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Medicare Watch

Medicare Watch articles are featured in a weekly newsletter that helps readers stay up-to-date on Medicare policy and advocacy developments, and learn about changes in Medicare benefits and rules.

New Enrollment Period Now Available for People with Medicare Advantage

Older adults and people with disabilities who are currently enrolled in a Medicare Advantage (MA) plan have until March 31 to switch to another MA plan or to Original Medicare with or without a stand-alone prescription drug plan (Part D) during the new Medicare Advantage Open Enrollment Period (MA OEP).

The MA OEP occurs each year from January 1 through March 31, and it is only available to people who have a Medicare Advantage plan. One change can be made during this period, which will take effect the first of the month following the month you enroll. For example, if you switch to a new Medicare Advantage Plan in February, your new coverage begins March 1.

Read More »

Medicaid Changes Likely in 2019

As 2019 gets underway, the Medicaid program continues to be in the spotlight. This week, the Kaiser Family Foundation (KFF) released an issue brief that highlights some of the major program changes that states, the Administration, and Congress may pursue in 2019.

Over 66 million people receive their health coverage through Medicaid, including older adults, people with disabilities, children, low-income parents, and other adults. Any changes to the program, therefore, have the potential to affect millions of families.

Read More »

Proposed Marketplace Changes Could Harm People with Medicare

In November, the Centers for Medicare & Medicaid Services proposed regulatory changes to the Affordable Care Act’s Health Insurance Marketplaces. We submitted comments this week, in which we raise concerns with several aspects of the proposed rule that could have negative implications for people with Medicare.

CMS indicates it is proposing this rule in part to ensure that people are in the “most appropriate type of coverage.” While Medicare Rights supports this goal, we disagree with the agency’s proposal to achieve it by automatically terminating Marketplace coverage for people who are eligible for or enrolled in Medicare Part A.

Read More »

Medicare Rights Responds to Proposed Changes for Medicare Advantage Plans in 2020

The Medicare Rights Center recently submitted comments in response to proposed rule changes from the Center for Medicare & Medicaid Services (CMS) pertaining to Medicare Parts C and D for 2020 and 2021. Many of the proposed rules implement changes that Congress made to the law that establishes Duals Special Needs Plans (D-SNPs). D-SNPs are special plans designed to serve the needs of people who are eligible for both Medicare and Medicaid, also known as “dual eligibles.”

Read More »

Administrative Proposal to Lower Medicare Drug Prices Shows Promise but Risks Remain

In November, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced new proposals that could potentially lower prices for some of the drugs covered by Medicare Part B but could threaten access to medications for people with Medicare. CMS invited comment on their proposals and, last month, Medicare Rights responded.

Health care affordability is a top issue on our national helpline each year, and the high cost of prescription drug coverage is one major component of this. Most of the medications people with Medicare take are covered under Part D. Part B only accounts for a small percentage of Medicare-covered drugs, but they are some of the most expensive. It is clear that Part B medications can drive significant out-of-pocket costs for people with Medicare with life-altering conditions like cancer, end-stage renal disease, or rheumatoid arthritis.

Read More »

Texas Affordable Care Act Decision Flawed; ACA is Still the Law of the Land

In a radical departure from established legal doctrine, a federal judge in Texas issued a ruling against the Affordable Care Act (ACA) on December 14, claiming that the entire law must fall. At the center of the lawsuit, brought by a coalition of Republican-led states, was the ACA’s individual mandate and penalty for failure to be insured. Congress repealed this penalty in last year’s tax bill. As a result, the lawsuit claimed the ACA was invalid. Unfortunately, the district court in Texas agreed with this flawed analysis, although legal scholars have denounced it across the ideological spectrum.

Read More »

CMS Issues Guidance to Help States Better Serve People with Medicare and Medicaid

Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a Dear State Medicaid Director letter highlighting ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid.

Medicaid is an important source of coverage for nearly 12 million people with Medicare. It covers needed services that Medicare does not, such as long-term care. Medicaid also helps make Medicare more affordable by helping pay Medicare premiums and/or cost-sharing, which can be high for people with low incomes.

Read More »

Leveling the Medigap Playing Field

At the Medicare Rights Center, we encourage states to provide equal protections for people with Medicare, regardless of age. Last week, we joined the American Kidney Fund to explain the importance of Medigap access for people under 65 to the National Conference of State Legislatures.

Most people with Medicare have two major options when choosing how to receive their Medicare coverage: Original Medicare or Medicare Advantage. While this decision is complicated, those who choose Original Medicare may have another decision to make as well—whether to add Medigap coverage.

Read More »

Congress Close to Finalizing Important Medicaid Extensions

On Tuesday, the U.S. House of Representatives passed the IMPROVE Act (H.R. 7217), which extends two critical Medicaid programs for older adults and people with disabilities. The U.S. Senate is expected to approve the bill before adjourning for the year.

First authorized in the Deficit Reduction Act of 2005, the Medicaid Money Follows the Person Demonstration Program (MFP) officially launched in 2007. Since then, it has helped over 88,000 older adults and people with disabilities transition from nursing and other facilities back to the community, and it has consistently been a cost-effective, successful program. According to independent, national evaluations MFP participants who have transitioned to community-based settings experience lasting improvements in quality of life, and they also decrease their overall Medicare and Medicaid expenditures by roughly 23%, generating considerable cost savings for the programs.

Read More »

New Enrollment Period Now Available for People with Medicare Advantage

Older adults and people with disabilities who are currently enrolled in a Medicare Advantage (MA) plan have until March 31 to switch to another MA plan or to Original Medicare with or without a stand-alone prescription drug plan (Part D) during the new Medicare Advantage Open Enrollment Period (MA OEP).

The MA OEP occurs each year from January 1 through March 31, and it is only available to people who have a Medicare Advantage plan. One change can be made during this period, which will take effect the first of the month following the month you enroll. For example, if you switch to a new Medicare Advantage Plan in February, your new coverage begins March 1.

Government Shutdown Threatens Programs for Older Adults and People with Disabilities

As the government shutdown continues, so do its impacts on older adults, people with disabilities, and their families. While Medicare and Medicaid are fully funded for the year, other critical programs—like affordable housing, food assistance, and transportation services—are not. This threatens the health and economic security of millions of Americans.

Medicaid Changes Likely in 2019

As 2019 gets underway, the Medicaid program continues to be in the spotlight. This week, the Kaiser Family Foundation (KFF) released an issue brief that highlights some of the major program changes that states, the Administration, and Congress may pursue in 2019.

Over 66 million people receive their health coverage through Medicaid, including older adults, people with disabilities, children, low-income parents, and other adults. Any changes to the program, therefore, have the potential to affect millions of families.

Proposed Marketplace Changes Could Harm People with Medicare

In November, the Centers for Medicare & Medicaid Services proposed regulatory changes to the Affordable Care Act’s Health Insurance Marketplaces. We submitted comments this week, in which we raise concerns with several aspects of the proposed rule that could have negative implications for people with Medicare.

CMS indicates it is proposing this rule in part to ensure that people are in the “most appropriate type of coverage.” While Medicare Rights supports this goal, we disagree with the agency’s proposal to achieve it by automatically terminating Marketplace coverage for people who are eligible for or enrolled in Medicare Part A.

Medicare Rights Responds to Proposed Changes for Medicare Advantage Plans in 2020

The Medicare Rights Center recently submitted comments in response to proposed rule changes from the Center for Medicare & Medicaid Services (CMS) pertaining to Medicare Parts C and D for 2020 and 2021. Many of the proposed rules implement changes that Congress made to the law that establishes Duals Special Needs Plans (D-SNPs). D-SNPs are special plans designed to serve the needs of people who are eligible for both Medicare and Medicaid, also known as “dual eligibles.”

Administrative Proposal to Lower Medicare Drug Prices Shows Promise but Risks Remain

In November, the Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—announced new proposals that could potentially lower prices for some of the drugs covered by Medicare Part B but could threaten access to medications for people with Medicare. CMS invited comment on their proposals and, last month, Medicare Rights responded.

Health care affordability is a top issue on our national helpline each year, and the high cost of prescription drug coverage is one major component of this. Most of the medications people with Medicare take are covered under Part D. Part B only accounts for a small percentage of Medicare-covered drugs, but they are some of the most expensive. It is clear that Part B medications can drive significant out-of-pocket costs for people with Medicare with life-altering conditions like cancer, end-stage renal disease, or rheumatoid arthritis.

Texas Affordable Care Act Decision Flawed; ACA is Still the Law of the Land

In a radical departure from established legal doctrine, a federal judge in Texas issued a ruling against the Affordable Care Act (ACA) on December 14, claiming that the entire law must fall. At the center of the lawsuit, brought by a coalition of Republican-led states, was the ACA’s individual mandate and penalty for failure to be insured. Congress repealed this penalty in last year’s tax bill. As a result, the lawsuit claimed the ACA was invalid. Unfortunately, the district court in Texas agreed with this flawed analysis, although legal scholars have denounced it across the ideological spectrum.

CMS Issues Guidance to Help States Better Serve People with Medicare and Medicaid

Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a Dear State Medicaid Director letter highlighting ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid.

Medicaid is an important source of coverage for nearly 12 million people with Medicare. It covers needed services that Medicare does not, such as long-term care. Medicaid also helps make Medicare more affordable by helping pay Medicare premiums and/or cost-sharing, which can be high for people with low incomes.

Leveling the Medigap Playing Field

At the Medicare Rights Center, we encourage states to provide equal protections for people with Medicare, regardless of age. Last week, we joined the American Kidney Fund to explain the importance of Medigap access for people under 65 to the National Conference of State Legislatures.

Most people with Medicare have two major options when choosing how to receive their Medicare coverage: Original Medicare or Medicare Advantage. While this decision is complicated, those who choose Original Medicare may have another decision to make as well—whether to add Medigap coverage.

Congress Close to Finalizing Important Medicaid Extensions

On Tuesday, the U.S. House of Representatives passed the IMPROVE Act (H.R. 7217), which extends two critical Medicaid programs for older adults and people with disabilities. The U.S. Senate is expected to approve the bill before adjourning for the year.

First authorized in the Deficit Reduction Act of 2005, the Medicaid Money Follows the Person Demonstration Program (MFP) officially launched in 2007. Since then, it has helped over 88,000 older adults and people with disabilities transition from nursing and other facilities back to the community, and it has consistently been a cost-effective, successful program. According to independent, national evaluations MFP participants who have transitioned to community-based settings experience lasting improvements in quality of life, and they also decrease their overall Medicare and Medicaid expenditures by roughly 23%, generating considerable cost savings for the programs.