BY MARK MILLER: CHICAGO (Reuters) – For many Americans entering retirement, it comes as an unwelcome surprise: Medicare premiums become much more expensive if you do not sign up on time.
The program tacks on a 10 percent penalty on monthly Part B premiums for each full 12-month period of late enrollment – and you keep on paying the penalties for the rest of your life. The aim is to avoid “adverse selection,” which occurs when people sign up for coverage only when they think they will need it. That helps keep premiums lower for all Medicare enrollees.
But a heads-up would be nice. And that is the intent of the Beneficiary Enrollment Notification and Eligibility Simplification Act (BENES Act), a bill introduced with bipartisan support last week in the U.S. Senate (companion legislation was introduced in the House of Representatives earlier). (read more)
BY AUSTIN FRAKT: Last month, as Republican leaders were preoccupied with another unsuccessful attempt to replace Obamacare, a senior Trump administration official issued a warning about a different major medical program, Medicare.
The official, Seema Verma, administrator of the Centers for Medicare and Medicaid Services, wrote in The Wall Street Journal that Medicare was facing a fiscal crisis. She announced that she was asking the agency’s innovation center for ideas to address it, and that part of the answer was to give consumers “incentives to be cost-conscious.” This has some Democrats worried that she’s trying to move Medicare toward something called premium support, which would be a huge change for consumers.
Before we get into the pros and cons, what’s the fiscal crisis? According to projections from this year’s Medicare Trustees’ report, the fund that pays for Medicare-financed hospital care will be depleted in 12 years, and care for other services will consume an ever-larger share of the economy and federal revenue. Citing trends like those, Republicans included the outlines of a Medicare premium support plan in the House of Representatives’ fiscal year 2018 budget resolution, as they did in several prior ones. (read more)
BY PATRICK CONNOLE: The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) applauded work in the House and Senate to develop a framework to repeal Medicare Part B outpatient therapy caps. The caps have been in place for two decades and are considered detrimental to the success of patient-centered quality initiatives and value-based payment models, according to the long term and post-acute care industry.
In response to the bipartisan, bicameral policy agreement on repeal, AHCA/NCAL President and Chief Executive Officer Mark Parkinson said the work by the House Energy and Commerce Committee, the House Ways and Means Committee, and the Senate Finance Committee is a positive development.
“These caps, first enacted 20 years ago have been historically problematic, requiring congressional patches periodically which create a cloud of uncertainty for the residents we care for, and jeopardizes the success of recent broader patient-centered quality initiatives and value-based payment models,” he said. (read more)
BY JOHN LOUIS CLARK III: Some Medicare eligible people view Medicare Advantage Plans as restrictive because they maintain a network (also known as HMO or Health Maintenance Organization). Plans like Medicare Advantage Plans rely on a network to help maintain and lower costs for the Medicare recipient.
Advantage Plans help to streamline and coordinate the insured’s healthcare. By maintaining a network, your primary doctor will recommend specialist or other doctors in the network. The action maintains costs and at the same time, allows your doctors to coordinate care, in a timelier manner, more seamlessly, share records and data pertaining to your health and healthcare. (read more)
BY MAURIE BACKMAN: Most Americans have heard of Medicare and have come to associate it with senior healthcare. But how much do you know about this key program? As of April 2017, there were nearly 58 million people enrolled in Medicare, which is close to 20% of the total U.S. population. Even if you’re not signing up for Medicare anytime soon, there are certain facts about the program you should be aware of. Here are just a few to commit to memory. (read more)