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Monthly Archives: November 2019

Time for Medicare Enrollment – Time to Talk Turkey!

Medicare Fall Open Enrollment continues through December 7 — so you still have time to make certain changes to your coverage, including switching prescription drug plans or between traditional (sometimes called Original) Medicare and Medicare Advantage (MA). As friends and families around the country gather for the Thanksgiving holiday, it’s […]

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Recent Changes Add Complexity to Medicare’s Fall Open Enrollment Period

Medicare’s Fall Open Enrollment Period (OEP) is a busy time for beneficiaries and those who help them evaluate their health care and prescription drug coverage options. From October 15 to December 7 each year, people with Medicare can make changes to their coverage, such as switching Part D prescription drug plans, or switching between Original Medicare and Medicare Advantage. This annual decision-making process can be complex, and several changes this year are making it even more so.

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Poll Finds Many Americans Worried about Health Care Costs and Struggle to Afford Care

A recent poll and study by Gallup and West Health found that most Americans are worried about rising health care costs, and many are also concerned about bankruptcy from major health events. Older adults have somewhat more confidence about their access to quality care than younger people, but they still experience difficulty with affordability, especially when it comes to paying for prescription drugs. These findings and more are an important indicator that more must be done to bring down health care costs.

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Upcoming Medicare Additions for Treatment for Opioid Use Disorder

The Centers for Medicare & Medicaid Services (CMS) recently finalized a rule that expands Medicare coverage for Opioid Use Disorder (OUD). Recent legislation, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, established a pathway for this more comprehensive Medicare coverage of OUD services. Beginning on January 1, 2020, Medicare Part B will cover OUD treatment—including methadone for Medication Assisted Therapy (MAT)—furnished by an Opioid Treatment Program (OTP) under a bundled payment mechanism. This means a significant improvement in access to OUD care for people with Medicare, including for those who are dually eligible for Medicaid.

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Court Blocks Sweeping Rule that Would Negatively Impact Patient Access to Care

This week, a federal court blocked a Trump administration rule that would have allowed health plans and providers to refuse to provide certain types of care they disagreed with on moral or religious grounds. Set to take effect on November 22, the rule would have permitted individuals to deny care even in circumstances where performing the refused service was a significant portion of their jobs, and even where the refusal could prevent patients from receiving the service altogether.

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New Report Details High Out-of-Pocket Costs for Some with Medicare

A new analysis from the Kaiser Family Foundation (KFF) underscores these challenges. According to the report, people with Original Medicare spent an average of $5,460 out of their own pockets for health care in 2016. Nearly half of this spending was for services outside of Medicare, such as LTSS (32%) and dental care (14%). The other half was largely devoted to meeting beneficiary cost-sharing obligations, including for provider-based care (22%) and prescription drugs (21%).

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