Medicare
- The Medicare Advantage ripoff every American should know about - Raw Storywww.rawstory.com The Medicare Advantage ripoff every American should know about
President George W. Bush and Republicans (and a handful of on-the-take Democrats) in Congress created the Medicare Advantage scam in 2003 as a way of routing hundreds of billions of taxpayer dollars into the pockets of for-profit insurance companies. Those companies, and their executives, then recyc...
If you hit a paywall, try this link: https://archive.ph/UGwzY
- Drugmakers opt in to Medicare drug price negotiations – here's what happens nextwww.cnbc.com Drugmakers opt in to Medicare drug price negotiations – here's what happens next
The lengthy negotiation process with Medicare won't end until August 2024, with reduced prices going into effect in January 2026.
>All drugmakers of the first 10 medicines selected for Medicare drug price negotiations have agreed to participate in the talks, even after many of them sued to halt the process last month.
- Medicare Premiums Are Going Up Next Year. Here's How Muchwww.cnet.com Medicare Premium Costs Are Going Up in 2024. Here's How Much
It's projected that Medicare Part B premiums will be more expensive in 2024, but Part D should be slightly cheaper.
- Brokers Earn More to Steer New Beneficiaries to Medicare Advantage -www.medpagetoday.com Brokers Earn More to Steer New Beneficiaries to Medicare Advantage
Agent says he would double earnings if he sold MA over Medigap plans to new clients
When a broker tells you they sell all products so they'll only recommend what works best for you, don't believe it.
There are enormous financial incentives for brokers to sell Medicare Advantage policies over Medigap policies.
- CMS Issues Draft Guidance on New Program to Allow People with Medicare to Pay Out-of-Pocket Prescription Drug Costs in Monthly Paymentswww.hhs.gov CMS Issues Draft Guidance on New Program to Allow People with Medicare to Pay Out-of-Pocket Prescription Drug Costs in Monthly Payments
New Medicare Prescription Payment Plan will help people pay Medicare Part D costs over the year instead of all at once
>By enabling seniors and people with disabilities with Medicare Part D coverage to spread out cost sharing over the year, the program could reduce the burden of high upfront out-of-pocket prescription drug costs.
>“For people with Medicare Part D who face high costs early in the year, today’s announcement will ease the burden of out-of-pocket prescription drug costs,” said HHS Secretary Xavier Becerra. “This is one more example of how the President’s prescription drug bill is reducing costs and increasing access to life-saving medicines for our Medicare beneficiaries.”
- Inflation Reduction Act Continues to Lower Out-of-Pocket Prescription Drug Costs for Drugs with Price Increases Above Inflationwww.cms.gov Inflation Reduction Act Continues to Lower Out-of-Pocket Prescription Drug Costs for Drugs with Price Increases Above Inflation | CMS
CMS announces savings for some people with Medicare on 34 Part B prescription drugs
- Medicare Advantage Plans Receive Bloated Bonus Payments with Little to Show for It - Center for Medicare Advocacymedicareadvocacy.org Medicare Advantage Plans Receive Bloated Bonus Payments with Little to Show for It - Center for Medicare Advocacy
Bonus payments don't mean better care, and ratings systems are flawed and inaccurate.
- Humana sues Biden admin to prevent Medicare clawbacks of billion of dollars in overpayments
Medicare projected it would recoup $4.7 billion from insurers in the next decade under the policy it finalized earlier this year.
This is Medicare fraud and it affects everyone. These are funds that should be used for patient care and medical payments. These insurers are stealing from all of us and it affects everyone's medical care, whether on Medicare or not.
- On the First Anniversary of the Inflation Reduction Act, Millions of Medicare Enrollees See Savings on Health Care Costswww.hhs.gov On the First Anniversary of the Inflation Reduction Act, Millions of Medicare Enrollees See Savings on Health Care Costs
One year ago today, on August 16, 2022, President Biden signed into law landmark legislation to lower health care costs for millions of Americans, known as the
- These 10 medications are likely targets for Medicare price negotiations this fallwww.cnbc.com These 10 medications are likely targets for Medicare price negotiations this fall
It's still unclear which drugs Medicare will select, but several companies have revealed in court filings that four of their medications are targets.
- Centers for Medicare and Medicaid notifying 645,000 Medicare members about data breachwww.databreaches.net Centers for Medicare and Medicaid notifying 645,000 Medicare members about MOVEit breach (UPDATED)
Update: This incident was reported to HHS as affecting 1,362,470 patients. The Centers for Medicare and Medicaid (CMS) has posted a notice on its site about a...
The article doesn't give a link to the bulletin from Centers for Medicare and Medicaid, but here is. https://www.cms.gov/newsroom/press-releases/cms-responding-data-breach-contractor
- Medicare Advantage Is A Scamcrooksandliars.com Medicare Advantage Is A Scam
Congressional Dems, Activists 'Raise the Alarm' About Medicare Advantage 'Scam'.
- 2024 Proposed Medicare Physician Fee Schedule Reaffirms Need for Congressional Actionwww.aafp.org 2024 Proposed Medicare Physician Fee Schedule Reaffirms Need for Congressional Action
2024 Proposed Medicare Physician Fee Schedule Reaffirms Need for Congressional Action.
- Biden administration finalizes rule to target 'misleading' Medicare Advantage ads | CNNwww.cnn.com Biden administration finalizes rule to target 'misleading' Medicare Advantage ads | CNN
US health officials have issued a final rule that not only makes some changes to Medicare -- including expanding access to behavioral health care and clarifying criteria guidelines -- it cracks down on "misleading" advertisements.
- Biden administration moves ahead with Medicare drug price negotiations amid industry lawsuits | CNN Politicswww.cnn.com Biden administration moves ahead with Medicare drug price negotiations amid industry lawsuits | CNN Politics
Undeterred by a growing number of lawsuits, the Biden administration on Friday released revised guidance for Medicare’s new drug price negotiation program.
- Where to start?
The U.S. Medicare program is complex and people just starting out can find it overwhelming. The two options generally available (besides basic Medicare coverage) are Medicare Advantage and Medigap. Each state can make their own rules about plans, so what's available to you can depend on where you live.
Medicare Advantage is not Medicare, it is private insurance and comes with most of the baggage people may have experienced with employee sponsored health insurance. There are prior authorizations, limited provider networks, geographical limitations, significant fine print, HMO's, PPO's and insurance companies who can and sometimes do deny care. MA plans can offer perks like dental and optical coverage, gym memberships, and nurse and doctor hotlines. They generally include some kind of drug coverage.
Medigap works alongside standard Medicare and all coverage determinations are made by Medicare. The portion of a bill that is not covered by Medicare is automatically forwarded to the Medigap insurer and they pay it with almost zero exceptions. There are no provider networks or geographical limitations (as long as you're getting care in the U.S.). If a provider takes Medicare they will also take Medigap. A separate drug plan will probably be required. If Medicare doesn't provide coverage for a doctor or service, neither will your Medigap plan. Some of the plans also offer perks such as optical and dental coverage.
The single most important thing to understand when choosing whether to go with an Advantage or Medigap plan is the Medigap open enrollment period.
During the first 6 months after becoming eligible for Medicare you can sign up for a Medigap plan at the very best rates. There is no medical underwriting (health questionnaires) and you can't be refused coverage. In the vast majority of states that changes completely after 6 months and signing up for a Medigap plan can become difficult or impossible. In other words if you choose a Medicare Advantage plan you may not be able to switch to a Medigap plan after your open enrollment period ends.
Medicare Advantage costs less if you don't need care and in many areas of the country can be a good choice, especially if you're lucky enough to have world-class facilities and doctors as part of your Advantage network. If you need care MA can cost much more than Medigap plans and be more difficult to manage.
Medigap plans can have higher fixed costs but if you need significant care can cost much less than Advantage plans. For high coverage Medigap plans like Plan G once you pay your deductible ($233 this year), pretty much all care is covered.
Agents who sell Advantage and Medigap plans work on commissions and those commissions continue to be paid as long as you keep a plan. Commissions vary by plan so keep in mind that the recommendations you receive from an agent may be very much affected by their commission structure.
Medicare.gov is the best overall source of information about the program, but it isn't without its issues. The site can be difficult to navigate and it takes time to figure out.
States also run SHIP - State Health Insurance Assistance Programs. A directory can be found at shiphelp.org.
These are good places to start.
The complexities of Medicare and the various associated programs are hard to overstate so these few paragraphs leave a lot out, but they're also a start.