Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
By Susan Jaffe
March 29, 2024
KFF Health News Original
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.
Beneficiarios de Medicare gastarán menos en medicamentos en 2025
By Susan Jaffe
October 21, 2024
KFF Health News Original
El período de inscripción anual para que los beneficiarios de Medicare renueven o cambien su cobertura de medicamentos, o elijan un plan Medicare Advantage, comenzó el 15 de octubre y se extiende hasta el 7 de diciembre.
Tiny, Rural Hospitals Feel the Pinch as Medicare Advantage Plans Grow
By Sarah Jane Tribble
October 23, 2023
KFF Health News Original
More than half of seniors are enrolled in private Medicare Advantage plans instead of traditional Medicare. Rural enrollment has increased fourfold and many small-town hospitals say that threatens their viability.
TV’s Dr. Oz Invested in Businesses Regulated by Agency Trump Wants Him To Lead
By Darius Tahir
November 21, 2024
KFF Health News Original
Celebrity doctor Mehmet Oz recently held broad investments in health care, tech, and food companies. Were he confirmed to run the Centers for Medicare & Medicaid Services, his job would involve interacting with giants of the industry that have contributed to his wealth.
KFF Health News' 'What the Health?': The Policy, and Politics, of Medicare Advantage
March 23, 2023
Podcast
Medicare Advantage, the private plan alternative to traditional Medicare, is embroiled in a growing controversy over whether insurers are being overpaid and what it would mean to reduce those payments. Meanwhile, even as maternal mortality in the U.S. continues to rise, providers of care to pregnant women say they’re leaving states with abortion bans that prevent them from treating pregnancy complications. Margot Sanger-Katz of The New York Times, Jessie Hellmann of CQ Roll Call, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KHN’s chief Washington correspondent Julie Rovner to discuss these issues and more.
Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients
By Susan Jaffe
October 5, 2023
KFF Health News Original
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.
New Medicare Advantage Plans Tailor Offerings to Asian Americans, Latinos, and LGBTQ+
By Stephanie Stephens
September 28, 2023
KFF Health News Original
As more seniors opt for Medicare Advantage, a few small insurers have begun offering plans that provide culturally targeted benefits for cohorts including Asian Americans, Latinos, and LGBTQ+ people. The approach, policy researchers say, has potential and perils.
An Arm and a Leg: The Medicare Episode
By Dan Weissmann
March 11, 2024
Podcast
On this episode of “An Arm and a Leg,” host Dan Weissmann breaks down the complicated and expensive world of Medicare with practical tips to pick the right plan and avoid penalties.
Vance Wrongly Blames Rural Hospital Closures on Immigrants in the Country Illegally
By Sam Whitehead
October 29, 2024
KFF Health News Original
Experts disputed the claim by Republican vice presidential candidate JD Vance, noting that a range of other issues — from low reimbursement rates to declining patient use — combine to cause these facilities to shutter.
Nuevos planes de Medicare Advantage adaptan ofertas para asiáticos, latinos y LGTBQ+
By Stephanie Stephens
September 28, 2023
KFF Health News Original
A medida que Medicare Advantage gana popularidad entre los adultos mayores, tres compañías del sur de California están lanzando nuevos planes que se enfocan en comunidades culturales y étnicas, con ofertas especiales y profesionales que hablan su idioma nativo.
Es el momento de revisar el plan de Medicare. Lo nuevo que hay que saber
By Julie Appleby
October 16, 2023
KFF Health News Original
Desde el 15 de octubre y hasta el 7 de diciembre, los afiliados al programa tradicional o a los planes de Medicare Advantage, que ofrecen aseguradoras privadas, pueden cambiar su cobertura.
An Arm and a Leg: Attack of the Medicare Machines
By Dan Weissmann
April 10, 2024
Podcast
In this episode of “An Arm and a Leg,” host Dan Weissmann tells a horror story. Instead of monsters and aliens, it’s about private health insurance companies and algorithms that call the shots on patient care.
Medicare Drug Plans Are Getting Better Next Year. Some Will Also Cost More.
By Susan Jaffe
October 21, 2024
KFF Health News Original
Every year, Medicare officials encourage beneficiaries to shop around for their drug coverage. Few take the time. This year, it might be more important than ever.
Medicare Enrollees Can Switch Coverage Now. Here’s What’s New and What to Consider.
By Julie Appleby
October 16, 2023
KFF Health News Original
Fall is the time when enrollees in the federal program for older people and people with certain disabilities can make changes to their health and drug plans. The decision can be complicated, but here are some key points to keep in mind.
Dodging the Medicare Enrollment Deadline Can Be Costly
By Susan Jaffe
December 7, 2023
KFF Health News Original
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.
Home Improvements Can Help People Age Independently. But Medicare Seldom Picks Up the Bill.
By Joanne Kenen
March 3, 2025
KFF Health News Original
A small program celebrated by its proponents helps people modify their homes and safely live independently as they age. But most insurers won’t pay for it, including Medicare.
Whistleblower Accuses Aledade, Largest US Independent Primary Care Network, of Medicare Fraud
By Fred Schulte
March 5, 2024
KFF Health News Original
A recently unsealed lawsuit alleges Aledade Inc. developed billing software that boosted revenues by making patients appear sicker than they were.
Biden Cracks Down on Prior Authorization — But There Are Limits
By Lauren Sausser
January 18, 2024
KFF Health News Original
More than a year after it was initially proposed, the Biden administration announced a final rule yesterday that will change how insurers in federal programs such as Medicare Advantage use prior authorization — a long-standing system that prevents many patients from accessing doctor-recommended care. “When a doctor says a patient needs a procedure, it is […]
‘They Won’t Help Me’: Sickest Patients Face Insurance Denials Despite Policy Fixes
By Lauren Sausser
March 31, 2025
KFF Health News Original
The fatal shooting of UnitedHealthcare CEO Brian Thompson prompted both grief and public outrage about the ways insurers deny treatment. Republicans and Democrats agree prior authorization needs fixing, but patients are growing impatient.
Did Your Health Plan Rip Off Medicare?
By Fred Schulte
January 27, 2023
KFF Health News Original
KHN has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.
