To the uninitiated, Medicare, Medicare Advantage (MA) and Medicare supplement plans can seem simple enough: Medicare covers 80% of hospital and physician costs and MA and supplement plans cover the rest.
But in reality, Medicare and its associated additional plans can be incredibly complex to navigate. This is one of many lessons that Kate Yandell has learned since 2018, when she began reporting on Medicare beneficiaries’ financial challenges after a cancer diagnosis. Continue reading
It’s still difficult for many eligible older adults in parts of the U.S. to get COVID-19 vaccination appointments. And that’s exactly what con artists are counting on.
The Centers for Medicare & Medicaid Services (CMS), the Federal Bureau of Investigation (FBI), and the Department of Health and Human Services Office of Inspector General (HHS-OIG) are warning the public — especially elders — about several fraud schemes related to COVID-19 vaccines.
A screenshot from a television ad on Friday for a Medicare Advantage plan from UnitedHealthcare.
Watching the TV ads during the evening news, you would think Medicare Advantage plans were the greatest health insurance bargain ever invented. Consumers should not be fooled, however.
It’s true that the federal Centers for Medicare and Medicaid Services made it possible for Medicare Advantage (MA) health plans to offer more benefits to seniors enrolled in Medicare. Some of these plans offer coverage for vision, hearing, and gym memberships) while not charging a monthly premium, and some MA plans will even pay for seniors’ Medicare Part B premium, said John Barkett, a senior director of policy affairs at the health care consulting firm Willis Towers Watson. Continue reading
Research released today shows that from 2016 through 2018, self-insured employers and commercial health insurers in 49 states and the District of Columbia paid 247% more, on average, than what the Medicare program would have paid for the same inpatient and outpatient hospital services.
Researchers from RAND analyzed hospital claims data from 3,112 hospitals in every state except Maryland, which was excluded because the state has an all-payer rate setting model in which hospitals charge prices that are equal to what Medicare and private insurers pay, the report explained. The claims totaled $33.8 billion and came from self-insured employers, six state all-payer claims databases and health plans from 2016 to 2018. Continue reading
Graphic: Health Care Cost InstituteResearchers from the Health Care Cost Institute reviewed 210 million claims from individuals with health insurance through their employers in 2017 and compared what insurers paid physicians and other providers for those services against what Medicare would have paid for the same services in 271 metropolitan areas. (Click to enlarge graphic.)
During the coronavirus pandemic, any number of good news stories seem to get little or no coverage because most health care journalists are busy covering COVID-19.
One such case in point was a report earlier this month from the Health Care Cost Institute. In Comparing Commercial and Medicare Professional Service Prices, HCCI researchers compared what health insurers paid to physicians and other providers with what Medicare pays for those services.
This report should not be overlooked for at least three reasons. Continue reading