan 6, 2018 18:59:33 GMT -5
Since nobody else said that they recalled Mike mentioning a Medicare coverage increase coming up in January, 2018, I went through his recent presentations and I could not find that claim. However, I only found one radio broadcast and I thought there were two. The one I found was the Wharton Business Radio Sirius XM that Sla posted. I searched for "radio" and "broadcast", but perhaps those words are not contained in it. Anyone know of another radio interview Mike did in Qtr 4? Say, 2 to 3 months ago. Otherwise, I'll just write it off to defective memory.
The only thing I did find is:
Expansion of payor coverage - Mike C said they were ready to sign with a large PBM in Jan 18.
That is probably what I was thinking of.
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Post by mnholdem on Jan 6, 2018 19:51:35 GMT -5
I'm now wondering if Afrezza was approved for Medicare Part D, but then MannKind must negotiate pricing with various payers that administer the Medicare coverage?
Medicare Part D with AARP would be a really BIG deal that could significantly boost sales of Afrezza.
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Post by sla55 on Jan 6, 2018 19:55:05 GMT -5
MiKe C. did mention this in the Q3 2017 Results - Earnings Call: "We continue to expect an increase in payer coverage as we go into 2018 and beyond."
I don't know if this is what you are referring to.
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Post by brotherm1 on Jan 6, 2018 20:19:13 GMT -5
I'm now wondering if Afrezza was approved for Medicare Part D, but then MannKind must negotiate pricing with various payers that administer the Medicare coverage? Medicare Part D with AARP would be a really BIG deal that could significantly boost sales of Afrezza. I don’t know how accurate the results are from searches on this site. I searched Aftezza through a handful of states earlier today without good results. Perhaps since it’s only the first week of the year, this site is not accurate. q1medicare.com/PartD-BrowseMedicare-2018PlanFormulary.php |
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Post by dreamboatcruise on Jan 6, 2018 20:58:45 GMT -5
Since nobody else said that they recalled Mike mentioning a Medicare coverage increase coming up in January, 2018, I went through his recent presentations and I could not find that claim. However, I only found one radio broadcast and I thought there were two. The one I found was the Wharton Business Radio Sirius XM that Sla posted. I searched for "radio" and "broadcast", but perhaps those words are not contained in it. Anyone know of another radio interview Mike did in Qtr 4? Say, 2 to 3 months ago. Otherwise, I'll just write it off to defective memory. The only thing I did find is: Expansion of payor coverage - Mike C said they were ready to sign with a large PBM in Jan 18. That is probably what I was thinking of. You may be recalling that sometime early in 2017 there was mention (not sure who it was) by management that Medicare formularies are updated once a year and thus they didn't expect dramatic change in Medicare coverage until Jan 2018. I, and I think some others, assumed that meant they had some confidence that they would get improvement starting Jan 2018, but in reality the statement may have really only said that it would be Jan 2018 at earliest that Medicare coverage would be improved significantly, but with no real indication of probability. |
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Post by sportsrancho on Jan 6, 2018 21:29:35 GMT -5
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Post by slugworth008 on Jan 6, 2018 21:41:40 GMT -5
I deal with UHC on a fairly regular basis in the state of Washington - Their dual snp plan is king out here - and Afrezza is no where to be seen and I meet with diabetics all the time - I typically put them in Royal Neighbors or Foresters policies as they are diabetic friendly with regards to rates and coverage (Whole life). Total bullshit IMO - But that is a company that Mike C and crew should focus on. If and when MNKD gets Afrezza on the UHC tier drug coverage - game friggen on IMO |
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