Your Weekly Medicare Consumer Advocacy Update
Brighter Financial Outlook for Medicare Trust Fund
Latest CBO Forecast Shows a Brighter Outlook for Medicare Trust Fund
According to the Congressional Budget Office’s (CBO) latest long-term budget outlook, Medicare’s projected financial health is significantly better than the CBO’s previous forecast only five months ago. In February of this year, the Medicare hospital insurance trust fund (Part A) was projected to remain financially solvent until 2025—today CBO projects that the trust fund will exhaust its reserves in 2030.
The forecast was extended due to the growing belief that the current slowing of the growth in Medicare spending is here to stay. One reason for this belief is due to revised estimates of the rate at what health care costs will increase compared to gross domestic product—CBO decreased their estimates saying health care costs will not grow as fast as they forecasted last year. Additionally, because of changes under the Affordable Care Act, more than $700 billion dollars was saved in the Medicare program.
Kaiser Family Foundation Releases Report on Retiree Coverage and Medicare
Retiree health coverage can come in various forms, but generally helps a Medicare beneficiary cover remaining health and/or drug costs after Medicare pays. In certain cases, retiree coverage provides additional benefits—such as vision, dental or long-term care—that Medicare does not cover. Today approximately 15 million Medicare beneficiaries receive supplemental retiree health benefits.
Earlier this year, the Kaiser Family Foundation (KFF) released a report on the landscape of retiree health benefits. The report found that the structure of retiree health benefits, especially for those who are Medicare-eligible, is rapidly changing. To date, there has been no decrease in the employers that provide retiree coverage. Yet, the number of employers offering coverage is expected to gradually decrease over time due to rising health costs.
Employers are adopting a series of strategies to combat rising costs. The first is to switch their retiree coverage to an employer-sponsored Medicare Advantage or Part D prescription drug plan with enhanced benefits. The second is to transition retirees to “private exchanges” that offer retirees a limited choice in how they receive their Medicare benefits, and the employer provides defined assistance in covering costs of the Medicare plan(s) that retirees choose. Both of these strategies limit employer responsibilities but often shift greater costs onto retirees. If public policy solutions are not found to reduce the rising health care costs, it is expected that fewer retiree plans will be offered, and a greater cost burden will be placed upon retirees.
Volume 5, Issue 28
Sometimes, you may want to get a second opinion on a medical recommendation or diagnosis from a different doctor. Original Medicare will pay for you to see a doctor and get a second opinion if a doctor has recommended that you have surgery or a major diagnostic or therapeutic procedure. Original Medicare will pay for a third opinion if the first and second opinions are different. The second and third opinions will be covered even if the surgery or other procedure is determined not to be covered.
If you are in a Medicare Advantage plan, your plan must cover the same services as Original Medicare does, but may have different rules you have to follow. For example, the plan may only cover second and third opinions if you see doctors that are in network or if you have a referral from your Primary Care doctor. Call your plan to find out the rules for getting second opinions.
A new report from the Centers for Disease Control and Prevention (CDC) highlights geographic differences in the health-related quality of life among older Americans. The report analyzes data from the National Health Interview survey conducted from 1997 through 2010 for older adults over 65 to score their health-related quality of life (lower scores indicate poorer health). According to the data, those living in Alaska, Alabama, Arkansas, Mississippi, and West Virginia had the lowest mean score, while those in Alaska, Alabama, Arkansas, Mississippi, and West Virginia had the highest.