The Implementation of the Medicare+Choice Program

The Implementation of the Medicare+Choice Program

Author: Craig Schneider

Publisher: LAP Lambert Academic Publishing

Published: 2009-09

Total Pages: 364

ISBN-13: 9783838309774

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The Balanced Budget Act of 1997 made the most substantial changes to the Medicare program since its inception in 1965. One of the most significant changes was the enactment of the Medicare+Choice program, which would create opportunities for four new types of private plan options for Medicare beneficiaries, along with the existing Medicare HMO option and the traditional fee-for-service option. This experiment was generally not successful, and this study was designed to explore the reasons that the program did not succeed. The methodology involves interviews with subject matter experts representing Congressional staff, Medicare officials, and insurance industry employees; exploration of analytical implementation models; and an original methodology termed assertion analysis. The research question that the study primarily addresses is what factor is most responsible for the problems of Medicare+Choice: the Congressional design of the program, the performance of CMS in implementing the program, or the dramatic changes in the healthcare system that occurred during the 1995-99 period.


Improving the Medicare Market

Improving the Medicare Market

Author: Institute of Medicine

Publisher: National Academies Press

Published: 1996-11-01

Total Pages: 384

ISBN-13: 0309175364

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Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.


Medicare Advantage Plan Enrollment Guidance

Medicare Advantage Plan Enrollment Guidance

Author: Charles Winthrop III

Publisher:

Published: 2017-07-24

Total Pages: 37

ISBN-13: 9781521923009

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Description:Learn what to expect from a Health Insurance Agent before you make the call.You may already have decided about Medicare part A and B. Perhaps, you were automatically enrolled. That only covers 80%. What are you going to do about the other 20%?Perhaps you can't afford a Supplement plan and want to consider a low-premium or even zero premium Medicare Advantage plan?This is a reference guide of conversations with Health Insurance Agents who must follow a very rigid script about how they discuss insurance and answer questions. Am confident that by reviewing an enrollment call with an Agent that results in a Medicare Advantage enrollment, the reader will be able to ask better questions of a Health Insurance Agent whether it is over the phone or in-person.You may want to include insurance from a private insurance company that may help with costs. This planning should be well on the way three months before you turn 65 and earlier if you are disabled. Basics:Medicare Advantage, may allow you to enroll with an effective date that starts the same time as Medicare but you can choose a plan, three months prior to your birthday with an effective date the same time as Original Medicare. Many disabled people enroll long before they reach 65. Two of the common, general choices include Supplements and Medicare Advantage Plans. This example you will read should prepare you for the questions when enrolling into a Medicare Advantage plan. You would want to discuss all types of plans, eligibility, and costs...as well as doctor and drug coverage.Purpose:The following information is for illustrative purposes only and does not reflect available plans in your area. However, the information is a guide about what to expect from a Health Insurance Agent who performs the enrollment over the phone. Sometimes, enrolling over the phone or even in-person may feel like high pressure so it is helpful to have an idea of what the interview questions may appear to be ahead of time. Please review the enrollment process by purchasing the Amazon Kindle or paperback option.


The Affordable Care Act

The Affordable Care Act

Author: Tamara Thompson

Publisher: Greenhaven Publishing LLC

Published: 2014-12-02

Total Pages: 130

ISBN-13: 0737771496

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The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.