Susan Jaffe

Strange Pricing Details Can Bedevil Medicare Beneficiaries

KHN Original

Pharmacist Gina Upchurch knows all the ins and outs of the Medicare prescription drug benefit and was sure she discovered something very wrong:  using the government’s online plan finder tool to help seniors compare dozens of 2014 drug policies, she noticed that some insurers charge higher prices for a prescription filled every two or three months […]

Shutdown Not Hurting Seniors’ Ability To Get Medicare Plan Information

KHN Original

The government may still be shut down — for now — and federal websites still caution visitors that information may not be up to date while the government is closed. But Medicare beneficiaries do not have to worry about getting accurate details from the plan finder website during the current open enrollment season, officials said. […]

Medicare To Delay Enforcement Of New Observation Rule

KHN Original

Medicare officials announced Thursday that they will delay enforcement of controversial new rules that define when hospital patients should receive observation care, rather than being admitted, a distinction that makes beneficiaries ineligible for follow-up nursing home coverage. The new rules take effect Tuesday, but officials said they will not be enforced until at least Jan. […]

Federal Judge Throws Out Lawsuit Over Hospital Observation Care

KHN Original

A federal court judge in Hartford, Conn., dismissed a lawsuit Monday which was filed against the government by 14 Medicare beneficiaries who were denied nursing home coverage. Under Medicare rules, only patients admitted to a hospital for at least three consecutive days are eligible for coverage of follow-up nursing home care. The beneficiaries who brought the suit […]

Seniors Need To Be Tenacious In Appeals To Medicare

KHN Original

Consumer advocates say that efforts to get Medicare to reverse a decision denying coverage of care are frequently rejected at first, but the chances of success are much better for beneficiaries who keep appealing until they reach the level handled by an administrative law judge.