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Inflexible NHI plans.

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Deductibles and Coinsurance↗

Health Care Financing Administration--Medicare program; payment for durable medical equipment. Final rule.

This regulation establishes criteria and procedures for payment for new and used durable medical equipment for beneficiaries under Part B (Supplementary Medical Insurance) of the Medicare program. It implements Section 16 of the Medicare-Medicaid Anti-Fraud and Abuse Amendments of 1977 (P.L. 95-142). Section 16 provides of purchase of durable medical equipment when purchase is less costly or more practical than rental, and authorizes the Secretary to take necessary administrative steps to encourage the availability of this equipment to beneficiaries on a lease-purchase basis. The purpose is to reduce program costs caused by long and costly rentals of equipment and reduce beneficiary expenses for annual deductibles and coinsurance for unnecessarily long rentals.

Aged↗

Consumer cost sharing in private health insurance: on the threshold of change.

Employers are asking employees to pay more for health care through higher premium contributions, share of contribution, and out-of-pocket maximums, along with variations in deductibles, co-pays, and coinsurance based on choice of providers, networks, drugs, and other services. This issue brief examines consumer cost-sharing trends in private insurance, discusses the outlook for cost sharing in employment-based benefits, and considers public policies to support health care markets for consumers.

Community Participation↗

Designing health insurance information for the Medicare beneficiary: a policy synthesis.

Can Medicare beneficiaries make rational and informed decisions about their coverage under the Medicare program? Recent policy developments in the Medicare program have been based on the theory of competition in medical care. One of the key assumptions of the competitive model is the free flow of adequate information, enabling the consumer to make an informed choice from among the various sellers of a particular product. Options for Medicare beneficiaries in supplementing their basic Medicare coverage include the purchase of private supplementary insurance policies or enrollment in a Medicare HMO. These consumers, in a complex health insurance market, have only limited information available to them because many health plans do not make adequate comparable product information available. Moreover, since the introduction of the Medicare HMO option, the long-range plan for management of the Medicare budget has become based on the large-scale voluntary enrollment of beneficiaries into capitated health plans. The policy instrument that has been used to improve beneficiary decisions on how to supplement Medicare coverage is the informational or educational program. This synthesis presents findings regarding the relative effectiveness of different types of health insurance information programs for the Medicare beneficiary in an effort to promote practical use of the most effective types of information.

Community Participation↗