Actuarial Outpost
 
Go Back   Actuarial Outpost > Actuarial Discussion Forum > Health - Disability
FlashChat Actuarial Discussion Preliminary Exams CAS/SOA Exams Cyberchat Around the World Suggestions

Actuarial Jobs by State

New York  New Jersey  Connecticut  Massachusetts 
California  Florida  Texas  Illinois  Colorado


View Poll Results: Should consumers worry about CVS buying Aetna?
Yes 7 38.89%
No 11 61.11%
Voters: 18. You may not vote on this poll

Reply
 
Thread Tools Search this Thread Display Modes
  #11  
Old 12-05-2017, 02:41 PM
mathmajor's Avatar
mathmajor mathmajor is offline
Member
SOA AAA
 
Join Date: Dec 2010
Location: Nowhere in particular
Studying for Japanese
College: B.S. Applied Math
Favorite beer: La Croix Grapefruit
Posts: 9,214
Default

PBMs have copay card programs already that detect these and allow their use, but don't allow the "assistance" amount to count toward deductibles and OOP maxes. Some programs actually assist the patient in finding copay assistance.
__________________
FSA

Exams or whatever
Reply With Quote
  #12  
Old 12-05-2017, 02:43 PM
mathmajor's Avatar
mathmajor mathmajor is offline
Member
SOA AAA
 
Join Date: Dec 2010
Location: Nowhere in particular
Studying for Japanese
College: B.S. Applied Math
Favorite beer: La Croix Grapefruit
Posts: 9,214
Default

Quote:
Originally Posted by Sredni Vashtar View Post
This was already happening. My company recently dropped coverage from all but one of the big pharmacy chains (I forget which).
What you are describing sounds like mandatory mail. You can use the mail order pharmacy or certain retail outlets for long-term 90 days fills. Acute meds should be covered in the normal network (which may exclude certain pharmacies but not all but one)

For CVS, it's CVS (duh) and ESI I think is Walgreens?
__________________
FSA

Exams or whatever
Reply With Quote
  #13  
Old 12-05-2017, 02:47 PM
mathmajor's Avatar
mathmajor mathmajor is offline
Member
SOA AAA
 
Join Date: Dec 2010
Location: Nowhere in particular
Studying for Japanese
College: B.S. Applied Math
Favorite beer: La Croix Grapefruit
Posts: 9,214
Default

Quote:
Originally Posted by DataDan View Post
my first thought was 'what will happen to the Aetna PBM contracts?'. Then I read that CVS is the Aetna PBM. So now CVS has the Insurer, the PBM, the Pharmacy, and if i read this right they are starting some non-rx medical services. Seems like a good leverage combo to negotiate with manufacturers.

Id say the biggest losers here are the stand alone PBMs and Big Pharma companies. For consumers, it just means walking into a different cattle shoot to get medical care.
What's the difference, going forward? Aetna has used CVS for a while and switched over Coventry's ESI business when they bought them. Aetna already has a pharmacy department and gets all the data it needs from CVS.

Now, it may spell trouble for folks wanting to use Aetna and carve out pharmacy to another PBM besides CVS, or not use whatever standard discount terms (probably lousy) they'll propose.

It may very well mean tighter care management but I sincerely doubt the systems will be merged anytime soon. They're two completely different platforms. ESI took forever to merge with Medco and they ran the same business.
__________________
FSA

Exams or whatever
Reply With Quote
Reply

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


All times are GMT -4. The time now is 07:49 PM.


Powered by vBulletin®
Copyright ©2000 - 2018, Jelsoft Enterprises Ltd.
*PLEASE NOTE: Posts are not checked for accuracy, and do not
represent the views of the Actuarial Outpost or its sponsors.
Page generated in 0.28412 seconds with 12 queries