There are several types of Medicare Advantage plans, and not all are available in all areas. Many are health maintenance organizations, but there are also preferred provider organizations and special needs plans, among others. Under traditional Medicare with a Medigap plan, you may go to any doctor who accepts Medicare. But in a Medicare Advantage HMO plan you need to use network healthcare providers in order to get coverage. If you are treated by non-network providers, you would be responsible for 100% of the out-of-pocket costs, and Medicare would not cover the cost of the claim. If the plan is a PPO, however, you would have greater flexibility to go out of network, but you would pay higher co-pays or co-insurance. Before selecting any Medicare Advantage plan, check the lists of network doctors, hospitals and other providers! It is not unheard of for Medicare Advantage plans to market to people who live a good distance from the nearest in network health care provider..If adopted, S. 99 would provide for the negotiation of lower covered Part D drug prices on behalf of Medicare beneficiaries and the establishment of a formulary by the Secretary of Health and Human Services under Medicare Part D..According to another report in the Washington Post, HHS Secretary Alex Azar and "Seema Verma, administrator of the Centers for Medicare and Medicaid Services, are distancing themselves from the idea, each emphasizing that they were not consulted by the White House before the president's announcement, said three officials familiar with their thinking.".Lawmakers Adjourn for Holiday Recess.Despite resistance from some lawmakers, appropriators in the House and Senate say that their work on the "cromnibus" is continuing. According to Harold Rogers, Chairman of the House Appropriations Committee, negotiations are "on schedule," and the bill should come to the floor by early next week. If it fails to get the necessary votes, lawmakers will likely adopt a continuing resolution to provide the government with short-term funding. At this point, leaders are saying that a government shutdown is not something that they're willing to consider..Finally, Rep. Rodney Davis's Social Security Fairness Act gained eight new cosponsors this week, bringing the total up to forty-six. They are: Reps. John Tierney, Joe Courtney, Julia Brownley, Aaron Schock, Peter Welch, James McGovern, Lois Capps, and Elijah Cummings. If signed into law, H.R. 1795 would repeal the Government Pension Offset and the Windfall Elimination Provision two provisions that unfairly reduce the earned Social Security benefits of millions of teachers, firefighters, peace officers, and other state or local government employees each year..As a father of three children attending public school, I want them to have access to the best educators. H.R. 973 will not only give our public servants the certainty they deserve but a chance to recruit and retain the best, brightest, and most dedicated educators so America can continue to compete..In the weeks ahead, The Senior Citizens League will be closely monitoring discussions in the House and Senate to repeal the ACA since they will impact older Americans in several ways. For instance, Medicare Part D beneficiaries who fall into the coverage gap or "doughnut hole" will face higher costs for their prescription drugs, and the Hospital Insurance Trust Fund that finances Medicare Part A will lose a critical stream of funding. For updates on the repeal of the ACA, visit the Legislative News section of our website, or follow TSCL on Facebook or Twitter..TSCL is supportive of the President's efforts, but we are taking a wait-and-see approach because, as so many things are in Washington, D.C., the devil is in the details.
