February’s newsletter is full of helpful, money saving ideas. 

Leading off is something you have heard me say before, this time with a twist. You can save a LOT of money on generics by using discount cards like GoodRx and SingleCare, but there are also ways to save on BRAND names by becoming an INFORMED SHOPPER.

You probably had no idea drug copays can change DURING the year, but they CAN. Check out DRUG FORMULARIES to learn more.

Roughly half the population age 65 and older have diabetes. Diabetes can cause heart attack, heart failure, stroke, kidney failure and coma. These complications can lead to your death. Cardiovascular disease in particular is the leading cause of death in adults with diabetes.

Learn more by reading What is Diabetes?

Did you know that, in some cases, insulin can be covered by Medicare Part B? This can lower your OOP cost by shifting what your insulin cost AWAY from your drug plan and charging it to Part B.

Learn about how the $35 insulin cap impacts you and learn about a diabetes DME provider that might offer more than your current resource. ADS files your eligible claims with Part B . . . something most drug stores cannot do. Learn more at DME supplies and Disease Management.

Finally, what is turmeric and can it naturally lower your blood sugar levels and blood pressure? Does it interfere with your prescription medications?

Read Should you add TURMERIC to your supplement list?

Most of the questions I get are about the PDP (Prescription Drug Plan). I spend a lot of time up front (and ongoing via my monthly newsletter) about ways to maximize your drug plan by not using it except when the plan produces a lower copay. Probably half of my clients have either the $7 SilverScript plan or the $11 Wellcare plan and use discount cards like GoodRx or SingleCare, mail order (including Canadian pharmacies),  PAP's or ask their provider to change them to a lower priced med.

Eliquis is a $500 drug with a copay as low as $47 on SilverScript Plus ($69 premium) until the insured hits the GAP.

Pradaxa is similar to Eliquis and has a generic that can be as low as $78 using SingleCare and will never push the client into the donut hole.

Educating  clients on the way their plans work, including PDP, goes a long way towards minimizing questions AND complaints.

https://q1medicare.com/faq/FAQ.php?cat=Monthly-Formulary-Changes&category_id=127

As new drugs are approved and more information about new uses for current drugs becomes available, pharmacy and therapeutic committees meet regularly to review their drug formularies and make adjustments.

This means that drugs can be added or removed from the drug formulary at any time. They can also move specific medications from tier to tier depending on several factors.

The Food and Drug Administration approves a new medication.

The Food and Drug Administration approves an existing medication as part of treatment for a new disease category.

A medication has been withdrawn from the market for safety reasons.

A medication becomes available without a prescription. Over-the-counter drugs are not typically covered under prescription drug plans.

A brand-name medication loses its patent and generic versions become available.

Insurers adjust based on the usage patterns

Because your drug formulary can change at any time, it is important that you check it regularly. If you haven’t already, look for a copy of your drug formulary on your health plan benefits website. You can also contact them on the phone and request a printed copy.

https://www.patientadvocate.org/explore-our-resources/drug-formulary-lists/can-my-drug-formulary-change/

Every plan creates its own formulary structure, decides which drugs it will cover and determines which tier a drug is on. One plan may cover a drug that another doesn’t. The same drug may be on tier 2 in one plan’s formulary and on tier 3 in a different plan’s formulary.

Formularies change. A plan may add or remove a drug from its formulary or move a drug into a different tier. Usually, plans must inform members in advance if a drug is to be removed.

https://www.uhc.com/news-articles/medicare-articles/what-is-a-tiered-formulary-and-what-does-it-mean-for-me

Roughly half of those who are age 65 and older have some form of diabetes. A percentage are type 1 (formerly referred to as “juvenile diabetes”) but the majority of diabetics are type 2.

There's no cure for type 2 diabetes, but losing weight, eating well and exercising can help you manage the disease. If diet and exercise aren't enough to manage your blood sugar, you may also need diabetes medications or insulin therapy.

Factors that may increase your risk of type 2 diabetes include:

Weight. Being overweight or obese is a main risk.

Fat distribution. Storing fat mainly in your abdomen — rather than your hips and thighs — indicates a greater risk. Your risk of type 2 diabetes rises if you're a man with a waist circumference above 40 inches (101.6 centimeters) or a woman with a measurement above 35 inches (88.9 centimeters).

Inactivity. The less active you are, the greater your risk. Physical activity helps control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.

Blood lipid levels. An increased risk is associated with low levels of high-density lipoprotein (HDL) cholesterol — the "good" cholesterol — and high levels of triglycerides.

Age. The risk of type 2 diabetes increases as you get older, especially after age 35.

Potential complications of diabetes and frequent comorbidities include:

Heart and blood vessel disease. Diabetes is associated with an increased risk of heart disease, stroke, high blood pressure and narrowing of blood vessels (atherosclerosis).

Nerve damage (neuropathy) in limbs. High blood sugar over time can damage or destroy nerves, resulting in tingling, numbness, burning, pain or eventual loss of feeling that usually begins at the tips of the toes or fingers and gradually spreads upward.

Other nerve damage. Damage to nerves of the heart can contribute to irregular heart rhythms. Nerve damage in the digestive system can cause problems with nausea, vomiting, diarrhea or constipation. For men, nerve damage may cause erectile dysfunction.

Kidney disease. Diabetes may lead to chronic kidney disease or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.

Hearing impairment. Hearing problems are more common in people with diabetes.

Sleep apnea. Obstructive sleep apnea is common in people living with type 2 diabetes. Obesity may be the main contributing factor to both conditions. It's not clear whether treating sleep apnea improves blood sugar control.

Dementia. Type 2 diabetes seems to increase the risk of Alzheimer's disease and other disorders that cause dementia. Poor control of blood sugar levels is linked to more-rapid decline in memory and other thinking skills.

Managing diabetes can be expensive but doesn’t have to be so. In addition to medication (insulin, oral medication, glucose monitors, insulin pumps, etc.) your health care costs can add up.

Here are some tips that you may not know about.

Original Medicare Part B only pays for insulin that is administered through an external insulin pump (continuous subcutaneous infusion pump). This coverage is provided under Part B

Many PDP formularies cap your insulin copay at $35 . . . but there is a catch. Your particular plan may or may not include the type of insulin you use, but that doesn’t have to be a roadblock.

Many types of insulin are interchangeable. If your insulin(s) is/are not offered by your plan for $35 ask your pharmacist to suggest a comparable substitute then have your doctor write a prescription for the suggested insulin.

Here is a bonus. In addition to catching a break on the front end with a reduced copay, when your insulin comes with a $35 copay you avoid the GAP (donut hole) unless you have other meds that still accumulate towards the drug levels

I recently discovered the “mother of all diabetes assistance” websites. If you are diabetic, especially insulin dependent, this webpage is for you.

https://insulinhelp.org/

You may also qualify for Copay Relief through the Patient Advocate Foundation. Note: the PAF has copay relief for a number of medical conditions, not just diabetes.

https://copays.org/funds/

I was recently introduced to a highly recommended DME provider that specializes in diabetic supplies.

ADS/North Coast carries all CGM brands and monitoring supplies, insulin pumps and pump supplies, and accessories.

As an accredited pharmacy and a durable medical equipment (DME) supplier, ADS helps customers save money by billing Medicare Part D and B, or private insurance.

Their Customer Care team will take the time necessary to answer any questions you may have about your insurance coverage, guidelines, requirements, new products, how to use your new products and much more.  Their goal is to provide you with the knowledge, products and services you need to help make managing your diabetes easier.

If you would like more information about this provider, please contact me for a referral to Brenda Anderson. She is very knowledgeable and helpful. You will NOT get a sales pitch. Brenda will listen to your questions and offer suggestions that can save you money and simplify your life. 

Should You Add Turmeric to your Supplement List?

Turmeric is a yellow-orange spice originating in southern Asia. It’s a popular ingredient in many Indian and Middle Eastern dishes as well.

It’s also consumed for its health benefits. Supplements containing turmeric or curcumin — its main active ingredient — are becoming increasingly common.

Turmeric can also lower blood sugar and may enhance the effects of antidiabetic drugs or insulin (Trusted Source)

Since turmeric can lower blood pressure, it may have additive effects with antihypertensive drugs

Dietary turmeric does not significantly influence how your body processes medications.

However, turmeric’s effects may increase or interfere with the actions of some of the medication you are taking.

For example, turmeric has an anticoagulation effect, meaning it can interfere with blood clotting. Taking curcumin with anticoagulant drugs or blood thinners such as aspirin, clopidogrel (Plavix), or warfarin (Jantoven) can increase their effects and may lead to excessive bleeding.

February . . .

February is the month remembered for Groundhog day and Valentines . . . but it also has a day devoted to DARK CHOCOLATE. If you missed the celebration there are no rules against celebrating late.

Learn more about this fascinating month and all the things you can celebrate at the National Day Calendar.

That’s all for now. Please forward this newsletter to your friends.