Effective September 30, 2024, the Centers for Medicare & Medicaid Services (CMS) began covering PrEP as a preventive service under Medicare Part B with no out-of-pocket costs. Preexposure Prophylaxis (PrEP) is highly effective in reducing the risk of getting HIV. Previously, PrEP was only covered under Medicare Part D and included significant out-of-pockets costs. CMS’s […]
This issue brief discusses why becoming a Part A buy-in state is important, how it reduces inequities among the lowest income populations, the advantages to becoming a Part A buy-in state, and a summary of strategies advocates can implement to enact this policy change.
The Low-Income Subsidy, known as LIS or “Extra Help ” is a program administered by the Social Security Administration (SSA) that provides financial assistance with Medicare Part D prescription drug costs including premiums and co-pays. Each year in September, some individuals with the LIS will receive notices from Medicare informing them that their LIS is […]
Starting in April 2023 and continuing through December 2025, older adults who are dually eligible for Medicare and Medicaid will face redeterminations of their Medicaid eligibility, a process that was suspended during the COVID-19 Public Health Emergency (PHE). During this “Medicaid unwinding” period, advocates working with people dually enrolled in Medicare and Medicaid should know […]
We gratefully acknowledge Georgia Burke, formerly Justice in Aging’s Director of Medicare Advocacy, for authoring the first edition of this issue brief in 2019. We would also like to thank Nancy Lorenz of Greater Boston Legal Services and Vicky Pulos of Massachusetts Law Reform Institute for their insight and contributions. Introduction Enrolling in the Medicare […]
In April, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that will affect how dually eligible individuals access Medicare Advantage plans and Medicare benefits. The rule changes: In addition, the rule improves how Special Supplemental Benefits for the Chronically Ill (SSBCI) are administered, limits D-SNP “look-alike plans” that are not subject to […]
As older adults leave incarceration and reenter our communities, they need support to connect them to health care benefits and other essential programs.
