The 2016 Medicare Part A and B General Enrollment Period runs from January 1 through March 31, 2016. As detailed below, this enrollment period is especially important for many individuals who are not eligible for premium-free Medicare Part A. Most people do not pay a premium for Medicare Part A because they have sufficient work history. … Read more

A recent Centers for Medicare & Medicaid Services (CMS) report, Access to Care Issues Among Qualified Medicare Beneficiaries (QMB), revealed several access to care problems for low-income Medicare beneficiaries enrolled in the QMB program. The report analyzed two studies focused on access to care for low-income beneficiaries. The first study utilized qualitative interviews with beneficiaries … Read more

On Tuesday, April 1st, President Obama signed into law the "Protecting Access to Medicare Act of 2014" (H.R. 4302).[1] This bill is a one year short-term "fix" or "patch" to pending Medicare physician payment cuts under the current physician payment formula called the "sustainable growth rate" or "SGR".  Passed by voice vote in the House … Read more

Programs that help low-income people afford their Medicare, including the Medicare Savings Programs and the Part D Low Income Subsidy (also called LIS or Extra Help) have income and resource eligibility guidelines that change yearly. The Federal poverty level (FPL) guidelines for 2014 were published in the Federal Register on January 22, 2014.[1]  These guidelines … Read more

Five years ago this month, the Medicare Improvements for Patients and Providers Act (MIPPA)[1] became law. Since then, MIPPA has successfully increased enrollment in the Medicare Savings Program and helped ensure that thousands of Medicare beneficiaries are able to afford necessary medical care. Despite MIPPA's success, Medicare low-income programs remain under-enrolled. Federal policy makers should … Read more

Balance Billing is Prohibited.  Period. New Guidance released jointly by the Center for Medicaid and CHIP Services (CMCS) and the Medicare-Medicaid Coordination Office (MMCO) once again highlights and advises about an issue that has created hardships for low-income people using Medicare and challenges for advocates trying to help them. The jointly-issued Guidance includes a link … Read more

The Social Security Administration (SSA) has released state by state information on numbers of individuals whose Part D low income subsidy (extra help) will end March 31 if they do not respond to SSA’s request for information concerning their continued eligibility.  Nationwide, 86,789 low-income Medicare beneficiaries subject to routine redeterminations had not responded to SSA … Read more

The 2011 Medicare Part A and B general enrollment period runs from January 1st through March 31, 2011.  Medicare Part A enrollment (to purchase Part A – for those who are not entitled to receive it without paying a premium) has become particularly important for low-income older people.  In addition to the important benefits covered … Read more

Federal poverty level (FPL) guidelines for 2011 were published in the Federal Register January 20, 2011. 76 FR 3637 (January 20, 2011).  The guidelines provide the baseline for eligibility levels for many public benefits, including health benefits for older people and people with disabilities.[1] The published poverty levels merely state a dollar figure for different-sized … Read more

Introduction Long-awaited guidance from the Centers for Medicare & Medicaid Services (CMS) concerning implementation of various provisions of the Medicare Improvements for Patients and Protections Act of 2008 (MIPPA), Pub. L. 110-275, was released on February 18, 2010. [1] The guidance, in the form of a State Medicaid Director Letter (SMDL # 10-003), signed by … Read more

Guidance released recently by the Centers for Medicare & Medicaid Services (CMS) sheds new light on an issue that has created hardships for beneficiaries and challenges for advocates trying to help them. The guidance addresses two issues: balance billing of Qualified Medicare Beneficiaries (QMBs)and payment of Medicare cost-sharing for dually eligible beneficiaries enrolled in Medicare … Read more