50 Medicare Wishes

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Create an individually tailored Annual Notice of Change for Medicare Advantage (MA) and Part D plans

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 […]

Enhance audit capacity and increase transparency on Medicare Advantage (MA) and Part D sanctions

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 […]

Improve beneficiary education on low-to-no cost preventive services and screenings

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 […]

May 8th, 2015|Categories: 50 Medicare Wishes, Enhance Education and Choice|

Improve Medicare Advantage (MA) and Part D denial notices

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 […]

May 7th, 2015|Categories: 50 Medicare Wishes, Enhance Education and Choice, Simplify Appeals|

Eliminate the 190-day lifetime cap on inpatient psychiatric hospital stays

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 […]

May 6th, 2015|Categories: 50 Medicare Wishes, Modernize Benefits|

Do away with the three-day stay required for skilled nursing facility 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 […]

May 5th, 2015|Categories: 50 Medicare Wishes, Increase Affordability, Modernize Benefits|

Count time spent in observation (outpatient) status toward the three-day rule for nursing care

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 […]

May 4th, 2015|Categories: 50 Medicare Wishes, Increase Affordability, Modernize Benefits|

Eliminate the homebound requirement for Medicare coverage of home health care services

Medicare coverage for care at home currently requires that a person be “homebound” and that they meet several other technical requirements. Medicare Rights often hears from beneficiaries who […]

May 3rd, 2015|Categories: 50 Medicare Wishes, Increase Affordability, Modernize Benefits|

Decrease limitations on coverage for Durable Medicare Equipment (DME) outside the home

Medicare only covers DME that is needed inside the home. This limitation restricts access to DME for those who are in skilled nursing facilities and altogether ignores a […]

May 2nd, 2015|Categories: 50 Medicare Wishes, Increase Affordability, Modernize Benefits|

Create Medicare Part E—a public supplement to Original Medicare with Part D benefits and a catastrophic cap

Medicare beneficiaries who opt for the flexibility and simplicity of Original Medicare should be protected from catastrophic costs by an out-of-pocket maximum and should benefit from an integrated […]

May 1st, 2015|Categories: 50 Medicare Wishes, Modernize Benefits, Strengthen Part D|