Medicare News

Whats new for Medicare in 2024?

Saving money on your prescription drugs Starting January 1, 2024, if you have Medicare drug coverage (Part D) and your drug costs are high enough to reach the catastrophic coverage phase, you don’t have to pay a copayment or coinsurance. Extra Help—a program that helps cover your Part D drug costs—will expand to cover more

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Does Medicare pay for all surgeries?

Medicare only covers medically necessary surgical procedures. Medicare defines medically necessary services as “health care services or supplies that are needed to diagnose or treat an illness, injury, condition, disease, or its symptoms – and that meet accepted standards of medicine.” Medicare further defines medically necessary services as ones that: Are proper and needed for

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What is the Medicare SNF Three-Day Rule?

Medicare covers skilled nursing facility (SNF) care in certain circumstances, but some situations can impact what is covered or even or if SNF care will be covered and your costs for that care. If you are in the hospital, your doctor can order observation services to decide if you should be admitted to the hospital

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What is the Two-Midnight rule in Medicare?

Whether or not to admit you as an inpatient to a hospital is a decision made by your doctor after reviewing your medical situation, and they decide whether it is necessary to admit you to the hospital. According to Medicare, an inpatient admission is generally appropriate when you’re expected to need 2 or more midnights

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Can I use my Medicare coverage to utilize telehealth services?

If you have original Medicare, Part B will cover telehealth services, and you will have to pay a 20% coinsurance of the Medicare-approved amount for your doctor or other health care provider’s services after you pay the Part B deductible. You will have to pay the same amount for most telehealth services as if you

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What does “step therapy” mean in Medicare drug coverage?

Each Medicare Part D plan has a list of covered drugs that are called a formulary.  Within every formulary, there are a set of rules applied to the prescription drugs covered by the plan. One of those rules is called step-therapy.  If you get a prescription for a medication that has step-therapy rules, there is

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