In its massive end-of-year spending bill, Congress slipped in some important changes that may improve Medicare coverage for hundreds of thousands of older adults who don’t enroll when they first are eligible. Unfortunately, lawmakers only did half the job. The changes will help, but Congress chose to ignore the real cause of the problem. This is complicated, just like everything [...]
Late last week, President Trump announced two new rules that he said would save Medicare enrollees billions of dollars in drug costs. They are unlikely to save a nickel. While there is a lot less to these new rules than President Trump claims, the real question is what steps President-elect Joe Biden and a divided Congress will take to lower [...]
No, PDGM is not a new disease. It is, instead, the way Medicare now pays for home health care. Shorthand for The Patient-Driven Groupings Model, PDGM is the Trump Administration’s latest effort to reduce Medicare costs. And it appears to be making it much harder for some patients living at home to receive occupational, physical, and speech therapy. PDGM is [...]
You are turning 65. But-- like 40 percent of other 65-year-olds-- you have not yet claimed your Social Security benefits. For many older adults, that choice makes good financial sense. Except for one problem: You may find yourself getting hit with big penalties for failing to enroll in Medicare. Why? Because you probably didn’t know you had to. Congress could [...]
Timed to show that they are not just about impeaching President Trump, House Democrats released a far-reaching plan to redesign the Medicare drug benefit. But the measure, which the House plans to vote on next week, goes well beyond an attempt lower drug prices. It would redesign Medicare Part D cost-sharing and add key core benefits to fee-for-service Medicare Part [...]
One of the biggest misconceptions seniors have about health care is this: I have Medicare so don’t need to worry about medical costs in old age. It is a dangerous mistake. Not only does traditional Medicare generally not pay for long-term supports and services (either at home or in a nursing home), but it doesn’t pay for a significant chunk [...]
In 2020, Medicare beneficiaries will have more opportunities to join Medicare Advantage (MA) managed care plans that offer limited personal supports and services such as home care, non-medical transportation, nutrition programs, and home modifications. The benefits, first allowed by the federal government for 2019, are not full-blown long-term care, but they do provide critical services and supports that may make [...]
This week’s second round of debates among Democratic presidential hopefuls is producing a (mostly healthy) conversation about health insurance. But for normal people, much of the argument is enormously confusing. What are these candidates talking about? And how are their plans different from today’s Medicare and from one another? One way to make this debate more comprehensible is to drop [...]
Patient advocates really, really want to believe that people discharged from a hospital are better off getting additional medical care and rehab at home than in a skilled nursing facility (SNF). But an important new study of 17 million Medicare claims over seven years tells a more ambiguous story. The study found that post-acute care at home resulted in significantly [...]
If you add up the proposed Medicare changes in President Trump’s 2020 budget, it looks like he would cut the program by $845 billion over the next decade. That’s generated outrage from Democrats, but a closer look suggests that the reductions are much smaller, most would affect providers rather than beneficiaries, and many recycle old ideas that have little chance of ever [...]