Medicare Update 2005: Part Two

WebMD Live Events Transcript

How well is Medicare working for you? Do you know how to get the most out of your benefits from this program? Medicare & Medicaid Services Administrator Mark B. McClellan, MD, PhD, joined us again on May 3, 2005 to answer your questions about Medicare coverage.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome back to WebMD Live, Dr. McClellan. Thank you for joining us today. What's new at Medicare since you visited us in January?

McCLELLAN:
First, I'd like to thank WebMD for inviting me back. It's a pleasure to join you and everyone who is logged in right now to hear more about the new changes in Medicare and Medicaid and our health care system.

Since January, the Medicare program, which is health insurance for seniors and people with a disability, has taken important new steps to provide up-to-date prevention-oriented coverage. That includes free screening benefits for heart disease, and diabetes, and it also includes new programs to help our beneficiaries with chronic illnesses avoid the complications of their diseases.

We are also getting ready for Medicare's new prescription drug coverage which will be available to all of our beneficiaries to help them with their drug costs starting on Jan. 1, 2006.

We are turning Medicare into a program that's not just there for seniors when they get sick, but is also their partner in helping them stay well.

MODERATOR:
Is there new coverage for ambulatory surgery centers?

McCLELLAN:
There are new services in ambulatory surgery centers that Medicare is now paying for. Some of the important trends in modern medicine are toward less invasive surgical procedures that have easier recoveries; we recently announced new coverage in Medicare for additional procedures that can be done safely and effectively in ambulatory surgery centers.

"Some people think Medicare covers long-term care; it mostly does not. Medicare covers long- term services that people sometimes need after they're in the hospital."

MEMBER QUESTION:
So are you saying that the less invasive procedures, whether we want them or not, will be done or nothing gets done?

McCLELLAN:
Medicare still covers care in hospitals, care from clinicians and care from other health care providers as it has done in the past. What we are trying to do now is make sure that we are also keeping up with modern medical technology. So if your physician and you decide that ambulatory surgery is a better option for you, we want to cover that, too.

MODERATOR:
You also announced more coverage for long-term care hospitals?

McCLELLAN:
We recently increased our payment rate for services for Medicare beneficiaries at long-term care hospitals. These are hospitals that provide high levels of care, like typical hospitals, on a long-term basis for patients with serious chronic illnesses and high medical needs. This is an important element of Medicare's coverage.

Some people think Medicare covers long-term care; it mostly does not. Medicare covers long- term services that people sometimes need after they're in the hospital. For example: After one of our beneficiaries gets a knee replacement they often need rehabilitation services which can be provided at home or in a nursing facility, but that's different than providing chronic long-term care for people who have long-term needs for supportive care. That's the type of care that is often provided in a nursing home or through long-term care services provided in the home. Medicare generally does not cover those services and that's something we want people to know so they can plan for their long-term needs effectively.