Medicare Monitor
The Palm Beach Post's veteran Washington correspondent, Larry Lipman, tracks policy makers and interest groups who are shaping the future of the federal health insurance program for the elderly.
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Medicare at a glance
Medicare is the federal health care system that covers about 36 million people age 65 and older, plus 7 million disabled. It has four parts:
Part A
Covers inpatient hospital care as well as nursing home, home health and hospice care. Nearly all elderly and disabled Americans qualify for Part A coverage.
Financed by a 2.9 percent payroll tax divided equally between employees and employers.
Part B
Covers outpatient care, doctor’s services, durable medical equipment, home health visits and preventive care. Part B coverage is voluntary, but roughly 40 million are enrolled.
Financed by beneficiary premiums and federal general revenue. Current monthly premiums are $93.50. Starting this year, individuals whose taxable income is more than $80,000 will pay a higher premium.
Part C
Medicare Advantage managed care plans provide health care normally covered by Medicare Parts A and B. They may also provide some other benefits, including prescription drugs, not covered by traditional Medicare. Oart C is voluntary; about 7 million beneficiaries are enrolled.
Financed by Medicare and beneficiary premiums, which vary among plans.
Part D
Medicare prescription drug plans come in two types, those that just cover prescription drugs and those that cover drugs as part of a broader managed care benefit. Part D is voluntary. About 9.2 million beneficiaries are in stand-alone drug plans and about 5.1 million are in managed care drug plans.
The plans are private and financed by Medicare and beneficiary premiums, which vary among plans.
-- Larry Lipman
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2008 > May > 13 > Entry
Nursing homes say Florida could lose $62 million
By Larry Lipman
| Tuesday, May 13, 2008, 01:58 PM
Florida nursing homes would lose an estimated $62 million next year under proposed rules designed to recoup “forecasting errors” in Medicare payments, according to a study released today by the American Health Care Association and the Alliance for Quality Nursing Home Care.
The nursing home groups have been slugging away at the proposed rules, which they say will trim $770 million nationwide from nursing homes.
“Florida seniors are facing the second-highest Medicare funding reduction in the nation (behind New York) on top of the state Medicaid cuts passed into state law in recent weeks,” Tony Marshall, senior vice president and chief operating officer of the Florida Health Care Association, said in a statement.
“Medicare and Medicaid funding are inextricably linked,” Marshall said. “The combination of cuts to both programs squeezes facilities in a manner harmful to older residents’ rising care needs, as well as to our local economy and caregiver jobs base.”
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By Leticia
May 14, 2008 1:55 PM | Link to this
Texas is the 4th highest level of cuts by these proposed changes, expecting to lose an estimated $47 million. A drastic cut like this, coupled with our 49th state ranking of our Medicaid reimbursment rate, creates a dangerous situation for Texas seniors. For more information, visit www.txhca.org.