We know firsthand about the importance of your overall health and its impact on health insurance coverage options and costs. One thing we can all do to contribute to community well-being is to keep our Connecticut shoreline a clean place to enjoy recreation, exercise and uphold our mental health by being outside and with others. To that end, our cities and towns have extensive programs in place to keep waste out of the Long Island Sound by recycling not just glass and plastic, but many of the household goods we throw out in abundance. Of course, donating or freecycling reusable items such as clothing and furniture is best. But when that’s not an option, we’ve prepared a handy chart highlighting some of our local recycling centers and events. Here’s to clean waters and trash-free parks! Take a look here.
Looking Ahead: Updates to 2024 Medicare Advantage Program and Part D Payment Policies
In an effort to ensure that Medicare Advantage and Part D drug programs remain strong, fair and viable, the Centers for Medicare & Medicaid Services (CMS) has ruled on commonsense updates for next year. Some abbreviated highlights:
Medicare Advantage
Guidelines are clarified to ensure equal access to medically necessary care as with Traditional Medicare.
When coverage criteria are not fully established, organizations may create internal coverage criteria based on current evidence in widely used treatment guidelines or clinical literature made publicly available.
To promote more transparent, clinically-based decisions, circumstances are explicitly stated under which plans may apply internal coverage criteria when making medical necessity decisions.
Part D
Cost-sharing will be eliminated for beneficiaries in the catastrophic phase of coverage.
The Low-Income Subsidy program (LIS) will be expanded.
Plans must not apply the deductible to any Part D-covered insulin product and must charge no more than $35 per month’s supply in the initial coverage phase and the coverage gap phase.
The annual growth in the Base Beneficiary Premium will be capped at 6 percent.
We will continue to provide updates as rulings change that could impact your existing overage or future Medicare decisions.
Source: cms.gov
Medicare Education is the Key: New Report Reveals Major Gaps in Medicare Comprehension Among Seniors
Distressingly, a recent study by a national healthcare consultancy of over 1,100 individuals aged 64 and older determined that for older Americans there is “widespread confusion and overwhelming enrollment challenges”1 surrounding Medicare. Unfortunately, this means that many Medicare-eligible Americans are selecting plans that do not meet their current and evolving healthcare coverage needs.
This research underscores why we are so committed at Health Directions to offering unbiased, client-focused, experienced Medicare advisory services. We recognize how difficult it is to navigate the tangled Medicare maze for everyone — especially for new enrollees and those with changing medical conditions! So contact us to set up your complimentary consultation.
More Medicare Screening News
In the April edition of The Compass, we shared news about expanded coverage for lung cancer screenings. In July, however, Centers for Medicare and Medicaid Services (CMS) did not support coverage of Computed Tomography Colonography (CTC), an alternative tool to screen for colorectal cancer. (If you’re interested, read about the decision here.)
The real reason we are highlighting this development is to point out that Medicare does cover your colonoscopy once every 24 months for those at high risk, once every 120 months if not at high risk and 48 months after a previous flexible sigmoidoscopy. There is no minimum age requirement. If you have delayed your colonoscopy due to COVID -19 or some other factor, this is your friendly (but firm) reminder to schedule one soon if your physician recommends it!
Evidence indicates that colorectal screening significantly reduces the risk of dying from colorectal cancer, even in older adults. This 2021 article from the National Cancer Institute (cancer.gov) provides highlights from some recent studies on colorectal screening in seniors.
This article is for information purposes only and is not intended to diagnose or treat any health condition. Please consult a medical professional for the healthcare that is right for you.
Your Medicare Checklist
There are so many variables to consider when weighing all your Medicare options! This is equally true whether you are approaching age 65 and are enrolling for the first time or whether you are already enrolled and evaluating your current selections ahead of Medicare Open Enrollment.
To ensure that you receive the coverage that supports your best healthcare choices, we’ve prepared this practical checklist of Medicare decision-making factors. We encourage you to answer the questions thoughtfully prior to meeting with us for your healthcare review or if you’re selecting your options yourself.
As always, your Health Directions experts are happy to answer questions or explain any implications of your checklist responses! We may also recommend working together with a wealth management professional or elder law attorney to align all the elements of your coverage needs and lifestyle goals.
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