Medicare currently covers the elderly and disabled for most hospital and physician treatment, but in order to be guarded against high out-of-pocket costs, beneficiaries still have to purchase supplemental plans — Medigap for copays and deductibles and Medicare Part D for prescription drugs.
Researchers proposed a new benefits options called “Medicare Essential,” which would bundle hospital, physician, prescription drug and supplemental health coverage into one, all-encompassing health plan. They said Medicare Essential could “offer better financial protection than traditional Medicare does, including a limit on out-of-pocket spending,” and beneficiaries could also save money by “selecting medical providers that deliver high-value care.”
Medicare Essential would basically set an out-of-pocket maximum for any beneficiary who wants to choose it, and it would be financed by traditional premiums — meaning it would not add to the federal deficit, and it would replace costly Medigap and Part D plans that mostly benefit private health insurers and pharmaceutical companies.
Hospitals and physicians that agree to be reimbursed through Medicare Essential would be tagged as “high-value providers,” and Medicare beneficiaries who choose those providers could save money through reduced cost-sharing, the researchers wrote.
“Given its potential, such an alternative should be a part of the debate over the future of Medicare. The nation needs a unified, patient-centered strategy to preserve access while securing a high-quality, more affordable health care system,” the authors wrote.
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