Medicare Legislation
May 30th, 2009
With the Obama stimulus plan cutting fees to insurance companies who offer Medicare PFFS plans in 2010 combined with the increased regulations, enforcement and red tape; two national carriers have decided to exit from offering PFFS plans in 2010 to include Coventry Health and Wellcare. In addition, local Rocky Mountain HMO Cost Contract is set to expire in 2009 that will force them to discontinue their Thrifty, Standard,and other cost plans. This will mean that Medicare beneficiaries will have to make a change during the 2010 Medicare Annual Election starting on November 15th, 2009 to another plan. Medicare beneficiaries affected by this will also likely get a one time right to get a guaranteed issue for a Medicare Supplement if it is considered a plan leaving the service area. This could be very ideal for a Medicare beneficiary who is needing to more medical coverage in the form of a supplement but was unable in the past due to unfavorable underwritting and outside of initial coverage election period. Stay tuned to see how this will impact your decision in 2010 but we do expect less options available in 2010 for Medicare beneficiaries with this recent legislation.
July 11, 2008
Medicare Beneficiaries - If you are new to Medicare, you may have difficulty finding a doctor to treat you under the new practices that are being implemented (see below) by Congress. BEFORE YOU TURN 65 - start early! Call your doctor, find out if they treat Medicare patients (ie. bill Medicare) and what plans they will accept if you broaden your coverage with a Medicare Advantage Plan or Medicare Supplements through a private insurer. Whether you choose Anthem, Aetna, Humana, 0r any other of the medical Advantage Plans or Medicare Supplements available in Mesa County of Colorado you will need to make sure your doctor is accepting. For those of you who have been on Medicare for some time, stay tuned to this site to make sure you are aware of the changes and how they will affect you.
June 30, 2008
Medicare beneficiaries - be aware of recent changes to this federally funded program. Congress has introduced some legislation that may require Medicare beneficiaries to “pay for” the increase in physician payments - in other words Medicare payments to doctors for Medicare Advantage Plans are proposed to be cut INCLUDING PFFS plans (Private-Fee-For-Service). These cuts are expected to be in the $6.4-$6.6 Billion range nation-wide - about 10.6% overall cut for physicians on average (Effective July 1, 2008). In the past, the legislation has always been in favor of maintaining or increasing physician payments. However, the economic look-out for Medicare funds is very poor - with the increase in baby boomers that are looking to turn 65 and exponentially increasing healthcare costs, the Medicare Hospital Insurance Trust Fund is expected to continue to pay out more expenses than it receives in taxes and other income. By 2019 the annual deficits are projected to deplete the Medicare fund. The recently passed legislation passed Congress’ House by an overwhelming majority (355-59) making it exempt from any Vetoes the President might have been considering. There will be another chance in July 2008 for Congress to vote again on this issue. In addition to the cuts, there were some favorable sections of the bill including improving coordination between providers, equates treatment of mental illnesses with physical illnesses for increased coverage options for those who need psychotherapy and other mental illness treatments. It would also provide an additional opportunity for ‘tele-help’ - connecting more providers and more facilities, a focus on e-prescribing and other hospital provisions such as allowing critical access hospitals to receive 101% of “reasonable costs” for clinical lab services. For more details, check out this news article: Bush Administration Delaying Medicare Fee Cut