medicare
When is the Medicare initial enrollment period?
Medicare initial enrollment period (IEP) occurs three months before your 65th birthday, the month of your 65th birthday, and the three months after your 65th birthday. You can enroll in Original Medicare, which includes Parts A and Part B. Once…
Ask Rusty – I’m a Retired Veteran; Why must I pay for Medicare?
Dear Rusty: I’m a retired Navy veteran who is going to be turning 65 years old this year. My question is concerning mandatory Medicare sign-up requirements. Why do I have to sign up for Medicare coverage at 65 when I…
Improving Seniors’ Timely Access to Care Act
Improving Seniors’ Timely Access to Care Act of 2025 was reintroduced by U.S. Senators Roger Marshall, M.D. and Mark Warner on May 20, 2025. The bill if passed will establish requirements with respect to the use of prior authorization under…
How do you qualify for a grocery allowance through Medicare Advantage?
We have all seen TV ads or social media posts about seniors qualifying for a grocery allowance, but who qualifies? First, you must be enrolled in original Medicare Parts A and B and choose to enroll in a Medicare Advantage…
About Fraud in Medicare and Medicaid
Seeking fraud and eliminating government waste seem to be popular buzz words today, and the primary targets on the potential fraud list are Medicare and Medicaid. Indeed, the U.S. Government Accountability Office recently suggested that the federal government loses between…
“Most favored nation” pricing model for certain drugs
According to a recent poll, three in four adults in the United States say the cost of medications is unaffordable. With drug prices in the U.S. higher than in other countries as much as 10 times, President Trump is expected…
Should CMS monitor biosimilar coverage on formularies?
The U.S. Department of Health and Human Services Office of Inspector General (OIG) released a study that found many Medicare Part D formularies included Humira Biosimilars for 2025. Humira is one of the best-selling prescription drugs in the world. However,…
Original Medicare covers most but not all healthcare services
Medicare is the government health insurance program for adults 65 and older and individuals under 65 with certain disabilities. However, Medicare does have its drawbacks. Original Medicare covers most, but not all, of the costs for approved health care services…
Ask Rusty – Must I take Medicare Part A even if I have VA or Medicaid Coverage?
Dear Rusty: Does everyone need to sign up for Medicare part A, even if you are ex-military? Or only on Medicaid, regardless of whether you are eligible for Social Security or not? Also is there a cost for just part…
The difference in care between Medicare and Medicare Advantage members
With the increasing enrollment by Medicare recipients in Medicare Advantage health plans and the issue of prior authorization requirements and limited provider networks, a team of health policy researchers at Harvard T.H. Chan School of Public Health looked at the…