Medicare News

Current news for Medicare beneficiaries and the community that serves them.

Nursing Home Residents Can Come Home for Celebrations

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Nursing home residents won’t lose their nursing facility coverage if they come home for the holidays.

Nursing home residents won’t lose their nursing facility coverage if they come home for the holidays.

Holidays are stressful enough without having to worry whether your loved ones will lose their nursing facility coverage if they come home for a celebration, reports the Center for Medicare Advocacy. According to Medicare law, nursing home residents may leave the facility occasionally without losing their Medicare coverage. Residents may be charged a “bed hold” fee, but cannot legally lose Medicare coverage for this reason.

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No Threat of Medicare Provider Shortage

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Media reports that Medicare beneficiaries are having trouble finding doctors who will accept their insurance are unfounded, reports the Kaiser Family Foundation through an issue brief. In fact, according to the report, people with Medicare have comparable or better access to doctors than privately insured individuals in most cases.

No Threat of Medicare Provider Shortage

Most people with Medicare (about 90 percent) are able to schedule timely appointments for routine and specialty care.

 

The report found that:

  • On a national level, Medicare patients have good access to physicians. The vast majority (96 percent) of Medicare beneficiaries report having a usual source of care, primarily a doctor’s office or doctor’s clinic.
  • Most people with Medicare – about 90 percent – are able to schedule timely appointments for routine and specialty care. Medicare seniors are more likely than privately insured adults age 50-64 to report “never” having to wait longer than they want for timely routine care appointments.
  • A small share of Medicare beneficiaries say they looked for a new physician in the past year, and only 2 percent of seniors with Medicare report problems finding one when needed – comparable to rates reported by privately insured adults age 50-64.
  • Medicare seniors report foregoing medical care at similar or lower rates than privately insured adults age 50-64. Certain subgroups of the Medicare population are more likely than others to report not seeing a doctor when they thought they needed to during the year, particularly beneficiaries who: are under age 65 and qualify for Medicare because of a permanent disability; have either Medicaid (dually eligible for Medicare and Medicaid) or no supplemental coverage; are Black; have lower incomes; are in fair or poor health, and/or have five or more chronic conditions. Even within these vulnerable subgroups, however, the majority do not report foregoing doctor visits when needed.
  • According to recently-released physician survey data, the majority (91 percent) of non-pediatric physicians accept new Medicare patients – the same rate that accept new patients with private non-capitated insurance. This correlation persists generally across states, indicating that physician acceptance of new Medicare patients may be more related to local market factors than issues unique to Medicare overall.
  • According to new physician data from Medicare, less than 1 percent of physicians in clinical practice have formally “opted-out” of the Medicare program, with psychiatrists accounting for the largest share (42 percent).

 

Read full report.


Taking Advantage of Free Medicare Preventive Services

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More than 25 million people covered by Original Medicare received at least one Medicare preventive service at no cost to them during the first eleven months of 2013 because of the Affordable Care Act, according to new data released by the Centers for Medicare & Medicaid Services (CMS).

Medicare Preventative Services

Seniors can receive important preventive services and screenings, such as an annual wellness visit, screening mammograms and colonoscopies, and smoking cessation at no cost to them.

 

Moreover, in the first eleven months of 2013, more than 3.5 million beneficiaries with Original Medicare took advantage of the Annual Wellness Visit established by the health care law – a significant increase from the 2.8 million who used this service by this point in the year in 2012.

“Thanks to the Affordable Care Act, millions of seniors have been able to receive important medicare preventive services and screenings such as an annual wellness visit, screening mammograms and colonoscopies, and smoking cessation at no cost to them,” said CMS Administrator Marilyn Tavenner. “Prevention and early detection are so vital to ensure that Americans are healthy and Medicare is healthy.”

Before the Affordable Care Act, Medicare recipients had to pay part of the cost for many preventive health services. For example, a person with Medicare could pay as much as $160 in cost-sharing for a colorectal cancer screening. Today, this important screening and many others are covered at no cost to beneficiaries (with no deductible or co-pay).

Preventive Visit and Yearly Wellness Exams

Medicare Part B (Medical Insurance) covers:

A “Welcome to Medicare” preventive visit: You can get this introductory visit only within the first 12 months you have Part B. This visit includes a review of your medical and social history related to your health and education and counseling about preventive services, including certain screenings, shots, and referrals for other care, if needed. It also includes: Read more