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Do Seniors Have Too Many Medicare Plans To Choose From?

By Phil Galewitz

May 14th, 2014, 5:00 AM

Most seniors face a dizzying array of options each year when it comes time to choose a Medicare health or prescription drug plan. Beneficiaries can select from an average of 18 health plans and 31 prescription drug plans. In South Florida, they have 88 plan choices altogether.

While choice may sound like a good thing, many seniors say they find it difficult to compare plans. As  a result, they often stick with the same plan even if it is not best suited to them, according to a new report from the Kaiser Family Foundation based on conversations with beneficiaries in Memphis, Tennessee; Tampa, Florida; Baltimore; and Seattle. (Kaiser Health News is an editorially independent program of the foundation.)

Many seniors said they did not want to switch plans because the process was so frustrating, the report said. That can cost them money because companies change prices and benefits almost every year.

At a briefing on the report Tuesday, Barry Schwartz, a psychology professor at Swarthmore College and author of the book, “Paradox of Choice,” explained that older people tend to make choices that are “good enough,” while younger people often search for the “perfect” choice.

But Judith Stein, executive director of the Center for Medicare Advocacy, a consumer advocacy group, said that Medicare beneficiaries sometimes find that a health plan that is “good enough” when they are healthy does not meet their needs when they are sick. That’s because a plan may not include coverage for the hospital or doctor they want, or may charge too much for the drug their doctor recommends.

Even with so many choices, most seniors flock to a small number of plans, said Joshua Raskin, senior analyst for investment firm Barclays Capital. He said plans with the most market share, including those run by insurer giants, Humana and UnitedHealthcare, have grown the fastest in recent years.

To give seniors tools to help them choose the best plans, the federal government several years ago began rating them based on factors such as access to doctors and customer service. But seniors seem to pay little attention. In recent years, the best-rated health plans, those with five stars, have increased enrollment at the slowest pace, compared to 8 percent in the market overall, Raskin said.

He said the fastest growing plans are those with three stars — which have seen 12 percent enrollment growth,

He said the fastest-growing plans have been those with just three stars – many of which have seen 12 percent enrollment growth. He added that price,  particularly monthly premiums, often drive seniors’ choices.

But one reason why seniors have not flocked to the best-rated plans may be because there are so few of them. For 2014, the Centers for Medicare and Medicaid Services awarded five-star ratings to 14 health plans and 5 prescription drug plans.

About 75 percent of Medicare’s 54 million beneficiaries are enrolled in a private health or drug plan. The rest get traditional Medicare.

Raskin said because health insurers know seniors are most likely to pick plans based on price, they are hesitant to charge a monthly premium if they have not had one, or to implement a major rate hike.

This entry was posted on Wednesday, May 14th, 2014 at 5:00 am.

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Kaiser Health News Answers Questions About Medicare Debate in the Presidential Election

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FAQ: Decoding The $716 Billion In Medicare Reductions

Topics: Medicare, Politics

By Mary Agnes Carey

KHN Staff Writer

Aug 17, 2012


The structure and financing of Medicare, the federal health insurance program that serves seniors and the disabled, has become a defining issue in the presidential and congressional campaigns since GOP presidential candidate Mitt Romney picked as his running mate Rep. Paul Ryan. KHN’s Mary Agnes Carey answers some frequently asked questions about the numbers and policy surrounding the Medicare debate.

Q:  Romney and other Republicans over the past two years have criticized President Barack Obama and Democrats for cutting $500 billion from the Medicare program over the next decade as part of the 2010 health care law.  In the past couple of weeks, the number that Romney is using has grown to $716 billion? Which is right?

A: They both are.  The $500 billion figure comes from a March 2010 analysis that estimated the 2010 federal health law’s effects on Medicare spending and was put together by the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT). It covered the budget years 2010-2019.

As part of their efforts to repeal the law, congressional Republicans in July asked the two agencies to estimate the impact of a repeal on Medicare.

That July analysis, which covered the years 2013-2022, determined that the health law is expected to reduce Medicare spending by $716 billion.  It is higher than the previous figure because it covers a later time frame that includes greater Medicare spending reductions.

Q. Is the federal government cutting its spending on Medicare?

A. No. Medicare spending will increase each year but at a slower rate. For example, before the health law was passed, Medicare was expected to grow by 6.8 percent a year for 2010 through 2019.  With the health law, that yearly growth rate is projected to be 5.6 percent during that same time frame, according to an analysis from the Kaiser Family Foundation. (KHN is an editorially independent program of the Foundation).

Q: Where might Medicare spending be reduced?

A: The July report from CBO and JCT — in explaining where some of the biggest reductions would occur –found that hospital reimbursements would be reduced by $260 billion from 2013-2022, while federal payments to Medicare Advantage, the private insurance plans in Medicare, would be cut by approximately $156 billion.  Other Medicare spending reductions include $39 billion less for skilled nursing services; $66 billion less for home health and $17 billion less for hospice. The law does not make any cuts to the amount of benefits beneficiaries receive and adds some new benefits, including closing the “doughnut hole” gap in Medicare prescription drug coverage, and new preventive services, such as an annual wellness visit with a physician.

Medicare’s trustees say the law prolongs the solvency of the Medicare trust fund. In addition, supporters say that hospitals and other health care providers would be able to bear reduced payments because the cuts would be offset somewhat by increased revenues from millions of new customers who would gain health insurance through the law. They also argue that the Medicare Advantage plans were being overpaid since the cost per beneficiary was higher than what beneficiaries of traditional Medicare cost the government. But critics and some independent analysts have questioned whether cutting payments to these providers will result in a loss of quality or push some providers to refuse to participate in Medicare.

“The question is whether reductions in payments to health care providers will impair either access to health care services or the quality of those services,” a recent Brookings Institution analysis said.

Q: Rep. Paul Ryan, R-Wis., has a Medicare overhaul plan that includes the Medicare spending reductions, right?

A: Yes, Ryan’s plan would keep the Democrat’s Medicare spending changes, but he says he would use the money to make sure  Medicare remained solvent, rather than directing it toward other areas, including funding the health law’s exchanges or its expansion of Medicaid, the federal-state program for the poor. Democrats say Ryan would use the Medicare savings to fund other areas of this budget plan, including tax cuts for wealthy Americans and increases in military spending.

In a recent blog post in National Review Online, James Capretta, a fellow at the Ethics and Public Policy Center, a conservative think tank, said it was an “oversimplification” to say that Ryan was keeping the Obama Medicare cuts.  “Ryan’s budget allows the substitution of sensible ways of saving money in Medicare for the arbitrary and harmful cuts contained in Obamacare,” he writes.

Ryan’s plan also calls for an overhaul of the program, offering beneficiaries a set amount of money that they would use toward buying a private plan or traditional Medicare. Democrats have argued that such a fundamental change could undermine the traditional Medicare program, because private plans might tailor their coverage to attract healthier beneficiaries, leaving sicker beneficiaries in traditional Medicare. Critics of Ryan’s plan also predict it will force seniors to eventually pay more for their health care because the federal payments will be capped at the rate of gross domestic product plus half a percentage point, an amount that may not keep up with the increase in medical costs. Under Ryan’s plan, insurers would have to provide benefits that are at least equal the value of those offered in traditional Medicare.

Q: Would Romney’s Medicare plan keep the cuts in place as well?

A: That’s unclear. While Romney has said his Medicare proposal is very similar to Ryan’s, he has also asserted that he would rescind the Medicare funding reductions in the health law. However he has not said what steps he would take to extend the financial solvency of the program. In a Facebook posting on Thursday, Romney said he and Ryan “are talking about what adjustments we should make to Medicare for young people so that when they come along and become seniors, that they have a program that’s solvent.”

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GPS Shoes for Wanderers

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The term “track,” as it pertains to shoes, is no longer only associated with a “track and field” competition. The new trend in the shoe market is shoes that use a global positioning system (GPS) located in the heel of the shoe to actually track the location of a person. Originally developed for serious runners and misplaced children, these GPS shoes have found a promising market with seniors who have Alzheimer’s disease and other forms of dementia.

Of the 5.3 million Americans who endure Alzheimer’s, about 60 percent of seniors with Alzheimer’s will wander off at some point during their illness and 70 percent will wander more than one time. This behavior puts the senior’s safety and health at risk and gives families reason for concern. The senior may become dehydrated, could fall or may become seriously injured. Families and caregivers are in a challenging position when their senior loved one is a wanderer. A tool such as the GPS shoes can make caring for that loved one more manageable.

Seniors who wear the GPS-enhanced shoe can continue with their normal activities. While most GPS shoes resemble sneaker-style footwear for comfort and exercise, shoemakers are introducing new styles all the time. For instance, California based GTX Groupis now making loafers and sandals to accommodate all walks of life.


GPS Shoe


The GPS technology is so small that it unnoticeably fits into the heel of the shoe. To work, the shoe’s GPS technology couples with a downloadable app for a computer and/or smart phone, or the device connects with a tracking service for a monthly fee.


Families of people with Alzheimer’s can easily track where their loved one is at at any given moment. A pre-set “safe zone” or “geo-fence” can be set on the app or with the tracking service. If the person wearing the GPS shoes meanders out of that area, the app sounds an alert or the tracking service sends a text message. Families or caregivers can locate the senior immediately and bring them back to a safe setting.

The GTX GPS Smart Shoe retails for more than $300 retail, and this high-tech footwear is available for purchase through Aetrex Worldwide, a company that specializes in pedorthic footwear, designed for optimal comfort.

“The GPS Shoe has the potential to be life-saving as well as life-changing technology for those afflicted and their caregivers,” said Andrew Carle, director of George Mason University’s Program in Senior Housing Administration and advisor to GTX Group. “The shoes also hold the potential to save governments hundreds of millions of dollars in search and rescue operations, as well as in health care costs for those otherwise injured.”

After Bill Johnston, an 83-year-old Alzheimer’s patient, had a wandering indicent, his family knew they needed to do something different before Bill was hurt.

“I had been leaving him at a McDonald’s and going to the grocery store nearby. I would say to him, ‘Ok, go in, drink your tea and wait for me, and I will come back.’ And he would do that,” Joan, Bill’s wife, explained. “But one time I spent a little longer in the grocery store and got back maybe 45 minutes later and I looked in McDonald’s and he wasn’t there. I opened the bathroom door and hollered ‘Bill,’ and no answer.”

Joan recalled, “I was looking all around the parking lots and the shopping center, across the street from McDonald’s I saw him. He was headed toward a major highway. He couldn’t remember when I would be back. When I wasn’t there, he said to himself, ‘Well where is she? I’ll just walk home.”

Seeking ways to control Bill’s wandering, Joan and her son, Alan, were led to George Mason University and Andrew Carle. Carle offered the Johnston’s a pair of GPS shoes to test.

Joan said the shoes gave her peace of mind. “When I lost him, you, you kind of panic.” she said.

“We discussed it, and we decided to try these shoes out on him.” said Alan, who takes care of the technological side of the GPS for his parents. “And we thought this would be a good match and kind of went from there.” “The shoes give you more control,” Alan Johnston said. “My mom can call me anytime, and I can give her immediate feedback on his location.”

Joan and Alan hope the GPS shoes will make life easier for them and safer for Bill.

About the development of the shoe, Carle said, “We’re trying to maximize the odds that wanderers are going to have this technology on them, and the best location is to put it in shoes.”

Other tracking devices include watches or bracelets with a GPS inside. However, it is easier for a person to forget to put those devices on before leaving the house. Shoes are more of a necessity, and most people don’t forget to slide their shoes on before going somewhere. This increases the chances that a person who wanders would be wearing the GPS device and therefore would be locatable.

The GPS technology in a pair of shoes can help bring peace of mind to families and caregivers while assuring a safer environment for seniors suffering from wandering behaviors.


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Welcome to Age With Grace

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Welcome to our new website!

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