What Are Guaranteed Issue Rights in Medicare?

While many people are currently assessing their health insurance options for fall’s Open Enrollment, running from October 15 through December 7, some may have questions about their options regarding Medicare, Medigap policies, and Guaranteed Issue Rights. If you are enrolled in or interested in enrolling in a Medigap policy, these policies are not subject to Medicare’s Open Enrollment period. A Medigap policy, or Medicare Supplement Insurance policy, helps to fill the “gaps” by serving as a supplement to Original Medicare, covering a portion of remaining health costs, such as copayments, coinsurance, and deductibles. These types of policies are sold by [...]

2021-11-26T15:05:51+00:00November 26, 2021|

Important Medicare Provisions Seniors Should Know About

Congress is gearing up to pass a budget reconciliation package, and there are several important Medicare provisions affecting seniors, including first-time Medicare coverage for vision, hearing, and dental care.      These Medicare provisions are proposed to phase in vision, hearing, and dental benefits in 2022, 2023, and 2028, respectively. The Congressional Budget Office has estimated that vision benefits would cost $30 billion over 10 years, hearing benefits would cost $89 billion over 10 years, and dental benefits would cost $238 billion over 10 years.  The legislation would also make broader changes to prescription drug coverage under Medicare. In addition to [...]

2021-11-09T16:19:33+00:00September 24, 2021|

FDA Approves New Alzheimer’s Drug

On June 7, 2021, the U.S. Food and Drug Administration (FDA) approved Aduhelm (aducanumab), a new Alzheimer’s drug for the treatment of the disease. Aduhelm was approved using the “accelerated approval pathway,” which can be used for a drug for a serious or life-threatening illness that provides a therapeutic advantage over existing treatment. According to the FDA, “accelerated approval can be based on the drug’s effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit to patients, with a required post-approval trial to verify that the drug provides the expected clinical benefit.” Was the approval of [...]

2021-11-09T16:31:38+00:00July 1, 2021|

Expanded Skilled Nursing Facility Medicare Coverage During the Pandemic

The COVID-19 pandemic has been particularly devastating for nursing homes and their residents. Aside from the tragically disproportionate loss of life, care for surviving residents has been delayed or interrupted due to infection, facility lockdowns, or other health system disruptions. As a result, the Centers for Medicare & Medicaid Services (CMS) has waived two limitations on Medicare Part A skilled nursing facility (SNF) coverage during the coronavirus pandemic: The 3-day qualifying hospital stay requirement; and The 100-day benefit period.  However, CMS treats the two SNF coverage expansions differently from each other with regard to its connection to COVID-19. Three Day [...]

2021-11-09T16:59:20+00:00March 4, 2021|
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