When Is Medicare Open Enrollment?

We cover everything you need to know about open enrollment in Medicare and the different open enrollment and special enrollment periods. When Is Medicare Open Enrollment? Medicare open enrollment lasts from October 15 to December 7 each year. Your coverage will start on January 1 of the new year. If you are already enrolled in…

The Best Supplement for Original Medicare

What is the Best Supplement for Original Medicare? If you anticipate needing a significant number of health care visits or care in a facility, you may want to think about adding a Medicare supplement and Part D drug plan to Part A and Part B. Part B has an annual deductible of $183 for 2018.…

Medicare Part F (Medigap) vs. Medicare Advantage.

What is Plan F, Plan G, and Medigap? Once you have Medicare Part A and B, you can buy either Part D along with a Medigap Plan F or Plan G or a Medicare Advantage Plan. We discuss your options. A Medigap Plan F Covers the Part A hospital and Part B outpatient deductibles Covers…

Supplemental Medicare Helps With Costs and Coverage Gaps

Medicare Doesn’t Cover Everything; Supplemental Medicare Can Help Original Medicare doesn’t cover everything, and this can result in high costs and coverage gaps. Supplemental Medicare coverage like Part D, Medigap, or Medicare Advantage (Part C) can help. Understanding What Medicare Does and Doesn’t Cover and What You Can Do About It Medicare enrollees lack crucial…

Understanding Medicare Cost-Sharing

What is Medicare Cost-Sharing? When you use Medicare, you share the cost of your care by paying premiums, deductibles, copayments, co-insurance, and out-of-pocket maximums. If you receive a paycheck, part of your check will be set aside for Medicare. You pay for the program when you work and pay again when you use it. When you…

How are Original Medicare and Medicare Advantage Different?

What is the Difference Between Original Medicare and Medicare Advantage Plans? We compare Original Medicare and Medicare Advantage to help you better understand the difference between Original Medicare and Medicare Advantage plans. Both Original Medicare and Medicare Advantage are Federally regulated and ACA-compliant, but the fact that aspects of Medicare are privatized means there are significant…

What is the Medicare Payment Advisory Commission (MedPAC)?

Who Oversees Medicare Costs? The Medicare Payment Advisory Commission (MedPAC) provides cost and access oversight for the Medicare Program for quality of care and access to services. The Balanced Budget Act of 1997 established the group, which is composed of 17 part-time members appointed for three-year terms by the Comptroller General. Some appointments expire each…

Could Medicare’s Independent Payment Advisory Board be a Death Panel?

What Does the “Death Panel” Rumor Have To Do With Medicare’s Independent Payment Advisory Board? We want to know the function of Medicare’s Independent Payment Advisory Board (IPAB) and whether the rumor that it might be used as a “Death Panel” is true. What is IPAB? Medicare’s Independent Payment Advisory Board (IPAB) is a group that does…

Why Networks and Drug Formularies in Medicare Plans are Important

Why do I Need to Know Which Drugs are Preferred in my Insurance Formulary or Which Physicians are In Network? We ask what drug formularies and preferred providers are and why you need to consider them when choosing a Medicare plan or any health insurance policy. Every insurance plan has a list of which drugs…

Is Medicare’s Independent Payment Advisory Board a Cause for Concern?

Why is the Medical Community Concerned About Medicare’s Independent Payment Advisory Board (IPAB) and MedPAC? IPAB and MedPAC are Medicare’s cost control systems. We discuss concerns that the medical community has about their potential to limit services and profits. What is The Independent Payment Advisory Board (IPAB)? The Independent Payment Advisory Board (IPAB) is, in theory,…

Can You Get Dental, Hearing, and Vision Care with Medicaid?

I need Dental, Hearing, and Vision Care. Can I get it through Medicare? Medicare provides limited dental, hearing, and vision care. It covers some surgeries but no routine care. Available policies have limited coverage. What Does Medicare Cover? Medicare will not pay for routine care but may pay for testing if you have a condition…

The History of Medicare

Medicine and Medicare in the U.S. The U.S. has had a Medicare program since the mid-1900’s and has accepted a theoretical responsibility to take care of the elderly, veterans, and the poor. Improved standards of living have increased our life expectancy tremendously. It was not unusual to see people in this country live only through…

What are Medicare Drug Formularies?

What are Drug Formularies For Medicare Plans? Medicare Prescription drug lists (formularies) are lists of covered drugs, placed into different tiers, where each tier has different costs. Each Medicare plan that provides drug coverage has its own list of covered drugs and costs that follow a set of common rules. Below we will explain more about…

Medicare and Hospital Costs

Medicare and Hospital Costs: Medicare Networks, Medicare Assignment, Balance Billing, and Other Factors Related to Hospital Costs On this page, we discuss Medicare networks, Medicare assignment, balance billing, and the way hospital costs vary within a hospital (such as in the ER). Hospitals often charge more, sometimes a dozen times more, for services provided in the emergency…

What is Medicare and How Can You Qualify?

What is Medicare? We explain what Medicare is, how you can qualify for Medicare, and how the Affordable Care Act affects Medicare. Medicare is a federal health insurance program that most people pay into while working and all citizens can access when they turn 65. Medicare is funded by two trust funds held by the US Treasury: the Hospital…

Advanced Care Planning (ACP)

What is Advanced Care Planning? Advanced Care Planning (ACP) is planning of end-of-life treatments with the assistance of doctors in order to give patients control. Advanced Care Planning and the Affordable Care Act (ObamaCare) As of July 2015 doctors aren’t paid to provide end of life counseling to Medicare and Medicaid patients, nor is their…

When Does the Donut Hole Go Away?

ObamaCare closes the Part D ‘donut hole’ from 2013 – 2020 lowering the amount you pay for generics and brand name drugs in the coverage gap to 25% by 2020.

Is the Medicare Shared Savings Program Working?

The Medicare Shared Savings Program (MSSP) established by the ACA allows healthcare providers to group together under ACOs to get paid for quality over quantity. Initial reports show savings for Medicare and providers under the Accountable Care Organization (ACO) model established under the ACA. Not all the initial “Pioneer ACO” groups faired equally as well, but overall…

ACOs (Accountable Care Organizations)

Account Care Organizations (ACOs) are groups of medical providers that accept payments based on quality under the Medicare Shared Savings Program (MSSP). This model is meant be an alternative to the traditional fee-for-service (FSS) aimed at reigning in unnecessary treatments, coordinating care, promoting quality over quantity, and curbing Medicare spending. The bottom line:  According to an August…