Health Reform News About Medicare Advantage And Supplement Plans
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Medicare Cuts In 2010
On January 26 2010, the Congressional Budget Office (CBO) released The Budget and Economic Outlook: Fiscal Years 2010 to 2020.
According to the CBO, the gross spending on the Medicare program is expected to total $528 billion in 2010. The CBO also expects for Medicare spending to rise from 3.5 percent of the Gross Domestic Product (GDP) in 2009 to 4.6 percent in 2020.
The CBO further estimates that Social Security, Medicare and Medicaid will account for about 70 percent of mandatory spending (excluding offsetting receipts) in 2010. The combined Medicare and Medicaid spending is expected to grow faster than the economy. The retirement of more members of the baby-boom generation and rising health care spending per person will cause outlays for Medicare, Medicaid, and Social Security to continue to grow fairly rapidly.
Due to the economic recession, in 2009 even revenues from social insurance taxes (primarily the payroll taxes for Social Security and Medicare) decreased by 1 percent ($9 billion), the first decline since 1946. If current laws and policies remained unchanged, the CBO estimates that the Federal budget might show an approximate $1.3 trillion deficit for fiscal year 2010.
“The single greatest threat to budget stability is the growth of federal spending on health care—pushed up both by increases in the number of beneficiaries of Medicare and Medicaid (because of the aging of the population) and by growth in spending per beneficiary that outstrips growth in per capita GDP. For the nation’s fiscal situation to be sustainable in future decades, growth in such spending will have to be reduced relative to its historical trend and to CBO’s projected path,” the report states in its outlook, and further projects for 2010:
“Similarly, fees paid for physicians’ services under Medicare are scheduled to be reduced by 21 percent beginning in March, although cuts in such payments have been delayed several times in the past.”
Source: The Budget and Economic Outlook: Fiscal Years 2010 to 2020
Humana Medicare Advantage Plans Very Popular
While other health insurers have been hurt by declines in employer-sponsored insurance enrollment, and Humana’s commercial business results did worse than anticipated, Humana Medicare Advantage Plan results for the fourth quarter of 2009 were better than expected.
Michael B. McCallister, president and chief executive of Humana, summed up 2009 as success for Humana despite a “challenging environment,” and added the company’s outlook for 2010 “Looking ahead, we see multiple revenue growth opportunities across our spectrum of products for 2010.”
While Humana Medicare Advantage plans gained 5 percent new members compared to 2008, the amount of members in its stand-alone Medicare prescription drug plans dropped by more than 1 million in 2009.
Humana is offering more than 100 Medicare Advantage plans in 2010, including the flexible affordable Humana Gold Choice PFFS. Humana Gold Choice® is a Medicare Advantage Private Fee-for-Service (PFFS) plan. That means you can see almost any doctor you choose, as long as the provider accepts Humana’s terms and conditions of payment. Most Humana Gold Choice Private Fee-for-Service plans combine all the benefits of Original Medicare, prescription drug coverage and many extras into one simple, easy-to-use plan.
The Humana Gold Choice Plan is available to anyone enrolled in both Part A and Part B of Medicare through age or disability.
Groups Press Congress To End Patients’ Wait For Medicare
Kaiser Health News staff writer Jessica Marcy reports: “Under federal rules, most people with disabilities who are younger than 65 aren’t eligible for Medicare until more than two years after they qualify for Social Security disability income. A coalition of more than 65 organizations led by the Medicare Rights Center has been pushing Congress to do away with the waiting period. But the effort has stalled because of the high cost to the federal government – an estimated $113 billion over 10 years, according to the Congressional Budget Office” (Kaiser Health News). Read the entire article. Watch the related slideshow.
Excerpt from:
Groups Press Congress To End Patients’ Wait For Medicare
Medicare Expands Coverage For Tobacco-Related Counseling
The Hill: “The Obama administration on Wednesday expanded Medicare to cover more seniors hoping to kick their tobacco habits.” Previously, Medicare rules allowed the program to cover tobacco-related counseling only for beneficiaries who already suffered from a tobacco-related disease. “Under the new policy, Medicare will cover up to two tobacco-cessation counseling tries each year, including as many as four individual sessions per attempt. … If successful, the new tobacco policy could pay dividends. Of the 46 million Americans estimated to smoke, roughly 4.5 million are seniors older than 65, HHS says. And nearly 1 million more smokers are younger than 65, but eligible for Medicare benefits. … Tobacco-related diseases are estimated to cost Medicare roughly $800 billion between 1995 and 2015″ (Lillis, 8/25).
The (Lakeland, Fla.) Ledger: “The U.S. Department of Health and Human Services calls tobacco use the leading cause of preventable illness and death in the U.S. Centers for Disease Control and Prevention estimates tobacco use causes 1 of 5 deaths in the U.S. each year” (Adams, 8/25).
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Medicare Expands Coverage For Tobacco-Related Counseling
Medicare Drug Plan Changes And Prices Could Surprise Seniors
The Associated Press: An effort to streamline the entangled field of Medicare drug plans could mean as many as 3 million seniors “could force 3 million seniors to switch plans next year whether they like it or not, says an independent analysis,” by Avalere Health: ”beneficiaries will see their prescription plan eliminated as part of a new effort by Medicare to winnow down duplicative coverage and offer consumers more meaningful choices. Seniors would not lose coverage, but they could see changes in their premiums and copayments.”
“For example, Medicare has already notified insurers they will no longer be able to offer more than one ‘basic’ drug plan in any given location.” Medicare officials dismissed the estimate as simple “guessing” (Alonso-Zaldivar, 8/25).
The New York Times: Meanwhile, a new report by the AARP “on retail prices of brand-name drugs shows the 217 products most used by older Americans increased by an average of 8.3 percent during 2009, the largest increase in years, even as inflation was negative.” In response, drug makers “pointed to a broader survey of drug prices showing they rose by 3.4 percent during 2009. The survey, conducted by the government for its official Consumer Price Index, includes generic as well as brand-name drug prices” (Wilson, 8/24).
The Bozeman Daily Chronicle: Many seniors are getting help with the costs. ”Thousands of Montanans using Medicare’s Part D prescription drug plan should be receiving rebate checks by mail soon, said a Medicare official touring the state to talk about changes to the federal program. Nearly 20,000 people who fall through the gap in Medicare prescription drug coverage should receive $250 rebate checks, issued by the federal government as part of the health care overhaul” (Russell, 8/25).
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Medicare Drug Plan Changes And Prices Could Surprise Seniors
Fewer N.C. Physicians Seeing Medicare Patients; Hospitals Try To Cut Medicare Readmissions
News outlets look at a variety of issues surrounding Medicare.
WRAL: “The national health care reform law, which was was designed to provide insurance coverage and access to physicians to more Americans, has no provision to help a group already having difficulty finding doctors to treat them – senior citizens. According to a report from Cigna Government Services, which processes Medicare claims in North Carolina and 17 other states, more than 80 physicians in North Carolina have opted out of Medicare in the past year. That’s in addition to the 100 physicians statewide who stopped seeing Medicare patients in 2008, the report states. … The gap has grown every year … as salaries and overhead costs have increased while the reimbursement rate under Medicare has remained relatively flat” (Chou, 8/23).
Modern Healthcare: “HHS Secretary Kathleen Sebelius has announced $32 million in funding to help improve access to healthcare services for rural Americans. The funding will be allocated to seven programs that are administered by the Office of Rural Health Policy in HHS’ Health Resources and Services Administration. … According to HHS, more than $22 million will go toward the Medicare Rural Hospital Flexibility Program, which supports improvements in healthcare quality in communities served by critical access hospitals; efforts to improve the hospitals’ financial and operating performance; and the development of collaborative regional and local delivery systems. More than 1,300 hospitals have converted to critical access hospital status with help from this program, HHS said” (Zigmond, 8/23).
MarketWatch: “About one in five Medicare patients suffers complications or other health problems that send them back to the hospital within a month of going home — and a lack of communication between hospitals and patients about follow-up care is a major reason why, experts say. But with new Medicare rules coming soon that will slash payments for return visits, hospitals nationwide are testing a simple solution to a problem that can lead to higher costs and sicker patients: They’re spending more time on discharge instructions to patients and their doctors and other caregivers. … Medicare spends $17.4 billion annually on unplanned readmissions that occur within 30 days of the patient being discharged, according to a 2009 study published in the New England Journal of Medicine” (Martin, 8/24).
Link:
Fewer N.C. Physicians Seeing Medicare Patients; Hospitals Try To Cut Medicare Readmissions
KHN Column: For Cost Control, Vouchers And Medicare Don’t Mix
In his latest Kaiser Health News column, Austin Frakt writes: “With the ambition of reducing the federal debt, Congressman Paul Ryan has offered a proposal to convert Medicare to a voucher-based program. Under the plan, in time all Medicare beneficiaries would receive program benefits from private plans subsidized by government payments (vouchers). In principle, such a system could reduce federal Medicare costs if the subsidy grows more slowly than medical inflation, shifting more of the costs to care to individuals. The history of Medicare and its politics suggest it is unlikely to work out that way” (8/19). Read the entire column.
The rest is here:
KHN Column: For Cost Control, Vouchers And Medicare Don’t Mix
Mental Health Services can be Covered by Medicare Part B
Medicare is about helping you and those around you deal with the conditions that you have so you can enjoy your life. There is a big part of the coverage that has to do with your physical well-being, but Medicare also covers the mental side of things. Medicare Part B, as a matter of fact, will pay for services to treat your mental health condition so you can live a normal life.
Medicare Part B will cover a psychiatric evaluation that may be necessary to diagnose your treatment so that you may seek assistance. This is a great service that can help you understand what your situation is and how you can deal with it on your own terms.
Medication management is also offered by Medicare Part B as a way of helping you understand what drugs you should use and why. This is a great way to learn about the effects that certain types of medication can have on you and can be beneficial for family as well.
Occupational therapy that’s part of your mental health treatment is covered by Medicare Part B so that you can function as close to normal as possible. The better you can get around in your normal life, the better your quality of life will be and that is the entire point of Medicare.
See more here:
Mental Health Services can be Covered by Medicare Part B
When do you have to pay your Medicare Premium?
When you get any kind of insurance coverage, including that of Medicare coverage of any kind, you will be required to pay a premium for the payment. Premium is just a fancy word for a monthly bill that will be required to be paid in order to keep your coverage valid. You will not always get a bill for your Medicare premium, but if you do it is very easy to pay.
First, understand that you will always receive a bill for your Medicare Part A insurance premiums, regardless of your situation. If you are receiving checks from the Railroad Retirement Board (RRB), Civil Services, or SSA (Social Security Administration) the Part B premium will be deducted from your check. If not you will receive a bill for your Part B and Part A premiums that you must pay on time.
All you have to do when you are ready to make your payment is to send the check to the Medicare payment processing center. You can mail your premium payments to the Medicare Premium Collection Center, P.O. Box 790355, St. Louis, MO 63179-0355. If you get a bill from the RRB, mail your premium payments to RRB, Medicare Premium Payments, P.O. Box 9024, St. Louis, MO 63197-9024.
