Health Insurance Matters: Good News for July, Happy Independence Day!

Many low-income retired people who were receiving Medi-Cal benefits are shocked to learn that once they have turned 65, a different set of qualification rules are applied, and it now becomes an out-of-pocket expense.

For those under age 65, the only criteria for assistance have been based on income. Assets, like your savings, investments, assets, etc. are not counted. Once you turn 65, the assets are looked at, and many lose their qualification for assistance. The limit for assistance was available if your assets of $2,000 for individuals and $3,000 for couples were no higher, excluding all but the very poor.

All that is about to change. Effective Friday, the asset limit will be increased to $130,000, essentially removing this roadblock for most people. One home and one car will continue to be exempt. Beginning January 2024, it goes away completely.

FTC, DOJ urged to probe blood thinner price hikes

Sen. Amy Klobuchar (D-MN) and Rep. Katie Porter (D-CA) sent a letter calling on the Justice Department and the Federal Trade Commission to investigate whether Johnson & Johnson (Xarelto) and Bristol Myers Squibb (Eliquis) illegally coordinated price increases for blood thinners whose prices have more than doubled since their market launch.

"The prices for these two competing products have risen every year since they entered the market at a rate far outpacing inflation, without any meaningful improvements to the medications or any apparent increase in production costs," the lawmakers wrote.

In related news, CVS Caremark, the prescription benefit manager (PBM), will be returning Eliquis to its Medicare formulary due to the public outcry about it being dropped off many of the Medicare prescription plans. I heard that there is a possibility that one or both of these medications will have very reduced co-pays once the 2023 Medicare Advantage plans are finalized. The recommendations are set to be submitted to the regulators in July.

Speaking of next year, I will hopefully announce in October that several plans will have lower costs on some insulin drugs.

Harry P. Thal, the Medicare Guru in Kernville, is available for free phone consultations. Call for a phone appointment at 760-376-2100 or 800-498-8425, or send an email to [email protected].