Watch now (2 mins) | The U.S. health care landscape is riddled with endless schemes that place profits ahead of patients. That’s why Congress has enacted a series of laws through the years designed to protect health care consumers from unscrupulous practices.
Quick correction regarding section 204 (Prescription Drug Data Collection): the data is not reported annually to congress. The data is used to create a biannual (one report every two years) public report. Although the data is collected by CMS, (per statute) ASPE is the agency in charge of delivering the biannual public report. She's correct that the first report has not been published yet. Go Julie! I love your work.
Good catch Daisy! I misspoke - should have said that PLANS are required to submit annual reporting to CMS. I did not realize that the report ASPE makes to Congress was biannual (still waiting to see the first one - think it might become triannual or quad-annual at this rate)!
Thanks very much for that clarifying info, and for the kind words. Much appreciated!
Yes, the first report still has not been posted. I’m only super wonky about RxDC bc (surprise) I work in the CMS team that collects the data. I really am a huge fan of your work. I know about RxDC and the CAA data collection implementations but I dream of being as knowledgeable as you. Keep up the great work!
I have a question about Federal HC Benefits. I have BCBS Federal plan and Medicare A (only). Why isn't my premium cheaper since Medicare A picks up the hospital (most expensive) portion of my healthcare coverage and risk? This is always baffling to me. Any ideas?
The reason why your premium for your BCBS Federal plan does not get cheaper is because while you are still employed, Medicare will always pay secondary to your BCBS Federal plan. That means that you will always receive the maximum allowable coverage from your BCBS Federal plan before Medicare A kicks in as secondary payer (it does not eliminate any of the risk from the primary plan).
Hopefully, however, you are receiving Medicare Part A for $0 additional premium (If you or your spouse have paid Medicare taxes for 40 or more quarters/10 years, you are eligible for Medicare Part A with a $0 premium). The Part A coverage also can reduce your out-of-pocket costs including, (depending on your specific health plan), deductibles, coinsurance, and charges that exceed your BCBS Federal plan's allowable charges.
Quick correction regarding section 204 (Prescription Drug Data Collection): the data is not reported annually to congress. The data is used to create a biannual (one report every two years) public report. Although the data is collected by CMS, (per statute) ASPE is the agency in charge of delivering the biannual public report. She's correct that the first report has not been published yet. Go Julie! I love your work.
Good catch Daisy! I misspoke - should have said that PLANS are required to submit annual reporting to CMS. I did not realize that the report ASPE makes to Congress was biannual (still waiting to see the first one - think it might become triannual or quad-annual at this rate)!
Thanks very much for that clarifying info, and for the kind words. Much appreciated!
Yes, the first report still has not been posted. I’m only super wonky about RxDC bc (surprise) I work in the CMS team that collects the data. I really am a huge fan of your work. I know about RxDC and the CAA data collection implementations but I dream of being as knowledgeable as you. Keep up the great work!
I have a question about Federal HC Benefits. I have BCBS Federal plan and Medicare A (only). Why isn't my premium cheaper since Medicare A picks up the hospital (most expensive) portion of my healthcare coverage and risk? This is always baffling to me. Any ideas?
Hi Diane,
The reason why your premium for your BCBS Federal plan does not get cheaper is because while you are still employed, Medicare will always pay secondary to your BCBS Federal plan. That means that you will always receive the maximum allowable coverage from your BCBS Federal plan before Medicare A kicks in as secondary payer (it does not eliminate any of the risk from the primary plan).
Hopefully, however, you are receiving Medicare Part A for $0 additional premium (If you or your spouse have paid Medicare taxes for 40 or more quarters/10 years, you are eligible for Medicare Part A with a $0 premium). The Part A coverage also can reduce your out-of-pocket costs including, (depending on your specific health plan), deductibles, coinsurance, and charges that exceed your BCBS Federal plan's allowable charges.
Hope that is a helpful response!
Sincerely,
Julie