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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

Can You Buy Medicare on the Health Insurance Marketplace?

Posted on 03/07/2017

When former President Obama introduced the Affordable Health Act (ACA), he completely changed the way health insurance was sold and administered in the United States. The ACA brought health insurance to millions who didn’t have it before while making it easier for people with pre-existing conditions to get the coverage they needed. Not only did Obama create a whole new

“Determined to Save Medicare” – The GOP’s Entitlement Problem

Posted on 02/28/2017

Medicare is considered an entitlement because most Americans get Medicare Part A, the part that covers hospitalization, for free when they turn 65 years old. Medicare Part B, the medical portion of the program, is usually a companion of Part A, but seniors pay a monthly premium for medical coverage. Medicare Part D, which covers prescriptions, also requires a monthly

President Trump is Taking on Big Pharma – Maybe

Posted on 02/26/2017

With all the news surrounding healthcare reform since President Trump took office in January, there’s been plenty of speculation and few facts on how the new administration is going to handle Medicare. The president’s campaign promises and conflicting statements from members of Congress don’t help. Trump also muddied the waters this week with statements on medication costs for those on

On Medicare? How Trump’s Healthcare Policies Might Affect Your Wallet

Posted on 02/22/2017

Healthcare has been at the center of the political debate for months, and there doesn’t seem to be any end in sight to the discussion. In fact, it seems as if the debate is just now heating up, fueled by promises made by President Trump and fellow Republicans who now control Congress. And while there are a lot of promises

Changes on the Horizon for Medicare

Posted on 02/16/2017

President Trump didn’t say much, if anything at all, about changing Medicare while he was on the campaign trail – and for good reason. Despite its status as an entitlement program, Medicare is popular among liberals and conservatives, Republicans and Democrats, and just about every American. But while he was mum on Medicare reform before he took office, Trump now