When Medicare was facing an impossible $13 trillion funding gap, Congress opted for a bold fix: It handed over part of the program to insurance companies, expecting them to provide better care at a lower cost. The new program was named Medicare Advantage.
My older brother Sean has cerebral palsy. He also listens to bebop and enjoys teaching our nephew Oliver about the virtues of counting from one to ten in the voice of The Count and was angered when the Bruins fired Claude Julien.
Look down this list to see if any of these situations apply to you. It will tell you what you should do about signing up for Part B. You receive financial help to buy an individual health plan through your state's Health Insurance Marketplace.
On the last week of April earlier this year, a small committee of doctors met quietly in a midsized ballroom at the Renaissance Hotel in Chicago.
In April, Nancy Niemi entered Vidant Medical Center in Greenville, N.C., with cardiac problems. She stayed four nights, at one point receiving a coronary stent. Then she went home, but felt faint and took several falls. Five days later, her primary care doctor sent her back to the hospital.
Lingering uncertainty about the fate of the Affordable Care Act has spurred the California legislature to consider adoption of a statewide single-payer health care system.
DEDHAM, Mass. — A dozen or so years into retirement, Rita Sherman had plenty going for her financially. Recently widowed, she had a net worth of roughly $600,000 as of 1998.
Medicare doesn't have to be complicated. Sure, there are many aspects to the federal healthcare program. The good news is that retirees don't have to master every single one of them. You do need to understand the basics of Medicare, however.
French women supposedly don’t get fat, and in the minds of many Americans, they also don’t get stuck with très gros medical bills. There’s long been a dream among some American progressives to truly live as the “Europeans1” do and have single-payer health care.
For now, at least, the attempt to repeal the Affordable Care Act appears dead.
WASHINGTON — In November, after a bad fall, 85-year-old Elizabeth Cannon was taken to a hospital outside Philadelphia for six and a half days of “observation,” followed by nearly five months at a nearby nursing home for rehabilitation and skilled nursing care. The cost: more than $40,000.
In dismantling Obamacare and slashing Medicaid, Republicans would strike a blow against signature victories for racial equality in America. It was a cold March night when Dr. Martin Luther King, Jr. turned his pulpit towards health care.
The number of doctors who each prescribe millions of dollars of medications annually in Medicare's drug program has soared, driven by expensive hepatitis C treatments and rising drug prices overall, federal data obtained by ProPublica show.
These are the stories we tell ourselves: I will never be poor. I will never be disabled. My child will develop normally. They stand a decent chance of being true, even. There is one tall tale, however, that ought to inspire a great deal of skepticism: I will be able to pay for myself in my old age.
The basic structure of the American health care system, in which most people have private insurance through their jobs, might seem historically inevitable, consistent with the capitalistic, individualist ethos of the nation. In truth, it was hardly preordained.
Edwina Kirby was having a hard time. She had tripped over a rug in her home in Livonia, Mich., and the fall broke a femur. After she had surgery and rehabilitation, an infection sent her back into the hospital.
During the campaign, Donald Trump often promised to be a different kind of Republican, one who would represent the interests of working-class voters who depend on major government programs.
Many older Americans who have Affordable Care Act insurance policies are going to miss a Sept. 30 deadline to enroll in Medicare, and they need more time to make the change, advocates say.
Medicare is big business. There are more than 57 millionAmericans enrolled in it, with more added to the program each month. Its net outlays are about $600 billionannually.If you're not covered by Medicare yet, you will probably be relying on it the future, so it's worth learning more about it.
President-elect Donald Trump and House Speaker Paul Ryan agree that repealing the Affordable Care Act and replacing it with some other health insurance system is a top priority. But they disagree on whether overhauling Medicare should be part of that plan.
The first of the 78 million baby boomers turned 65 on January 1, 2011, and some 10,000 boomers a day will reportedly reach that milestone between now and 2030. If you are about to turn 65, then it is time to think about Medicare.
At any given moment, there is a large group of citizens who want nothing more than to make absolutely certain that they are impoverished enough to qualify for Medicaid sooner rather than later. Someday, you might be one of them.
The Trump administration has taken a major step in allowing states to impose work requirements on Medicaid recipients for the first time.
If you do not have a Medicare Advantage plan that includes Part D drug coverage, you must sign up for it separately. You should sign up for Medicare Part D at the same time that you enroll in Part B.
DENVER — Inside a senior center here, nestled along a bustling commercial strip, Vivian Malveaux scans her bingo card for a winning number. Her 81-year-old eyes are warm, lively and occasionally set adrift by the dementia plundering her mind.
INVESTIGATORS in New York were looking for health-care fraud hot-spots. Agents suggested Oceana, a cluster of luxury condos in Brighton Beach. The 865-unit complex had a garage full of Porsches and Aston Martins—and 500 residents claiming Medicaid, which is meant for the poor and disabled.
Medicare officials thought they had finally figured out how to do their part to fix the troubling problem of opioids being overprescribed to the old and disabled: In 2016, a staggering one in three of the 43.6 million beneficiaries of the program’s drug plan had been prescribed the painkillers.
Each year, thousands of Americans miss their deadline to enroll in Medicare, and federal officials and consumer advocates worry that many of them mistakenly think they don't need to sign up because they have purchased insurance on the Affordable Care Act's marketplaces.
The Justice Department has sued UnitedHealth Group, saying that senior executives knew the company was overbilling Medicare by hundreds of millions of dollars a year, and halted a repayment plan in 2014 so the money could be used to meet Wall Street’s revenue expectations.
Has the time for Medicare for All finally arrived? Many on the Left certainly think so. This is not just idle chitchat. A January Pew Research survey found that 60 percent of Americans think the government “has a responsibility to make sure all Americans have health care coverage.
So, what do you think about those Medicare numbers? What, you haven’t heard about them? Well, they haven’t been front-page news. But something remarkable has been happening on the health-spending front, and it should (but probably won’t) transform a lot of our political debate.
Is health care a right? The United States remains the only developed country in the world unable to come to agreement on an answer. Earlier this year, I was visiting Athens, Ohio, the town in the Appalachian foothills where I grew up.
A growing proportion of Medicare beneficiaries are opting out of the government-run insurance program. They are instead choosing a private plan alternative, one of the Medicare Advantage plans.
WASHINGTON — Donald J. Trump once declared that campaigning for “substantial” changes to Medicare would be a political death wish.
Imagine your mother needs to move into a nursing home. It’s going to cost her almost $100,000 a year. Very few people have private insurance to cover this. Your mother will most likely run out her savings until she qualifies for Medicaid. This is not a rare event.
When Sol Shipotow enrolled in a new Medicare Advantage health plan earlier this year, he expected to keep the doctor who treats his serious eye condition. Shipotow said he had to scramble to get back onto a health plan that he could afford and that his longtime eye specialist would accept.
On Oct. 24, 1995, Newt Gingrich made an assertion about what would happen to Medicare if its beneficiaries could choose between it and private plans. Medicare is “going to wither on the vine because we think people are voluntarily going to leave it — voluntarily.
Accordingto Fidelity Investments, a 65-year-old couple retiring this year will spend, on average, about $260,000 out of pocket on healthcare in retirement. One way to keep your healthcare costs in check is to be smart about Medicare and make savvy decisions. Here are three critical things to know.
Listed below are basic costs for people with Medicare. If you want to see and compare costs for specific health care plans, visit the Medicare Plan Finder.
Promises of “decadent” hot baths on demand, putting greens and gurgling waterfalls to calm the mind: These luxurious touches rarely conjure images of a stay in a nursing home.
In the months leading up to the fall Medicare open enrollment season, your mailbox may be overflowing with sales brochures from Medicare Advantage plans. Our advice is to ignore them. There are better, unbiased ways to pick the right plan for you.
Within the broad Democratic coalition, it’s pretty clear that the discussion of health care has shifted to the left. Mainstream figures like Senator Kirsten Gillibrand, a potential presidential candidate in 2020, are embracing single payer.
To hear some hospital executives tell it, they have to make up payment shortfalls from Medicaid and Medicare by charging higher prices to privately insured patients. How else could a hospital stay afloat if it didn’t? But this logic is flawed.
President Obama’s Affordable Care Act marketplaces were supposed to give consumers choices of health plans from insurers that compete to keep premiums down. But fewer insurers are participating, and premiums are increasing sharply.
This short assessment was created by the non-profit National Council on Aging (NCOA)—a trusted resource for Medicare information for over 50 years. It can help you:
“DRUGS have been marketed at such extraordinarily high prices that many people will simply not be able to afford them,” wrote a top cancer doctor in a scathing editorial in the Washington Post. That was in 2004.
President Trump’s proposed budget for fiscal 2018 is being condemned, right and left, for the cuts it imposes on various federal programs. Too little attention is being paid to the necessary economizing the Trump budget avoids — specifically, with regard to Medicare.
You can get help from your state paying your Medicare premiums. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, coinsurance, and copayments if you meet certain conditions.
Colin Campbell needs help dressing, bathing and moving between his bed and his wheelchair. He has a feeding tube because his partially paralyzed tongue makes swallowing "almost impossible," he says.
In April, the government will start sending out new Medicare cards, launching a massive, yearlong effort to alter how 59 million people enrolled in the federal health insurance program are identified.
Drug companies could be forgiven if they're confused about whether President Donald Trump thinks the government should get involved in negotiating the price of prescription drugs for Medicare patients.
One cannot think of a more tone-deaf political response to the 2016 election than an effort to privatize Medicare.
Update, 7/1/2013: Today was the day that Health Quality Partners -- the wildly successful Medicare experiment I profiled back in April -- was supposed to shut down. But on Thursday, Medicare hit "snooze" on the doomsday clock. HQP, they said, could have another 18 months. Here's their reasoning:
A number of Republican health care policy proposals that seemed out of favor in the Obama era are now being given new life. One of these involves Medicare, the government health insurance program primarily for older Americans, and is known as premium support.
Since we launched in 2010, No Labels has had a distinct focus: Bringing America’s leaders together to solve big problems. For the past two years, No Labels has worked diligently to create a playbook for our next president that represents both good politics and good policy.
Medicare offers prescription drug coverage to everyone with Medicare. If you decide not to get Medicare drug coverage when you're first eligible, you'll likely pay a late enrollment penalty unless one of these applies:
The Medicare Advantage program was supposed to save taxpayers money by allowing insurers to offer older Americans private alternatives to Medicare. The plans now cover 19 million people, a third of all those who qualify for Medicare.
Medicare Advantage plans — private plans that serve as alternatives to the traditional, public program for those that qualify for it — underperform traditional Medicare in one respect: They cost 6 percent more. But they outperform traditional Medicare in another way: They offer higher quality.
That is a rule that, surely, Donald Trump knows. And yet in suggesting that Medicare could find big discounts by letting the government negotiate directly over drug prices, he seems to have forgotten it. Mr.
A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.
Three diseases, leading killers of Americans, often involve long periods of decline before death. Two of them — heart disease and cancer — usually require expensive drugs, surgeries and hospitalizations. The third, dementia, has no effective treatments to slow its course.
The saga of Trumpcare may finally be behind us. The wretched bill would have wrenched coverage from tens of millions, and — by many estimates — cost tens of thousands of lives a year. Liberals and leftists rightly united in opposition against it.
GRAND JUNCTION, Colo. — As part of his push for the Affordable Care Act in 2009, President Obama came to Central High School to laud this community as a model of better, cheaper health care. “You’re getting better results while wasting less money,” he told the crowd.
WASHINGTON — The Trump administration is signaling it will pursue significant changes to Medicare that could put beneficiaries on the hook for higher costs. In an informal proposal on Wednesday, federal health officials hinted at several new pilot programs it may implement in the months ahead.
SPECIAL rules apply to older people who contribute to tax-favored health savings accounts as they near age 65 and become eligible for federal Medicare coverage. Under current rules, once people enroll in Medicare, they can no longer make new contributions to an H.S.A.
Fifty years ago, Congress created Medicare and Medicaid and remade American health care. The number of elderly citizens lacking access to hospitals and doctors plummeted. Hospitals, physicians, and state and local governments came to depend on this federal funding.
The Washington Post and Vox have done excellent reporting that shows U.S. spends so much more than other countries for one simple reason — price.
I am a general surgeon with more than three decades in private clinical practice. And I am fed up. Since the late 1970s, I have witnessed remarkable technological revolutions in medicine, from CT scans to robot-assisted surgery.
Our new issue, “Earth, Wind, & Fire,” is out now. Check out the table of contents and subscribe today! The existing system of insurance in America — a heavily commodified, limited-coverage, multi-payer model — represents the abject failure of market liberalism.
The prospect of a universal single-payer healthcare system in California — in which the state covers all residents’ healthcare costs — has enthralled liberal activists, exasperated business interests and upended the political landscape in the state Capitol.
People covered by Medicare have a few more weeks to change their prescription drug plans, during the program’s annual open enrollment period. Much attention has been paid to Affordable Care Act coverage, because the annual sign-up period for plans sold on government marketplaces began this week.
During the 2016 campaign, Andrea Barton Gurney thought that single-payer health care was simply out of the question. A self-described moderate, Ms. Gurney, 56, assumed that Hillary Clinton and the Democrats would keep trying to make the Affordable Care Act work. Now she has changed her mind.
Original Medicare is the familiar program that's been around since 1965. In original Medicare, the government pays Medicare's share of your medical bills directly to doctors and hospitals. You can go to any doctor or hospital anywhere in the country that accepts Medicare reimbursement.
After one of her operations, my sister-in-law left the hospital so quickly that she couldn’t eat for days; after other stays, she wasn’t discharged until she felt physically and mentally prepared.
In August 2015, Turing Pharmaceuticals and its then-chief executive, Martin Shkreli, purchased a drug called Daraprim and immediately raised its price more than 5,000 percent. Within days, Turing contacted Patient Services Inc.
Republicans are in a bind. They’ve been promising to repeal Obamacare for seven years, and having won control of the White House and Congress, they had to try to deliver.
Sen. Bernie Sanders (I-VT) will release a proposal Wednesday afternoon to transition the United States to a single-payer health care system, one where a single government-run plan provides insurance coverage to all Americans.
How much do Medicare beneficiaries pay for healthcare? The short answer is that the average American with "original Medicare" (Parts A and B) can expect to pay a total of $7,620 out of pocket for healthcare expenses this year. However, that number doesn't tell the whole story.
Recent setbacks in states’ exchanges show just how hard it is to make treatment both affordable and widely accessible.
NOW that you’re about to retire, there’s good news and bad news about your health insurance. The good news: When you turn 65, you’re eligible for Medicare — all in all, a pretty affordable way to get coverage for doctor bills, hospitalizations and, more recently, prescription drugs.
If you were contracting for a kitchen remodeling, you’d probably solicit bids and select the lowest one that meets your quality standard.
Medigap health plans are basically bookkeeping operations. Unlike Medicare Advantage plans, Medigap plans don't make any decisions about what to cover. They don't have networks of doctors or hospitals.
WASHINGTON — Doctors are improperly billing poor people on Medicare for deductibles, co-payments and other costs from which they are supposed to be exempt, the Obama administration says.
Recent hurricanes and the wildfires in California caused major devastation, have disrupted mail delivery, and affected enrollment operations. Some people weren’t able to make their Part A or Part B enrollment requests during their Initial Enrollment Period (IEP) or Special Enrollment Period (SEP).
Bernie Sanders doesn’t just want to play defense on health care — he’s introducing a bill that would expand the Medicare program to everybody in America, creating a single-payer health care system.