Author: Emery S.

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The Shocking Murder of UnitedHealthcare CEO: Unraveling the Mystery and Examining U.S. Healthcare Insurance

by Emery S.

The recent murder of UnitedHealthcare CEO Brian Thompson has sent shockwaves through the healthcare industry and beyond. On December 4, 2024, Thompson was fatally shot outside a New York City hotel, where he was set to address colleagues and investors at a conference. As the investigation unfolds, authorities are piecing together clues to understand the motive behind this brazen attack and its implications for the healthcare insurance landscape in the United States.

The Incident

Brian Thompson, a prominent figure in the healthcare industry, was ambushed and shot multiple times by…

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How PBMs Determine Medication Prices

by Emery S.

Pharmacy Benefit Managers (PBMs) play a crucial role in the prescription drug supply chain, acting as intermediaries between drug manufacturers, pharmacies, and insurance companies. They help manage prescription drug benefits, negotiate prices, and determine which drugs are included in health plan formularies. But how do they come up with the prices for medications, and what are contracted rates?

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Sarah’s Journey Through Prescription Coverage for GLP-1 Medications

by Emery S.

Imagine Sarah, a dedicated mother of two, who has been battling Type 2 diabetes for years. Despite her best efforts with diet and exercise, her blood sugar levels remained stubbornly high. Her doctor suggested trying a GLP-1 medication, a promising new treatment that could help her manage her diabetes and even lose some weight. Little did Sarah know, this was just the beginning of her journey…

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GLP-1 Medications

by Emery S.

GLP-1 medications, also known as glucagon-like peptide-1 agonists, are a class of drugs primarily used to treat Type 2 diabetes and obesity. They work by mimicking the action of the naturally occurring GLP-1 hormone, which helps regulate blood sugar levels and promotes a feeling of fullness1.

Here are some key points about GLP-1 medications…

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Navigating Step Therapy

by Emery S.

Imagine this: Jane, a dedicated teacher, was recently diagnosed with rheumatoid arthritis. The diagnosis itself was overwhelming, but what followed was equally challenging—managing her prescription coverage and understanding step therapy.

The Beginning of the Journey

Jane’s doctor prescribed a medication that could potentially ease her pain and improve her quality of life. Eager to start her treatment, she headed to the pharmacy, only to learn that her insurance required something called “step therapy.”

Unpacking Step Therapy

Step therapy is essentially a process used by insurance companies to control the cost and ensure…

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Key Terminologies Explained

by Emery S.

Navigating the world of prescription coverage insurance can feel like learning a new language. But fear not—once you understand the key terminologies, it all starts to make sense. Here’s a guide to help you decode the jargon and make informed decisions about your healthcare.