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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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PubMed1999

Supplemental health insurance for Medicare beneficiaries.

Because Medicare leaves beneficiaries at risk for significant health care costs, most need to obtain some form of supplemental coverage to protect themselves against the financial burden of illnesses. Close to nine out of ten Medicare beneficiaries age 65 or older now have some health coverage that provides additional benefits beyond standard Medicare Part A and Part B. The most common types of supplementation are insurance coverage offered by former employers, policies that individual beneficiaries purchase, benefits offered by Medicare managed care plans and assistance provided through the Medicaid program. This supplementation is expensive--to beneficiaries, employers, states, and to the federal government. The availability and extent of financial protection offered by supplemental coverage provided by former employers and through managed care also appears to be increasingly unstable. Structural reform of the Medicare program needs to include a broad reexamination of the basic benefits package and of the potential benefits and costs of public and private supplementation of the health insurance coverage promised to beneficiaries.

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PubMed2000

Long-term care financing: are current methods enough?

Financing long-term care services can be extremely cost prohibitive to the average United States citizen. Given the complex patchwork of multidisciplinary services that may be required, operational issues and system efficiencies often draw considerable attention. Notwithstanding these challenges, this article reviews the major sources of long-term care financing, including some lesser-known options. Potential advantages and disadvantages are presented. A descriptive analysis of existing policies and consumer practices raises the question of whether recent incremental reforms will lead to future solutions for the major constituents most affected by their implementation.

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PubMed2002

Healthcare options for Medicare beneficiaries.

Medicare beneficiaries often need to purchase supplemental coverage or join a federally approved HMO to gain prescription coverage and other benefits. In general, obtaining additional coverage may include a premium payment that is dependent on age. There is an array of choices in Oklahoma.

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PubMed2002

Explaining Medicare to caregivers.

In addition to providing help with tasks such as bathing, dressing and preparing meals, many caregivers also assist with health-care decision making, including making choices about Medicare. Caregivers therefore may require education about issues related to Medicare benefits. In this brief we explore the special Medicare education needs of caregivers.

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PubMed2001

Beneficiary decisionmaking: the impact of labeling health plan choices.

One critical health plan decision concerns choosing an original Medicare plan or a Medicare managed care plan. Evidence suggests that people are confused by the phrase "Original Medicare plan." Using focus group and Q-sort methodology, the authors sought to identify a name for the Medicare fee-for-service (FFS) product. Two key insights were gained. First, participants used the word "Medicare" to name the FFS product. Second, participants did not choose between two plans. Rather, they decided between supplemental insurance and a managed care product. These factors should influence how CMS "brands" not only the FFS product but also the overall Medicare program.

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PubMed2003

Special issues for younger Medicare beneficiaries with disabilities.

While most people know that older Americans are eligible for Medicare and Social Security retirement benefits at age 65, many do not know that people with disabilities under age 65 can also be covered by Medicare. In this brief we focus on how people with disabilities qualify for Medicare and how their Medicare benefits coordinate with other types of health benefits they may have.

Adult↗
PubMed1992

Issues regarding health plan payments under Medicare and recommendations for reform.

The failures of the market for current Medicare health plans include poor information and price distortions and can be attributed to government policy. Reforms that could improve its structure are annual open enrollment periods, premium rebates from health management organizations (HMOs) to members, and termination of the federal government's subsidy of Medicare supplementary insurance. However, the price for a basic Medicare benefits package would still be distorted because Medicare bases its contribution on the cost of a comparable package in the fee-for-service (FFS) sector rather than on the cost of the most efficient plan available to beneficiaries in each market area. The present Medicare HMO program almost certainly increases total Medicare costs and actually discourages HMO growth by shielding beneficiaries from the true price difference between basic benefits in the HMO and FFS sectors. Lacking payment reforms, the Medicare HMO program should be terminated.

Capitation Fee↗
PubMed1992

The effect of the illness episode approach on Medicare beneficiaries' health insurance decisions.

This article reports on a quasi-experimental test of the Illness Episode Approach (IEA), a new approach to providing Medicare beneficiaries with information about the financial consequences of alternative health care coverage decisions. Beneficiaries were randomly assigned to free, three-hour workshops, half using materials developed through application of the IEA, half using traditional comparative information on insurance options. Analysis of data collected before and after the workshops indicates that participants in the Illness Episode sessions were more likely to drop duplicative coverage, to spend less on premiums, and to report that their decisions to change coverage had met their expectations. The entire sample of workshop participants showed significant increases in knowledge of Medicare and their own insurance, as well as improved satisfaction with the cost of their health care coverage.

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PubMed2003

Coordination of benefits.

Figuring out who is supposed to "pay first" when your client has Medicare and other health benefits can be confusing both for you and your clients. In this brief we discuss how Medicare coordinates payment of claims with other health benefits.

Cost Sharing↗