Susan Jaffe

Author's posts

Medicare open enrollment ends today. Ignoring the deadline could cost you

As the period for changing health plans ends, many seniors are tuning out. They could wind up with a surprise next year: higher costs and reduced access to health care providers.

Dodging the Medicare Enrollment Deadline Can Be Costly

As open enrollment ends, many people are tuning out. They could wind up with a surprise next year: higher costs and less access to health care providers.

Uncle Sam Wants You … to Help Stop Insurers’ Bogus Medicare Advantage Sales Tactics

The Biden administration wants to crack down on deceptive or misleading Medicare Advantage and drug plan sales tactics. It’s counting on beneficiaries to help catch offenders.

Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients

Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.

U.S. to rein in technology that limits Medicare Advantage care

Patients noticed that one tool often predicted a patient’s date of discharge that coincided with the date their insurer cut off coverage.

A Covid Test Medicare Scam May Be a Trial Run for Further Fraud

Before the covid-19 public health emergency ended, Medicare advocates around the country noticed a rise in complaints from beneficiaries who received at-home covid tests they never requested. Bad actors may have used seniors’ Medicare information to improperly bill the federal government — and could do it again, say federal investigators.

Medicare Plan Finder Likely Won’t Note New $35 Cap on Out-of-Pocket Insulin Costs

In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare dozens of drug and medical plans. Federal officials say beneficiaries who use insulin will have the opportunity to switch plans after open enrollment ends Dec. 7.

After Congress Fails to Add Dental Coverage, Medicare Weighs Limited Benefit Expansion

Medicare can pay for some dental care if it is medically necessary to safely treat another covered medical condition, and federal officials have asked for suggestions on whether that list of conditions should be expanded.

Nursing Home Surprise: Advantage Plans May Shorten Stays to Less Time Than Medicare Covers

Private Medicare Advantage health plans are increasingly ending coverage for skilled nursing or rehab services before medical providers think patients are healthy enough to go home, doctors and patient advocates say.

Medicaid Weighs Attaching Strings to Nursing Home Payments to Improve Patient Care

The Biden administration is considering whether Medicaid, which pays the bills for 62% of nursing home residents, should require that most of that funding be used to provide care, rather than for maintenance, capital improvements, or profits.