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Today’s Hot Topics in Medicare News

8 Misconceptions About Health Care Costs in Retirement

BY RACHEL HARTMAN: While many Americans are aware that health care expenses will be significant during retirement, it can be tough to decipher exact amounts to set aside for medical treatment. Four out of five workers have not calculated how much they will need for health costs in retirement, according to a 2018 Employee Benefit Research Institute and Greenwald & Associates survey. Among retirees, six out of 10 have not estimated what they will need for medical bills, the survey found.

Understanding the realities of health care costs can make the budgeting process easier. Here are common myths about medical expenses in retirement, as well as the truth behind them. (read more)

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There's never been an easy way for Medicare beneficiaries to save on services and products not covered by Medicare alone, until now.

Providers Oppose Collapsing Medicare Reimbursement for E/M Visits

BY JACQUELINE LAPOINTE: Providers are calling on CMS to not finalize a proposal to collapse Medicare reimbursement for evaluation and management (E/M) visits into a single, blended payment rate for E/M Levels 2 through 5 visits.

In a recently proposed rule for the 2019 Medicare Physician Fee Schedule, CMS proposed the Medicare reimbursement change for E/M visits to improve payment accuracy and simplify documentation. If finalized the rule would only require providers to apply a minimum documentation standard. (read more)

HARROP: How about Medicare Advantage for all?

BY FROMA HARROP: A resurfaced Barack Obama has uttered those three little words: “Medicare for all.”

Does that mean that the Affordable Care Act, aka Obamacare, was a bad idea? Not at all.

The ACA was a triumph in that it cut the number of uninsured Americans by 20 million. And it hardened the idea that no American, regardless of income or pre-existing conditions, should suffer or die for lack of health coverage. (read more)

A Policy Option to Enhance Access and Affordability for Medicare’s Low-Income Beneficiaries

BY CATHY SCHOEN, KAREN DAVIS, AMBER WILLINK, and CHRISTINE BUTTORFF: Although Medicare provides a stable, trusted source of health insurance for elderly and disabled beneficiaries, the program’s benefit design can leave beneficiaries exposed to high out-of-pocket costs. These include high deductibles for hospital care and 20 percent cost-sharing for physician visits and other ambulatory care services. In addition, there is no limit on out-of-pocket costs for covered benefits. Core benefits exclude dental, vision, hearing, and long-term care services and support. (read more)

What We’re Reading: Investigating PBMs; A Guide to Medicare-for-All; Reality of Precision Medicine

BY AJMC STAFF: Pharmacy benefit managers (PBMs) make part of their profit on spread pricing, in which companies mark up the difference between the amount they reimburse for a drug and what they charge clients. A new investigation from Bloomberg showed that not only do PBMs profit thousands of percent using this tactic, but the spreads are growing. Spread pricing is most common with generic drugs that cost pennies compared with brand-name drugs. While use of generic drugs has been promoted to control rising drug costs, spread pricing may be undercutting those expected savings, according to critics of the tactic. (read more)

The new Medicare Plus Card saves you up to 75% on things not covered by Medicare

Medicare doesn’t cover everything. Luckily, those on Medicare can now start saving on out of pocket expenses like prescription drugs, dental, vision, hearing, and more. Over 1 million people have already received their free Medicare Plus Card.

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