BY BOB BLANCATO AND MEREDITH PONDER: Three recent pieces of news out of Washington, D.C., may mean more certainty and better coverage for current and future beneficiaries of Medicare — the federal health program for people 65 and older.
No. 1: House Speaker Paul Ryan announced he will leave Congress at the end of his current term. As elder advocates, we believe this means Congress will lose its single strongest proponent of converting Medicare into a voucher program known as “premium support,” which aims to reduce the growth in Medicare spending and could end Medicare’s guaranteed benefits. Congress will also lose a key leader in attempts to take away The Affordable Care Act’s benefits to Medicare enrollees. (read more)
BY ANA RADELAT: Sen. Chris Murphy on Wednesday introduced legislation that would allow individuals and businesses to purchase Medicare coverage.
A Medicare option would be available in all state and federal Affordable Care Act exchanges, according to Murphy’s bill, which was co-sponsored by Sen. Jeff Merkley, D-Ore. Medicare, a government-run health plan, is currently limited to Americans 65 years old and older.
Murphy acknowledged the plan has little chance of approval with a Congress and White House controlled by the GOP, but said it’s important to have conversations with constituents on proposals to shore up the nation’s health care system. (read more)
BY PAIGE WINFIELD CUNNINGHAM: If you want to sell Americans a bill expanding the government’s role in health care, be sure to include “Medicare” in the title.
A crop of health-care legislation named after the popular and well-known federal insurance program for the elderly has sprung up over the past six months. The trend is happening as Democrats and progressives seek to move the conversation away from repealing Obamacare and excite the public about scaling up government benefits instead.
You’ve probably heard of Sen. Bernie Sanders’s (I-Vt.) “Medicare for All,” a measure one-third of Democratic senators are backing. But there are other options, too, such as “Medicare X” from Sens. Tim Kaine (D-Va.) and Michael Bennet (D-Colo.), or “Medicare Extra for All” from the liberal Center for American Progress. (read more)
BY PHILIP MOELLER: Jerry – Colo.: I recently traveled to Arizona, which is out of the service area for my insurance. I had to have knee surgery. While the doctor and surgery center understood that I was out of my insurance service area, they immediately accepted my Medicare A and B. Now my insurance billing says that Medicare will not cover this? Is there an appeal process?
Phil Moeller: You certainly can appeal this, but I am not hopeful you will get relief. Your note doesn’t say what kind of Medicare coverage you have. If you have basic Medicare (Parts A and B), you should be able to see any doctor in the country who accepts Medicare’s payment schedule, and Medicare will cover you. (read more)
BY JUDITH GRAHAM: Several weeks ago, Medicare launched an initiative to prevent seniors and people with serious disabilities from developing Type 2 diabetes, one of the most common and costly medical conditions in the U.S.
But the April 1 rollout of the Medicare Diabetes Prevention Program, a major new benefit that could help millions of people, is getting off to a rocky start, according to interviews with nearly a dozen experts.
In all but a few locations, experts said, Medicare’s new prevention program — a yearlong series of classes about healthy eating, physical activity and behavioral change for people at high risk of developing diabetes — isn’t up and running yet. And there’s no easy way (no phone number or website) to learn where it’s available.
A Medicare spokesman declined to indicate where the diabetes program is currently available, saying only that officials had approved three providers to date. (read more)