Judi Health™, the enterprise health technology company and benefits administrator, today announced the launch of Judi Rx Retire™. This newly formed Medicare Part D health plan was granted a contract and approved by the Centers for Medicare & Medicaid Services (CMS) as an Employer Group Waiver Plan (PDP-EGWP), enabling it to deliver prescription drug coverage to employer groups and their Medicare-eligible retirees. Leveraging Judi Health’s enterprise health platform, Judi®, Judi Rx Retire brings proven transparency, financial alignment, and better outcomes to Medicare-eligible retirees and the plan sponsors who cover them.

Plan sponsors are facing relentless pressure to manage rising healthcare costs, which are increasingly attributable to pharmacy benefits and skyrocketing specialty drug expenditures for the average plan. Judi Rx Retire provides a new option that brings industry-leading pharmacy benefit management (PBM) to employers without compromising quality or member care. And as more employers scrutinize their claims data and the language and pricing embedded in their PBM contracts, demand for truly transparent solutions will continue to accelerate. Judi Rx Retire answers that demand and complements Judi Rx™, which has been paying Medicare claims and providing world-class service to Medicare members since 2022.

“Retirees are often an afterthought in a healthcare system that continues to defy logic and reward complexity over clarity,” said AJ Loiacono, Chief Executive Officer of Judi Health. “With Judi Rx Retire, we’re providing necessary innovation and transparency. If pricing and the real cost of care are aligned, retirees receive better, more predictable benefits.”

Additionally, EGWP plans will now be able to access their claims data, remove unnecessary third-party ‘rent-seekers’ from their ecosystems, and verify the full value of the CMS subsidy. “In an industry where detailed claims transparency is the exception, not the rule, we believe clients deserve to see the details behind every dollar spent,” Loiacono added.

A New Standard for Retiree Pharmacy Benefits

Traditional EGWPs often obscure the true cost of medications through complex rebate arrangements and opaque pricing structures. “Judi Rx Retire takes a different approach, aligning the interests of retirees, employers, and the plan itself. Like Judi Rx, our new EGWP solution is powered by Judi and purpose-built for how retirees actually use their benefits, not the way legacy systems were designed to bill for them,” said Jason Barretto, SVP of Government Programs at Judi Health.

Judi Rx Retire plan coverage is built on a CMS-compliant formulary and includes standard Part D components such as pharmacy networks, cost sharing, deductibles, and the Medicare Prescription Payment Program (MPPP). The plan remains highly customizable, allowing employers to add coverage beyond standard Part D if desired.

Highlights of the Judi Rx Retire model vs. traditional EGWP administration include, but are not limited to:

  • One plan sponsor, one accountable party. Judi Rx Retire owns the CMS contract and direct CMS coordination, rather than splitting compliance, enrollment, and claims across multiple vendors.

  • Compliance is built into Judi, not bolted on. Continuous regulatory change management, annual and ongoing risk assessments, data validation and program audits, and required reporting and attestations.

  • One unified system of record. Eligibility, claims, network, formulary, prior authorization, MPPP, PDE management, and reporting all live in Judi, not stitched together across legacy platforms.

  • Plain-English adjudication. Every paid or rejected claim comes with a clear reason, reducing SME reliance and shortening inquiry resolution.

  • Proactive fraud, waste, and abuse defense. Every claim and provider is analyzed, and predictive models, real-time alerts, and detection rules are updated as the market and risks evolve.

  • An award-winning member care team, not an average call center. 24/7/365 domestic support is the standard, with under 30 seconds to reach a care advisor and 97% first-call resolution.

The launch of Judi Rx Retire reflects Judi Health’s broader commitment to innovation and rebuilding how pharmacy benefits and healthcare are delivered from the ground up. Rather than adapting outdated models or growing through acquisitions, the company builds solutions designed for the realities of modern healthcare and the people who depend on it.

To learn more about Judi Rx Retire, please contact our team.

About Judi Health™

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry’s first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.

At Judi Health, we’re deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.

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