LegisBrief: Obesity: Progress and Challenges - published May 2014 (PDF File) Richard Cauchi - email Beginning in 2012, the federal Affordable Care Act (ACA) allowed states to select an existing insurance plan to be the statewide “benchmark plan," a step toward more uniform and in-depth coverage nationwide such plans have to cover specified. This process led to 33 states selecting—or allowing the U.S. Department of Health and Human Services to establish as a federal default—two types of coverage for diagnoses and treatment of obesity as a medically recognized disease.  As a result, for most 2015 and 2016 policies -- In addition, as of Jan.1, 2014, the ACA requires: The table below lists state-specific Essential Health Benefits (EHB) and what specific obesity-related services and treatments are covered by each benchmark plan for 2013-2016 health plans, including individual state links. NOTE TO CONSUMERS: NCSL provides this information primarily as a tool for state policymakers to understand current state and federal standards. 

It is not intended as legal or medical advice related to individual insurance policies or patients.  For information about such specific coverage, authors advise contacting the individual health insurance carriers or the state insurance department, which in most states has oversight authority regarding the applicability of mandates and EHB coverage and reimbursement.Seat Covers On Leather Heated Seats The box allows you to conduct a full text search or use the dropdown menu option to select a state.Shark Tank Weight Loss Pill About the Authors:  Richard Cauchi, program director. Mobile Home Movers Columbus OhioAdditional research by Ashley Noble, policy associate, NCSL Heath Program, DenverLearn about drugs included in your plan

This page links you to information about the prescription drugs Humana covers. This information is for members with insurance through their employer. The Drug List is a list of prescription drugs developed and maintained by a medical committee comprised of doctors and pharmacists. The type of coverage your employer purchased may cause variances in drug coverage. Certain drugs may have coverage limitations based on duration or dosage or may require pre-approval. If you have specific questions about a medication or need a drug that does not appear on the list, please call the Customer Care number on the back of your member ID card. You can look up a specific drug and view coverage details. You can also see possible generic equivalents and alternative medications. You can download a printable list of the most widely prescribed drugs. Your plan's drug coverage may include specialty drugs for chronic and complex illnesses. Many of these medications may be obtained through specialty pharmacies in your network, like Humana Specialty Pharmacy.

Members in Puerto Rico need to use CVS/Caremark for specialty drugs. Other pharmacies are available in your network. Humana’s plans give you access to mail delivery pharmacies like Humana Pharmacy®. Humana pharmacy can ship your medications right to your door. With Humana Pharmacy, you can: Fill prescriptions for maintenance medications 3 months at a time. Receive most medications 10 to 14 days after you place your Humana Pharmacy order, and in 7 to 10 days for a refill. Talk directly to a pharmacist. Pharmacists review each new prescription. For more information, call Humana Pharmacy: 1-800-379-0092. If you use a TTY, call 711. Available Monday – Friday, 8 a.m. – 11 p.m. Eastern time; Saturday, 8 a.m. – 6:30 p.m. Eastern time. More about Humana’s Drug Lists Items on the Drug Lists may be added, changed or deleted from the Drug Lists at any time. This could affect the amount you pay for prescription drugs. Humana does not determine brand or generic status for the medications on our Drug Lists.

A nationally recognized, contracted healthcare vendor with Humana determines whether a drug is classified as a generic or brand-name drug. One of the primary factors for determining the status of a drug is the price. If pricing for a particular drug changes—as determined by using the average wholesale price—the brand or generic status may also change.The requested URL /register/april2013/proposed/16%20DE%20Reg%201028%2004-01-13.htm was not found on this server. Medicare Prescription Drug Plans are available from private insurance companies contracted with Medicare to provide and coordinate prescription benefits to beneficiaries. As a Medicare beneficiary, there are two ways for you to get prescription drug coverage (Medicare Part D): through a stand-alone Medicare Prescription Drug Plan, if you have Original Medicare, or through a Medicare Advantage Prescription Drug plan. Because these plans are offered through Medicare-approved private insurance companies, this basically means that each Medicare Prescription Drug Plan will provide different types of prescription drug coverage.

It's the insurance company that ultimately decides which drugs to cover under its prescription drug plan and at what benefit level. The different levels of covered drugs under the Prescription Drug Plan are called "tiers." The tiers represent how much you pay out of pocket for the Part D drugs listed in each particular tier. For example, the plan may have one tier for generic drugs, another for brand-name drugs, and even a third tier for preventive drugs used to control certain medical conditions. This list of covered prescription drugs is called a "formulary," and it contains all the drugs that the Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan will cover. Keep in mind that formularies may change at any time; your Medicare plan will notify you if necessary. Generally, a plan covers drugs that cost less at a higher level, meaning you pay less out of pocket. Thus, it's always in your interest to ask your doctor to prescribe drugs that are on your Medicare Prescription Drug Plan's formulary.

Usually, generic drugs are the least expensive. Each Medicare Prescription Drug Plan is required to publish its formulary on the plan’s website. The plan must also tell you when it removes drugs from the Part D formulary. The formulary may change at any time. You will receive notice from your plan when necessary. Medicare Prescription Drug Plans are restricted from making changes to the listed drugs -- or changing the tiered pricing -- between the beginning of the plan's annual election period until 60 days after the plan coverage begins. The exception to this is if the FDA determines a drug is unsafe or a manufacturer removes a drug from the market. Mid-year changes to formulary drugs are limited, and your plan must always notify you of such changes. The notification of change must include the name of the drugs, Part D change type (e.g., add/remove/tier change), the reason for the change, alternate drugs, new Part D cost sharing, and exceptions. Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug plans cover all commercially available vaccine drugs when medically necessary to prevent illness.