New Marketing Guidance Leaves Too Many Unanswered Questions

Julie CarterMedicare Watch0 Comments

Myriams-Fotos/Pixabay.com

Last week, the Medicare Rights Center submitted comments on new federal marketing guidance that will apply to Medicare Advantage (MA) and Part D prescription drug plans in 2019. The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, updates and releases marketing guidance every year so that MA and drug plans have current, uniform rules for marketing their products safely and accurately, without discriminating against people with Medicare. Some years see minor tweaks to the rules, but other years, like this one, see wholesale changes in how plans may be marketed. Read More...

Tell your Members of Congress to Support Medically Necessary Dental Care

Mitchell ClarkIn the Know, Medicare Watch0 Comments

Photo by Daniel Frank on Unsplash

People with Medicare face significant health risks because they do not have access to medically necessary dental care. There is an ongoing effort to urge CMS to use their existing administrative authority to allow this coverage, and we need your help! Ask your members of Congress to sign on to letters asking CMS to provide Medicare coverage for medically necessary dental care, as authorized by law. Read More...

As Health and Financial Challenges Grow, More Older Adults File for Bankruptcy

Lindsey CopelandMedicare Watch0 Comments

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According to a recent study featured in the New York Times, bankruptcy among older Americans is on the rise. The rate of people age 65 and older filing for bankruptcy is three times what it was in 1991, and this group now accounts for 12% of all filers, a far greater share than in 1991 (2%). Driving the surge, the study suggests, is a three-decade shift of financial risk from government and employers to individuals. This pattern—which includes people waiting longer for full Social Security benefits, employers replacing pensions with defined contribution savings plans, and soaring out-of-pocket health care costs—has transferred many of the health and economic challenges associated with aging onto older adults. Read More...

CMS to Allow Medicare Advantage Plans to Restrict Access to Drugs Covered Under Part B

Casey SchwarzMedicare Watch0 Comments

This week, the Centers for Medicare & Medicaid Services (CMS) announced that next year, Medicare Advantage (MA) Plans will be able to limit options for people who get Part B-covered drugs by using many of the same tools plans currently use in Part D. The Trump administration argues that this will enable plans to negotiate better prices for the “preferred” medications – those that the plan will cover as a first-line treatment. Other drugs will only be covered if a person tries the preferred medication first and it doesn’t work or causes them harm, also known as step therapy. Read More...

Trump Administration Expands “Short-Term” Health Plans, Jeopardizing Coverage for Millions

Lindsey CopelandMedicare Watch0 Comments

Lisa F. Young/Shutterstock.com

This week, the Trump Administration issued a final rule expanding the availability of “short-term” health plans that do not have to comply with the Affordable Care Act’s (ACA) consumer protections and coverage requirements. In particular, short-term plans are free from the ACA’s insurance regulations–including the mandate to cover essential health benefits like maternity care, prescription drugs, and mental health treatment—as well as from the health law’s consumer protections that prevent insurers from charging sick people more than healthy people, excluding coverage of pre-existing conditions, and denying coverage based on medical history. Under the final rule, these policies will now last up to 12 months, and consumers will be able to renew them for a maximum of 36 months. Previously, the plans were limited to three months and were not renewable. Read More...