What To Do if Medicare Denies Coverage for Prescription Drug

Congress recently made significant changes to Medicare's Part D prescription drug benefit as part of the Inflation Reduction Act. While some changes aim to help seniors afford their medications, others may have unintended consequences.On the positive side, insulin costs are now capped at $35 per month for Medicare beneficiaries. This has already provided relief for many seniors with diabetes.Starting in 2025, out-of-pocket Part D drug costs will be capped at $2,000 annually. Seniors will also have the option to spread these costs throughout the year through the new Medicare Prescription Payment Plan. These changes can benefit seniors who rely on multiple brand-name medicines or have fixed incomes.However, awareness of the new payment plan is low. Medicare could do more to inform seniors about this option, which requires opting in. Seniors should consider contacting their Part D insurers during open enrollment if they would benefit from spreading out pharmacy costs.The law's drug price negotiation provision has led to some unintended effects on drug development. At least 36 research programs and 22 experimental drugs have been discontinued as a result.Part D premiums have also increased. This year, standalone Part D plans were set to cost 21% more on average compared to last year. Many seniors switched to lower-cost options as a result. The number of available plans has decreased by about 25% since 2020.Some insurers have moved certain medications to tiers requiring higher out-of-pocket costs, restricting access to previously covered drugs. New rules like step therapy requirements have also been implemented, potentially making it harder for patients to access drugs their doctors recommend.It's important for seniors to understand these changes and their potential impacts on drug access before Medicare's open enrollment period begins in October.  Contact Carleen Lachman, Independent Insurance Specialist at 724-571-4688 to learn more.  

Note: this is not medical advice and should not replace a discussion with your own treating physician. This document was created after compiling helpful over the counter and home remedies from patients and colleagues.Winter is a beautiful time of the year, but it also brings along various illnesses. With the constant change in temperature and dry air, it's easy to catch a cold or flu. However, being sick doesn't have to be miserable. Here are some tips to help you through your winter sickness.First off, make sure you are getting enough rest. Your body needs time to fight off the illness, so getting plenty of sleep is essential. Drinking lots of fluids is also crucial to staying hydrated. Warm liquids such as tea or soup can help soothe your throat and loosen congestion. Second, take over-the-counter medication to relieve your symptoms. Decongestants can help relieve nasal congestion, and pain relievers such as acetaminophen or ibuprofen can help reduce fever and body aches. However, be sure to read the instructions carefully and consult with a doctor if you have any doubts.Lastly, try to avoid spreading your illness to others. Cover your mouth and nose when you cough or sneeze, and wash your hands frequently with soap and water. Stay home if you're feeling unwell to prevent spreading the illness to others, and mask up if you need to leave the house. Reminder that we are fortunate enough to have vaccinations against flu, COVID and RSV which cause significant respiratory illness.In conclusion, being sick during the winter can be tough, but with plenty of rest, hydration, and medication, you can make it through. Ive gathered up some of the most common remedies used by myself, my patients, and my followers on social media and shared them below. Remember to take care of yourself and stay warm during the chilly winter weather.  Straight Off the ShelfNote: if you take other medications, its important to talk with your physician or pharmacist about how these over the counter meds may interact with your prescribed meds       Cough o   Vicks Vapo Rub on the chest and bottoms of feet o   Coricidin (good for those with cough and high blood pressure) o   Delsym Cough Medicine: dextromethorphan containing cough meds help with cough suppression, for dry coughs o   Mucinex: guaifenesin containing meds help to loosen up mucus in your though to help you cough it up, for wet coughs o   Sudafed: pseudoephedrine is a decongestant and can make you pretty wired/awake. caution if you have high blood pressure o   Dimetapp for kiddos 6 and older       Congestion/sore throat o   Afrin nasal spray: temporary congestion relief o   Flonase nasal spray: great for post nasal drip that causes sore throat o   Saline nasal rinses       General cold/flu symptoms o   Dayquil/Nyquil: remember, these contain acetaminophen aka Tylenol. so dont mix with additional tylenol unless instructed by your physician Know your meds! acetaminophen is also known as Tylenol; ibuprofen is also known as Motrin and is the same class of medications as naproxen aka Aleve  Home/Herbal RemediesNote: if you take other medications, its important to talk with your physician or pharmacist about how these remedies may interact with your prescribed meds      Nin Jiom Pei Pa Koa-Chinese herbal throat and cough syrup       Green tea       Ginger tea       Boom boom inhaler stick       Lemon, honey, and chamomile tea       Sleep      Epsom salts baths       Oscillococcinum       Black elderberry syrup       Raw garlic with honey       Mullein tincture       Electrolyte rich drinks like liquid IV, LMNT, pedialyte-- monitor sugar content       Fermented foods       Reishi       Ashwaghanda       Foods high in vitamin C (citrus!)  Soothing Tea RecipeIn a saucepan, bring the following to a boil, then remove from heat and enjoy: tips and enjoy:       8 oz water       1 tbsp apple cider vinegar      1 tbsp honey       1 cinnamon stick       1 clove of peeled and smashed garlic       small piece of peeled ginger             Tips & Tricks From a PCP:      after a viral infection, cough can last 4-6 weeks in some cases. if you have fever with the cough or its getting worse, talk with your doctor as it could indicate a bacterial infection       never underestimate the power of sleep and resting your body       a fever is technically a temperature over 100.4 degrees F       the symptoms of COVID, flu, and RSV overlap significantly. getting tested for these infections may be helpful in determining if you need further intervention       your gut health is key to your immune system. you may not be able to fully prevent getting sick, but a healthy mind and body will help you with resilience and recovery. focusing on fiber, mindfulness, sleep and regular exercise can help your gut stay strong!       most viral infections last about 5-7 days. but if you are experiencing shortness of breath, chest pain, high fevers, difficulty swallowing, dizziness, or wheezing, contact your physician immediately

Switching to a healthier lifestyle often involves making significant changes to your diet, and one of the most challenging aspects can be finding nutritious and satisfying snacks. Traditional snack options, like chips, candy, and cookies, are often loaded with unhealthy fats, sugars, and artificial additives. Fortunately, there's a convenient and delicious solution: SnackEver.SnackEver is a subscription service that delivers a curated selection of healthy snacks directly to your doorstep each month. With a variety of boxes to choose from, there's something to suit every taste and dietary preference. Whether you're looking for gluten-free, vegan, keto friendly, organic, kosher, dairy free, or low-calorie options, SnackEver has you covered.Why Choose SnackEver?Convenience: Say goodbye to the hassle of searching for healthy snacks at the grocery store. SnackEver takes the guesswork out of snacking by delivering a carefully curated box of delicious and nutritious treats right to your door.Variety: With SnackEver, you'll never get bored of your snacks. Each month, you'll receive a new assortment of healthy goodies, including everything from protein bars and nuts to fruit chews and trail mix.Customization: SnackEver offers a variety of subscription options to cater to your individual needs and preferences. You can choose from monthly, bi-monthly, or quarterly plans, and you can even customize your box by selecting specific snacks or dietary restrictions.Cost-Effective: While healthy snacks can often be expensive, SnackEver offers a convenient and affordable way to enjoy nutritious treats. By subscribing, you'll often get a discount on the individual price of each snack.Discover New Favorites: SnackEver is a great way to discover new and exciting healthy snacks. With each box, you'll have the opportunity to try products from different brands and categories, helping you to find your new favorite go-to snack.The Benefits of Healthy SnackingIncorporating healthy snacks into your diet can have numerous benefits for your overall health and well-being. Here are just a few:Increased Energy: Eating healthy snacks throughout the day can help to stabilize your blood sugar levels and prevent energy crashes.Weight Management: By choosing nutritious snacks over unhealthy options, you can help to control your calorie intake and support weight loss or maintenance.Improved Nutrient Intake: Healthy snacks can be a great way to increase your intake of essential vitamins, minerals, and fiber.Enhanced Focus: Eating a balanced diet, including healthy snacks, can help to improve your cognitive function and concentration.If you're looking for a convenient and delicious way to incorporate more healthy snacks into your diet, SnackEver is the perfect solution. With its wide variety of options, customizable plans, and commitment to quality, SnackEver can help you achieve your health goals while enjoying delicious and satisfying treats.