In 1972, Congress granted Medicare benefits to people receiving Social Security disability benefits. This historic step forward was marred by an arbitrary limit, requiring that people with disabilities […]
Beneficiaries enrolled in MA plans should be able to count on stability in their plan networks and the knowledge that their doctors will be there when they need […]
Information about which health care providers are in network and out of network is vital for helping beneficiaries make smart decisions about their coverage. Yet this critical information […]
Annual changes to MA and Part D plan coverage rules, cost-sharing amounts, and provider networks are commonplace. At the same time, comparing and contrasting plan options during the […]
The federal government is currently only able to audit 10 percent (about 30 of 300) of Medicare private health plan sponsors each year. Recent audits uncovered noncompliance among […]
Prior to the Affordable Care Act, many preventive screenings were not covered by Medicare. Now, not only are certain preventive services covered, most of the time they are […]
The most common call to the Medicare Rights national helpline comes from a beneficiary denied access to a health care service or prescription medication, and most of these […]
The Medicare Improvements for Patients and Providers Act of 2008 achieved partial mental health parity in Medicare, but unequal treatment remains. For instance, Medicare caps coverage for care […]
Medicare will only cover a beneficiary’s medically necessary stay in a skilled nursing facility if that person is first an inpatient in a hospital for three days—a rule […]
Absent elimination of the three-day stay rule, Congress should count all time a patient spends in the hospital—as an inpatient or outpatient—toward the three-day rule. Shifting hospital practices […]