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Watchdog Estimates $7.5 Billion Medicare Advantage Overpayment from “Questionable” Health Risk Assessments
When the Centers for Medicare & Medicaid Services (CMS) pays Medicare Advantage (MA) organizations, they increase the payments when plans enroll sicker people. This is called risk adjustment, and it is an important guardrail to ensure that all people with Medicare...
Unpacking the changes to Medicare in 2025
Medicare coverage is personal — and changes to those plans and benefits may feel unnerving as it affects one’s overall health and well-being. Originally passed in 2022, the Inflation Reduction Act brought about many changes to Medicare that are now being implemented...
What If My Medicare Doctor “Opts Out”?
Finding a doctor you like and trust can be a long process, so I understand that it can be frustrating when your doctor no longer accepts Medicare. If your doctor has “opted out” of Medicare, this means that he or she no longer accepts Medicare assignment...
Home health care through Medicare
It’s important to plan for your health care needs, but sometimes life throws unexpected curve balls. And when that happens, you’ll need to know what’s covered. Fortunately, there are ways you and your loved ones can get the necessary care at home. Here’s what you need...
Correcting the Record: The Facts on Medicare Advantage Payment and Accountability
The Wall Street Journal recently published a story regarding diagnoses and plan payments in Medicare Advantage. The story was fundamentally flawed and overlooked the value of Medicare Advantage for millions of American seniors. Here are the facts: More than 33 million...
New bipartisan survey reveals a supermajority of seniors oppose reducing funding to Medicare Advantage — and will factor that into their vote in November
Today, more Americans than ever are choosing Medicare Advantage for affordable, quality health care — with over 33 million seniors and people with disabilities enrolled in the program. BMA wanted to learn more about seniors’ views on Medicare Advantage and how...
How Medicare Advantage In-Home Health Assessments Keep Seniors Healthier
How Medicare Advantage In-Home Health Assessments Keep Seniors Healthier Today, Medicare Advantage delivers affordable, high-quality care to more than 33 million seniors and people with disabilities, with better health outcomes than Fee-for-Service Medicare (FFS). One...
Will My Specialist’s Services be Covered under My Medicare Plan?
Whether you’re switching from one type of Medicare coverage to another, or you’re new to Medicare, you might be concerned about being able to continue seeing your health-care specialist. Will your specialist’s services be covered by Medicare? That may depend upon:...
7 Medicare Changes You’ll See in 2025
Expensive medications? You’ll save thousands. Dementia or mental health care? More options Key takeaways Changes from Inflation Reduction Act will take effect next year. Lower out-of-pocket limit in Part D drug plans erases old “donut hole.” You may find weight loss...