"That combination elevates the risk of disruptions to care, and unexpected, uncovered costs — two problems that could plague seniors shifted to new managed-care plans," Hyland says. Most states are expected to "passively enroll" beneficiaries into the plans requiring beneficiaries to take the initiative to opt out. "It is too early to know what type of choices those wishing to opt out will have," Hyland notes. "Without a strong notification and education process, many of the affected dual eligibles may not be aware, or understand, that they have new health coverage, " he says. "A new health plan can mean a change of doctor if their former providers don't participate," Hyland explains. .There are two points to remember about the first rule: Medicare has always been barred from negotiating prices directly with drug companies; and other countries regulate their health care spending more heavily, including for prescription drugs. .This week, key legislators revealed that they will not pass a permanent repeal of Medicare's sustainable growth rate (SGR) formula before the March 31st deadline. .Two Provisions That Can Reduce Or Eliminate Social Security Benefits .It remains to be seen whether or not lawmakers in the Senate will reach an agreement before the midnight deadline. If not, the federal government will shut down like it did back in 201While not likely, an extended government shutdown could result in negative impacts for Social Security beneficiaries and doctors who treat Medicare patients. .On its website the BLS explains that it calculates the COLA this way: .TSCL's members and supporters are sending in thousands of petition signatures to fight the cuts that threaten senior benefits. Senior voter outcry, especially in an election year, is a highly effective means to make lawmakers wary of making major changes. .Also putting pressure on the program, TSCL anticipates that more people will file claims for benefits. While employment was at record levels just a few months ago, many older adults postponed filing for benefits to allow their Social Security payouts and retirement accounts to grow. Now, faced with paid sick leave and unemployment benefits ending, older workers are unlikely to be able to afford to wait to file for benefits if they have lost their jobs. In addition, workers lucky enough to have 401(k)s and IRAs have experienced significant losses in the value of those retirement accounts and will be depending on Social Security all the more. Big changes in equity prices reduce the distributions from those accounts. .Resources: The Medicare Rights Center has an online tool called "Medicare Interactive" that can answer more of your questions about prescription drug coverage. Try it at www.MedicareInteractive.org.