A Transparent Medicare Plan

A Transparent Medicare Plan

A group of passionate pharmacy owners said enough is enough. After seeing the way insurance companies treat pharmacies, we decided to build Troy Medicare, a new insurance company that treats pharmacies right, with no DIR fees and recognition of the clinical role pharmacies play day-to-day. Press play on the video below and read on to learn more.

Pharmacy Transparency

We will bring transparency to pharmacy reimbursements in the following ways:

1. Instead of AWP and MAC, we will use NADAC, a transparent pricing Medicaid already uses throughout the country. NADAC is published on a weekly basis here: www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing/index.html
2. We will pay a fair dispensing fee between $4 and $10 for the community pharmacies in our network.
3. We will pay pharmacies a $360 – $500 per member per year payment for clinical services that reduce the healthcare costs for Troy Medicare patients.
4. No mail order

Medicare Advantage

eCare plans and the work CCNC has done with CPESN show that combining drugs with health is the future. The health insurance plans that cover both pharmacy and doctor costs see the direct savings of pharmacies driving down their health costs.

Nearly 40% of seniors are now on a Medicare Advantage, due to lower premiums, increased health benefits, and expanding provider networks. Troy Medicare will have a $0 premium and offer competitive health benefits with the top plans in each county.

“A plan that covers both pharmacy and health costs can see the direct savings of pharmacies driving down their health costs.”