HEARING - U.S. Senate Special Committee on Aging

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- Loon exhaustion of all Medicare hospital inpatient coverage, Including the
lifetime reserve days, coverage of 9X of all Medicare Part A eligible ex-
penses for hospitalization for up to an additional 365 days; and
- Coverage of 2C% of the amount of Medicare eligible expenses under Part B,
subject to a maxien calendar year out-ot-pocket deductible of S200 and a
maximum benefit of $5,X0 per calendar year.
Bear in mind that these are purely minimum standards, and that insurance
companies are not precluded tron the inclusion of higher levels of coverage or
additional benefits. In fact, the vast majority of plans exceed these minimum
standards.
SUGGESTIONS FOR ENMANCING THE VALUE
OF MEDICARE AND MEDIGAP BENEFITS TO BENEFICIARIES
If the federal government wants to enhance the value to beneficiaries of
their Medicare benefits as well as their private Medicare supplonent policies,
the Htalth Care Financing Administration could do much more to identify for
Medicare beneficiaries these physicians and other providers who regularly
accept assignment. By helping beneficiaries find Medicare participating
physicians, HCFA could greatly relieve the high insurance costs and
out-of-pocket costs that stem from provider balance billing. HCFA could
publish directories with the names of participating physicians and provide
toll-free hotlines. It could also develop incentives for electronic billing
of physician claims and for streamlining the coordination of billing for
Medicare and Medigap benefits.