It’s a Shame: Low-Income Medicare Beneficiaries Continue to Be Plagued With Balance Billing

Federal law prohibits traditional Medicare and Medicare Advantage providers and suppliers from billing people who are qualified Medicare beneficiaries (QMBs) for Medicare deductibles, coinsurance and copayments — a practice known as balance billing. Qualified Medicare beneficiaries (QMBs) are people with Medicare who have incomes at or below 100 percent of the federal poverty level — or a higher level set by their state — and very few resources. In spite of the prohibition, many QMBs are receiving and, out of …

Cost of Retiree Dental Plans May Give You a Toothache

Boomers retiring without dental benefits, and Medicare recipients who don’t have a Medicare Advantage plan, may be surprised and dismayed by the latest study on the cost of dental coverage. Consumers paid an average $382 annual premium for a stand-alone dental plan through a government exchange this year, and that didn’t include deductibles and copays, according to the analysis of dental plans on the federal exchange by the website HealthPocket, which compares health plans. Deductibles averaged about $500 a year …

Will Court Block Insurers from Dropping Doctors?

By Susan Jaffe, Kaiser Health News In a decision that could have national implications, a federal judge in Connecticut temporarily blocked UnitedHealthcare late Thursday from dropping an estimated 2,200 physicians from its Medicare Advantage plan in that state. While the judge’s decision affects only the physicians in Fairfield and Hartford Counties who brought suit, several other medical groups are considering filing similar actions. “This is very good news from Connecticut,” said Dr. Sam L. Unterricht, president of the Medical Society …

Memo to Doctors: Why Are You Over-Drugging Seniors?

What the heck is going on with doctors in some parts of the country who prescribe risky drugs for older adults? According to an analysis of more than 6 million seniors on Medicare Advantage, more than 20 percent are prescribed at least one high-risk medication. The problem is most common in the South, among women, and in relatively poor areas, report public health researchers with Brown University. Risky medications are ones that health authorities have specifically recommended against prescribing to …

Do Medicare Advantage Plans Skim Off The Healthiest?

By Jordan Rau, Senior Correspondent, Kaiser Health News New research finds that many seniors who switch from their HMO-style Medicare Advantage plan to traditional Medicare have higher levels of significant health problems, fueling concerns that the private plans cater to more profitable, healthy beneficiaries but don’t provide the most attractive care for the very ill. More than 13 million people, a quarter of all Medicare beneficiaries, are enrolled in these private plans. Enrollment has been growing, in part because the …

Medicare Advantage Plans: Should You Aim for the Stars?

By Ankita Rao of Kaiser Health News Older Americans are benefiting from a star rating system that ranks the quality of Medicare Advantage plans, according to a study published in the Journal of the American Medical Association. Authors affiliated with the Centers for Medicare & Medicaid Services (CMS) conducted a study of almost 1.3 million Medicare beneficiaries. They found a positive relationship: a one-star higher rating was associated with a 9.5 percentage point increase in likelihood to enroll. The rating system …