With three weeks remaining in Medicare's annual open-enrollment
period, a new study that looks at the research available to compare
traditional Medicare and Medicare Advantage plans finds that
consumers have little good evidence to make informed decisions.
Medicare beneficiaries have until Dec. 7 to change their
insurance plans for the coming calendar year. Among the biggest
decisions for any participant: choosing between traditional
fee-for-service Medicare and Medicare Advantage plans, which are
operated by private companies, including health-maintenance
organizations and preferred-provider organizations. About 30% of
all beneficiaries are now enrolled in the latter.
The growing interest in Medicare Advantage means more consumers
are asking how the care provided to enrollees in the two options
differs. But a study published last week by the Kaiser Family
Foundation, a nonprofit that specializes in health-policy analysis,
finds "substantial limitations" in the available evidence.
"Despite great interest in comparisons between traditional
Medicare and Medicare Advantage," Kaiser states, "studies comparing
overall quality and access to care between Medicare Advantage plans
and traditional Medicare tend to be based on relatively old data,
and a limited set of measures."
In all, Kaiser looked at 45 studies published since 2000 that
examine the Medicare program. Among the findings:
Medicare HMOs tend to do a better job than traditional Medicare
of providing preventive services. But that comparison runs only
through 2009.
Traditional Medicare tends to get better ratings than Medicare
Advantage when beneficiaries are asked about quality of care and
access to care. But one study indicated that the gap could be
narrowing.
Among beneficiaries who are sick, traditional Medicare typically
gets better reviews. But "very few studies," Kaiser notes, include
evidence based on all types of Medicare Advantage plans, including
local and regional PPOs, where enrollment is growing.
Yes, some help is available. Consumers can compare Medicare
Advantage plans and prescription-drug plans (Medicare Part D) on
the Medicare website. The site also has an online version of the
2015 "Medicare & You" handbook, which offers basic guidance
about the differences between traditional Medicare and Medicare
Advantage plans. And Medicare (800-633-4227) can direct you to
counseling centers, where volunteers can discuss enrollment
options.
Glenn Ruffenach, Total Return blog, WSJ.com Jobless Claims Stay
Low
The number of new claims for jobless benefits rose last week,
but extended their sub-300,000 run for the longest stretch since
2000.
Initial claims for unemployment benefits increased by 12,000 to
a seasonally adjusted 290,000 in the week ended Nov. 8, the Labor
Department said. That was above the 281,000 claims forecast by
economists surveyed by The Wall Street Journal and returned them to
their highest level since late September.
Still, claims have been under 300,000 for nine consecutive
weeks. Employers added 214,000 jobs to payrolls in October, the
Labor Department's jobs report showed last week, putting the
economy on pace to post the best yearly gain in employment since
1999.
The steady job growth has pushed the nation's unemployment rate
down to 5.8%, closer to a level many economists consider
healthy.
But a large share of the new jobs are in low-paying professions
or in part-time positions. That has been one factor constraining
incomes and restraining consumer spending. As a result, the economy
grew 2.3% during the 12 months ending in September, roughly
matching the modest gains of the prior three years.
Jonathan House, The Wall Street Journal
Should You Pay For Premium Plastic?
Banks are pitching credit cards with annual fees more
aggressively this year. Before you sign up, consider whether it
makes sense to pay up to $500 a year for the perks that come with
premium plastic.
The stiff price tags on high-end cards might be worth it if you
are a frequent traveler or spend significant sums on dining or
entertainment. High-fee cards typically come with spending-based
rewards such as help securing tickets to popular concerts and
sporting events.
But cardholders should be sure that they won't ramp up their
purchases just to justify paying the annual fee--particularly if
spending more would increase the odds that they wouldn't pay the
credit-card bill in full each month.
Besides, cardholders can sometimes earn as many rewards points
with a free card as with a fee-based card from the same issuer,
though they generally won't enjoy access to the same range of
services.
Most credit cards that give cardholders rewards charge no annual
fee, but about 20% do, according to CardHub.com, a credit-card
comparison site. The average fee is $84.18.
AnnaMaria Andriotis, The Wall Street Journal Gun Trusts Smooth
Firearms Transfer
Estate planning can get complicated when it involves
transferring a collection of art, cars or other such possessions.
It gets trickier still for guns.
Whether it is grandpa's Browning rifle from World War II, an
antique pistol from the Revolutionary War passed down through
generations, or a collection of hunting guns, firearms present some
unique legal challenges.
Some lawyers and advisers say these often can be solved through
the use of a so-called gun trust. Typically set up as a revocable
living trust, a gun trust is crafted specifically to hold firearms,
with the gun owner generally acting as trustee.
They are most commonly used to hold certain federally restricted
items, such as silencers, because they can help cut down on
paperwork needed to possess, transfer and own such possessions. But
estate planners say they're increasingly being used to create a
road map for families left to handle a deceased loved-one's
collection.
For one thing, many executors or trustees might not be familiar
with state and federal laws for firearms, as well as safety,
storage, or the best way to liquidate a collection.
By setting up a specific gun trust, a successor trustee that is
well-versed in firearms and the laws affecting them can be named to
handle the transfer of the collection.
Anna Prior, The Wall Street Journal