As open enrollment ends, many people are tuning out. They could wind up with a surprise next year: higher costs and less access to health care providers.
Funcionarios de los Centros de Servicios de Medicare y Medicaid le han pedido a las personas mayores y a otros miembros de la comunidad que sean detectives contra el fraude, denunciando tácticas de venta engañosas al 800-MEDICARE.
The Biden administration wants to crack down on deceptive or misleading Medicare Advantage and drug plan sales tactics. It’s counting on beneficiaries to help catch offenders.
Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.
Before the covid-19 public health emergency ended, Medicare advocates around the country noticed a rise in complaints from beneficiaries who received at-home covid tests they never requested. Bad actors may have used seniors’ Medicare information to improperly bill the federal government — and could do it again, say federal investigators.
La cobertura de Medicare para las pruebas caseras de covid-19 finalizó hace pocos días, pero las estafas generadas por este beneficio temporal podrían tener consecuencias persistentes para las personas mayores.
In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare dozens of drug and medical plans. Federal officials say beneficiaries who use insulin will have the opportunity to switch plans after open enrollment ends Dec. 7.
Medicare can pay for some dental care if it is medically necessary to safely treat another covered medical condition, and federal officials have asked for suggestions on whether that list of conditions should be expanded.
Private Medicare Advantage health plans are increasingly ending coverage for skilled nursing or rehab services before medical providers think patients are healthy enough to go home, doctors and patient advocates say.
The Biden administration is considering whether Medicaid, which pays the bills for 62% of nursing home residents, should require that most of that funding be used to provide care, rather than for maintenance, capital improvements, or profits.
Even the savviest Medicare drug plan shoppers can get a shock when they fill prescriptions: That great deal on medications is no bargain after prices go up.
Private and public employers are increasingly using the government’s Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the “overwhelming majority” of medical costs, according to an industry analyst.
If federal officials accept a court’s decision, some patients will get a chance to seek refunds for their nursing home and other expenses.
Funcionarios federales dicen que están aumentando las quejas de personas mayores engañadas para que compren pólizas sin su consentimiento, o atraídas por información cuestionable, que pueden no cubrir sus medicamentos ni incluir a sus médicos.
Medicare officials say complaints are rising from seniors lured into private plans with misleading information or enrolled without their consent. In response, officials have threatened to penalize the private companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers.
Following the devastating impact of covid-19 on nursing homes, state lawmakers want to be sure that government and private payments primarily go to improve care and staffing.
This year, 23 states passed more than 70 pandemic-related provisions affecting nursing homes, including measures setting minimum staffing levels, expanding visitation protections and limiting owners’ profit margins.
Connecticut residents who learned how to communicate with family and friends through digital technology when their nursing homes closed to visitors last year used that skill to testify remotely during legislative hearings on bills affecting them.
A Trump administration Medicare rule will push some hospital patients into a Catch-22: The government says several hundred procedures no longer need to be done in a hospital, but it did not approve them to be performed elsewhere. So patients will still need to use a hospital while not officially admitted — and may be charged more out-of-pocket for the care.
Under pressure from organizations representing doctors, nurses, hospitals and other care providers, a handful of states are offering them protections from civil lawsuits over medical treatment.