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Results for “Insurance, Medigap”

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206 records · Page 12Linked to original sources

PubMed1992

Helping consumers to select an appropriate long-term care insurance policy.

Consumers who purchase long term care insurance policies can get good value for their money but there are several residual risks. Advisers have an important responsibility to make sure that their clients fully understand these risks. We recommend that consumers who are appropriate candidates for long term care insurance take into account the following guidelines: Make sure that a policy is bought from a well-known, financially secure company that has an A.M. Best Company rating of A or A+ or at least an A rating from Standard & Poor's. Avoid companies that have a history of consumer complaints, post-claims underwriting, high agent commissions, high lapse rates, or abuses in the Medigap market. Buy a policy with level premiums but understand that in the absence of explicit rate guarantees, premiums may be increased in the future. Seek policies that are guaranteed renewable, explicitly ensure fair access to policy upgrades, provide protection in case of late premium payments, and guarantee protection from potential changes in government benefits.

Consumer Advocacy↗

PubMed1981

Privacy Act of 1974; report of new system--Health Care Financing Administration. Notice of new system of records.

In accordance with the requirements of the Privacy Act of 1974, we are proposing to establish a new system of records. Study of the Comparative Effectiveness of State Approaches to the Regulation of Medicare Supplemental Policies: Medigap, HHS/HCFA/ORDS No. 09-70-0026. We have provided background information about the proposed system in the "Supplementary Information" section below. HCFA invites public comments by October 2, 1981, with respect to routine uses of the system.

Confidentiality↗

PubMedDate not supplied

How do seniors use their prescription drug discount cards?

This study examines how seniors enrolled in a major national prescription drug discount program used their cards in the year before the Medicare discount card program's implementation, to establish baseline information. Seniors who actively enrolled relied heavily on the card for their purchases. They saved 20 percent overall but still spent more than dollar 1,300 annually on prescriptions, on average. Fewer than half of those who were automatically enrolled as a free Medigap benefit used the card. This suggests that some had other options or that more effort is needed to assure that seniors understand the value of drug savings programs and how to use them.

Aged↗

PubMedDate not supplied

Medicare extra: a comprehensive benefit option for Medicare beneficiaries.

The proposed Part E, Medicare Extra, outlined in this paper adds a comprehensive benefit option to Medicare, eliminating the need for beneficiaries to purchase a private drug plan and Medigap supplemental coverage. Financed by a budget-neutral beneficiary premium, it has the advantages of greater simplicity, efficiency, and value without adding to federal costs. Beneficiaries now enrolled in Medigap plans would save money, as could employers by choosing a lower-cost alternative to current retiree health plans. Eliminating some of the excess payments to Medicare Advantage plans would yield savings that could be used to help finance premium subsidies for low-income beneficiaries.

Aged↗

PubMed1994

The role of third-party support in the detection and treatment of cancer in the elderly.

Third-party support and reimbursement in cancer detection and treatment has increased over the past 10 years. Research in the early 1980s and more recently has shown the impact that early diagnosis and treatment can have. Medicare, Medicaid, managed care, and even state Medigap rules have expanded the benefits for Pap smears and mammographic screening, and hospice care. Surprisingly, usage of these benefits is mixed. Of special importance are the findings that use is directly related to a physicians' recommending various tests. This paper will review some of the changes that have occurred, the issues involved, and the impacts measured on third-party support care in the elderly and in urban and rural settings.

Aged↗

PubMedDate not supplied

Medicare managed care: policy concerns.

This paper briefly reviews the extent of current drug coverage for Medicare beneficiaries and describes the most important issues faced by aged beneficiaries who receive or seek drug coverage through a Medicare managed care plan. Changes in payment rates to these plans as a result of the Balanced Budget Act of 1997 may result in plans reducing or eliminating drug coverage. Under current law beneficiaries in these plans will have severely limited options for replacing drug coverage; as a result, many will not be able to obtain this coverage either through Medigap or previous retiree coverage. In the absence of any change in current law, one approach to addressing these issues is to refocus Medicare managed care plans on managing the total cost of caring for patients over time and across settings. Only through such an integrated approach will Medicare managed care plans have the tools to function within the new payment rates and realize the value of the pharmaceutical benefit to the plan and the patients.

Aged↗

PubMedDate not supplied

Should Medicare HMO benefits be standardized?

Legislation enacted in 1990 standardized Medigap benefits but not the benefits of health maintenance organizations (HMOs) that serve Medicare beneficiaries. An examination of marketing materials in two large counties reveals the potential for enormous confusion among beneficiaries because of differences in wording to describe the same benefit, health plans' failure to list Medicare-covered services, and the differences in the benefits themselves. To date, the Health Care Financing Administration (HCFA) has not been able to overcome this confusion through the comparative material distributed on its Web site; indeed, significant errors were found, reflecting to some extent the underlying difficulties in characterizing benefits. Ways of ameliorating the situation are discussed.

Health Maintenance Organizations↗

PubMed2006

Cost-related medication nonadherence among elderly and disabled medicare beneficiaries: a national survey 1 year before the medicare drug benefit.

BACKGROUND: Prior to implementation of the Medicare drug benefit, we estimated the prevalence of cost-related medication nonadherence (CRN) among Medicare enrollees, including elderly and nonelderly disabled beneficiaries. METHODS: In the fall of 2004, detailed measures of CRN (skipping or reducing doses or not filling prescriptions because of cost) were added to the Medicare Current Beneficiary Survey. We examined the prevalence of CRN nationally and by Medicare eligibility subgroups (elderly vs nonelderly disabled beneficiaries), drug coverage status, socioeconomic status, self-rated health, and number of chronic medical conditions. RESULTS: In a national sample of 13 835 noninstitutionalized Medicare enrollees, 29% of the disabled and 13% of the elderly beneficiaries reported CRN; those in fair to poor health with multiple comorbidities and without coverage were most at risk. Among the disabled enrollees with 4 or more morbidities, 52% (95% confidence interval [CI], 43.3%-60.3%) without drug coverage skipped prescriptions or doses compared with 26% (95% CI, 17.7%-34.8%) with Medicaid drug coverage. Those with partial drug coverage through Medigap policies or Medicare health maintenance organizations reported intermediate rates of CRN. The adjusted odds ratio of CRN among disabled enrollees in poor (vs good) health was 3.9 (95% CI, 1.7-9.2), whereas for those with 4 or more (vs <4) comorbidities, the odds ratio of CRN was 2.7 (95% CI, 1.7-4.1). CONCLUSIONS: One year before Medicare Part D implementation, Medicare beneficiaries reported high rates of CRN. Rates are highest among nonelderly disabled beneficiaries, but among both elderly and disabled beneficiaries, CRN is exacerbated by poor health, multiple morbidities, and limited drug coverage. Given the high cost sharing under Part D, it is important to closely monitor CRN in high-risk subgroups.

Aged↗