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Creating Technologies to Help Retirees Choose Their Optimal Health Insurance

21.10.2017 07.27 UTC

A recent article (politico.com) discusses a number of important issues regarding the unique health care needs of the aged. The overall framework of the article is that, in the case of health care for the aged, “less is more.” The points raised...

Healthcare for the Elderly: When Less is More

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in this article should be considered by anyone with an interest in those covered by Medicare: •      It is estimated that a significant portion (between 25 percent and 33 percent) of health care services provided in the U.S. are unnecessary. Unnecessary care has both financial and health implications. The financial implications are straightforward – eliminating unnecessary care could help reduce the cost of healthcare in the U.S. However, unnecessary procedures and medications also pose an extra threat to the physical...

02.08.2017 03.36 UTC

More Americans are working past 65 and continue to have employer-sponsored health insurance. However, the intersection of Medicare and employer coverage has a number of traps for the unwary and some of these traps come with real financial consequences. This makes it more...

Medicare and Your Employer Health Coverage: Too Much of a Good Thing?

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important than ever that you (and your employer) understand the complex rules for starting coverage under Medicare. This blog post will identify some of the traps in these rules. Medicare Part A and HSAs. If you (or your spouse) has paid Medicare taxes for at least ten years, you do not pay monthly premiums for Medicare Part A (hospital) coverage. Because Part A does not require premiums, most workers start Part A at 65 even if actively employed. •      Trap...

28.01.2016 03.26 UTC

Health insurance is an empty promise if your doctor or hospital is not covered. Headlines keep on reminding us that insurance companies are restricting the doctors and hospitals covered by their plans. People covered by Medicare have their own separate rules and these...

Is My Doctor Covered?

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Medicare-specific rules have both good news and bad news—but mostly good news. The good news—people covered by “original” Medicare have broad access to the doctor of their choice. Over 90% of doctors take Medicare[1]. The bad news: the Medicare rules are complicated and are filled with traps for the unwary. This blog post will be the first in a series to discuss Medicare coverage. The Basics People covered by Medicare can be divided into two groups: People who have “original” Medicare—where the federal...

10.11.2015 04.22 UTC

There has been a lot in the media about the recent budget deal and changes to the Medicare Part B premium.  What just happened? Here is the bottom line (and its confusing): ·      If you are a current Medicare beneficiary and pay your Part B...

Medicare Premiums: The YoYo Effect

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premium though a deduction to your Social Security check, your Part B premium will stay at $104.90/month for the time being. ·      If you are a Medicare beneficiary, but do not pay your Part B premium through a Social Security deduction—or are new to Medicare--your Part B premium will rise to about $123. But as is often the case, the reality is more complicated…. Medicare premiums are supposed to cover 25% of the cost of Medicare. If there was a typical...

01.07.2015 10.03 UTC

Both the popular press and the benefits/HR trade publications have been sounding the alarm—older workers are not adequately saving for their health care costs in retirement.  There are many reasons for this “retiree medical adequacy” gap—including limited resources and competing needs (e.g., housing,...

Older Workers Are Not Adequately Planning for Retiree Health Care Expenses

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children’s’ education, and retirement income needs) and confusion over the best asset-accumulation vehicles (e.g., 401(k)/403(b), Roth, IRA, and HSA). Many of the challenges to retiree medical adequacy are based on financial constraints and filling these financial gaps will be difficult in an era of limited wage growth and increasing longevity.  However, there is another gap that can be addressed much more readily—the understanding gap. The transition from pre-Medicare coverage to Medicare is complex, with few unbiased resources to assist in...

26.04.2015 09.45 UTC

On April 16 President Obama signed The Medicare and CHIP Reauthorization Act (“MACRA”). The focus of the law is to change how physicians are reimbursed under Medicare, but MACRA contains a number of provisions that may have far-reaching consequences for all of the...

Congress Tries New Remedy

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“stakeholders” in Medicare—especially for consumers and their physicians. Most importantly, MACRA changes more than how much physicians are paid—it shifts how they are paid. Under MACRA, annual increases (and possible cuts) in physician reimbursements will be based on the physicians’ performance under standards to be established in the coming years. So, MACRA continues Medicare’s movement away from the 1960’s mindset of compensating physicians for volume—and represents an attempt to use economic incentives (rather than government mandates) to modify physicians’...

08.04.2015 06.06 UTC

There is an ongoing controversy between hospitals and government regulators (The Centers for Medicare and Medicaid Services, or “CMS”)—with Medicare beneficiaries caught in the middle. Although the issue seems technical and bureaucratic, it raises some significant issues for those covered by Medicare. What is...

“Observation” Status: More than Just a One-Night Stand (Part I)

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Going On? Hospitals can label a stay as an “admission” to the hospital—or as a stay for “observation.” In recent years the use of observation status has skyrocketed; as noted by the Kaiser News Network, the use of observation status rose 88% between 2006 and 2012 and the number of observation stays lasting more than 48 hours increased five-fold in the same period. This use of observation status can add to the cost Medicare—and to the amounts paid by Medicare...

10.01.2015 07.35 UTC

The 401(k) plan was born in 1978 and has since “grown up” to become the dominant employer-sponsored retirement vehicle in the U.S. During that time, employers have learned many lessons about how to play the role of plan sponsor—encouraging employees to contribute (through...

Employer experiences with 401(k) plans provide some valuable lessons

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the use of tools such as matching contributions and automatic enrollment), offering the right investment options (such as through balanced funds and “qualified” default investments), and helping employees through complex investment decisions (such as through target date funds and automatic rebalancing). Throughout this period, employers have labored mightily to teach employees key principles of saving and investing. This has been a Sisyphean job—a seemingly futile task that must be constantly repeated. And yet, employers continue to provide financial education...

20.12.2014 04.35 UTC

Telemedicine—the use of telecommunication and information technology to provide health care at a distance—is rapidly growing. And, projections are for more growth—estimated at 18.5% per year for the next few years. Telemedicine is becoming more widely accepted, in part, because it holds out the...

Telemedicine is rapidly growing

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promise of significant cost savings. But telemedicine is promising for other reasons—monitoring individuals to reduce the rate of readmission following a hospitalization, providing better care to individuals with limited mobility, monitoring key clinical measures for patients with certain chronic conditions, and the longer term potential to help reduce the projected shortage of physicians. To date, there has been very limited focus on the potential impact of telemedicine on Medicare. Medicare allows telemedicine only for those in rural areas and...

10.10.2014 08.42 UTC

As the U.S. health care system continues to change, more Americans are being told “your doctor is not in the network” or “your insurance won’t cover that.” This concern also affects Americans on Medicare. The good news is that most Medicare beneficiaries can...

Is My Doctor in the Network?

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use Medicare to pay for 99% of the physicians in America. The bad news is that the system is complicated and can cause unnecessary concerns about coverage. Let’s try to cut through some of the clutter. First, a few key points. If you are on Medicare, your health care is paid for through “traditional” Medicare unless you choose to be covered by a Medicare Advantage (or “MA”) plan. If you choose an MA plan, your health care is paid for...