Medicare

On March 15th, the Department of Health and Human Services, through CMS, announced 27 prescription drugs covered under Medicare Part B that may have lower beneficiary coinsurances. From April 1, 2023 through June 30, 2023, some people with Medicare who take these drugs may save between $2 and $390 per average dose, depending on the beneficiary’s coverage. Under the Inflation Reduction Act, signed into law in August 2022, drug companies that raise their drug prices faster than the rate of information are required to pay a rebate to Medicare. Starting April 1, 2023, Medicare beneficiaries may pay a lower coinsurance for certain Part B drugs if the drug’s price increased faster than the rate of inflation in a benchmark quarter.

AARP’s Public Policy Institute released a report titled “Underused Medicare Savings Programs Can Help Many More Older Adults Afford Health Care”. Medicare Savings Programs or MSPs provide financial assistance with certain Medicare costs for eligible low-income Medicare beneficiaries, and are administered by state Medicaid agencies. According to the report, about 16 percent of all Medicare beneficiaries are enrolled in MSPs; however, the number of individuals eligible for these programs is estimated to be much higher. The paper discusses the findings from the organization’s analysis and research, and proposes areas states can consider to increase enrollment and expand eligibility.

The Medicaid and CHIP Payment and Access Commission (MACPAC) and the Medicare Payment Advisory Commission (MedPAC) have released an updated data book which presents information on the demographic and other personal characteristics, expenditures, and health care utilization of individuals who are dually eligible for Medicare and Medicaid coverage.

The annual Medicare open enrollment period for Medicare Advantage and Part D plans ends Wednesday, December 7, 2022. To assist individuals who counsel Medicare clients, the National Council on Aging or NCOA developed a “Medicare Open Enrollment Toolkit”. The Toolkit includes many useful resources designed for professionals, advocates, caregivers, and/or older adults, including a fact sheet on changes to Medicare in 2023; information on Medicare Part A and Part B premiums and cost-sharing in 2023; a 2023 Medicare Part D cost-sharing chart; and other helpful information and guidance.

CMS recently announced the 2023 Medicare costs, including premiums, deductibles, and coinsurance amounts. The standard monthly Part B premium will decrease three percent or $5.20 – the first time in a decade the cost was lowered. CMS attributes the decrease in the Part B premium to lower spending on the Alzheimer drug, Aduhelm, and other Part B items and services.

The SHIP TA Center has published a one-page handout called “Medicare coverage of the COVID-19 vaccine," which comes with a companion guide for aging network professionals, "Talking about Medicare Coverage of the COVID-19 Vaccine.” The guide addresses biases, engagement & building a trusting relationship, session structure & sample scripts, handling strong emotions or difficult behaviors, frequently asked questions about Medicare coverage and the vaccine, and how to find other COVID resources.

CMS announced the 2022 Medicare & You Handbook will be available in Chinese, Vietnamese, and Korean, as well as English and Spanish. Medicare & You is a resource designed to help Medicare enrollees make decisions about their coverage. The new Chinese version, along with Spanish, large print, audio book, and braille versions of Medicare & You are available on Medicare.gov.

The SHIP TA Center has posted a series of videos from their Welcome to Medicare virtual fair that explain basics about enrollment, coverage, and benefits. The goal of the series is to educate Medicare-eligible individuals on the program.

NCOA and Health Management Associates (HMA) have released a new report detailing eight strategies and approaches to expand funding for evidence-based health programs. NCOA and HMA reviewed five states and one city- California, Colorado, Maine, Massachusetts, New York City, and Washington- with community-based organizations that have strong partnerships with Medicaid agencies and managed-care organizations.

The CMS Office of the Actuary released the 2018 National Health Expenditures. The study includes estimates on health care services and goods, health insurance costs, government administration, public health activities, and other areas related to health care including personal care, residential services, and nursing care facilities.