Susan Jaffe - KFF Health News

Every year, Medicare officials encourage beneficiaries to shop around for their drug coverage. Few take the time. This year, it might be more important than ever.

President Joe Biden is campaigning on his efforts to cut drug costs for Medicare patients. But independent pharmacists say one strategy makes it unaffordable for them to keep some brand-name medicines in stock.

Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are stuck in the middle, but there’s a way out.

As the period for changing health plans ends, many seniors are tuning out. They could wind up with a surprise next year: higher costs and reduced access to health care providers.

Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and predicts what kind of care an individual will need. New rules will ensure humans are part of the process.

In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare drug and medical plans.

Medicare can pay for some dental care if it is medically necessary to safely treat another covered medical condition, and federal officials have asked for suggestions on whether that list of conditions should be expanded.

Private Medicare Advantage health plans are increasingly ending coverage for skilled nursing or rehab services before medical providers think patients are healthy enough to go home, doctors and patient advocates say.

The Biden administration is considering whether Medicaid, which pays the bills for 62% of nursing home residents, should require that most of that funding be used to provide care, rather than for maintenance, capital improvements, or profits.

Private and public employers are increasingly using the government’s Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the “overwhelming majority” of medical costs, according to an industry analyst.