Seniors in premium arrears face payment suspension
Government has confirmed that seniors who fall behind on paying their FutureCare premiums will have payments suspended on prescription drugs.
However, the coverage will be restored once arrears are paid up.
A Health department spokeswoman said: “It is standard practice for any health insurer to suspend paying claims when a premium has not been paid. This is ordinarily resolved through reminders to the policy holder, and it is not unique to FutureCare.
“The general public understands this. As with utility bills, cell phone, or any other bill, if a bill is not paid, after a time the service is normally suspended.”
FutureCare’s pharmacy benefit covers 80 percent of the bill for prescription drugs, up to a yearly maximum of $2,000 per calendar year. If a policy holders falls more than 30 days into arrears, the benefits lapse and they must pay full cost for prescriptions.
“The pharmacy claims for persons in arrears with premium payment have always been rejected upon receipt by FutureCare,” the spokeswoman added. “ However, the pharmacies now have more accurate information about who is current with their premium. This allows them to charge seniors who are in lapse status at the point of issuing the prescription drugs instead of receiving a rejection notice from FutureCare and then having to pursue seniors for the full payment of the drugs.”
Letters have been sent out to FutureCare policy holders, leading One Bermuda Alliance seniors advocate Louise Jackson to decry the policy as a first.
The Ministry called this “incorrect”.
“Pharmacy claims under FutureCare have consistently been denied when persons are in arrears with premium payment,” the spokeswoman told
The Royal Gazette. “Pharmacy claims were denied under HIP (when it had a prescription drug benefit) when persons were in arrears with premium payments. All other medical claims for individuals on FutureCare were and continue to be denied for non-payment of premium.”
Once seniors catch up in payments, receipts for prescriptions will be reimbursed for FutureCare’s portion.
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