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Excellus BlueCross BlueShield plans to introduce three new programs to reduce the cost of diabetic medications for members in 2021.
The health plan noted that one in 10 adults has diabetes and the cost of medications such as insulin continues to increase. More than $1 billion a year is spent on drugs to treat diabetes in Upstate New York, Excellus officials said.
“We recognize the connection the increasing prices of these medications can have on our members’ ability to take their medications as needed,” said Mona Chitre, chief pharmacy officer and vice president integrated clinical strategy for Excellus. “The availability of these new programs will help our members continue to have access to high-quality medications at a lower cost.”
Beginning Jan. 1, Excellus will offer savings on insulin and other diabetic medications for members enrolled in select commercial and Medicare health plans:
• NYS $100 Insulin Max — A program that limits the out-of-pocket expense for prescription insulin medications to no more than $100 for a 30-day supply of covered insulin.
• Patient Assurance Program — Members will pay no more than $25 for a 30-day supply of eligible Tier 2 diabetic drugs.
• Part D Senior Savings Model — Excellus will lower the cost of select insulin products to a maximum copay of $30 through the deductible, initial and coverage gap phases on select Medicare Advantage Direct Pay plans.
“Out-of-pocket costs can fluctuate one month to the next because of the different phases in the Part D prescription drug benefit. This program provides Medicare members with a set copay for their insulin from the beginning of the plan year through the coverage gap,” Chitre said of the Part D Senior Savings Model program. “Ensuring a consistent copay for members can lead to better adherence, and taking medication as directed can result in better health outcomes.”
The Part D program is expected to save Medicare beneficiaries roughly $446 in annual out-of-pocket costs for select insulins.
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