- You can’t understand Medicare without getting a handle on its alphabet, from A to D.
- Medicare also has a robust role for private insurance. About one-third of beneficiaries opt to join private insurance plans that contract with the federal government to provide an alternative to the traditional, fee-for-service government program. And that business is highly profitable for private insurance.
- As Americans age, many fondly look forward to Medicare, imagining it will pay all their health bills. But the program has hefty cost-sharing requirements and doesn’t cover many expenses, including long-term nursing home care, dental care and most vision care.
- Federal officials are eager to find ways to cut Medicare’s drug costs. But that raises many questions, such as whether Medicare should negotiate with drugmakers over prices or set up its own formulary of drugs it would cover.
- An even harder question is how Medicare can work to control costs for the pricey drugs administered in doctors’ offices. Strong congressional lobbying from doctors and drugmakers has derailed efforts to do so in the past.
- A vexing issue for some seniors is getting observation care at the hospital when they are not sick enough to be admitted but are too sick to go home. Patients receiving observation care likely face bigger cost sharing than if they were admitted and Medicare won’t pay for any nursing home care.
- Share on X (Opens in new window) X
- Share on Facebook (Opens in new window) Facebook
- Share on LinkedIn (Opens in new window) LinkedIn
- Email a link to a friend (Opens in new window) Email
- Print (Opens in new window) Print
Some elements may be removed from this article due to republishing restrictions. If you have questions about available photos or other content, please contact NewsWeb@kff.org.