2015 Medicare Blog

Information on new 2015 Medicare Rules & Plans are starting to become available. This blog will keep you posted on the latest Medicare Information.

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Open Enrollment For 2014 Medicare Plans:


Whether you are already a Medicare recipient, or you want to enroll in a Medicare Health Plan for the first time, October 15 through December 7 is when ALL people can make changes to their Medicare Health Plan such as a Medicare Advantage Plan or a Stand-Alone Prescription Drug Plan for 2014.

*This Medicare open enrollment period is not to be confused with the Obamacare open enrollment period. Obamacare open enrollment is from October 1- March 31st and is the window for people under 65 to enroll in a qualified health plan through the health exchanges. Everyone in the country is required to enroll in some form of health insurance plan in order to avoid tax penalties, but if you are enrolled in Medicare, the Obamacare open enrollment and health exchanges that you are hearing so much about won’t affect your coverage! 

A Medicare Advantage plan with or without prescription drug coverage is a private insurance policy option that millions of American seniors choose. These options usually save money and often provide a more coverage through a list of covered services at a low premium or absolutely free depending on your regional Medicare options.


Outside of Medicare Open Enrollment

Making changes to Medicare enrollment outside of this specific open enrollment period is only allowed for applicants with special circumstances or those with special needs.  

More information on 2014 Medicare managed care plan options and 2014 Medicare open enrollment will be available beginning in October. People with Medicare can call 1-800-MEDICARE or visit www.medicare.gov for plan information. If a person is satisfied that their current plan will meet their needs for next year, they don’t need to do anything.


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CMS (The Centers for Medicare & Medicaid Services) 2014 proposed rules for the hospital outpatient prospective system (OPPS), which was released this week offers payment increases and “packaging” of certain outpatient services.

The proposed CMS rule would increase hospital outpatient prospective system payments by $4.37 billion or 9.5 percent. Also announced for 2014 Medicare payments made to ambulatory surgical centers (ASCs) by $133 million which is 3.51 percent over 2013 spending according to a Center for Medicare Services press release.

In a CMS effort to streamline their payment system, CMS is proposing to bundle certain services into 7 new categories. 

Additionally, CMS proposes collapsing the five active levels of outpatient visit coding into just one. CMS says that it will remove incentives that hospitals now may have to provide unnecessary medical services. 

The proposed new rule would end on December 31, 2013 the direct supervision enforcement delay for critical access hospitals and small rural hospitals. The new rule would create twenty nine separate and comprehensive ambulatory payment classifications which would replace existing device-dependent APCs.

If you would like to comment to Centers for Medicare Services you must do so by September 6, 2013. The final rules are expected by November 1, 2013 according to the agency's  press release. 

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