Tag: open enrollment

Trumpeted New Medicare Advantage Benefits Will Be Hard For Seniors To Find

By Susan Jaffe  | Kaiser Health News | November 9, 2018 | This KHN story also ran on 

For some older adults, private Medicare Advantage plans next year will offer a host of new benefits, such as transportation to medical appointments, home-delivered meals, wheelchair ramps, bathroom grab bars or air conditioners for asthma sufferers.

But the new benefits will not be widely available, and they won’t be easy to find.

Of the 3,700 plans across the country next year, only 273 in 21 states will offer at least one. About 7 percent of Advantage members — 1.5 million people — will have access, Medicare officials estimate.

That means even for the savviest shoppers it will be a challenge to figure out which plans offer the new benefits and who qualifies for them.

Medicare officials have touted the expansion as historic and an innovative way to keep seniors healthy and independent. Despite that enthusiasm, a full listing of the new services is not available on the web-based “Medicare Plan Finder,” the government tool used by beneficiaries, counselors and insurance agents to sort through dozens of plan options. [Continued at Kaiser Health News, NPR and CNN]…

COBRA, Retiree Plans, VA Benefits Don’t Alleviate Need To Sign Up For Medicare

By Susan Jaffe  | Kaiser Health News | December 14, 2016 | This KHN story also ran on     

When Cindy Hunter received her Medicare card in the mail last spring, she said she “didn’t know a lot about Medicare.” She and her husband, retired teachers who live in a Philadelphia suburb, decided she didn’t need it because she shared his retiree health insurance, which covered her treatment for ovarian cancer.

Cindy Hunter, who is battling ovarian cancer, says she mistakenly thought she didn’t need to enroll in Medicare because her husband’s retiree insurance would cover her. (Steph Brecht/Courtesy of Cindy Hunter)

“We were so thankful we had good insurance,” she said. So she sent back the card, telling officials she would keep Medicare Part A, which is free for most older or disabled Americans and covers hospitalization, some nursing home stays and home health care. But she turned down Part B, which covers doctor visits and other outpatient care and comes with a monthly premium charge. A new Medicare card arrived that says she only has Part A.

Her story isn’t unique.

When Stan Withers left a job at a medical device company to become vice president of a small start-up near Sacramento, Calif., he took his health insurance with him. Under a federal law known as COBRA, he paid the full cost to continue his coverage from his previous employer. A few years earlier, when he turned 65, he signed up for

This KHN article also ran in The Philadelphia Inquirer.

Medicare’s Part A. With the addition of a COBRA plan, he thought he didn’t need Medicare Part B.

Hunter and Withers now know they were wrong and are stuck with medical bills their insurance won’t cover. …Advocates for seniors and some members of Congress want to fix the problem, backed by a broad, unlikely group of unions, health insurers, patient organizations, health care providers and even eight former Medicare administrators.  [Continued on Kaiser Health News or NPR or The Philadelphia Inquirer]…

Decline of Medicare subsidized drug plans leaves seniors with less choice

By Susan Jaffe, Kaiser Health News | November 21, 2015 | and also published in USA Today logo 2012
Even though health problems forced Denise Scott to retire several years ago, she feels “very blessed” because her medicine is still relatively inexpensive and a subsidy for low-income Medicare beneficiaries covers the full cost of her monthly drug plan premiums. But the subsidy is not going to stretch as far next year.

Denise-Scott-04

That’s because the premium for Scott’s current plan will cost more than her federal subsidy. The 64-year-old from Cleveland is among  the 2 million older or disabled Americans who will have to find new coverage that accepts the subsidy as full premium payment or else pay for the shortfall. As beneficiaries explore options during the current Medicare enrollment period, there are only 227 such plans from which they can choose next year, 20% fewer than this year, and the lowest number since the drug benefit was added to Medicare in 2006, according to the Centers for Medicare & Medicaid Services. [Continued in USA Today, Kaiser Health News and PBS NewsHour]
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Medicare May Help Seniors If Advantage Plans Drop Doctors

By Susan Jaffe | December 23, 2014 Connecticut Health Investigative Team and The Hartford Courant

Next year, seniors with private Medicare Advantage insurance policies whose doctors leave their plan may be able to leave, too, under a new Medicare rule.

The Centers for Medicare & Medicaid Services (CMS), which oversee Medicare Advantage programs, will create a special three-month enrollment period in any state where insurers make network changes “considered significant based on the affect or potential to affect, current plan enrollees,” according to an update to Medicare’s Managed Care Manual.

The special enrollment period – if granted by CMS – would allow Medicare Advantage members to switch out of their plans and join traditional Medicare or another Medicare Advantage plan whose provider network includes their doctors.

…U.S. Sen. Richard Blumenthal criticized the new rule because it’s not clear what “significant” network changes would trigger a special enrollment period. Instead, he spearheaded a letter sent last Friday to Medicare chief Marilyn Tavenner, asking her to prohibit mid-year provider network changes. The letter was also signed by U.S. Sens. Sherrod Brown of Ohio and Rand Paul of Kentucky, along with U.S. Reps. Rosa DeLauro, Joe Courtney, Jim Himes, Elizabeth Esty and 13 other members of Congress.
“This blatant bait and switch should not be allowed,” they wrote. [CONTINUED in Connecticut Health Investigative Team and in The Courant ] …

Second round of enrolment begins under Affordable Care Act

image Volume 384, Issue 9956, 15 November 2014 

WORLD REPORT Ahead of the next phase of enrolment for insurance plans, Republicans vowed to target the health law following their election win. Susan Jaffe, Washington correspondent, reports.

Federal health officials promise that last year’s embarrassing enrolment problems will not be repeated when the sign-up season begins on Nov 15 for 2015 health insurance policies offered under the Affordable Care Act (ACA). But even as more insurance companies and millions more Americans enter the second year of the health insurance programme, the opportunity for critics to chip away at it will never be better when Republicans regain control of Congress in January.

…Under the law, all adults are required to have health insurance and, with some exceptions, those without it are penalised. People who don’t get health coverage through their jobs can buy policies through the online state or federal insurance exchanges from Nov 15 to Feb 15. To minimise the delays many experienced last year, federal officials who run the exchanges in 37 states have shortened the application and no longer require shoppers to spend time setting up accounts before they can review the plans.

Although this month marks the second enrolment period, US Department of Health and Human Services (HHS) Secretary Sylvia Matthews Burwell has been eager to stress that it won’t be a rerun of last year. “It’s not year two”, she told reporters recently, because this is the first time the exchanges will be renewing current policies while also handling first-time applications. [MORE full text or PDF ] …

Challenges loom for US health law as new insurance begins

lancet cover 2

Volume 383, Issue 9928, 3 May 2014

 

WORLD REPORT Millions of Americans met the mid-April extended deadline to enrol in coverage under the Affordable Care Act; now the real test of the law begins. Susan Jaffe reports from Washington, DC.

Just a few days after April’s extended enrolment deadline, President Barack Obama announced that some 8 million Americans had signed up for health insurance under his health-care law, exceeding the predictions dampened by a rocky rollout 6 months ago that prompted jokes on late-night talk shows, fuelled the opposition, and ultimately led to the resignation of his Health and Human Services secretary, Kathleen Sebelius, the nation’s top health official.

“The repeal debate is and should be over”, Obama proclaimed, referring to the 54 times Republicans in the US House of Representatives have voted to repeal or modify the law. “The Affordable Care Act [ACA] is working.”

But even the programme’s supporters say the next few months will be crucial to its success. [MORE] [PDF]…

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By Susan Jaffe  | October 15, 2013 |  Kaiser Health News produced in collaboration with 

The seven-week enrollment period for next year’s Medicare prescription drug and managed-care plans begins Tuesday, but seniors shouldn’t simply renew their policies and assume the current coverage will stay the same. There’s a likely payoff for those who pay close attention to the details.[More in KHN] [More in USA Today]

Seniors Cautioned To Pay Close Attention To Details As Enrollment Begins In Medicare Plans

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Susan Jaffe, Kaiser Health News produced in collaboration with 

August 25, 2013 – While the Obama administration is stepping up efforts encouraging uninsured Americans to enroll in health coverage from the new online insurance marketplaces, officials are planning a campaign to convince millions of seniors to please stay away – don’t call and don’t sign up.

“You hear programs on the radio about the health care law and they never talk about seniors and what we are supposed to do,” said Barbara Bonner, 72, of Reston, Va. “Do we have to go sign up like they’re saying everyone else has to? Does the new law apply to us seniors at all and if so, how?” [More in KHN] [More in USA Today]

No Shopping Zone: Medicare Is Not Part Of New Insurance Marketplaces