Today’s Hot Topics in Medicare News

More Than One-Third of People with Traditional Medicare Spent at Least 20 Percent of Their Total Income on Health Care in 2013

How Medicare can help with mental health

BY Greg Dill: Let’s hope it never happens, but there may come a time in your life when you need mental health care. Medicare covers a variety of such services, in both hospital inpatient and outpatient settings.

If you have Medicare Part A (hospital insurance), you’re eligible for mental health services when you’re admitted to a hospital as an inpatient. You can get these services either in a general hospital or in a psychiatric hospital that only cares for people with mental health conditions.

Part A pays for up to 190 days of inpatient psychiatric hospital services during your lifetime. (read more)


Future of Medicare: Funding for Extenders and Payment Policy Priorities

BY BAKER DONELSON BEARMAN CALDWELL & BERKOWITZ: Looking beyond extenders, the prospects for broader entitlement reform to advance in Congress remain unlikely. Although House Speaker Paul Ryan (R-WI) signaled interest at the end of last year in pursuing entitlement reform, he has walked back those comments after Senate Majority Leader Mitch McConnell (R-KY) publicly stated that entitlement reform is unlikely to gain traction in the Senate in 2018. This is in line with conventional political wisdom, which suggests that Republicans would be less likely to push for significant Medicare reform in an election year – especially given their slim Senate majority. (read more)

Fred Goldenberg: Medicare changes make decisions difficult

BY FRED GOLDENBERG: Mrs. Smith has been on Medicare for quite some time. When she signed up for Medicare she also purchased a Plan F Medigap supplement. In conjunction with Medicare Part’s A and B, Mrs. Smith’s medical expenses are covered 100 percent. Since the day she went on the plan Mrs. Smith hasn’t had to lay out one penny for coverage other then paying her monthly premium.

When Mr. Jones went on Medicare he chose Plan C for his Medigap coverage. Plan C covers nearly all the Medicare gaps that you would usually be required to pay, just like Plan F. The only exception is the Part B excess charges. Excess charges are surcharges that your doctor can charge above and beyond what Medicare will reimburse. They are limited to 15 percent beyond what Medicare pays. Many doctors do not charge excess charges, but occasionally they do. (read more)

Bernie Sanders Just Sidestepped Corporate Media to Promote Medicare for All to 1 Million Viewers

BY THEO ANDERSON: The revolution will not be televised, but it might be live-streamed.

“It ain’t gonna be on CBS, it ain’t gonna be on NBC,” Sen. Bernie Sanders said on Tuesday evening, near the end of a “Medicare for All Town Hall” that was streamed to an estimated audience of more than a million people over three social media outlets—Now This, Attn: and The Young Turks Network (YTN). Sanders was referring specifically to serious debate about our healthcare system, but his words spoke to more than that.

Sanders’ town hall showed the senator—currently the most popular politician in the United States—freed from the confines of traditional mainstream media and able to dig in to issues ranging from healthcare to campaign financing to the corruption of our political system. (read more)

Are Medicare Managed Care Plans Steering Members To Low-Quality Nursing Facilities?

BY HOWARD GLECKMAN: Last year, a friend with complex medical needs had multiple stays at a skilled nursing facility (SNF). He was a member of a Medicare Advantage managed care plan and, as a result, could choose among only a handful of in-network facilities within a reasonable distance of his home. The care he received at the available facility was poor and since observing his experience, I wondered whether it was typical for a Medicare Advantage member. A new Brown University study suggests it might be.

Last year, about 19 million Americans, one-third of Medicare participants, were enrolled in MA plans. This model holds the promise of fully integrating health care and long-term services and supports—a great benefit for frail older adults. But critics worry that when managed care organizations are at financial risk for the cost of care, they may skimp on quality to save money. That certainly was my concern when visiting my friend.  And  a new study in the journal Health Affairs (paywall) suggests that fear may be well-founded when it comes to skilled nursing care. (read more)

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