by Kenny | Jan 31, 2025
Key takeaways: The Medicare Part D coverage gap known as the “donut hole” will end in 2024. As of January 1, 2025, Medicare Part D plans will have a $2,000 out-of-pocket limit. If you reach that threshold, your plan will pay for all of your covered medications in full...
by Kenny | Jan 24, 2025
Two important changes are coming for Medicare Part D beneficiaries in 2025 as a result of the Inflation Reduction Act: Annual out-of-pocket (OOP) cap of $2,000 for prescription drugs. Medicare Prescription Payment Plan (MPPP), which will allow beneficiaries who opt in...
by Kenny | Jan 12, 2025
Big changes are coming to Medicare in 2025, and they could make a major difference in your prescription drug costs. Thanks to the Inflation Reduction Act, Medicare beneficiaries will see the most significant updates to the program’s drug coverage since it was first...
by Kenny | Jan 6, 2025
Last week, the Centers for Medicare & Medicaid Services (CMS) released information about Medicare costs in 2025, including the 2025 premium, deductible and coinsurance amounts for Medicare Part A and Part B. The agency also announced the income-related monthly...
by Kenny | Dec 27, 2024
Key components of the Inflation Reduction Act’s Part D reforms will be fully implemented for plans offered in 2025. These changes, including the total elimination of the “coverage gap” coverage period, the establishment of a $2,000 cap on beneficiary out-of-pocket...
by Kenny | Dec 20, 2024
Medicare payment rules prohibit coverage for a service if a beneficiary is not financially responsible for the care or if another government entity is obligated to provide or pay for the item or service. For years, the Medicare rules interpreting and implementing this...
by Kenny | Dec 14, 2024
A new report from the U.S. Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) examines trends in health care access and outcomes in rural America. While insurance rates in these areas are improving,...
by Kenny | Nov 29, 2024
The Inflation Reduction Act (IRA) made significant improvements to Medicare prescription drug access and affordability, including by restructuring the Part D benefit to limit enrollee expenses. Those changes began in January 2024, when the IRA eliminated cost sharing...
by Kenny | Nov 23, 2024
Now is the time for people who need health insurance in 2025 to shop for coverage. For those without employer, Medicare, or Medicaid coverage, Healthcare.gov or their state exchange is the place to shop for Affordable Care Act (ACA) plans. Most shoppers will be able...
by Kenny | Nov 17, 2024
When the Centers for Medicare & Medicaid Services (CMS) pays Medicare Advantage (MA) organizations, they increase the payments when plans enroll sicker people. This is called risk adjustment, and it is an important guardrail to ensure that all people with Medicare...
by Kenny | Nov 8, 2024
Medicare coverage is personal — and changes to those plans and benefits may feel unnerving as it affects one’s overall health and well-being. Originally passed in 2022, the Inflation Reduction Act brought about many changes to Medicare that are now being implemented...
by Kenny | Nov 1, 2024
Finding a doctor you like and trust can be a long process, so I understand that it can be frustrating when your doctor no longer accepts Medicare. If your doctor has “opted out” of Medicare, this means that he or she no longer accepts Medicare assignment...
by Kenny | Oct 25, 2024
It’s important to plan for your health care needs, but sometimes life throws unexpected curve balls. And when that happens, you’ll need to know what’s covered. Fortunately, there are ways you and your loved ones can get the necessary care at home. Here’s what you need...
by Kenny | Oct 12, 2024
The Wall Street Journal recently published a story regarding diagnoses and plan payments in Medicare Advantage. The story was fundamentally flawed and overlooked the value of Medicare Advantage for millions of American seniors. Here are the facts: More than 33 million...
by Kenny | Oct 4, 2024
Today, more Americans than ever are choosing Medicare Advantage for affordable, quality health care — with over 33 million seniors and people with disabilities enrolled in the program. BMA wanted to learn more about seniors’ views on Medicare Advantage and how...
by Kenny | Sep 27, 2024
How Medicare Advantage In-Home Health Assessments Keep Seniors Healthier Today, Medicare Advantage delivers affordable, high-quality care to more than 33 million seniors and people with disabilities, with better health outcomes than Fee-for-Service Medicare (FFS). One...
by Kenny | Sep 20, 2024
Whether you’re switching from one type of Medicare coverage to another, or you’re new to Medicare, you might be concerned about being able to continue seeing your health-care specialist. Will your specialist’s services be covered by Medicare? That may depend upon:...
by Kenny | Sep 13, 2024
Expensive medications? You’ll save thousands. Dementia or mental health care? More options Key takeaways Changes from Inflation Reduction Act will take effect next year. Lower out-of-pocket limit in Part D drug plans erases old “donut hole.” You may find weight loss...
