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Since 2011, we've helped more than 5 million people understand their Medicare coverage.
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The Medicare Improvements to Patients and Providers Act (MIPPA) is legislation that made significant changes to Medicare, establishing mental health parity in Medicare, changing eligibility and enrollment, in Medicare Savings Programs (MSP), prohibiting certain sales activities by insurers and brokers, and funding Medicare education services.
Congress overrode a presidential veto by voting overwhelmingly for the legislation.
Prior to the law’s implementation, Medicare beneficiaries were required to pay 50 percent of the cost of outpatient mental health treatment, while Medicare Part B covered 80% of other outpatient services. While Medigap plans could cover Part B cost sharing, not everyone is able to afford Medigap. MIPPA aligned Part B’s coinsurance for mental health care with other types of visits starting in 2014, after a phase-in period that began in 2010.
Medicare Advantage plans must provide some level of mental health parity because their benefit packages have to be “actuarially equivalent” to Original Medicare, although these insurers can and often do apply a speciality co-pay to mental health treatment. (Lifetime Part A coverage for inpatient care in a psychiatric hospital is still limited to 190 days, although patients can receive further care in the psychiatric wing of a general hospital.)
The law barred insurers, agents and brokers selling Medicare Advantage and Part D plans from offering gifts or promotional items above a nominal value, and prohibited door-to-door sales and cold calling of potential enrollees. Insurers can no longer offer cash rebates or provide meals during marketing events, and are prohibited from using sales or marketing activities to cross-sell other non-health-related products, such as annuities and life insurance.
MIPPA increased the federal asset limits for MSPs to align them with the federal Extra Help program. The legislation expanded access to MSPs by requiring Social Security, which administers Extra Help, to share information about Extra Help applicants with state Medicaid programs for the purpose of screening and enrolling them into an MSP.
The legislation also provided additional funding to State Health Insurance Assistance Programs (SHIPs) and Area Agencies on Aging for outreach to eligible beneficiaries about their health care benefits.
How and why was Medicare launched? Credit goes to President Harry S Truman and his administration for making the idea of government-led health insurance a reality for older Americans.
How and why was Medicare launched? Credit goes to President Harry S Truman and his administration for making the idea of government-led health insurance a reality for older Americans.
