Medicare Blog

what did congress change on medicare last week?

by Mr. Patrick Wilderman V Published 3 years ago Updated 2 years ago
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What changes did Congress make to Medicare Advantage plans?

Congress also made numerous and potentially far-reaching changes to the rules for Medicare Advantage plans. That includes allowing such plans to pay for limited long-term care expenses – something that until now has not been covered by Medicare.

Did president Trump sign these Medicare changes into law?

President Trump signed these Medicare changes into law. Here’s what to watch for Editor’s Note: Journalist Philip Moeller is here to provide the answers you need on aging and retirement.

How has Medicare enrollment changed over time?

The total number of Medicare beneficiaries has been steadily growing as well, but the growth in Medicare Advantage enrollment has far outpaced overall Medicare enrollment growth. In 2004, just 13% of Medicare beneficiaries had Medicare Advantage plans. That had grown to more than 43% by 2021.

Is it time for Congress to expand Medicaid?

Medicare proponents say Congress has given the states that have not expanded Medicaid ample time and incentive to do so, and it is time to focus on other priorities. The $1.9 trillion pandemic rescue bill this year included huge new subsidies for those states if they agreed to expand Medicaid.

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What is the Medicare for All Act of 2021?

The Medicare for All Act builds upon and expands Medicare to provide comprehensive benefits to every person in the United States. This includes primary care, vision, dental, prescription drugs, mental health, substance abuse, long-term services and supports, reproductive health care, and more.

What is in the Medicare reform bill?

The new health care bill expands Medicare coverage to all individuals and families whose income is at or less than 133% of the federal poverty level -- and the federal government will pay all costs of coverage for those who are newly Medicare-eligible, through 2016.

What are the Medicare cuts for 2022?

Audiologists and speech-language pathologists (SLPs) providing Medicare Part B (outpatient) services paid under the Medicare Physician Fee Schedule (MPFS) should prepare for a 1% cut on all claims to go into effect for services provided on or after April 1, 2022.

What are Medicare sequestration cuts?

Medicare FFS claims: 2% payment adjustment (sequestration) changes. The Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare fee-for-service claims: No payment adjustment through March 31, 2022. 1% payment adjustment April 1 – June 30, 2022.

What does the Postal Reform Act mean for retirees?

Advertisement. In particular, the legislation requires USPS retirees enrolled in the Federal Employees Health Benefits (FEHB) program to also enroll in Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) when they are first eligible (for almost all retirees, when they become age 65).

What is the Affordable Care Act of 2021?

Introduced in Senate (02/22/2021) To amend the Patient Protection and Affordable Care Act to reduce health care costs and expand health care coverage to more Americans. To amend the Patient Protection and Affordable Care Act to reduce health care costs and expand health care coverage to more Americans.

Is Congress cutting Medicare benefits?

Most of Congress warns CMS against any Medicare Advantage cuts, calls for benefit flexibility. A large swath of House and Senate lawmakers is pushing the Biden administration not to install any cuts to Medicare Advantage (MA) plans in the coming 2023 rates.

How can I reduce my Medicare premiums?

How Can I Reduce My Medicare Premiums?File a Medicare IRMAA Appeal. ... Pay Medicare Premiums with your HSA. ... Get Help Paying Medicare Premiums. ... Low Income Subsidy. ... Medicare Advantage with Part B Premium Reduction. ... Deduct your Medicare Premiums from your Taxes. ... Grow Part-time Income to Pay Your Medicare Premiums.

Did Medicare reimbursement go up in 2022?

This represents a 0.82% cut from the 2021 conversion factor of $34.8931. However, it also reflects an increase from the initial 2022 conversion factor of $33.5983 announced in the 2022 Medicare physician fee schedule final rule.

Is sequestration still in effect in 2021?

Jun. 3, 2021 Update: Congress has passed legislation that continued the moratorium on sequestration. As a result, CMS has extended the moratorium on sequestration until December 31, 2021.

What is the 2% Medicare sequestration?

Under a BCA mandatory sequestration order, Medicare benefit payments and Medicare Integrity Program spending cannot be reduced by more than 2%. Under a Statutory PAYGO sequestration order, Medicare benefit payments and Medicare Program Integrity spending cannot be reduced by more than 4%.

Is sequestration still in effect in 2022?

Delay of sequestration. The act also suspends the full sequestration cuts of 2% through March 31, 2022, and phases the sequestration cut back in with a 1% cut from April 1, 2022, to June 30, 2022. The full 2% sequestration adjustment will begin July 1, 2022.

Q: What are the changes to Medicare benefits for 2022?

A: There are several changes for Medicare enrollees in 2022. Some of them apply to Medicare Advantage and Medicare Part D, which are the plans that...

How much will the Part B deductible increase for 2022?

The Part B deductible for 2022 is $233. That’s an increase from $203 in 2021, and a much more significant increase than normal.

Are Part A premiums increasing in 2022?

Roughly 1% of Medicare Part A enrollees pay premiums; the rest get it for free based on their work history or a spouse’s work history. Part A premi...

Is the Medicare Part A deductible increasing for 2022?

Part A has a deductible that applies to each benefit period (rather than a calendar year deductible like Part B or private insurance plans). The de...

How much is the Medicare Part A coinsurance for 2022?

The Part A deductible covers the enrollee’s first 60 inpatient days during a benefit period. If the person needs additional inpatient coverage duri...

Can I still buy Medigap Plans C and F?

As a result of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medigap plans C and F (including the high-deductible Plan F) are n...

Are there inflation adjustments for Medicare beneficiaries in high-income brackets?

Medicare beneficiaries with high incomes pay more for Part B and Part D. But what exactly does “high income” mean? The high-income brackets were in...

How are Medicare Advantage premiums changing for 2021?

According to CMS, the average Medicare Advantage (Medicare Part C) premiums for 2022 is about $19/month (in addition to the cost of Part B), which...

Is the Medicare Advantage out-of-pocket maximum changing for 2022?

Medicare Advantage plans are required to cap enrollees’ out-of-pocket costs for Part A and Part B services (unlike Original Medicare, which does no...

How is Medicare Part D prescription drug coverage changing for 2022?

For stand-alone Part D prescription drug plans, the maximum allowable deductible for standard Part D plans is $480 in 2022, up from $445 in 2021. A...

When will Medicare stop allowing C and F?

As a result of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Medigap plans C and F (including the high-deductible Plan F) are no longer available for purchase by people who become newly-eligible for Medicare on or after January 1, 2020.

When will Medicare Part D change to Advantage?

Some of them apply to Medicare Advantage and Medicare Part D, which are the plans that beneficiaries can change during the annual fall enrollment period that runs from October 15 to December 7.

What is the maximum out of pocket limit for Medicare Advantage?

The maximum out-of-pocket limit for Medicare Advantage plans is increasing to $7,550 for 2021. Part D donut hole no longer exists, but a standard plan’s maximum deductible is increasing to $445 in 2021, and the threshold for entering the catastrophic coverage phase (where out-of-pocket spending decreases significantly) is increasing to $6,550.

What is the Medicare premium for 2021?

The standard premium for Medicare Part B is $148.50/month in 2021. This is an increase of less than $4/month over the standard 2020 premium of $144.60/month. It had been projected to increase more significantly, but in October 2020, the federal government enacted a short-term spending bill that included a provision to limit ...

How much is the Medicare coinsurance for 2021?

For 2021, it’s $371 per day for the 61st through 90th day of inpatient care (up from $352 per day in 2020). The coinsurance for lifetime reserve days is $742 per day in 2021, up from $704 per day in 2020.

How many people will have Medicare Advantage in 2020?

People who enroll in Medicare Advantage pay their Part B premium and whatever the premium is for their Medicare Advantage plan, and the private insurer wraps all of the coverage into one plan.) About 24 million people had Medicare Advantage plans in 2020, and CMS projects that it will grow to 26 million in 2021.

What is the income bracket for Medicare Part B and D?

The income brackets for high-income premium adjustments for Medicare Part B and D will start at $88,000 for a single person, and the high-income surcharges for Part D and Part B will increase in 2021. Medicare Advantage enrollment is expected to continue to increase to a projected 26 million. Medicare Advantage plans are available ...

When will Medicare waive late enrollment penalties?

To help them with this transition, Medicare has waived late-enrollment penalties until the end of September.

When will the coverage gap end?

The much-maligned coverage gap (or donut hole) in these plans has been shrinking for years under the Affordable Care Act, and was supposed to end in 2020, at which time consumers in the gap would pay no more than 25 percent of the costs of their drugs. That end date was moved up a year to 2019.

How much does Medicare pay for Part B and D?

Medicare’s high-income premium surcharges will carry even more of a bite for wealthier enrollees. Those making more than $500,000 a year ($750,000 for couples) will pay 85 percent of the actual costs of Part B and D in 2019, up from 80 percent this year. Most Medicare enrollees pay premiums that equal about 25 percent of these costs.

How long have people been bumped against the cap?

People with persistent therapy needs have bumped against these caps for more than 20 years, and Congress has regularly eased those rules. While claims above current cap levels may be subject to review, people who legitimately need extensive therapy will not have to depend on year-to-year congressional fixes.

Does Tricare cover Part B?

Part B only pays 80 percent of covered expenses, Tricare should cover you as a secondary insurer here. You should check with Tricare about its coverage. You also could get a Part D drug plan but it’s my understanding that VA coverage is quite good for prescription drugs, making a separate Part D plan unnecessary.

Who is Phil from Medicare?

Phil is the author of the new book, “Get What’s Yours for Medicare,” and co-author of “Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security.”. Send your questions to Phil; and he will answer as many as he can. Seemingly overnight, big changes to Medicare morphed from being an item on various congressional wish lists ...

Has Medicare been killed?

However, the law has already been signed by President Trump, so whether these are good changes or not is moot for the time being. Medicare’s Independent Payment Advisory Board has been killed. It was authorized by the Affordable Care Act to serve as a check on higher Medicare expenses.

What are the changes to Medicare?

Two items buried in Trump’s budget call for big changes to Medicare 1 Trump’s budget is essentially a rundown of administration priorities and goals versus a mandate, and any changes to the program would need to make it through Congress. 2 One of the proposals would let Social Security recipients opt out of Medicare Part A, which currently is tricky to do. 3 The other aims to give Medicare recipients the ability to contribute to health savings accounts and to medical savings accounts.

Can I contribute to an HSA if I have Medicare?

However, as mentioned, you can’t contribute to an HSA if you’re on Medicare, even if just Part A.

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