It Is Medicare open-enrollment season. And retirees are confronting the usual confusion about what to do. Perhaps the biggest question: Should I enroll in a Medicare Advantage managed care plan or in traditional, fee-for-service Medicare? Like almost everything in the world of insurance, the answer is: It depends. In 2022, almost half of all Medicare beneficiaries were enrolled in MA [...]
Medicare Advantage (MA) managed care plans have the potential to vastly improve care for older adults in the US. A fully-integrated health model that combines primary and specialty care, physical therapy, hospital care and even some limited personal supports could improve the quality of life for patients and save the government a substantial amount of money. But increasingly, analysts say [...]
The Medicare trustees’ new estimate that the program’s Part A Hospital Insurance (HI) Trust fund will remain solvent for an extra two years—to 2028—sounds like good news. But dig deeper into the 257-page report and the news is grim for the future of Medicare and its 64 million beneficiaries. Headlines from the trustees’ annual report always focus on the depletion [...]
Medicare Advantage managed care plans, which in 2021 covered 26 million enrollees, will get an average 8.5 percent increase in total Medicare payments next year. At the same time, MA plans are rapidly embracing a wide range of social services and supports for older adults living at home. Sometimes called long-term care lite, these benefits range from meal and food [...]
Congressional Democrats are expected to include a broad expansion of traditional Medicare benefits-- including dental, vision, and hearing—in a $3.5 trillion social spending bill they’ll consider later this year. The move would be the biggest expansion of Medicare since Congress added a drug benefit in 2003 and would go a long way toward improving the health and well-being of millions [...]
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 [...]