Today’s Hot Topics in Medicare News

Observation and inpatient hospital status

How observation and inpatient hospital status affects Medicare coverage

BY CHICAGO TRIBUNE: If you’re wearing a hospital gown and lying in bed in a hospital room, it might seem logical to assume that you’ve been admitted to the hospital. However, this assumption could be wrong. You might actually be in the hospital with an observation status, which can dramatically affect your coverage during and after your stay. Knowing the difference between inpatient and observation status is important to understand.

Observation status
If you go to the hospital emergency room or are at the hospital for outpatient surgery, lab tests, X-rays or other services, you are most likely there on an observation status. Sometimes, you may even stay overnight or several nights in order to complete tests yet still be under observation instead of being an inpatient. Unless the doctor writes an order to admit you to the hospital, you are considered as a patient for observation. Admitting someone to the hospital is a complex medical decision so doctors sometimes require testing to be completed first in order to address the medical issues properly. (read more)

How Medicare Beneficiaries Can Save Money on Prescription Drugs

BY KIMBERLY LEONARD: Medication costs can make up a large part of peoples’ budgets, but a few simple steps can easily save hundreds of dollars a year. The biggest single cost-saver? Picking the right Medicare plan. Whether you’re preparing for Medicare fall open enrollment or signing up for Medicare for the first time, you’ll want to make a careful selection so you don’t end up spending more than you need to. Asking your doctors a few key questions – such as, “Is there a generic?” – can save you a bundle.

First, focus on choosing the right prescription drug plan, which depends in part on which medications you take. The majority of individuals are enrolled under Original Medicare, which includes hospital insurance (Medicare Part A) and medical insurance (Medicare Part B). (read more)

Walmart eyes Medicare Advantage beneficiaries in Humana talks

BY BRITTANY DE LEA: Walmart is reportedly in talks with health insurer Humana regarding a potential deal that could help the brick-and-mortar giant protect its customer base from rival Amazon.

Humana is known for catering to seniors as one of the largest providers of Medicare Advantage plans.

“Think about the Walmart consumer and think about the average Medicare Advantage [recipient],” David Friend, managing director of BDO’s Center for Healthcare Excellence & Innovation, told FOX Business. “There’s probably a lot of overlap.” Medicare Advantage, in particular, is a health care segment poised for growth. Enrollment has been steadily climbing over the past decade, with 33% of Medicare’s overall beneficiaries, or 19 million people, enrolled in a Medicare Advantage plan in 2017, according to data from the Kaiser Family Foundation. UnitedHealth and Humana accounted for 41% of the enrollment in these plans. (read more)

Chronic pain patients fear upcoming Medicare change limiting opioid access

BY BENJAMIN HARDY: The NYT reports this morning on an upcoming federal rule change that would stop Medicare from paying for high-dose opioid prescriptions over the long term. It’s expected to be approved in early April and go into effect at the beginning of 2019. Cancer patients and those in hospice would be excluded.

The point is to curb addiction, of course. But the flip side to the story is the suffering of chronic pain patients who have come to depend on prescription opioids to live something like a normal life. 

State-level officials are also looking for ways to rein in prescriptions, as David Koon explained in a February cover story on the addiction crisis for the Arkansas Times. (read more)

7 Things a Medicare Plan Broker Learned From Making a Medicare Education App

BY ALLISON BELL: Agents with functional, virus-checked apps can avoid struggling to court newspapers’ gatekeeper editors, or radio stations’ gatekeeper managers. But, to get to that stage, an agent has to figure out how to make an app.

Nichols, the president of the Cincinnati-based S.A. Nichols Brokerage, has a solution: Agents can put their contact information in his company’s mobile app, MMQ APP.

Nichols’ company has been producing a series of Medicare education web videos, for the MyMedicareQuestion YouTube channel, since 2015. A month ago, for example, the company posted a video about the Medicare card shift.

The company added a free mobile app, the MMQ APP, in 2017. The company offers a Spanish-language version as well as an English-language version. (read more)

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