“It’s a riskier approach to health care,” Caughill says, which can also end up being more expensive.įor example, a recent Kaiser study found that about half of all Medicare Advantage enrollees would end up paying more than those in traditional Medicare for a seven-day hospital stay. “Some people in Medicare Advantage end up paying unexpectedly high costs when they become ill or find their network lacks the providers they need,” says Tricia Neuman, senior vice president at Kaiser.īut Medicare Advantage plans typically require that you get care from a more limited network of providers, and you may need pre-authorization to see specialists, says Melinda Caughill, a co-founder of 65 Incorporated, a firm that provides Medicare enrollment guidance. And Advantage plans can carry hidden risks, especially for people with major health issues. Choosing between the two requires careful consideration of your finances and health needs. Some also offer benefits not in Original Medicare, such as fitness classes or some vision and dental care. Plus, many people pay extra for Medigap, to cover copays and other out-of-pocket costs, as well as a Part D plan for drugs.Īdvantage plans (also called Part C), on the other hand, provide the benefits of Parts A, B, and often D, usually for about the same amount, with lower copays, so there’s no need for Medigap. That typically costs about $165 a month (with the cost deducted from your Social Security check). It’s easy to see the appeal: Original Medicare requires piecing together care from what’s called Part A, for in-patient hospital and skilled nursing care, and Part B, for doctor services. By 2032 about 60 percent of beneficiaries are expected to sign up for these plans. The pitches work: In 2022 nearly half of those eligible for Medicare were enrolled in Advantage plans, up from about a third in 2016, according to the Kaiser Family Foundation. That’s when you can switch coverage between Original Medicare and Medicare Advantage, or change your prescription drug plan. This marketing tsunami is timed to Medicare open enrollment, which runs from Oct. In your mailbox and on TV you’re being inundated with ads for Medicare Advantage plans, star-powered by the likes of William Shatner, all promising great care with low- or zero-cost premiums. Beginning next week, that's going to change - quarterly updates will include those citations.Ĭare compare can be found online at /care-compare.If you’re one of the 64 million Americans enrolled in Medicare, you know that a deluge has begun. "What we're seeing is the very intentional move by CMS to say we know this is still an issue even though there are safeguards in place, like Medicare and Medicaid banning the use of these types of chemical restraints without a schizophrenia diagnosis."Ĭare Compare also posts inspections based on complaints, but those don't show up while nursing homes challenge the findings. That's been a problem for decades, Smith said. Violators will see their ratings plummet. Recently, CMS announced it will audit nursing homes for the misuse of antipsychotic drugs. "The Care Compare tool is an absolute necessity for anyone who is wanting to look into whether or not a nursing home meets a five-star rating criteria, if there are any infractions or any kind of violations that have occurred within their facility," said AARP Florida director of advocacy Zayne Smith. That's where the Centers for Medicaid & Medicare Services gives an overall star rating along with details on health care, staffing and quality. You'll want to use the Care Compare website if you're ever looking for a nursing home. The federal agency that runs Medicaid and Medicare is taking steps to bolster its consumer-focused ratings of nursing homes.
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