A basic guide and resources if you want to get Medicare to reverse a coverage decision.
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.
If young adults can’t afford health insurance policies available in 2014 under the health care law, state insurance officials are worried they won’t buy them. And that could drive up the cost of insurance for the mostly older, sicker people who do purchase coverage. That’s a potential problem even in states like California and Rhode Island, […]
The group argues that increasing cost-sharing would stop people from seeking necessary care.
Health care providers who appealed to Medicare judges won more often than patients did, according to a report by the inspector general at the U. S. Department of Health and Human Services. Hospitals, physicians, medical equipment suppliers and other providers also filed 85 percent of the cases decided by the administrative law judges in fiscal […]
Medicare beneficiaries battered by Superstorm Sandy have one less problem to worry about: Federal officials have extended the Dec. 7 deadline to enroll in a private medical or drug plan for next year for those still coping with storm damage. The Centers for Medicare & Medicaid Services “understands that many Medicare beneficiaries have been affected by […]
Government is sending letters to a half million beneficiaries to alert them to their plans’ poor performance.
Today, Medicare beneficiaries can begin choosing their drug and medical coverage for 2013, and most seniors are expected to stick with the same policies they have already, despite price changes and a rating system that shows some plans may be better than others. Seniors have been reluctant to change plans, even if there are cheaper […]
The government is testing new hospital payment rules to see if fewer beneficiaries will be classified as observation patients, which can be a costly designation for seniors.
Congress may be in recess, but Rep. Joe Courtney (D-Conn.) isn’t taking a vacation just yet. He went to a New London nursing home Wednesday to drum up support for legislation that would help residents such as a 98-year-old woman whose life savings were wiped out by nursing home bills Medicare wouldn’t pay. That woman’s niece, […]
The pharmaceutical industry agreed in the health debate to reduce brand-name drug costs by 50 percent for Medicare beneficiaries who reach the coverage gap known as the doughnut hole.
The number of Medicare patients who enter the hospital for observation rose dramatically even though Medicare enrollment and hospital admissions declined slightly, according to a study by gerontologists at Brown University in Providence, R.I. The researchers analyzed medical records and hospital claims for 29 million people in traditional Medicare from 2007 to 2009. They found […]
If a Medicare staff recommendation is approved, health insurance exchanges may be up for a rebranding.
People who are not admitted to the hospital
New consumer-friendly statements urge seniors to report suspicious charges and make it easier to appeal denials of coverage.
The rules detail standard, easy-to-understand information that insurance plans will be required to provide consumers.
Leaders from some of the nation’s top consumer and seniors advocacy groups today urged President Barack Obama not to weaken a key consumer provision of his signature health care overhaul law. The provision requires health insurers and employers to use standardized, easy-to-understand information documents to describe health plan benefits and costs. These forms would explain how […]
Extra time is limited only to seniors who have had trouble signing up and contact one of several organizations that are working to help beneficiaries.
BOSTON – When choosing the right nursing home, most consumers lack one of the best sources of inside information about the facilities – from the residents themselves. But at the annual meeting of the Gerontological Society of America, researchers from Minnesota and Ohio explained how consumers in those states can find summaries of nursing home […]
Money for the federal programs that millions of seniors rely on to live independently in their own homes will not rise with the growing demand, Kathy Greenlee, head of the Administration on Aging, told members of the Gerontological Society of America during its annual meeting. More than 3,800 researchers, scientists, educators and health professionals specializing in […]