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In the ever-evolving landscape of health care, one critical challenge has been ensuring that Medicare recipients receive the coverage they need without undue financial burdens. A new legislative effort aims to address a particularly perplexing issue: the distinction between hospital observation status and inpatient status, and its effects on Medicare coverage.

Cost and health considerations have led to a push for expanded coverage of weight loss drugs under public and private health insurance plans. While Medicare is forbidden to cover weight loss drugs, it can cover certain medications, including Ozempic and Wegovy, when they’re prescribed to treat conditions other than weight loss.

The Center for Medicare and Medicaid Services (CMS) finalized its rule regarding prior authorizations earlier this month. The rule, published in February 2024, outlines new timetables and requirements under which health insurers must process prior authorization requests.

In 2023, seniors were happy to see their Medicare Part B standard monthly premiums and annual deductibles go down for the first time in more than a decade. Unfortunately, that’s not the case for 2024, when these charges will be back on the rise.

Some Medicare Advantage beneficiaries receive Medicare flex cards, pre-paid debit cards for qualifying expenses, as part of their benefits. The U.S. government does not issue Medicare flex cards. This benefit is only available on select Medicare Advantage plans, a private alternative to Medicare.

Although Medicare funds some home health care services, a recent study has found that Medicare beneficiaries are underutilizing the program’s home health care options. Many older adults do not receive the home-based clinical care or home-based long-term services and supports that could benefit them.

Seniors and disabled citizens will receive more access to the Medicare Extra Help Program as of the beginning of 2024, the federal government announced. This expansion of benefits could enable up to 3 million people to reduce their prescription drug costs.

As we near retirement, we may assume that once Medicare kicks in, our medical insurance premiums will be fixed. However, many people may not realize that there are special rules regarding how much they pay for Medicare Parts B and D if they are in a higher income range.

A health savings account may help you save money on medical expenses, depending on your insurance type. If you are eligible, you can use your health savings account (HSA) to cover certain medical costs.

Traditional Medicare does not pay for assisted living, but Medicaid might.

In November 2022, the Centers for Medicare and Medicaid Services (CMS) announced that Medicare coverage will be expanded to include medically necessary dental services.

As a beneficiary of Medicare, you have the right to appeal a denial.

Medigap premiums for plans from insurance companies offering the same benefits vary widely, so it pays to be a smart shopper.

Medicare is federal health insurance for people over 65, some younger people with disabilities, and those with end-stage renal disease. Coverage of housekeeping services under Medicare can depend on several factors.

Although original Medicare does not offer food benefits, some Medicare Advantage plans provide a grocery allowance or cover meal delivery. Some programs also include nutrition education and cooking classes.

For the first time in more than 10 years, Medicare Part B enrollees will see some of their costs decline. In an announcement issued by the Centers for Medicare and Medicaid Services (CMS), the agency outlined changes to the premium, deductible, and co-payment amounts for numerous Medicare costs taking effect in 2023.

A federal court has ruled that hospitalized Medicare beneficiaries who were switched from inpatient to observation status can appeal the decision, making it easier for them to receive coverage for subsequent nursing home care. The ruling appears to bring to an end more than a decade of litigation on behalf of Medicare recipients.

In an alarming number of instances, private Medicare Advantage plans are denying coverage for medical services that would be covered under original Medicare, according to a federal investigation. These denials are likely preventing or delaying medically necessary care for tens of thousands of Medicare Advantage beneficiaries each year.

In recent months, phone lines at the SSA were experiencing major technical issues, preventing some individuals from being able to reach the SSA via telephone in a timely manner.

The Biden administration is moving forward with a pilot program that would hand over the care of millions of Medicare beneficiaries to private, mostly for-profit, groups. 

Medicare premiums are rising sharply next year, cutting into the large Social Security cost-of-living increase. The basic monthly premium will jump 15.5 percent, or $21.60, from $148.50 to $170.10 a month.

Every year Medicare gives beneficiaries a window of opportunity to shop around and determine if their current Medicare plan is still the best one for them. During Medicare's Open Enrollment Period, which runs from October 15 to December 7, beneficiaries can freely enroll in or switch plans.

Medicare is not free; there are premiums and deductibles. If you don't qualify for Medicaid and can't afford a Medigap policy, you may be able to get help paying for the costs of Medicare.

Medicare premiums are set to rise a modest amount next year, but still cut into any Social Security gains. The basic monthly premium will increase $3.90, from $144.60 a month to $148.50.

Medigap policies that supplement Medicare’s basic coverage can cost vastly different amounts, depending on the company selling the policy, according to a new study. The findings highlight the importance of shopping around before purchasing a policy.