Author: CNBC News

If you’re signing up for Medicare, you’ve likely discovered that there are a lot of out-of-pocket costs that come with your coverage.

For about 23% of Medicare’s 65.1 million beneficiaries, the solution for covering those outlays is a so-called Medigap plan.

These policies, sold by private insurance companies, generally pick up part or most of the cost-sharing — i.e., deductibles, copays and coinsurance — that comes with basic Medicare (Part A hospital coverage and Part B outpatient care).

However, they do have limitations, and monthly premiums can be pricey.

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Nevertheless, some beneficiaries determine that pairing basic Medicare with a Medigap policy is a better fit than choosing to get their Parts A and B benefits delivered through an Advantage Plan (or having no supplemental insurance at all). Those plans, which can restrict coverage to in-network providers, also usually include Part D prescription drug coverage, often come with no premium and may offer extras such as dental and vision. 

The reasons that some beneficiaries instead choose Medigap alongside basic Medicare vary from person to person, according to Elizabeth Gavino, founder of Lewin & Gavino and an independent broker and general agent for Medicare plans.

For example, she said, they may want more freedom in choosing doctors and other providers or need coverage while away from home  — i.e., they travel a lot, sometimes for extended stays. (Advantage Plans may disenroll you if you remain outside their service area for a certain time — typically six months.)

Here’s what to know about Medigap policies if you’re considering purchasing one.

For instance, some may pay the full Part A deductible ($1,600 per benefit period in 2023), while others don’t. The Centers for Medicare & Medicaid Services has a chart on its website that shows the differences. You also can use the agency’s search tool to find available plans in your ZIP code.

When you first enroll in Part B, you generally get six months to purchase a Medigap policy without an insurance company checking on your health history and deciding whether to insure you.

After that, depending on the specifics of your situation and the state you live in, you may have to go through medical underwriting.

Another difference in Medigap premiums can come from how the plans are “rated.” If you know this, it may help you anticipate what may or may not happen to your premium down the road.

Some plans are “community-rated,” which means everyone who buys a particular one pays the same rate regardless of their age. 

Others are based on “attained age,” which means the rate you get at purchase is based on your age and will increase as you get older. Still others use “issue age”: The rate won’t change as you age, but it’s based on your age at the time you purchase the policy (so younger people may pay less).

Markets closed out the first week of 2023 on a high note, with the S&P 500 closing up more than 2%, as stocks rallied on fresh signs inflation may be easing.

The Food and Drug Administration on Friday granted accelerated approval for the Alzheimer’s drug lecanemab, the second treatment from Biogen and its Japanese partner Eisai to receive an early green light in less than two years.

The FDA’s approval comes after clinical trial results published in November indicated that lecanemab slows cognitive decline somewhat in people with mild impairment due to Alzheimer’s disease, but the treatment also carries risks of brain swelling and bleeding.

Eisai, which led the development of lecanemab, is pricing the treatment at $26,500 per year in the U.S. It will be sold under the name Leqembi.

The FDA can accelerate approval of a drug to quickly bring it to market if it’s expected to help patients suffering from serious conditions more than what is currently available. Biogen and Eisai applied for accelerated approval in July.

“Alzheimer’s disease immeasurably incapacitates the lives of those who suffer from it and has devastating effects on their loved ones,” said Dr. Billy Dunn, director of the FDA’s neuroscience division, in a statement. “This treatment option is the latest therapy to target and affect the underlying disease process of Alzheimer’s, instead of only treating the symptoms of the disease.”

More than 6.5 million people in the U.S. suffer from Alzheimer’s. The irreversible disease destroys memory, thinking skills, and eventually the ability to carry out simple tasks.

The decision on lecanameb comes after Congress issued a scathing report last week about how the FDA handled the controversial approval of another Alzheimer’s drug developed by Biogen and Eisai, called Aduhelm. The 2021 approval of that treatment, which experts said did not show a clear clinical benefit, was “rife with irregularities,” according to the report.

The congressional report said the “FDA must take swift action to ensure that its processes for reviewing future Alzheimer’s disease treatments do not lead to the same doubts about the integrity of FDA’s review.”

The clinical trial results, published in the New England Journal of Medicine, found that cognitive decline was 27% slower over 18 months in people who received lecanemab compared with those who did not receive the treatment. The study was funded by Biogen and Eisai.

Cognitive decline was measured using a system called the clinical dementia rating, which is an 18-point scale with a higher score indicating a greater level of impairment. It measures cognitive functions such as memory, judgement and problem solving.

Alzheimer’s disease progressed 1.21 points on average in the group that received lecanemab compared with 1.66 points in the group that did not receive the treatment, a modest difference of 0.45 points.

Nearly 1,800 people ages 50 to 90 years old with early Alzheimer’s participated in the trial, about half of whom received lecanemab and half of whom did not.

The death of a clinical trial participant in the Chicago area could also possibly be linked to lecanemab, according to a research letter published in the New England Journal of Medicine this week.

The 65-year-old suffered a stroke and was hospitalized four days after their third lecanemab infusion. A CT scan performed after the patient’s stroke found extensive bleeding in the brain. An MRI performed 81 days before the stroke had not found any bleeding.

The patient had also received a medication, called t-PA, used to break apart blood clots that cause strokes. But extensive brain bleeding would be an unusual complication of this medication alone, according to the physicians who penned the research letter.

Researchers involved in the lecanemab clinical trial, in a response letter, argued that the blood clot medication appeared to be the immediate cause of the patient’s death, with the first symptoms occurring 8 minutes after they received an infusion of the blood-clot buster.

WASHINGTON — The U.S. House adjourned for a third night without a speaker — the longest the chamber has gone leaderless in generations — after GOP leader Kevin McCarthy lost an 11th vote for the gavel and scrambled to work out a deal with far-right Republicans to back his bid.

The House plans to reconvene at noon ET on Friday, as McCarthy and his allies try to iron out a rough offer that would give hardline conservatives more power in the new GOP majority.

Ahead of Thursday’s final speaker vote, two members of the bloc of 20 Republican holdouts opposing McCarthy’s speakership nominated alternative candidates to McCarthy: The first pick was GOP Rep. Kevin Hern of Oklahoma, who leads the influential Republican Study Committee. The second nominee was former President Donald Trump, who was put forward by his longtime ally, Florida GOP Rep. Matt Gaetz.

Hern has consistently voted for McCarthy for speaker, but he has not said outright that he would reject the job if McCarthy withdraws his name.

The emergence of another potential alternative to McCarthy was the latest setback in a frustrating day for the longtime GOP leader. Meanwhile, Democrats appeared to revel in the repeated GOP failures, enthusiastically shouting down a proposed voice vote to adjourn just before 8 p.m. ET on Thursday. Republicans then voted to end proceedings for the night in a recorded vote.

“We should stay here all night … all weekend until we get a speaker,” Rep. Ro Khanna, D-Calif., told CNN.

McCarthy lost 20 Republicans on the 11th vote, with one GOP member-elect voting “present.” With 222 Republicans in the newly elected House, he could afford to lose only four of them to reach the 218 needed to win the speakership.

The speaker election is now guaranteed to go at least 12 votes. It has gone longer than a dozen ballots only four times in U.S. history.

Earlier in the day, McCarthy sounded optimistic about talks between his top lieutenants and a group of holdouts.

“I think everyone in the conversation wants to find a solution,” McCarthy said on his way into the House chamber for the day’s first vote.

But less than two hours after votes began, another influential McCarthy holdout, Rep. Scott Perry, Pa., posted an angry tweet accusing McCarthy of leaking details of internal negotiations.

The continued absence of a speaker has left the House in disarray, largely due to the fact that rank-and-file members can’t be sworn into office until a speaker is elected and cannot set up their local or Washington offices. This leaves all 434 members of the House technically still members-elect, not official voting representatives. 

Ahead of Thursday’s votes, Democratic Party leaders berated Republicans for the party’s dysfunction, and emphasized the harm that going days without a House speaker was inflicting on the legislative branch and the nation.

“We cannot organize our district offices, get our new members doing that political work of our constituent services, helping serve the people who sent us here on their behalf,” incoming Democratic Whip Katherine Clark, D-Mass., told reporters in the Capitol Thursday morning. “Kevin McCarthy’s ego in his pursuit of the speakership at all costs is drowning out the voices and the needs of the American people.”

Democrats also emphasized that the absence of a speaker was threatening U.S. national security by keeping members of Congress from accessing classified intelligence that is available to lawmakers only after they have taken the oath of office, which none of them can take without a speaker.

“At the end of the day, all we are asking Republicans to do is to figure out a way for themselves to organize so the Congress can get together and do the business of the American people,” Democratic Minority Leader Hakeem Jeffries said at a news conference with Clark.

Clark accused McCarthy of being “held hostage to his own ambitions.”

“This is about your responsibility to organize government. It is fundamental to who we are as members of Congress,” she said.

Democrats, meanwhile, have remained in lockstep throughout all the votes, casting their 212 ballots for Jeffries.

Navigating the health insurance system is often difficult and overwhelming, even in the best of times. For patients with long Covid, a relatively new condition that frequently leaves patients with a lengthy and unpredictable list of debilitating symptoms, it can be especially nightmarish.

“Even if you remain on the same [health insurance] plan you had before Covid, you will probably utilize the health-care system more, whether it be more office visits, more prescription medications or even more medical devices,” said Caitlin Donovan, a spokesperson for the National Patient Advocate Foundation.

Indeed, nearly half of people with long Covid reported increased medical expenses, according to a recent survey conducted by the Patient Advocate Foundation. The nonprofit, NPAF’s sister organization, polled 64 people with the condition between 2020 and 2022. Meanwhile, 13% of respondents in the PAF survey said they’d experienced changes to their health-care coverage as a result of long Covid.

In all, one Harvard University researcher estimated that long Covid could leave patients with an extra $9,000 a year in medical expenses.

Here’s what you need to know about navigating health insurance with the condition.

Between 2 million and 4 million full-time workers are out of the labor force due to long Covid, according to recent research from the Brookings Institution.

If long Covid causes you to lose or leave your job and, therefore, your employer-sponsored health insurance, don’t panic. You may have several options for getting new coverage, said Karen Pollitz, a senior fellow at the Kaiser Family Foundation.

There are resources you can turn to for help deciding the best route to getting reinsured. If you have a diagnosed condition, including long Covid, you may be able to get support deciding on and enrolling in a plan with the Patient Advocate Foundation.

At no charge, you can also consult with a local health-care “navigator,” an expert who can help you search insurance plans and enroll in one on the Affordable Care Act’s marketplace.

1. Join a family member’s plan

Losing your job-based coverage triggers a 30-day special enrollment opportunity to join a family member’s plan, Pollitz said. You might consider getting covered through your spouse’s employer or a parent’s, if you’re under 26.

2. Extend workplace coverage

If your former company had at least 20 employees, you might also have the option to get insured through the Consolidated Omnibus Budget Reconciliation Act, or COBRA, Pollitz said.

COBRA typically allows people who leave a company to remain on their workplace insurance plan for up to 18 months — although it’s not cheap. (It tends to be pricey because you pick up the part of the health insurance tab your former company was covering.)

There are exceptions that can stretch coverage. If the Social Security Administration considers you disabled (long Covid can qualify as a disability), you may be able to stay on COBRA for an additional 11 months. Those who qualify for Medicare around the time they part with a company may also qualify for an extension beyond the typical 18 months.

3. See if you qualify for Medicaid

If your job loss has left your household with a substantially lower income, you may be able to enroll in Medicaid, Pollitz said. “This is comprehensive public coverage with no monthly premium,” she said. Eligibility is based on your current income, Pollitz added, and you can sign up year-round.

If you’re receiving disability benefits from a private insurer and/or through your employer, that income won’t necessarily disqualify you for Medicaid; you’ll want to check whether or not the payments are subject to taxes.

“If the benefits are taxable as income, then they would count toward Medicaid eligibility,” Pollitz said.

4. Sign up for a plan on the public exchange

Long Covid patients who have recently become unemployed may also be able to get health insurance on the Affordable Care Act’s marketplace. Losing your job triggers a 60-day enrollment period on the marketplace, where many of the plans are subsidized.

“Fortunately, ACA insurers are not allowed to discriminate based on health,” said Jonathan Gruber, a professor at the Massachusetts Institute of Technology and a former director of the health-care program at the National Bureau of Economic Research. “So having long Covid will not raise costs.”

5. Explore Medicare eligibility

Lastly, if you end up qualifying for Social Security Disability Insurance because of your long Covid, you may become eligible for Medicare, even if you’re younger than 65, after a two-year waiting period.

If you’re already 65 or older when you lose your job, Medicare may be your best option for coverage, Donovan said.

“Medicare comes with the benefit of an almost universal network, in contrast to marketplace plans,” Donovan said, adding that delaying enrollment once you’re eligible can also subject you to financial penalties.

If your case of long Covid hasn’t disrupted your employment and you remain insured at work, you’ll want to make sure you’re signed up in a robust plan, Donovan said.

A more comprehensive workplace plan typically comes with a higher monthly premium but lower out-of-pocket expenses and more options, Donovan said. It’s especially important, she added, that you get the most generous prescription drug plan, if your company offers a variety of them.

Educate yourself as much as you can about your coverage, Donovan said, including information on providers and treatments that you might formerly not have considered.

Long Covid patients, for example, often seek physical therapy and mental health services, she said.

You’ll also want to make sure you’re up to date on your employer’s paid time off and sick days policy.

Trials take place all over the country, and some are even virtual, Donovan said. People can find out more at clinicaltrials.gov and by talking to their doctor.

Keep in mind, Donovan said, that your health insurance plan may require any trials be in-network and it may only cover certain costs of the experience.

Still, Donovan said, “it’s worth investigating.”

Meanwhile, those looking to save money on prescription costs should ask about generic options, which tend to be cheaper than the brand-name medicines.

In addition, Donovan said, programs like GoodRx may help you cut costs on certain drugs. And the Patient Advocate Foundation has a charitable copay program to which those struggling financially can apply.

Finally, Donovan said, with so much still unknown about long Covid, insurers may be more likely to reject coverage for a particular treatment or service. Patients should fight back, she said.

“Don’t lose hope,” Donovan said. “Go through the appeal process: Over 40% of denials are overturned in the patient’s favor.”

BEIJING — China will likely be able to live with Covid-19 by the end of March, based on how quickly people have returned to the streets, said Larry Hu, chief China economist at Macquarie.

Subway and road data show traffic in major cities is rebounding, he pointed out, indicating the worst of the latest Covid wave has passed.

“The dramatic U-turn in China’s Covid policy since mid-Nov implies deeper short-term economic contraction but faster reopening and recovery,” Hu said in a report Wednesday. “The economy could see a strong recovery in Spring.”

In the last several days, the southern city of Guangzhou and the tourist destination of Sanya said they’d passed the peak of the Covid wave.

Chongqing municipal health authorities said Tuesday that daily visitors to major fever clinics was just over 3,000 — down sharply from Dec. 16 when the number of patients received topped 30,000. The province-level region has a population of about 32 million.

Chongqing was the most congested city in mainland China during Thursday morning’s rush hour, according to Baidu traffic data. The figures showed increased traffic from a week ago across Beijing, Shanghai, Guangzhou and other major cities.

As of Wednesday, subway ridership in Beijing, Shanghai and Guangzhou had climbed significantly from the lows of the last few weeks — but had only recovered to about two-thirds of last year’s levels, according to Wind Information.

Caixin’s monthly survey of services businesses in December found they were the most optimistic they’d been in about a year-and-a-half, according to a release Thursday. The seasonally adjusted business activity index rose to 48 in December, up from a six-month low of 46.7 in November.

That below-50 reading still indicates a contraction in business activity. The index for a separate Caixin survey of manufacturers edged down to 49 in December, from 49.4 in November. Their optimism was the highest in ten months.

However, amid a lack of timely information, the World Health Organization said Wednesday it was asking China for “more rapid, regular, reliable data on hospitalizations and deaths, as well as more comprehensive, real-time viral sequencing.”

China in early December abruptly ended many of its stringent Covid controls that had restricted business and social activity. On Sunday, the country is set to formally end a quarantine requirement for inbound travelers, while restoring the ability of Chinese citizens to travel abroad for leisure. The country imposed strict border controls beginning in March 2020 in an attempt to contain Covid domestically.

Tesla’s Chinese suppliers jumped after the electric automaker slashed prices for some models in China.

In a Weibo post, the company said its Model 3 and Model Y vehicles in China would now be priced at 229,900 yuan (about $33,374) and 259,900 yuan, respectively.

The latest prices represent a drop of 13% to 24% from four months ago, according to Reuters calculations.

Shenzhen-listed shares of Tesla’s Chinese suppliers rallied on optimism the price cut could boost demand.

Shares of Anhui Shiny Electronic Technology closed 8.8% higher and Hengdian Group DMEGC Magnetics gained nearly 9%. Zhejiang Chint Electrics closed 7.92% higher and Shandong Jinjing Science & Tech rose more than 6%.

Tesla previously cut prices in China in late October in a bid to prop up sales and its competitive edge against rivals including BYD, which recently unveiled new luxury models.

Grace Tao, a Tesla vice president of external affairs in China, said in a Weibo post that the latest price adjustments were meant to boost demand.

The moves “respond to the government’s call with practical actions to promote economic development and encourage consumption,” Tao wrote.

Separately, the China Passenger Car Association reported on Thursday that Tesla’s December sales of China-made cars fell to 55,796, the lowest in five months.

— CNBC’s Evelyn Cheng contributed to this report.

The postponed Buffalo Bills-Cincinnati Bengals game will not be made up following the terrifying collapse of safety Damar Hamlin, the league said Thursday.

With one game left in the regular season, the NFL is still working out the details of how the now-canceled game will affect seeding for the playoffs, which begin Jan. 14-15.

The NFL acknowledged that canceling the game “creates potential competitive inequities in certain playoff scenarios,” and said NFL clubs will consider a resolution at a special league meeting Friday.

Part of it could involve the Jan. 29 AFC Championship Game being played at a neutral site.

NFL Commissioner Roger Goodell said in Thursday’s statement that “This has been a very difficult week,” and the league is focused on Hamlin’s recovery.

Because of the one canceled game, the Bills and Bengals will have played 16 games, while all other NFL teams will have played 17.

The Bills had long ago clinched the AFC East and were in the driver’s seat for the No. 1 seed in the conference. Now at 12-3, Buffalo trails 13-3 Kansas City for the AFC’s top spot, which carries a first-round playoff bye.

Had the Bills won Monday night, they would have had as many wins as the Chiefs while holding a tiebreaker over Kansas City.

This weekend, Buffalo plays New England; Cincinnati plays Baltimore; and Kansas City plays Las Vegas.

In the resolution to be considered by NFL teams Friday, the AFC Championship Game would be played at a neutral site under three scenarios, according to the NFL:

• If Buffalo and Kansas City both win or both tie, Buffalo vs. Kansas City would be at a neutral site for the championship.
• If Buffalo and Kansas City both lose and Baltimore wins or ties, Buffalo vs. Kansas City would be at a neutral site.
• And if Buffalo and Kansas City both lose and Cincinnati wins, a Buffalo or Cincinnati vs. Kansas City championship game would be at a neutral site.

Another component is if Baltimore beats Cincinnati, the NFL said. In that case, Baltimore would not host a playoff game because Cincinnati will have a higher winning percentage based on the games each played.

If Baltimore beats Cincinnati and both teams end up facing each other in the Wild Card, a coin toss will determine who hosts.

Monday’s key contest between first-place Bills and Bengals was called off shortly after 10 p.m. ET that night, with the NFL saying the game had been “postponed” — leaving the door slightly ajar for Buffalo and Cincinnati to restart play at another time.

When Hamlin went down, the Bengals were leading, 7-3, in the first quarter.

Hamlin collapsed moments after tackling Bengals receiver Tee Higgins. The play appeared to be routine as Hamlin quickly got up and briefly grabbed or adjusted his own face mask before falling backward.

Hamlin suffered cardiac arrest, but his brain function appeared to be in good condition, the Buffalo Bills said Thursday, following days of uncertainty and worry.

“Damar has shown remarkable improvement over the past 24 hours,” the team tweeted. “While still critically ill, he has demonstrated that he appears to be neurologically intact.”

In their final regular season games, the Bills will host the New England Patriots and the Bengals are home to the Baltimore Ravens. Both games are at 1 p.m. ET on Sunday.

The now-canceled game wouldn’t have mattered as far as any other team making or not making the playoffs, which the NFL said was a factor in the decision.

In Thursday’s statement about the canceled game and postseason, Goodell said the league strove to minimize disruptions and inequalities.

“I recognize that there is no perfect solution,” Goodell said. “The proposal we are asking the ownership to consider, however, addresses the most significant potential equitable issues created by the difficult, but necessary, decision not to play the game under these extraordinary circumstances.”