Capsules: Medicare Could Save Billions By Scrapping Random Drug Plan Assignment; Pre-Existing Condition Bans – Are They Really Gone?

Now on Kaiser Health News’ blog, Julie Rovner writes about a new study regarding Medicare’s drug plan assignment process: “In 2013, an estimated 10 million people who participate in the Medicare prescription drug program, known as Part D, received government subsidies to help pay for that coverage. They account for an estimated three-quarters of the program’s cost. Most of those low-income enrollees are randomly placed in a plan that costs less than the average for the region where the person lives” (Rovner, 6/2). 

Also on the blog, Rovner tells her own experience with insurance coverage and pre-existing conditions: “Now, as a health reporter, I knew the first letter was a mistake. The 1996 Health Insurance Portability and Accountability Act (HIPAA) provides that if you’ve had continuous coverage, meaning coverage without a break of more than 63 days, your new insurer may not impose a pre-existing condition waiting period. Obviously I hadn’t had a break of more than 63 days. I hadn’t had a break of even one day. I did that quite purposefully. But the mix up raised a broader question – What about the requirement of the Affordable Care Act that prohibited pretty much all pre-existing condition exclusions as of Jan. 1, 2014? Under the law, the only plans that may continue to exclude coverage for pre-existing conditions after that date are individual plans that are ‘grandfathered,’ or haven’t changed substantially since the law was passed in 2010’” (Rovner, 6/2). Check out what else is on the blog.

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