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New Waivers for States Could Signal Flexible, Affordable Health Insurance Markets

Posted on 07/29/2019

On October 22, the Centers for Medicare & Medicaid Services (CMS) announced that states would be given authority to relax some of the guidelines for insurance under the Affordable Care Act (ACA). Framed as giving states “the flexibility to lower premiums and increase choices” for consumers, it’s also a weakening of ACA regulations that are designed to keep the insurance

Affected by the Hurricanes? You Might Have Longer to Sign Up During Medicare Open Enrollment

Posted on 10/18/2017

In late August and early September, three hurricanes – Harvey, Irma and Maria – swept through the southern United States, Puerto Rico and the U.S. Virgin Islands resulting in mass displacement, lost properties, loss of income and other devastation. Last month, the Centers for Medicare and Medicaid Services (CMS) announced that open enrollment would be extended this year for those

Simultaneous Coverage with Medicare

Posted on 05/11/2017

If you’re about to become eligible for Medicare, then you’ve probably done lots of research already on what to expect, how to enroll and what kind of plan you need. But Medicare can be tough to unravel. To complicate things, if you have coverage through another source already, you may be wondering what happens to that plan once you sign

Medicare Part D vs. Medicare Advantage Plans

Posted on 04/14/2017

Choosing which Medicare plan works best for you can be overwhelming. If you are one of many seniors who also takes prescription drugs, there are added considerations. Two different options exist for prescription drug coverage in Medicare: enrolling in a Medicare Part D plan or choosing a Medicare Advantage plan that includes prescription drug coverage. Which one is better? The

Want to Lower Your Rx Drug Costs? Here are 5 Simple Ways to Do It

Posted on 04/13/2017

Medicare can help to cover many of your medical costs as you age, such as medically necessary doctor visits, blood tests and hospital stays, but it doesn’t cover everything. In fact, people on a fixed income, especially senior citizens, find themselves struggling to pay their prescription drug co-pays, even if they’re on Medicare. If you’re on Medicare and your prescription

Part D Donut Hole: What Happens Under Trump?

Posted on 03/07/2017

The Medicare Part D coverage gap, also known as the “donut hole,” presents a complex issue in healthcare. Under the Affordable Care Act (ACA) of 2010, the donut hole was set to be completely eliminated by 2020. With the new administration and the promise of healthcare reform, no one is sure what will happen to the donut hole. What is

Quality Payment Program Tool

Posted on 03/07/2017

As the payment model for healthcare services moves from a fee-for-service to a fee-for-value model, the Centers for Medicare and Medicaid Services (CMS) has rolled out a number of new metrics and tools to help track patient care for healthcare service providers. Recently, the CMS unveiled the Merit-based Payment System (MIPS), an incentive program that pays providers a more positive

What Are Medicare Advantage Plans and Should You Keep Yours?

Posted on 03/07/2017

Medicare Advantage plans, also called Medicare Part C, are insurance plans offered by private companies approved by Medicare. These plans cover the same services and treatments as original Medicare along with different extras depending on plan type. This isn’t the same as a Medicare Supplement Insurance Policy, known as Medigap, which covers things like copayments, coinsurance and deductibles. Medicare Advantage

CMS Updates Drug Spending Dashboard

Posted on 03/07/2017

In 2015, the Centers for Medicare and Medicaid Services released an online tool to check the prices of prescription drugs used by Medicare patients, and that tool has now been updated with the latest figures on spending. The drug tracking tool was necessary because of the rise in prices over the last few years, something that shows no signs of

What is the CMS Equity Plan?

Posted on 03/07/2017

In 2015, the Centers for Medicare and Medicaid Services (CMS) set out to help reconcile the perceived disparities in the care their funding provides to minority groups versus the rest of the general population. According to the CMS, the Equity Plan contains a three-part path to equity framework: increasing understanding and awareness of care disparities, solution development and dissemination, and