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Author Archives: Tom
Dec5
0

Try Medicare Disadvantage

By Tom Matteson - Uncategorized

Opinion

Medicare Advantage? More like Medicare Disadvantage.

Image without a caption
By Helaine Olen

Columnist |

November 30, 2022 at 7:00 a.m. EST
(Sergio Azenha/Alamy Stock Photo)

When the annual enrollment period for Medicare ends on Dec. 7, analysts expect that, for the first time, more seniors will receive their 2023 health-care coverage from Medicare Advantage than the traditional program.That’s not a good thing for either elderly Americans or federal coffers. And while seniors are well advised to approach these plans with caution, we should all be paying attention to what’s going on.

Medicare Advantage plans, which are private insurance plans for seniors paid for with federal dollars, originated as a government savings strategy, on the theory that the private sector could improve on government performance at a lower cost. But over the past two decades, it has become clear that Medicare Advantage does not result in improved care for less money. Instead, it will come as no surprise to Americans familiar with the health insurance industry that insurers found a way to turn it into yet another profit center, while putting bureaucratic roadblocks in the way of patients.

The problems are so pronounced that Reps. Ro Khanna (D-Calif.) and Mark Pocan (D-Wis.) — both advocates of Medicare-for-all — recently introduced little-noticed legislation that would ban private insurers from using the word “Medicare” in their names or advertisements. “Medicare implies universal coverage. You can go to any doctor, you can get your claims reimbursed,” Khanna told me. “You shouldn’t be able to appropriate the trust and faith people have in Medicare to sell a private product for personal profit that doesn’t have the same rules.”Insurers in Medicare Advantage are paid a flat fee by the government, based on the enrollee’s health. These insurance companies often want their members to appear as ill as possible — at least as far as the Feds are concerned. They might “upcode,” in doctor speak, maximizing the amount of money they receive. (The federal government calls that practice “fraud” and has sued several of the largest insurers in federal court for it, including Anthem and Cigna, in cases still ongoing.)

As a result, multiple studies have found that seniors on Medicare Advantage cost the government more than those in the traditional program, exactly the opposite of what is intended. A government advisory panel recently estimated the overpayment was $12 billion in 2020.

This flood of money is fattening the bottom line of the health insurance giants even as they’re increasing pressure on the Medicare Hospital Insurance Trust Fund, which is projected to run out of funds in 2026. And Congress is loath to crack down, thanks to the combined power of health insurance lobbying and the program’s popularity with cash-strapped seniors.

Meanwhile, it’s not like seniors are getting better care for the money the federal government is spending — in fact, it can be worse. A research brief posted on the National Bureau of Economic Research website found picking the right plan could literally be a matter of life or death.

It’s “widespread” for Medicare Advantage plans to initially deny coverage for doctor-advised care, according to a report released this year by the Department of Health and Human Services. Plans erect roadblocks to treatment by demanding prior authorization for services traditional Medicare covers without questions. Plans can — and sometimes do — refuse to cover necessary prescription drugs. There are increasing complaints that private insurers rush patients out of skilled nursing and rehab facilities.

So why do people sign up? Traditional Medicare is not simple. It’s a complicated stew of different parts — for hospitalization, for doctors and for prescriptions. Seniors might feel they have to purchase supplemental coverage known as Medigap, which helps cover the co-pays and deductibles that Medicare does not cover.

Many Medicare Advantage plans eliminate or significantly reduce these out-of-pocket costs, as long as beneficiaries stay within their approved network. The private policies also frequently offer vision and dental coverage, not to mention gym memberships, something not on offer in Medicare itself.

These extras have an appeal. But a streamlined plan that can end up costing seniors more is no bargain — and Medicare Advantage sometimes relies on deceptive marketing to get them in the door. A report issued earlier this year by the Senate Finance Committee’s Democratic majority found that unscrupulous insurance agents — who are paid significantly more to sign up seniors for Medicare Advantage plans than for the traditional offering — will sometimes be misleading about networks and benefits, and even pursue seniors suffering from dementia. Ads featuring celebrities claim the plans will put more money in seniors’ pockets.

Medicare Advantage defenders are quick to point out that surveys show their enrollees are more likely to receive such preventive health and wellness services as monitoring of high blood pressure than those with the traditional program. But it’s usually when someone gets seriously ill that Medicare Advantage’s weaknesses become clear.

What would be best would be to fix Medicare, to make it more generous to enrollees and less generous to insurers. That’s unlikely to happen. But we can at least insist on calling it out for what it is: Try Medicare Disadvantage.

Feb2
0

Medicare Costs Increase For 2022

By Tom Matteson - Uncategorized

 

Money Talks News

5 Medicare Changes Arriving in 2022

By Maryalene LaPonsie. 2 days ago
More than 60 million Americans rely on Medicare for their health insurance coverage, and they will see some significant changes to the program in 2022.
1. A sharply higher Part B premium — for now, The standard monthly Part B premium increased by $21.60.
2. Higher deductibles, Part B annual deductible increased by $30 to $233, and the Part A deductible has gone up by $72 to $1,556.
3. More mental health options, This year, the government insurance program will cover mental health services provided via telehealth, including audio-only phone calls.
4. More access to physician assistants’ services, Physician assistants can receive direct payments from Medicare in 2022. Increases access to diagnosing illness, prescriptions, managing treatment plans.
5. More options for insulin savings, The Part D “Senior Savings Model” could drop senior’s co-payments to $35-per-month. 2100 plans have joined the Part D Senior Savings Model
Nov10
1

The Truth About Medicare Advantage Plans And All Those Commercials We See All Day Long

By Tom Matteson - Uncategorized

The Truth About Those Medicare Advantage TV Commercials

Why the ‘Friends Talk Money’ podcast hosts say the ‘free’ policy come-ons can be misleading

By Richard Eisenberg November 5, 2021
Odds are, you’ve seen those Medicare Advantage TV commercials featuring the likes of William Shatner, George Foreman, Jimmie Walker and Joe Namath touting the “free” health insurance plans offering enticing benefits not available from so-called “Original Medicare” (also called “traditional Medicare”). But are they for real?
A person selling Medicare Advantage Plan outside. Next Avenue

Credit: Bill Clark/CQ Roll Call via PBS

Now that it’s Medicare Open Enrollment season through Dec. 7, if you’re 65 or older and eligible for Medicare, or a loved one is, you’ll want to know the answer.

“We’re going to give you a Turkey on Thanksgiving! They promise so much.”

My “Friends Talk Money” podcast co-hosts and I just looked into the popular Medicare Advantage plans (also called Medicare Part C plans) for our latest episode, speaking with Medicare maven Diane Omdahl, of the 65Incorporated.com site. These plans, now chosen by 42% of Medicare beneficiaries, are sold by private health insurers, as opposed to the alternative Original Medicare program offered by the federal government.

The commercials, said “Friends Talk Money” co-host Terry Savage, a syndicated personal finance columnist and author and Medicare expert, promote their one-stop shopping and potential money savings.

What the Medicare Advantage Commercials Say

Savage noted the ads often say: “Let us do everything! And we’re going to give you hearing [coverage] and we’re going to give you dental and we’re going to pick you up and drive you to your doctor’s appointments. We’re going to give you a turkey on Thanksgiving! They promise so much.”

Omdahl told listeners: “Based on the commercials that are on television every day, people see something they think is going to be more cost effective and then they opt for that [Medicare Advantage] coverage without really knowing what they’re getting into.”

She’s right. A recent survey by the Kaiser Family Foundation found that seven in 10 Medicare beneficiaries didn’t compare coverage options during the most recent Open Enrollment period. And in a MedicareAdvantage.com survey of over 1,000 beneficiaries, three out of four called Medicare “confusing and difficult to understand.”

According to the Kaiser Family Foundation, the average Medicare beneficiary has a choice of 54 Medicare plans, there are 766 Medicare Part D prescription drug plans and a record 3,834 Medicare Advantage plans will be available in 2022 (up 8% from 2021).

Here’s the bottom line from Omdahl and the “Friends Talk Money” hosts: Some of what you hear on those Medicare Advantage TV ads is true, but the fine print shows that “free” isn’t really “free.” When the commercials say “zero premium, zero deductible and zero co-pay,” that’s not the whole story.

A surgery team in a hospital. Next Avenue, medicare, health care costs, medicare coverage, covered by medicare

Recommended

Despite Medicare, Health Costs Are Painful for Americans 65+ | Money & Policy

How high out-of-pocket health costs are causing them financial pain

Before I explain the truth about Medicare Advantage’s costs and coverage, it may help to provide a little context about Open Enrollment and Medicare Advantage plans. (Buckle up: Medicare Open Enrollment rules are complicated.)

During annual Open Enrollment, Medicare enrollees can switch from Original Medicare to Medicare Advantage or the other way around; switch from one Medicare Advantage plan to another and enroll in a Medicare Part D prescription drug plan in certain instances.

There’s also a Medicare Advantage Open Enrollment period, from Jan. 1 through March 31, when you can switch your Advantage plan to a different one or switch back to Original Medicare and sign up for a Part D plan.

The Fine Print of Medicare Advantage Plans

Medicare Advantage plans, usually bundled with prescription drug coverage, typically require you to use health care providers in their network. The policies limit your annual out-of-pocket costs for covered services.

“They think ‘zero premium’ means it’s free, which it’s not.”

“People need to go beyond the commercials” to understand the fine print of Medicare Advantage plans, Omdahl said. “There are indeed zero-premium Advantage plans and many of the plans do not have any [annual out-of-pocket] deductibles. But the zero co-pay is misleading. Zero co-pay is for your primary doctor; depending on where you live, co-pays may apply in other situations.”

In addition, noted Omdahl, “start digging into the evidence of coverage and you will see that Medicare Advantage is pay-as-you go: fifty dollars to see a specialist, four hundred dollars a day for five or six days of hospitalization. So you are writing checks, and that’s what people don’t realize. They think ‘zero premium’ means it’s free, which it’s not.”

Savage said that due to the Medicare program’s rules, Medicare Advantage enrollees could wind up paying out of pocket as much as $7,500 a year; more than $11,000 a year if you use out-of-network health care providers.

“These plans work best if you don’t get sick,” she said. “Once you need to see a lot of specialists, then you start paying.”

Omdahl said that before signing up for a Medicare Advantage plan, understand that anytime you want care other than an emergency, the plan has to approve it.

“If you need physical therapy, for instance, the plan has to approve the request for the service and then they’ll usually say the person gets three visits or five visits or whatever. So, they are controlling the utilization of services of the members,” she explained.

Savage said if you’re in a Medicare Advantage plan and want to switch back to traditional Medicare for 2022, you could run into a problem. “If you have become ill, there’s a medical underwriting [a health care provider must check you out before you’re granted coverage] and in most states they can turn you down for the most comprehensive Medicare supplement [Medigap] plan.”

Think Before You Switch

So, Savage advised, “think very carefully before you switch out of traditional Medicare, which lets you see just about any doctor or go to any hospital.”

I noted a recent study by the nonprofit health care research group The Commonwealth Fund that looked at Medicare Advantage plans and traditional Medicare. Overwhelming majorities of Medicare beneficiaries in both traditional Medicare and Medicare Advantage were satisfied with their care.

The researchers discovered that the Advantage plans didn’t substantially improve beneficiaries’ health care experiences compared to traditional Medicare, but did offer somewhat more care management.  That means of those with a health condition, a larger share of Medicare Advantage enrollees in the study said that a health care professional had given them clear instructions about symptoms to monitor and had discussed their priorities in caring for the condition.

Oct12
0

Huge Metformin Recall Due To Cancer Causing Contaminant

By Tom Matteson - Uncategorized

Diabetes Drug Recalled Due To High Levels Of Cancer-Causing Contaminant

October 11, 2020 at 9:44 am

NEW YORK (CBSNewYork/CNN) — A widely-used diabetes drug is being recalled after manufacturers found it contained unacceptably high levels of a cancer-causing contaminant.

Indian pharmaceutical company Marksans Pharma Limited is recalling metformin hydrochloride extended-release tablets because their levels of NDMA, a “probable human carcinogen,” were higher than the acceptable daily intake limit of 96 nanograms per day, according to a recall published this week by the US Food and Drug Administration (FDA).

Metformin tablets are used to treat type 2 diabetes and are designed to lower glucose levels.

The recall applies to metformin tablets between 500 mg and 750 mg, sold under the brand name Time-Cap Labs, Inc.

RELATED STORY: Study Shows Adolescents, Young Adults At Increasing Risk For Prediabetes

The recall expands an earlier recall of the same product from this summer. But it’s just one of several metformin products that have been found to contain NDMA in the last year. Seven other pharmaceutical companies have issued recalls for metformin hydrochloride extended-release tablets due to their carcinogenic contents.

The FDA is still investigating where NDMA comes from and how it ends up in metformin products. Most levels found in medications are generally low and fall within the FDA’s accepted daily intake, but recently recalled medications exceed that. Marksans Pharma Limited, India, however, did not reveal how much NDMA its recalled products contained.

The recall applies to the following products, which can be identified by their National Drug Code numbers listed below (National Drug Codes can be used to search and identify products online through the FDA). The tablets are either embossed with 101 or 102 on one side and are plain on the other.

Metformin Hydrochloride Extended-Release Tablets, USP 500mg:

90 counts: 49483-623-09

100 counts: 49483-623-01

500 counts: 49483-623-50

1000 counts: 49483-623-10

Metformin Hydrochloride Extended-Release Tablets, USP 750mg:

100 counts: 49483-624-01

You can get the latest news, sports and weather on our brand new CBS New York app. Download here.

(© Copyright 2020 CBS Broadcasting Inc. All Rights Reserved. Cable News Network, Inc., a WarnerMedia Company, contributed to this report.)

Aug27
0

Med Sup Cost Comparison

By Tom Matteson - Uncategorized

New 2020 Medigap Cost Comparison study focuses on Plan G

By

Insurance Forums Staff

February 11, 2020

The American Association for Medicare Supplement Insurance just completed its 2020 Medigap Cost Comparison for those turning 65, and it reveals an important finding that has real significance for insurance agents marketing Med Supps.

“With Medigap Plan F no longer available for new enrollees, we compared Plan G that we expect will become 2020’s No. 1-selling option,” says AAMSI Director Jesse Slome.

Here’s what they found: A 65-year-old man in Manhattan buying Medicare Supplement insurance (Plan G) could pay as little as $268 a month or as much as $476 a month. A 65-year-old woman shopping for Medigap Plan G in Dallas could find coverage for $99 or $381 (monthly).

The Association’s 2020 Price Comparison examined costs for Medicare Plan G costs for Top 10 U.S. Metro Areas. The chart shows the increase in costs for both men and women who will be first applying at age 65. No one Medicare insurance company was consistently the lowest cost for Plan G. No one company was the highest. In fact, for the 20 Zip Codes, the survey found 13 different Medicare insurance companies had either the lowest or the highest prices.

To get the most competitive rate in your area click this link for a free quote: https://mic-financial.com/get-a-quote

 

 

Jun3
0

Aetna and CVS team up to open 1000 Covid-19 testing sites across the US

By Tom Matteson - Uncategorized

The Potential for the Coronavirus in Africa

 

 

CVS Health establishes 1,000 COVID-19 test sites across the country

 

CVS Health is uniquely positioned to play a vital role in helping support both local communities and the overall health care system in addressing the COVID-19 pandemic. Our ability to coordinate the availability of COVID-19 testing helps bolster the country’s efforts to manage the spread of the virus. Read more.

What you need to know

  • Starting May 29, we’ll have a total of 1,000 testing sites across more than 30 states and Washington, DC (AZ, CA, FL, GA, HI, IL, IN, KY, LA, MA, MD, ME, MI, MN, MO, NC, NE, NH, NJ, NM, NY, NV, OH, OK, PA, RI, SC, TX, TN, VA and WI).
  • Individuals must register in advance at CVS.com to schedule an appointment. Once registered, they will be provided with an appointment window for that same day or up to two days out.

 

 

Jan16
0

Changes to Medicare in 2020

By Tom Matteson - Uncategorized

Here’s what you need to know about your 2020 Medicare costs

Published Mon, Dec 30 20199:05 AM EST
Sarah O’Brien
Key Points
  • Certain costs are adjusted yearly by the government and can affect premiums, deductibles and other cost-sharing aspects of Medicare.
  • Even though each change doesn’t necessarily involve huge dollar amounts, they can add up and should be factored into your monthly health-care spending.
  • Beneficiaries with limited income might qualify for Medicaid or other programs that cover Medicare expenses, while higher-income beneficiaries pay more for some parts of coverage.

The maze that is Medicare includes some higher costs for 2020 that beneficiaries might want to factor into their health-care budgets.

For the program’s 61 million beneficiaries — most of whom are 65 or older — certain costs are adjusted by the government from year to year and can affect premiums, deductibles and other cost-sharing aspects of Medicare. While each of the changes don’t necessarily involve huge dollar amounts, experts say it’s important to plan for how any increases will affect your household spending.

“For someone on a fixed income, all of those little changes really add up,” said Elizabeth Gavino, founder of Lewin & Gavino in New York and an independent broker and general agent for Medicare plans.

Premium: Doctor and patient conversation healthcare
Hero Images | Getty Images

Basic Medicare consists of Part A (hospital coverage) and Part B (outpatient care). About a third of beneficiaries choose to get those benefits delivered through an Advantage Plan, which are offered by private insurers.

Those plans typically also include Part D prescription drug coverage, as well as extras such as dental or vision. They also limit what you pay out of pocket for Parts A and B services.

Other beneficiaries stick with basic Medicare and pair it with a standalone Part D prescription drug plan. About 30% of them also purchase a supplement plan — aka “Medigap” — which picks up some of the costs that come with basic Medicare, such as coinsurance or copays

Overall, your coverage choices can affect how much you pay in premiums, deductibles and copays or co-insurance. And, of course, how often you use the health-care system can contribute to your costs.  Your income also is a determining factor. Beneficiaries with limited income might qualify for Medicaid or other programs that cover Medicare expenses. On the other hand, higher-income beneficiaries pay more for certain parts of coverage.

And then, there are those in-between.

“We’ve got a subset of people who aren’t eligible for Medicaid or other types of assistance, but they fall into a category where every penny counts,” Gavino said.

Here are costs that have changed for 2020.

Parts A & B

Most Medicare beneficiaries pay no premium for Part A because they (or their spouse) have enough of a work history — at least 10 years — of paying into the system through payroll taxes to qualify for it premium-free.

If you don’t meet the minimum requirement, though, monthly premiums could be as much as $458 a month, depending on whether you’ve paid any taxes into the Medicare system at all. That maximum is up from $437 in 2019.

And, regardless of whether you pay a premium, there are cost-sharing aspects that go with Part A.

We’ve got a subset of people who aren’t eligible for Medicaid or other types of assistance, but they fall into a category where every penny counts.
Elizabeth Gavino
founder of Lewin & Gavino

For those who don’t have additional coverage beyond basic Medicare, the amount you’d pay when admitted to the hospital will be $1,408 next year, up from $1,364 in 2019. That covers the first 60 days of Medicare-covered inpatient hospital care in a benefit period.

For the 61st through 90th days of a hospitalization, beneficiaries will pay $352 per day, up from $341 in 2019, and then $704 per day for 60 “lifetime reserve” days, up from $682 this year.

Meanwhile, for Part B, the standard premium in 2020 will be $144.60 monthly, up $9.10 from $135.50 in 2019.

Some recipients won’t pay the full standard premium due to a “hold harmless” provision that prevents their Part B premiums from rising more than their Social Security cost-of-living adjustment, or COLA.

Others, however, will pay more than the standard due to income-adjusted surcharges (see tables below).

CH 20191227_medicare_part_b_premiums_individual_and_married_jointly.png

Keep in mind that the government uses your tax return from two years earlier to determine whether you’ll pay those monthly adjustments. So for 2020, it would be your 2018 return. To request a reduction in that income-related amount due to a life-changing event such as retirement, the Social Security Administration has a form you can fill out.

The annual deductible for Part B will rise to $198, up from $185 in 2019. Once you meet that deductible, you typically pay 20% of covered services. Keep in mind that beneficiaries in Advantage Plans might pay a different amount through copays, and Medigap policies either fully or partially cover that coinsurance.

CH 20191227_medicare_part_b_premiums_married_separately.png

Also, while Advantage Plan premiums vary among plans — the average for 2020 is $23, down from about $27 this year — any monthly charge would be on top of your Part B premium. And, some of those options either have no monthly charge or will pay your Part B premium.

(If you don’t like your Advantage Plan, you can switch or drop it in the first three months of the year.)

Part D

How much you pay for drug coverage depends partly on the plan you choose, along with your income.

The average monthly premium for a standalone drug plan in 2020 will be $30, according to the Centers for Medicare and Medicaid Services, down from $32.50 in 2019. As with Part B premiums, higher earners pay extra (see chart below).

Those surcharges were adjusted slightly downward: for example, individuals with income above $500,000 (again, based on 2018 tax returns) will pay $76.40 extra each month, vs. $77.40 in 2019.

CH 20191227_medicare_part_d_2020_adjustments

Be aware that those charges are not tacked on to your plan premium — they either come out of your Social Security check or you get a bill.

Also, while not everyone pays a deductible for Part D coverage — some plans don’t have one — the maximum it can be is $435 in 2020, up from $415 in 2019.

For people with high prescription costs, be aware that the amount that Part D enrollees pay out of pocket before qualifying for “catastrophic coverage” will jump to $6,350 in 2020 from $5,100 this year. In that phase of coverage, your share of prescription costs drops.

Remember, though, there are no out-of-pocket limits when it comes to Part D coverage. Sometimes, you can find medicines at a cheaper cost than through your plan, such as with a free drug-discount card or program, such as GoodRx or Blink Health, Gavino said.

However, she said, if you go this route instead of through your insurance, your plan won’t count the medicine’s cost and your copay toward your deductible or other calculations it uses to determine your share.

 

Nov22
0

Medicare Changes Create Confusion For 2019 OEP

By Tom Matteson - Uncategorized

Recent Changes Add Complexity to Medicare’s Fall Open Enrollment Period

Lindsey CopelandNovember 21, 2019Medicare Watch13 Comments

 

Medicare’s Fall Open Enrollment Period (OEP) is a busy time for beneficiaries and those who help them evaluate their health care and prescription drug coverage options. From October 15 to December 7 each year, people with Medicare can make changes to their coverage, such as switching Part D prescription drug plans, or switching between Original Medicare and Medicare Advantage. This annual decision-making process can be complex, and several changes this year are making it even more so.

First, people with Medicare must compare more plans than ever before. A new analysis from the Kaiser Family Foundation (KFF) finds the average Medicare beneficiary will have a choice of 28 prescription drug plans (PDPs) in 2020, a 29% increase from just three years ago. And these decisions aren’t getting any easier, as plan premiums continue to vary widely. Among the 20 PDPs available nationwide, average premiums range from $13 to $83 per month.

Second, an unprecedented number of beneficiaries are facing premium increases if they don’t change plans by December 7. According to KFF, two-thirds of Part D enrollees without low-income subsidies—9 million enrollees—will see their monthly premium increase in 2020 if they maintain current coverage. This is largely due to plan changes and consolidations. For example, Humana recently consolidated two of its PDPs (Humana Walmart Rx and Humana Enhanced) into one new plan, Humana Premier Rx, which will carry a $57 monthly premium in 2020. As a result, unless they switch plans, 1.9 million enrollees without low-income subsidies in the Humana Walmart Rx Plan—the third most popular PDP in 2019—will see their monthly premium double in 2020, from $28 to $57.

Third, for this year’s OEP, the Centers for Medicare & Medicaid Services (CMS) redesigned the Medicare Plan Finder (MPF) tool on which millions rely for accurate plan information. Medicare Rights appreciates CMS’s work to modernize MPF; many of the changes are significant improvements. However, we remain concerned that this well-intended revamp may further complicate the plan comparison process for some looking to make plan changes this fall. Specifically, that issues with the new tool’s roll out, content, and functionality could cause beneficiaries to make sub-optimal coverage decisions for 2020, errors they may not discover until well into next year. A recent Health Affairs article underscores this concern, noting that many of the MPF revisions will make the tool more user-friendly—while others may undermine plan selection efforts, including by steering beneficiaries away from lower-cost options.

To mitigate these potential hardships and improve MPF ongoingly, Medicare Rights is working with CMS and other stakeholders to address problems with the tool; we applaud the agency’s responsiveness in quickly adopting many of our initial recommendations. We are also urging CMS to take steps to prevent beneficiaries from experiencing any MPF-related enrollment complications in 2020. We look forward to continuing to work to strengthen this important resource in ways that empower people with Medicare to make informed decisions about their care.

Additionally, amid these trends and changes, Medicare Rights is helping people with Medicare weigh their options. Read more about the services and resources we provide during Fall Open Enrollment, including Medicare Plan Finder appointments, and call our National Consumer Helpline (800-333-4114) today with any questions. We also offer a free, downloadable Fall Open Enrollment guide to connect beneficiaries with accurate, unbiased Medicare information, as well as this online resource to help people get started with the new MPF.

Nov21
0

MIC Executive Spotlight as heard on WFLA 970 Tampa Bay

By Tom Matteson - Uncategorized

 

https://api.spreaker.com/v2/episodes/20054662/download.mp3
Oct3
1

Help Is On The Way To Help Lower The Cost Of Prescription Medications For Seniors On Medicare

By Tom Matteson - Uncategorized

Trump to Unveil Order Aiming to Boost Medicare Health Program

Trump to Unveil Order Aiming to Boost Medicare Health Program
(Natalya Buzuevskaya/Dreamstime)

Thursday, 03 October 2019

President Donald Trump will unveil an executive order on Thursday aimed at strengthening the Medicare health program for seniors by seeking to improve its fiscal position and offer more affordable plan options, administration officials told Reuters.

The order, which Trump will discuss during a visit to a retirement community in Florida known as the Villages, is the Republican president’s answer to some Democrats who are arguing for a broad and expensive expansion of Medicare to cover all Americans, plans that Republicans reject.

It follows measures rolled out in recent months by the administration designed to curtail drug prices and correct other perceived problems with the U.S. healthcare system, though policy experts say those efforts are unlikely to slow the tide of rising drug prices in a meaningful way.

The Medicare program covers Americans who are 65 and older and includes traditional fee-for-service coverage in which the government pays healthcare providers directly and Medicare Advantage plans, in which private insurers manage patient benefits on its behalf.

Seniors are a key constituency for Republicans and Democrats, and Florida is a political swing state that both parties woo in presidential elections.

The order is designed to show Trump’s commitment to keeping Medicare focused on seniors, said one administration official who described its contents ahead of the announcement.

The order pushes for Medicare to use more medical telehealth services, which is care delivered by phone or digital means.

The official said that would reduce costs by cutting down on the number of expensive emergency room visits by patients; lower costs would help strengthen the program’s finances.

The order directs the government to work to allow private insurers who operate Medicare Advantage plans to use new plan pricing methods, such as allowing beneficiaries to share in the savings when they choose lower-cost health services.

It also aims to bring payments for the traditional Medicare fee-for-service program in line with payments for Medicare Advantage.

Trump’s plans contrast with the Medicare for All program promoted by Bernie Sanders, a Democratic socialist who is running to become the Democratic Party’s nominee against Trump in the 2020 presidential election.

Sanders’ proposal, backed by left-leaning Democrats but opposed by moderates such as former Vice President Joe Biden, would create a single-payer system, effectively eliminating private insurance by providing government coverage to everyone, using the Medicare model.

The senior Trump administration official said Democrats advancing such ideas were “trying to steal the brand of Medicare and the good reputation it has in order to mask what would be a disastrous healthcare plan.”

He said Trump’s plan sought to modernize the program and preserve it for senior citizens going forward.

The White House is eager to show Trump making progress on healthcare, an issue Democrats successfully used to garner support and take control of the House of Representatives in the 2018 midterm elections. Trump campaigned in 2016 on a promise to repeal and replace the Affordable Care Act, his predecessor President Barack Obama’s signature healthcare law also known as “Obamacare,” but was not successful.

In July, the U.S. Department of Health and Human Services (HHS) said it would propose a rule for imports of cheaper drugs from Canada into the United States. A formal rule has not yet been unveiled.

The administration also issued an executive order in June demanding that hospitals and insurers make the prices they charge patients more transparent, as well as another in July encouraging novel treatments for kidney disease.

Trump considered other proposals that did not reach fruition.

A federal judge in July shot down an executive order that would have forced drugmakers to display their list prices in advertisements, and Trump scrapped another planned order that would have banned some of the rebate payments drugmakers make to payers.

The administration is also mulling a plan to tie some Medicare reimbursement rates for drugs to the price paid for those drugs by foreign governments, Reuters reported.

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  • Medicare Math” Changes to 2025 Medicare calculations for prescription drugs
  • New book sheds light on how Medicare advantage plans really work.
  • Older Americans say they feel trapped in Medicare Advantage plans
  • Try Medicare Disadvantage
  • Medicare Costs Increase For 2022

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Tampa, Florida 33614
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Medicare Insurance Consultants, LLC, Insurance  Medicare Supplement, Tampa, FL