US 8,265,953 B2 · Medicare pharmacy calculator II

Abstract

A method and apparatus for providing a Medicare Part D Pharmacy Benefits Calculator. A computer user inputs data for prescriptions to be purchased by a prospective insured for a plan period. The prescription data includes a quantity, a days supply, and a number of fills. The data for each prescription the user enters is used to calculate anticipated out-of-pocket costs for the prescriptions for one or more pharmacy benefits plans available to the prospective insured. The cost data is presented to the user in a way that illustrates how out-of-pocket costs will vary over the course of a plan period. The user may view costs for alternative drugs and alternatives sources of drugs. The user may vary and expand the presentation of the cost data to better understand the available plan benefits. The invention helps prospective insureds decide among alternative Medicare Part D pharmacy benefits plans offered by one or more insurance companies.

Claims28

Dependent claims

A computerized method for calculating and displaying to a computer user anticipated out-of-pocket pharmacy costs under at least one Medicare Part D pharmacy benefit plan, comprising:

a) receiving at a server from said computer user prescription data for a plurality of drugs, said prescription data comprising a drug identifier and a number of fills during a plan period;
b) defining at said server a schedule for purchasing said drugs, said schedule comprising:
1) for each month of said plan period, drug fills assigned to said month;
and
2) a number of drug fills for one month that differs from a number of drug fills for another month;
c) calculating at said server an anticipated out-of-pocket cost for each drug fill according to said schedule of drug fill assignments wherein calculating an anticipated out-of-pocket cost for each drug fill comprises:
i) applying simulated adjudication to each drug fill to determine a cost for said drug fill under said at least one Medicare Part D pharmacy benefit plan according to said schedule;
ii) identifying at least one Medicare Part D stage applicable to said drug fill;
iii) determining an anticipated out-of-pocket cost for said drug fill according to each applicable Medicare Part D stage;
iv) storing data for said anticipated out-of-pocket cost for said drug fill according to said assignments;
v) repeating steps i-iv for each drug fill;
and
d) generating at said server for display to said computer user anticipated out-of-pocket costs for said plan period according to said schedule by:
i) presenting for each applicable month of said plan period an anticipated out-of-pocket cost for each drug fill assigned to said month;
and
ii) presenting in association with each applicable month an indicator of whether more than one Medicare Part D stage is applicable to said month.

13 more elements

A computerized method for calculating and displaying anticipated out-of-pocket pharmacy costs to a computer user under at least one Medicare Part D pharmacy benefit plan, comprising:

a) receiving at a server from said computer user prescription data for a plurality of drugs, said prescription data comprising a drug identifier and a number of fills during a plan period;
b) defining at said server a schedule for purchasing said drugs, said schedule comprising:
1) for each month of said plan period, drug fills assigned to said month;
and
2) a number of drug fills for one month that differs from a number of drug fills for another month;
c) calculating and storing at said server an anticipated out-of-pocket cost for each drug fill according to said schedule of drug fill assignments by:
i) applying simulated adjudication to each drug fill to determine for each drug fill an anticipated cost under said at least one Medicare Part D pharmacy benefit plan according to said schedule;
ii) identifying at least one Medicate Part D stage applicable to said drug fill;
and
lii) determining an anticipated out-of-pocket cost for said drug fill according to each applicable Medicare Part D stage;
d) calculating and storing at said server for each month of said plan period a total anticipated out-of-pocket cost by summing for each month of said plan period an anticipated out-of-pocket cost for each drug fill anticipated to be purchased during said month;
and
e) generating at said server for display to said computer user a list of month-by-month anticipated out-of-pocket costs for applicable months of said plan period wherein said list comprises:
i) an identifier for a month;
ii) an anticipated out-of-pocket cost for said month;
and
iii) an indicator for a Medicare Part D stage applicable to said month.

14 more elements

A computerized method for calculating and displaying anticipated out-of-pocket pharmacy costs to a computer user under at least one Medicare Part D pharmacy benefit plan, comprising:

a) receiving at a server from said computer user prescription data for a plurality of drugs, said prescription data comprising a drug identifier and a number of fills during a plan period;
b) defining at said server a schedule for purchasing said plurality of drugs, said schedule comprising:
1) for each month of said plan period, drug fills assigned to said month;
and
2) a number of drug fills for one month that differs from a number of drug fills for another month;
c) calculating at said server an anticipated out-of-pocket cost for each drug fill according to said schedule of drug fill assignments wherein calculating an anticipated out-of-pocket cost comprises:
i) applying simulated adjudication to determine at said server a cost for said drug fill under said at least one Medicare Part D pharmacy benefit plan according to said schedule;
ii) identifying at said server at least one Medicare Part D stage applicable to said drug fill;
iii) determining at said server an anticipated out-of-pocket cost for said drug fill according to each applicable Medicare Part D stage;
iv) storing at said server data for said anticipated out-of-pocket cost for each drug fill according to said assignments;
v) repeating steps i-iv for each drug fill;
and
d) generating at said server for display to said computer user according to said schedule month-by-month anticipated out-of-pocket costs organized in a table comprising:
i) a listing of months for said plan period;
ii) a list of drug fills for each month;
iii) an anticipated out-of-pocket cost for each drug fill;
and
iv) an indicator of whether more than one Medicare Part D stage is applicable to said drug fills for said month.

15 more elements

A computerized method for calculating and displaying to a computer user anticipated out-of-pocket pharmacy costs under at least one Medicare Part D pharmacy benefit plan, comprising:

a) receiving at a server from said computer user prescription data for a plurality of drugs, said prescription data comprising a drug identifier and a number of fills during a plan period;
b) defining at said server a schedule for purchasing said drugs, said schedule comprising:
1) for each month of said plan period, drug fills assigned to said month;
and
2) a number of drug fills for one month that differs from a number of drug fills for another month;
c) simulating adjudication of each drug fill assignment to calculate at said server an anticipated out-of-pocket cost for each drug fill under said at least one Medicare Part D pharmacy benefit plan according to said schedule;
d) generating at said server for display to said computer user anticipated out-of-pocket costs for said plan period according to said schedule by:
i) presenting for each applicable month of said plan period an anticipated out-of-pocket cost for each drug fill assigned to said month;
and
ii) presenting in association with each applicable month an indicator of at least one Medicare Part D stage applicable to said month.

7 more elements

Dependencies are inferred from the claim text.

Medicare pharmacy calculator II

Life of this patent

Medicare pharmacy calculator II

Life of this patent

Abstract

Claims28