UnitedHealthcare will launch its national gold-card program on Oct. 1. The program will reward contracted provider groups that "consistently adhere to evidence-based care guidelines," according to an Aug. 1 policy update from UnitedHealthcare. The program will apply to all UnitedHealthcare commercial, individual exchange, Medicare Advantage and community plans. The payer...

UnitedHealthcare launching national gold-card program

Writers represent independent, third-party users who have joined our contributor program and self-verified their accounts. Writers are expected, like all users, to adhere to our Community Standards.

writer

Dicle Belul

Medicare Advantage has experienced an increase in denied prior authorization requests in recent years, with 7.4% of requests being denied in 2022, up from 5.8% in 2021. This trend is concerning for seniors relying on Medicare Advantage for their healthcare needs. The denial of prior authorization requests can lead to frustration and obstacles in accessing necessary treatments and services. While prior authorization is intended to ensure the medical necessity of a service, some seniors feel their needs are being unfairly rejected.

Rising Denials in Medicare Advantage Impede Senior Care

“I am worried about a phone call I received from someone claiming to be from Medicare who had my personal information and was verifying it. The caller mentioned that I would receive a new plastic Medicare card with a chip the following day. It has now been over a week, and I still haven’t received the card. I think I may have made a serious mistake by confirming my details and responding to the questions the caller posed to me. What steps should I take or whom should I contact to verify if this was a legitimate communication from Medicare?” – Jeanette.

Latest Medicare Scam Targeting Seniors

Massachusetts State

Retirement Daily

Understand Medicaid's impact on your parents' assets.

Medicaid & Nursing Homes: Will Your Parents Lose Their House?

HealthPartners, a prominent healthcare provider, has announced plans to withdraw from the Medicare Advantage plan offered by UnitedHealthcare starting in 2025. This decision will affect approximately 30,000 patients and marks a considerable shift in the relationship between the two healthcare giants. A potential coverage gap is anticipated for the affected...

HealthPartners to exit UnitedHealthcare’s Medicare plan in 2025

“Private Medicare plans now cover more than half of Medicare beneficiaries, but how well they actually serve people differs from county to county,” Maya Goldman writes over at Axios. “Medicare enrollees living in communities of color and with high rates of poverty had less access to top-rated Medicare Advantage plans last year than those living in wealthier places that are majority white. These disparities could contribute to unequal health outcomes for seniors across the country as Medicare Advantage enrollment grows, particularly among seniors from diverse and low-income backgrounds. The geographic quality differences in Medicare availability drive home the longstanding point that where someone lives in America can determine the caliber of their health care options. ‘Nobody can really easily move to another location to get the health care services they need,’ said Jeannie Fuglesten Biniek, associate director of KFF’s program on Medicare policy. ‘It’s even harder for people who are Medicare beneficiaries.’ … Medicare Advantage plans offered in more disadvantaged counties were less likely to be rated 4.5 stars or higher, according to research published last week in JAMA Network Open.” Maya Goldman, “Medicare Advantage’s geographic disparities,” Axios.

Medicare Advantage worse in some places

FinanceBuzz

Depending on your plans for the future, your budget, and your health, Medicare Advantage might not be the best retirement healthcare solution for you.

The 9 Biggest Disadvantages to Medicare Advantage

Will the looming changes address the concerns of the patient assistance community?. In just a few weeks, open enrollment begins for the more than 63 million people enrolled in Medicare programs in the US. During this time, many will evaluate and select a Part D plan that best meets their health needs. It is also a time when those enrolled in Medicare will learn more about two important changes to the Medicare Part D program taking effect Jan. 1, 2025:

Looking Ahead to Medicare Reforms Coming in 2025

Medicare Advantage plans are denying an increasingly large share of prior authorization requests, limiting beneficiaries’ access to services like home health and dialysis, according to new reports by KFF. KFF examined Medicare Advantage contract data for 2022, which is the year with the most recent available figures. KFF’s analysis...

MA prior authorization denial rates continue steady climb, analysis finds

ABLE accounts provide a tax-advantaged way for disabled individuals to save money. Yet 10 years after Congress first created these accounts, many eligible individuals still aren't using them. Several new congressional proposals aim to raise awareness of the accounts and make it easier to put money in them. Congress enacted...

New bill proposals aim to make it easier for disabled individuals to save money

Contributors represent independent, third-party users who have joined our contributor program and self-verified their accounts. They have also demonstrated their experience writing hard news for other outlets. Contributors are expected, like all users, to adhere to our Community Standards.

contributor

Bucks County Beacon

Conservatives have done the United States a huge favor by explaining in detail what they’ll try to do if Donald Trump is reelected. Project 2025 , a “presidential transition project” of the Heritage Foundation, helpfully lays out how a group of former Trump officials would like to transform the country into a right-wing dystopia where the rich thrive and the rest of us die aspiring to be rich.

Project 2025’s Plan to Gut Medicare and Medicaid

San Diego, CA

The process of seeking care for your elderly loved one can be confusing as there are so many options and their needs evolve as they age and their age-related symptoms progress. As the founder and proprietor of a home-based Residential Care Facility for the Elderly (RCFE) in San Diego called...

When is it Time for a “Home-Based” Residential Care Facility for the Elderly (RCFE)?

Expert advice on delaying Medicare enrollment and avoiding penalties while still employed.

Medicare Enrollment Pitfalls: Tips for Employed Seniors

When your loved one’s care requirements exceed what can be safely managed at home, it might be time to consider specialized care in a facility. Here are some key considerations. Navigating the complexities of caring for a loved one with Alzheimer’s disease or related dementias (ADRD) can be challenging...

Your Guide on When to Move Your Loved One with Alzheimer’s to Inpatient Care

New Jersey State

Morristown Minute

A new initiative aims to provide housing for vulnerable Medicaid members, enhancing community wellness and support. MORRIS COUNTY, N.J. - In a significant move to tackle housing instability among Medicaid recipients, New Jersey's Human Services Commissioner Sarah Adelman, along with Community Affairs Commissioner Jacquelyn A. Suárez, today announced the availability of $95 million in funding for developers. This initiative, part of the Healthy Homes program, is designed to create affordable housing opportunities for NJ FamilyCare members who are either homeless, at risk of homelessness, or currently living in institutional settings.

$95 Million for Healthy Homes: Housing for Medicaid Members

Great Falls, MT

Montana Free Press

The state’s largest nursing home plans to close its doors weeks after being terminated from the federal Medicare and Medicaid program after “a history of serious quality issues” and violations for deficient patient care. In a recent public notice, the Centers for Medicare and Medicaid announced that...

State’s largest nursing home prepares to close following patient safety violations

New York State

Democratic U.S. Congressman Pat Ryan of New York has proposed the Improving Access to Emergency Medical Services for Seniors Act, aiming to introduce at-home care services under Medicare coverage. The bill advocates for a "treatment-in-place model" to provide minor health issue treatment at home, eliminating the need for Medicare patients to be transported to hospitals for reimbursement. This change attempts to alleviate the financial burden on taxpayers and recognizes the essential role of emergency medical service providers.

Expanding Medicare: Enhancing Care for Seniors

Colorado State

David Heitz

A bill quietly introduced this spring in the Colorado legislature to decriminalize the possession of drug paraphernalia obtained by harm reductionists has become law. As low-key as the legislation was introduced, the bill was signed into law without fanfare June 6. It garnered little to no media attention.

Colorado legalizes needles, pipes for meth and crack if obtained by harm reduction group

Medicare Advantage customer service supports a less healthy, higher-need population, indicating that it should be designed and staffed to effectively serve complex, high-need patients. ABSTRACT. Objectives: To examine characteristics of Medicare Advantage (MA) enrollees who use their plan’s customer service to help plans understand how to better meet members’ needs....

Medicare Advantage Customer Service Is Used Most by Higher-Need Patients

Florida State

Uncovering Florida

With hurricane season posing a consistent threat six months out of the year, who would not like a little help getting their home ready for the harsh weather to come? Senate Bill 7028: My Safe Florida Home Program, approved by Governor DeSantis on April 24, 2024, and effective as of July 1, appropriates a one-time total of $200 million from 2024 to 2025 for the purpose of funding hurricane mitigation grants and inspections, as well as outreach and administration costs, to support homeowners in Florida.

DeSantis Signs New Bill Giving $200 Million To Homeowners

NewsBreak

How to Navigate Rising Medicare Costs and Changing Rules

Medicare is confusing. There. We said it. With an ever-shifting landscape of rules and the rather cryptic naming conventions for their plans – Parts A, B,...

How to Navigate Rising Medicare Costs and Changing Rules

Comments / 0