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Medicare, the federal health program for adults 65 and older, has been prohibited by law from covering weight loss drugs for older Americans who are obese but do not have diabetes or heart disease.
North Carolina stopped covering weight loss drugs such as Ozempic for state employees without diabetes. But it extended coverage for Medicaid recipients.
About 5.3 million people with Medicare prescription drug coverage used these medications from November 2023 through October 2024 at a cost of $41 billion to the government-funded health program ...
2.6 million were in the "coverage gap" due to the 19 states that chose not to expand the Medicaid program under the ACA/Obamacare, meaning their income was above the Medicaid eligibility limit but below the threshold for subsidies on the ACA exchanges (~44% to 100% of the federal poverty level or FPL); 5.4 million were undocumented immigrants;
The Medicaid Drug Rebate Program is a program in the United States that was created by the Omnibus Budget Reconciliation Act of 1990 (OBRA'90). The program establishes mandatory rebates that drug manufacturers must pay state Medicaid agencies related to the dispensing of outpatient prescription drugs covered by Medicaid .
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...
GLP-1 agonists like Ozempic have exploded over the past few years, thanks to data that show they can help people lose a significant amount of weight. But these medications aren’t perfect, and it ...
The primary public programs are Medicare, a federal social insurance program for seniors (generally persons aged 65 and over) and certain disabled individuals; Medicaid, funded jointly by the federal government and states but administered at the state level, which covers certain very low income children and their families; and CHIP, also a ...
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