Medicare enrollment

.S. Department of Health and Human Services

There's less than a week left in the Annual Election Period for Floridians enrolled in Medicare to change their plans.

With time running out on open enrollment season, many seniors are facing sharply higher premiums for Medicare's popular prescription drug program. The reason: rising drug costs have overtaken a long stretch of stable premiums.

.S. Department of Health and Human Services

One month into Medicare's enrollment period for seniors, the federal government announced that Medicare Part B premiums will be going up in 2016 for new enrollees.

Not every American 65 and older is worrying about Medicare's open enrollment period, now underway. Some who are eligible for the government insurance plan are staying on the job, and gaining access to employer-based plans they say are a better option. 

Longboat Key News

Sarasota Memorial Hospital will continue to be “in-network” for UnitedHealthcare Medicare Advantage and employer-based policyholders under a new contract, the Sarasota Herald-Tribune reports. 

Senior Medicare Patrol Ready to Help

Nov 20, 2014

To The Editor:

The Nov. 3 Health News Florida article on Doc Feuds Prompts Fraud Investigation, does an excellent job highlighting the problem of Medicare fraud in Florida.

One thing the article didn't touch on is how beneficiaries can help to report Medicare fraud.  The Florida Senior Medicare Patrol (SMP) Program stresses that Medicare fraud prevention begins with the individual. 

Medicare Advantage plans that draw a lot of their enrollment from the poor side of town say they're at a disadvantage on the government's five-star ratings scale, which commands respect and governs pay.

One company pressing the issue is WellCare Health Plans, based in Tampa. Its Medicare Advantage plans are rated at 3 or 3 1/2 stars, below the 4-star minimum required for plans to qualify for bonus payments. Plans' premium and bonus payments are kept confidential, but other media report that the bonuses amount to a few hundred dollars per member.

Ultimate Health Plans, a scrappy little company north of Tampa, is offering Medicare HMO deals that  sound too good to be true: no premium, no deductible, free gym membership and even cash back. 

What's not to like? Ask the Florida Office of Insurance Regulation, which suspects the company lacks sufficient funds to pay claims for its 3,000 members. OIR issued a suspension order Oct. 2, but it was  placed on hold when Ultimate invoked its right to a hearing. It can take months, sometimes years, for the hearing process to unfold.

.S. Department of Health and Human Services

Just a handful of Florida Medicare Advantage plans offered for 2015 received below average scores in a federal quality rating system, a breakdown of data by Avalere Health shows.

Many Florida shoppers at Medicare.gov will find Day Break and Sunrise among their lowest-priced HMO options. But if they call to enroll in either one, they’re out of luck.

Florida Healthcare Plus, a small Coral Gables company that sponsors the two Medicare Advantage plans, is under state and federal suspension, unable to sign up new members during the current open-enrollment season for Medicare, Oct. 15-Dec. 7. Being frozen at this time of year can be a death sentence for such plans.

The Medicare “Part B” premium that most older people pay for outpatient care will stay the same in 2015 — $104.90 a month.

The government says it’s the third consecutive year that the basic monthly premium has held steady.

Higher premiums paid by upper-income beneficiaries also are unchanged. These are for people with an income greater than $85,000 a year, or $170,000 for married couples.

Just in time for Medicare's open enrollment season, a Florida-based HMO has won the federal government's coveted  five-star rating, a rare honor that brings more than bragging rights. Such plans receive the freedom to enroll new members all year long. 

The winner, CarePlus Health Plans Inc., is a subsidiary of Humana Inc., Florida's largest Medicare vendor. Humana did well in the quality ratings, too,  but was outscored by the little plan it bought in 2005.

.S. Department of Health and Human Services

As of Nov. 1, I will be on Medicare, which means I have to enroll this month. I should have plenty of company, since open enrollment for 2015 begins Oct. 15.

As a reporter and editor on the health-care beat, I’ve been explaining Medicare to the public since 1976. So people assume that I understand it thoroughly.  

But writing about Medicare is one thing; living it is another. For advice, I called Barbara Katz, a former reporter and lawyer who recently moved to Longboat Key from another state.  She enrolled in Medicare and a supplemental plan six years ago.

Former Orlando Health patients may have to help repay the Centers for Medicare and Medicaid Services after a federal audit discovered the hospital overbilled Medicare by $1.45 million, the Orlando Sentinel reports.

Readmission Fines Hit FL Hospitals

Oct 6, 2014
Kaiser Health News

Medicare is fining a record number of hospitals – including more than 140 in Florida – for having too many patients return within a month for additional treatments, newly released federal records show.

Even though the nation’s readmission rate is dropping, Medicare’s average fines will be higher, with 39 hospitals receiving the largest penalty allowed, including the nation’s oldest hospital, Pennsylvania Hospital in Philadelphia.

Medicare Open Enrollment is Fast Approaching -- Here's What We Know So Far

Oct 1, 2014

Medicare beneficiaries who want to make changes to their prescription drug plans or Medicare Advantage coverage can do so starting Oct. 15 during the Medicare's program’s annual open enrollment period. There will be somewhat fewer plans to pick from this year, but in general people will have plenty of options, experts say.

The nation's respite from troublesome health care inflation is ending, the government said Wednesday in a report that renews a crucial budget challenge for lawmakers, taxpayers, businesses and patients.

Economic recovery, an aging society, and more people insured under the new health care law are driving the long-term trend, according to the report published online by the journal Health Affairs.

Linked In

Florida Healthcare Plus, a Medicare HMO and drug plan, is under state review for making a $600,000 error in a financial statement and has been temporarily blocked from enrolling any new members, its chief executive says.

The company, based in Coral Gables, was also recently fined $113,200 by the federal Centers for Medicare and Medicaid Services (CMS) for a different type of infraction -- "systemic failures" to provide all the benefits due to members under CMS rules.

Lottie Watts/WUSF / WUSF

More than half of the Medicare Advantage plans available for enrollment now in Florida for 2014 coverage earned a rating of at least four stars out of five, according to data organized by Avalere Health

Four Florida plans -- all sponsored by Cigna -- earned the coveted five-star rating: three plans in Bay County and one in Miami-Dade. There were no five-star Advantage plans available in 2013 anywhere in Florida.

Lottie Watts / WUSF

It's open enrollment season for Medicare, the time when beneficiaries can switch plans if they want. Plenty of private insurance companies are competing to enroll them in Medicare Advantage plans.

If you have Medicare, or you're getting close to age 65, your mailbox is likely overflowing with offers. The ads are coming at you on TV, too.