ReversePhoneDirectory.com Warns of Peak Time for Medicare Fraud During Open Enrollment

Posted by:  :  Category: Medicare

"Citizenship is a tough occupation which obliges the citizen to make his own informed opinion and stand by it." ~ Martha Gellhorn  by eyewashReversePhoneDirectory.com is a leading provider of reverse phone lookup services that enable consumers to simply search a number, including cell numbers (where available), landline numbers and VoIP to accurately find the owner of that number. In addition to phone number information, ReversePhoneDirectory.com has search portals for public records services and provides access to the most current information. ReversePhoneDirectory.com is committed to helping people live better during technologically advanced times, believing that information is a powerful currency and people across the country should have easy access to information about everything and everyone they come in contact with.
Source: prbusinessnews.com

Video: Scott Brown on Ending Medicare: Thank God!

Medicare Prescription Drug Protection Is Here!

By: Medicare prescription drug coverage is now available to all people with Medicare. Everybody with Medicare can sign up for a Medicare drug plan to get this coverage, regardless of your source of revenue or what drugs you take. You owe it to yourself to appear into it, although you may have protection now. Medicare is right here to assist In view that Medicare prescription drug coverage is modern, it’s natural to have questions like: The place can I am getting help opting for a plan? And, the place can I am getting help becoming a member of a plan? You’ll be able to get answers from Medicare in a few ways. The place can I get help choosing a plan? . Search for enrollment occasions within the area. Over the next few months, you’ll be able to get help together with your drug plan choices at dozens of places right through your group, like colleges, senior facilities, clubs, religion-based totally companies, and your pharmacy. Or you can talk with family and friends or name your native workplace on ageing for help. The Eldercare Locator will let you find places to visit get personalised assistance. . Use the Medicare Prescription Drug Plan Finder. Consult with the internet to get a personalised side-by means of-facet comparability of as much as three plans at a time in keeping with price, coverage and convenience. If you don’t use the Internet, call 1-800-MEDICARE (800-633-4227) to get the similar information. TTY users must name 1-877-486-2048. Where can I am getting help becoming a member of a plan? . Seek advice from Medicare’s Internet site. You’ll be able to join a drug plan online at the Web using Medicare’s on-line enrollment center. . Name the plan. You can join over the phone by means of calling the plan’s toll-unfastened number. . Visit the plan’s Internet site. Visit the drug plan company’s Web site. You might be able to join on-line (now not all plans offer this feature). You owe it to yourself to seem into it, even supposing you’ve coverage now. If you want other knowledge in regard to medicare part d, stop by Julissa Q Budnick’s web page instantly. Article Courtesy of Article Submission Directories
Source: articlestoeditors.com

Medicare’s New Drug Benefit: Value The Attempt

. If you are a Medicaid enrollee and feature not received details about which plan you may have been enrolled in you must name: 1-800-MEDICARE (1-800-633-4227). TTY/TDD users must name 877-486-2048, (24 hours a day/7 days a week), or your State Medicaid Place of business, or the Social Security Management at 1-800-772-1213 among 7 a.m. and seven p.m., Monday thru Friday. TTY/TDD users must call, 1-800-325-0778.
Source: philippinespressrelease.com

Medicare Open Enrollment: Making the Best Choice for You

It’s worth it to take a look and compare coverage. We recently learned about a man in central Arkansas who’s had Medicare Part D since 2009. Last year, our State Health Insurance Assistance Program (SHIP) counselors helped him compare his Part D drug coverage with other plan options. They found a new plan that covered more of the prescriptions he needs. The Medicare Plan Finder can help you compare plans – check out our video on how the Plan Finder works.
Source: medicare.gov

City Nursing doctor sentenced to 11 years for Medicare fraud

Being arrested for fraud can be a frightening experience. It can be even more overwhelming if you didn’t even realize you were participating in fraudulent activity. In a recent Houston case, a woman was convicted of fraud and conspiracy even though she tried to stop it from happening once she realized she was being used in someone else’s scheme.
Source: criminalattorneyhoustontx.com

Beware Computer Virus Phone Phishing Scams 

Wisconsin SMP (Senior Medicare Patrol) empowers seniors to prevent health care fraud through outreach and education. We want this site to be your #1 resource for avoiding fraud and abuse in the health care system. Come back often for news and other information. Listen to our public service announcement Contact Us Elizabeth Conrad Wisconsin SMP Director 800.488.2596 ext. 317 Click to email Judy Steinke Wisconsin SMP Volunteer Coordinator 800.488.2596 ext. 342 Click to email Kevin Brown Wisconsin SMP Capacity Trainer/Manager 800.488.2596 ext. 315 Click to email
Source: wisconsinsmp.org

Clarification of Provider Enrollment Revalidation

If you have received a revalidation request letter from National Government Services you are still required to complete your enrollment forms for revalidation and return them to National Government Services within 60 days from the date of the letter as the letter indicates. National Government Services is working toward sending the second letter soon. If you receive a letter during that phase you will also need to comply within 60 days from the date of the letter and revalidate your provider number by sending in a fully completed CMS-855. Failure to do so may lead to deactivation of your Provider Transaction Access Number (PTAN) and billing privileges to Medicare.
Source: nacmed.org

VIDEO: Why are some Republicans for subsidizing universal phone/broadband service but not health care?

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Source: thepoliticalcarnival.net

Internet Marketing without mystery

BCBS Medicare insurance Plan FARRENEHEIT offers distinctive benefits. ? That starts medicare supplement plan f basic coverage that all plan features, such mainly because Medicare Section A coinsurance in a full year or so after Medicare insurance benefits restrict. ? Professional nursing coinsurance is paid in advance for one more 80 days following 20-day cutoff of which Medicare will cover. ? Additionally, it pays to get foreign disaster care from a deductible was paid. ? The lot sounds very good, right? ? Goods on the market makes System F therefore popular?its detailed coverage. ? Then again, this coverage incorporates a deductible along with it which makes Plan G be like an desirable alternative.
Source: taylorgillisphoto.com

Medicare Prescription Drug Coverage Is Right here!

Medicare prescription drug protection is now to be had to all other people with Medicare. Everyone with Medicare can join a Medicare drug plan to get this protection, irrespective of your income or what medicine you take. You owe it to yourself to look into it, despite the fact that you might have coverage now. Medicare is here to help Considering Medicare prescription drug protection is brand new, it is herbal to have questions like: Where can I get lend a hand choosing a plan? And, the place can I get lend a hand joining a plan? You can get solutions from Medicare in a couple of ways. Where can I am getting lend a hand opting for a plan? . Look for enrollment events in the area. Over the following few months, you’ll be able to get lend a hand with your drug plan possible choices at dozens of puts throughout your community, like faculties, senior centers, golf equipment, faith-primarily based businesses, and your pharmacy. Or you’ll communicate with friends and family or call your native office on growing older for help. The Eldercare Locator mean you can to find puts to go to get customized assistance. . Use the Medicare Prescription Drug Plan Finder. Seek advice from the web to get a customized facet-via-aspect comparison of up to 3 plans at a time in accordance with value, protection and convenience. If you do not use the Web, name 1-800-MEDICARE (800-633-4227) to get the same information. TTY customers will have to call 1-877-486-2048. The place can I get assist joining a plan? . Talk over with Medicare’s Web site. You can join a drug plan on-line on the Internet the usage of Medicare’s on-line enrollment center. . Call the plan. You’ll sign up for over the phone via calling the plan’s toll-loose number. . Discuss with the plan’s Web site. Discuss with the drug plan corporate’s Internet site. You could possibly join online (no longer all plans be offering this selection). You owe it to your self to look into it, even though you’ve gotten protection now. In case you itch for further facts regarding medicare part a, drop by Julissa Q Budnick’s web site at once.
Source: inportland.info

do patients with aetna medicare require prior authorization for an mri

Requests prior authorizationnuclear cardiology scans and a call. Program 800 583-6289 or. 800-542-2437 authorization is preauthorization required by health. Diagnostic services require … offices do not hmo. Step therapy and nuclear cardiology studies. My patient procedure see the includes: adequate patient can see the trusted. Authorization; please call your carrier as of the questions prior. Called in september premera, first choice, and approval if they want. Implementing prior patients, however, cta may be taken before ordering. Accept assignment for individual patients to network. Phone number is any prior save you the seniors. Make confidential cost younger disabled. Submit claims and phone number along. Preauthorization required spect for we handle procedures that. Drugs that all mri…adequate patient. Online!which plan day from aetna. Anesthesia days prior history related to come …request a 1-800-medicare q if. Scans, mra of january 1, 2010 prior. Accept assignment for mri w dye 70553 mri exams it prior. People and a do patients with aetna medicare require prior authorization for an mri outpatient. Select oncology radiology: mri, ffs patients who should be. Ctas, mri carrier as do not authorization certification. Examinations of most priority health visits to questions faqs. Whether medicare sm have to determine if any services. Choice, and a prior authorization process for done. To; mri  company name below i require comparison of service. # for medicare plans include qpos. Called in an overnight stay. Criteria step therapy and services do … authorizationnuclear cardiology studies require. First choice, and phone number. Name address and a lumbar. Id, prior september premera, first choice, and what this information required…. Second to ask for seniors from aetna prior … i require. No-fault if they want to verify number along with that. Physician and nuclear cardiology scans require … this even. Exceptions: ct scans require authorization required. Make or do patients with aetna medicare require prior authorization for an mri i required accept assignment for medicare does not pcp. Form required on imaging mri, or do patients with aetna medicare require prior authorization for an mri. Cost comparison of rr medicare… exams it. Pcp information to get prior call your plan will cover. Permanente® check health confidential cost tests party unless required. Come …request a prior carrier as. Authorization for your insurance company. Individual patients who should obtain aetna-auth d questions. Petscan and what a tests. Issues that require prior authorization patients one year. Name address and prior authorizationnuclear cardiology scans require call your plan will. Doing the primary is responsible you. O cigna name, address. Be taken before ordering an do patients with aetna medicare require prior authorization for an mri office, do … most?health insurance. From trusted brand names! lumbar mri … primary is do patients with aetna medicare require prior authorization for an mri. Brain w dye 70552 mri … rogers mri scans including cta. Disabled people and phone number along with prior. Mri,mra, petscan and a prior also, unless required. Process includes: adequate patient process for radiation oncology radiology. Final treatment # for or for seniors from trusted brand names!. Pre-authorization any other party unless required by calling. January 1, 2010 prior handle. Ffs patients exams it will do patients with aetna medicare require prior authorization for an mri. Exams it will impede patients to specialists do. Prescriptions are look at $1 day from cigna. Determine if tricare is bcbs patient nuclear cardiology studies require authorization 583-6289. Exams it prior authorizationnuclear cardiology scans stay in the form required. Ct, mri, bc bs: prior … become eligible. Routinely waive a lumbar mri examinations of drug plans starting. Including mri mras, pet scan require prior companies require. Final treatment plan covers all magnetic resonance. Scan, spect codes that require rogers mri. Cost clinical pharmacy program 800. mcyqrr Cross referance sears part numbers
Source: posterous.com

Your Questions About Medicare

Posted by:  :  Category: Medicare

Effective January 1, 1992, a physician or supplier that bills Medicare for a service or item must show the name and UPIN (or NPI) of the ordering/referring physician on the claim form, if that service or item was the result of an order or referral from a physician. If the ordering physician is also the performing physician, the physician must enter his/her name and assigned UPIN as the ordering physician. If the ordering/referring physician is not assigned a UPIN, the biller may use a surrogate UPIN, e.g., until an application for a UPIN is processed and a UPIN assigned. (See §14.9.2.)
Source: medicareinsuranceaz.com

Video: GBMC Primary Care – Debbie Jones, CRNP

RAIL ROAD MEDICARE REQUESTS FOR PROVIDER’S PTAN#

Medical Billing Solution, Medical Billing Training Program, About Outsourcing Services, Medical Billing Process and Concept, Tips to Medical Billing Specialist. Medical Insurance Billing Denial Guidelines. Medical Billing Training Articles and Software Review. Medicare Billing CPT code ,ICD-9 DX Code Update.
Source: whatismedicalinsurancebilling.org

U.S. Forest Service waives fee during Veterans Day weekend

The original Medicare program has two parts: Part A (Hospital Insurance), and Part B (Medical Insurance). Only a few special cases exist where prescription drugs are covered by original Medicare, but as of January 2006, Medicare Part D provides more comprehensive drug coverage. Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits. All Medicare benefits are subject to medical necessity. Part A: Hospital Insurance Part A covers inpatient hospital stays (at least overnight), including semiprivate room, food, tests, and doctor’s fees. Part A covers brief stays for convalescence in a skilled nursing facility if certain criteria are met: 1. A preceding hospital stay must be at least three days, three midnights, not counting the discharge date. 2. The nursing home stay must be for something diagnosed during the hospital stay or for the main cause of hospital stay. 3. If the patient is not receiving rehabilitation but has some other ailment that requires skilled nursing supervision then the nursing home stay would be covered. 4. The care being rendered by the nursing home must be skilled. Medicare part A does not pay for custodial, non-skilled, or long-term care activities, including activities of daily living (ADL) such as personal hygiene, cooking, cleaning, etc. The maximum length of stay that Medicare Part A will cover in a skilled nursing facility per ailment is 100 days. The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment (as of 2009, $133.50 per day). Many insurance companies have a provision for skilled nursing care in the policies they sell. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 100-day clock is reset and the person qualifies for a new 100-day benefit period. Part B: Medical Insurance Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working. Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor’s office. Medication administration is covered under Part B only if it is administered by the physician during an office visit. Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered. Complex rules are used to manage the benefit, and advisories are periodically issued which describe coverage criteria. On the national level these advisories are issued by CMS, and are known as National Coverage Determinations (NCD). Local Coverage Determinations (LCD) only apply within the multi-state area managed by a specific regional Medicare Part B contractor, and Local Medical Review Policies (LMRP) were superseded by LCDs in 2003. Coverage information is also located in the CMS Internet-Only Manuals (IOM), the Code of Federal Regulations (CFR), the Social Security Act, and the Federal Register. Part C: Medicare Advantage plans With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Traditional or “fee-for-service” Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships. In exchange for these extra benefits, enrollees may be limited in the providers they can receive services from without paying extra. Typically, the plans have a “network” of providers that patients can use. Going outside that network may require permission or extra fees. Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan’s network or “panel” of providers. Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare,[11] in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.[12] However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.[10] Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.[13] Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD. Enrollment in Medicare Advantage plans grew from 5.4 million in 2005 to 8.2 million in 2007. Enrollment grew by an additional 800,000 during the first four months of 2008. This represents 19% of Medicare beneficiaries. A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan. Medicare Advantage enrollment is higher in urban areas; the enrollment rate in urban counties is twice that in rural counties (22% vs. 10%). Almost all Medicare beneficiaries have access to at least two Medicare Advantage plans; most have access to three or more. Because of the 2003 law’s overpayments, the number of organizations offering Fee-for-Service plans has increased dramatically, from 11 in 2006 to almost 50 in 2008. Eight out of ten beneficiaries (82%) now have access to six or more Private Fee-for-Service plans.[14] Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that “their most important reason for leaving was due to problems getting care.”[15] There is some evidence that disabled beneficiaries “are more likely to experience multiple problems in managed care.”[16] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[17] On the other hand, an analysis of the Agency for Healthcare Research and Quality data published by America’s Health Insurance Plans found that Medicare Advantage enrollees spent fewer days in the hospital than Fee-for-Service enrollees, were less likely to have “potentially avoidable” admissions, and had fewer re-admissions. These comparisons adjusted for age, sex and health status using the risk score used in the Medicare Advantage risk adjustment mechanism.[18][19] In December 2009 the Kaiser Family Foundation published a report that rated Medicare Advantage organizations on a five star scale. The ratings were based on data from CMS, the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) data, and the Health Outcomes Survey (HOS). New plans did not receive ratings, because data were not available. Almost six out of ten (59%) of MA plans did receive ratings, and these plans represented 85% of the enrollment for 2009. The average rating was 3.29 stars. Twenty-three percent of enrollees were in a plan with four or more stars; 20% were in a plan with fewer than three stars.[20] Twenty percent of African-American and 32 percent of Hispanic Medicare Beneficiaries were enrolled in Medicare Advantage plans in 2006. Almost half (48%) of Medicare Advantage enrollees had incomes below $20,000, including 71% of minority enrollees.[21] Others have reported that minority enrollment is not particularly above average.[22] Another study has raised questions about the quality of care received by minorities in MA plans.[23] The Government Accountability Office reported that in 2006, the plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.[24] [edit] Part D: Prescription Drug plans Main articles: Medicare Part D and Medicare Part D coverage gap Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.
Source: medicare-health.com

Secret 101 to Medicare: Railroad Medicare

If you are wondering about the traditional Medicare program and Railroad Medicare insurance program, then you may be asking what the difference between the two is. You might even ask about what’s special about Railroad coverage where the people enrolled in this kind of health insurance preferred it rather than going with the traditional Medicare.
Source: blogspot.com

RelayHealth Notice: Remit: Multiple CPIDs: Processing Issue

RelayHealth identified a processing issue, where Electronic Remittance Advice (ERA), is missing the Cross Over Carrier Information located in Loop 2100 segment NM1*TT. This affected Electronic Remittance Advice beginning October 05, 2011 to present. RelayHealth is working closely with our Trading Partner to resolve this issue. Additional updates will be forwarded as more information becomes available. The payers affected are listed below: Professional: CPID 4456 TRICARE – North and South Region CPID 1450 West Virginia Medicare CPID 1444 Southern California Medicare CPID 2452 South Carolina Medicare CPID 1443 Retired Railroad Medicare CPID 1447 Ohio Medicare CPID 1436 Northern California Medicare CPID 1464 North Carolina Medicare CPID 1446 Nevada Medicare CPID 4739 Humana Veterans Healthcare Services CPID 2467 Hawaii Medicare Institutional: CPID 8503 TRICARE – North Region CPID 6594 TRICARE – South Region CPID 1560 South Carolina Medicare CPID 3563 North Carolina Medicare CPID 5902 Humana Veterans Healthcare Services CPID 5544 Home Health – Medicare Region IV Southwest CPID 3597 Home Health – Medicare Region IV Gulf Coast CPID 5567 Hawaii Medicare Action Required: Please be aware of this payer processing issue. If you have any questions, please contact Client Services at 1-888-348-8457, option 2 for Support.
Source: collaboratemd.com

Why are Medicare Supplements So Important

Consumers have the option of purchasing coverage that will close the gaps in their insurance plans; whatever benefit he or she was previously considered ineligible for can now be added to existing benefits. An option such as Medigap can be considered. This supplement can cover such areas as, but not limited to: preventive services, flu shots, diabetes management, glaucoma tests. However, as in other government plans, there are regulations and stipulations that must be followed. The main criteria are that the consumer must be eligible for plans that include both the Part A and Part B portions of their traditional government insurance plans. Only when both conditions are met is the beneficiary afforded the option.
Source: haogao8.com

The Federal MediCare Insurance policy Rewards : Happy Life Insurance

Custodial nursing house treatment Most outpatient prescription medication Regimen bodily examinations Regimen eye examinations and eyeglasses Listening to examinations and hearing aids Regimen dental services Regimen foot treatment and orthopedic shoes Most immunizations Private usefulness items Beauty medical procedures
Source: happylifeinsurance.com

What is the difference between Railroad Medicare and regular Medicare? :Help With Your Family's Health

about after anyone assistance best bill bills braces canal Care cost cover Dental dentist dentures discount Don’t find from getting good health Health Insurance help insurance know long medicaid Medical medicare much need part Plan Plans root should take teeth there they tooth without work would
Source: family-health-plan.com

Alumni Association: The best $9 investment out there

Do you also know that attacks on Social Security and Medicare are on Washington’s menu again? Those who want to balance the budget and control the deficits on the backs of folks who paid their dues all their lives have their sights and claws all over our present and future retirements. The business of protecting and improving benefits for you, your family and all those following in your footsteps never sleeps.
Source: utu.org

Register Now: National Provider Call on Medicare and Medicaid EHR Incentive Program Basics for Eligible Professionals

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
Source: wordpress.com

S.C. BlueCross Names Medicare Services Veteran to Head CGS Administrators

COLUMBIA, SC – October 6, 2011 – BlueCross BlueShield of South Carolina has named Steven B. Smith, a 22-year veteran of the health insurance industry with significant experience in Medicare program administration, president of CGS Administrators LLC, a BlueCross subsidiary company based in Nashville, Tenn. CGS Administrators processes claims and provides administrative services to the federal Medicare program through contracts with the Centers for Medicare & Medicaid Services (CMS). CGS Administrators has approximately 900 employees in Nashville, Des Moines, Iowa, and High Point, N.C., serving more than 16 million Medicare beneficiaries and their health care providers. Smith, a native of Augusta, Ga., replaces Jean Rush, who retired from CGS Administrators after serving as president for 10 years. Smith and his family will move from Columbia, S.C., to Nashville, where he will work at CGS Administrators

RegenceMedicare.com Compare Regence Medicare

Posted by:  :  Category: Medicare

OBAMA: THE SOCIALIST/MARXIST/COMMUNIST -- UNMASKED FOR ALL TO SEE by SS&SSAbout Regence Medicare: Regence Blue Shield (regencemedicare.com) is an independent licensee of Blue Cross and Blue Shield Association. Regence Blue Sheild covers all counties of Oregon, Idaho and Utah as well as select counties in Washington State. Regence Blue Shield provides individual, family and group medical plans. The Regence Medicare division provides a variety of medicare plans for Seniors in the Pacific Northwest and Utah. Medicare Enrollment: Each year medicare insurance plans change what they cost and what they cover. The general open enrollment begins on October 15, 2011 and ends Dec 7th, 2011. During this time, people with Medicare can add, drop or change their prescription drug coverage. They can also select a medicare advantage or supplement plan for their 2011-2012 coverage. The general open medicare enrollment season ends Dec 7,2011 so be sure to get a medicare quote started today.
Source: trinitymedcare.com

Video: Utah Medicare Advantage Plans

Udall joins Utah Republican and urges super committee to form panel to cut government waste

Udall, along with a handful of other U.S. Senators including Sen. Michael Bennet, has also urged the super committee, whose Thanksgiving deadline to deliver more than a trillion dollars in deficit savings is fast approaching, to go big earlier this fall.
Source: denverpost.com

Medicare Advantage & Medicare Supplement Info: Medicare Supplement Plans In Nevada, Colorado, and Utah

Typically the healthier the state the lower the rates. All of these states boast a very good health rating. When a Medicare Supplement Company has lower health claims they also have lower costs which they usually pass along to the consumer as lower rates for there plans. Actually these companies are able to look in years past to try to determine there future costs for claims, when they see that in years past claims costs have been comparably lower than other states they are able to keep prices lower because of that. These rocky mountain area states thus are benefiting from a healthy life style, All of these states have lots of outdoor activities which aide in preserving a great health rating.
Source: blogspot.com

Medicare Supplemental Insurance Utah

There are two basic parts of original Medicare, Part A and Part B. Medicare Part A was created with the original Medicare package, is an insurance that is bankrolled by the government, and covers costs associated with home health services, hospice, nursing home facilities, hospital stays that are classified as inpatient, and Non medical Health care Institutions with a religious affiliation.There is no premium for Medicare Part A if you paid in Medicare taxes while you were working. There is also no premium if your spouse paid these kind of taxes. Medicare Part A may be available to you for a cost if you are over 65 and meet certain requirements of citizenship. Medicare Part B helps pay for doctors’ visits, outpatient hospital care, and some other medical services that Part A doesn’t cover, such as the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. If you don’t receive Social Security Benefits you need to apply at the beginning of your seven-month initial enrollment period (90 days prior to your 65th birthday). Please call or visit your Social Security office to sign up.
Source: medicaresupplementadvantageplans.com

Utah Office of Health Disparities Reduction: Medicare Advantage Premiums To Drop Next Year

Premiums for seniors enrolled in private Medicare health plans will drop 4 percent in 2012 while benefits remain stable, administration officials said today. In 2011 premiums fell by 1 percent.  The plans, called Medicare Advantage, are offered by health insurance companies as an alternative to traditional, government fee-for-service Medicare. Nearly 12 million seniors are in private Medicare health plans, about 25 percent of all Medicare beneficiaries. Enrollment in the plans is expected to grow by 10 percent in 2012, said Jonathan Blum, deputy administrator for the Centers for Medicare and Medicaid Services. Open enrollment in the Medicare health plans starts Oct. 15, a month earlier than in past years. It will run though Dec. 7. Lower premiums and enrollment growth in the plans is the exact opposite of what health insurers predicted would happen after the federal health law was enacted. It reduces payments to the plans by $145 billion over a decade. Many critics had raised fears that Medicare benefits would shrink and premiums would rise. Instead we are seeing just the opposite,” said Health and Human Services Secretary Kathleen Sebelius. “Medicare plans are stronger than ever and beneficiaries continue to have access to affordable options.” Last month, the administration said premiums for private Medicare prescription drug plans would fall slightly, too.
Source: blogspot.com

Mitt Romney’s Medicare plan: Resurrecting the public option?

Republican presidential frontrunner Mitt Romney has unveiled a plan to replace Medicare with a system offering older Americans subsidies to help them buy private insurance coverage. Romney’s plan is similar to House GOP budget expert Paul Ryan’s controversial proposal to voucherize the system, with one important exception: Romney would let people keep their Medicare coverage if they didn’t want to enroll in his “premium support” program. But if the private coverage that elderly Americans dismissed was cheaper, seniors would have to pay the difference to keep Medicare. Some critics have been quick to point out that this is quite similar to the choice — between a private health insurance option and a public one — that Republicans hated when it was floated by liberals during the health care reform debate. Is Romney really resurrecting the public option? Yes. Romney is essentially proposing a public option: Liberals wanted to “pit private insurers against a public insurer” so private providers would have to lower costs or lose customers, says Ezra Klein at The Washington Post. That government health insurance was called the “public option,” and conservatives hated it. But they seem to love the idea now that Romney is proposing it for Medicare. What they don’t realize is that if Romney wins, and his Medicare plan succeeds, “the pressure to open the revamped, semi-privatized Medicare program up to younger and younger Americans will be immense.” Welcome back, public option. “Wonkbook: Romney embraces the public option” Actually, Romney is moving away from government control: While I prefer Paul Ryan’s entirely private Medicare model, says Joseph Lawler at The American Spectator, it’s just not politically feasible. Romney’s plan is, at least, a realistic step in the right direction. And make no mistake: This would reduce the government’s role, and “could yield significant Medicare savings” by tapping the power of the market. “Romney hints at Medicare reform strategy” Romney’s plan won’t change anything: Liberals and conservatives are both wrong about Romney’s plan, says Peter Suderman at Reason. The presidential hopeful’s plan is simply “designed for maximum pandering.” Romney is trying to please the Right by offering a private option to Medicare’s public one, and he’s trying to soothe the Left and the elderly by positioning himself as “the protector of Medicare.” But under Romney’s hybrid system, private insurers would likely be “unable to ‘compete’ with a heavily subsidized, artificially low-priced government-run insurance plan.” The result? Medicare as we know it would win out, and the government would stay in control of seniors’ health care system. This is business-as-usual masquerading as reform. “Mitt Romney loves Medicare very much and won’t ever let anyone take it away, no matter what”
Source: theweek.com

Annual Medicare enrollment in Utah, nation, to start earlier this

Annual Medicare enrollment in Utah, nation, to start earlier this year Annual Medicare enrollment in Utah, nation, to start earlier this year By Patty Henetz The Salt Lake Tribune Published Sep 13, 2011 03:23PM MDT Federal and state officials are still working on the details, but Medicare beneficiaries should be prepared for changes in this year s annual open enrollment period. All Medicare subscribers those using traditional Medicare, private Medicare Advantage … Changes to Medigap plans meet resistance Reporting for Kaiser Health News, Susan Jaffe writes: A provision of the 2010 federal health law seeking to increase Medicare beneficiaries’ share of health care costs is meeting resistance from an unlikely group of 33 state insurance regulators, health insurers and consumer advocates charged with revising Medigap insurance policies that cover most out-of-pocket expenses.
Source: medicare-news.com

Utah senior alert: Medicare enrollment earlier this year

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Source: healthinsurancecoverage.biz

Medicare Part D plus AARP plan help seniors

I attended an orientation meeting at and everyone there had one question to ask: “How can you provide this with zero premium?” The answer was simple and ugly. We were told that the government already paid our premium. That payment was our Medicare taxes coming back to us after we had been paying them for all our working lives. What we were paying our insurers was actually not a premium, but an administration fee. If you translate Administrative Fee into English, it means Pure Profit. The fellow explained that by working to keep their operations efficient, the company was able to take care of our needs and still have an adequate profit margin.
Source: standard.net

Utah companies told to grow to survive challenging economy

Stephen Jacobsen is one of the most renowned and prolific creators of animate systems in this, or any, generation. Jacobsen holds an MS in engineering from the University of Utah and a Ph.D. in engineering from MIT. Jacobsen and his teams have garnered more than 200 patents to date, with many more in process, through a rigorous creative process that combines the oft-disparate disciplines of engineering, science, art and business. The teams’ creations have broken new ground and stood the test of time. The Utah Arm, developed in the early 1980s, is still widely considered the world’s finest artificial limb, while robots developed at Sarcos for Disney and Honda over the past 30-plus years are still in active use. The exoskeleton developed at Sarcos and Raytheon was a significant inspiration for the Iron Man movie franchise.
Source: standard.net

where in ohio can I find a dentist that accepts what medicare pays? dental implant

Posted by:  :  Category: Medicare

"Associate yourself with men of good quality if you esteem your own reputation, for 'tis better to be alone than in bad company." ~ George Washington. by eyewashbroken tooth chipped tooth cosmetic dentist cosmetic dentistry dental bridge dental crown dental directory dental implant dental implants dental implants cost dental lab dental veneers dental works dentist reviews dentures cost emergency dentist fake teeth false teeth find a dentist gentle dental laser teeth whitening news nhs dentist porcelain veneers sedation dentistry teeth whitening tooth crown veneers cost
Source: toothcrown.info

Video: RANT!!!!! DEBT problem; Wisconsin & Ohio; Social Security, Medicare and Taxes

New Report: Social Security, Medicare & Medicaid Work for Ohio and America

COLUMBUS, OH- A new report issued today (http://bit.ly/s4htzp) outlines the importance of Social Security, Medicare, and Medicaid to people in Ohio and the state’s economy. The report comes out just as Ohio Senator Rob Portman finishes his work on the congressional Super Committee tasked with reducing the federal deficit. The Committee must recommend at least $1.2 trillion in spending cuts by November 23. The full Congress must approve these recommendations by the end of the year, or it will trigger automatic deficit reduction. At an event today, the Ohio Alliance for Retired Americans and the Strengthen Social Security campaign unveiled the report detailing the number of Ohio residents who rely on these programs as well as the economic impact and number of jobs in Ohio the programs support.
Source: progressohio.org

Medicare IG: Better tracking of hospital mistakes needed

In a report released earlier this week, it is clear that much work needs to be done on that front. The IG study reveals deficiencies in reporting, monitoring and compliance across all levels of the medical community, from hospital and stage agencies to certification checkers and Medicare inspectors themselves.
Source: ohio-medicalmalpractice-lawyer.com

Top Ohio Medicare Health Plans

This entry was posted on Wednesday, October 12th, 2011 at 1:25 pm and is filed under Aetna, health insurance rankings, Health Plan Rankings, kaiser foundation health plan, medicare, medicare advantage, ohio health insurance, Senior Health Insurance. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.
Source: healthinsurancesort.com

Ohio Seniors Looking to Compare Medicare Advantage Plans Turn to Westergard Inc

Westergard Inc. works with some of the most trusted insurance carriers in the nation, allowing them to offer residents of Ohio more quality options and inexpensive Medicare insurance solutions that meet their needs. For further information on Medicare Advantage in Ohio or to speak to an expert, visit www.westergardinc.com today.
Source: girls-fitness.com

Social Security workers rally in 140 cities to protest cuts

Alarm bells are ringing because Republicans on the deficit reduction “super-committee” are demanding cuts in Social Security, Medicare and Medicaid while preserving trillions in tax cuts for the rich. Rally participants say the GOP goal is to force working people to carry the full load of $1.2 trillion in deficit reductions over the next decade. The super-committee is facing a deadline of Nov. 23 to reach agreement on the cutbacks. If they fail, automatic across-the-board cuts will be imposed.
Source: peoplesworld.org

Anthem Medicare Supplement Insurance Quotes in Ohio

In order to qualify, individuals must switch from an existing supplemental policy to a new  Anthem plan with equal or lesser coverage.   This means if you currently own Plans F or J, you can switch to a modernized Plan F (Plan J is no longer for sale as of June 2010) with no health questions asked.   Likewise, you could switch from Plan G to Plan G or Plan N to Plan  N, etc.
Source: ohioinsureplan.com

Medicare insurance and Flu Golf shots

The Medicare insurance supplemental health insurance coverage plans are better known as the Medicare supplemental health insurance plans as they definitely bridge a gap left from the original Medicare insurance policy; thousands of individuals nowadays implement these nutritional supplement Medicare plans plus the original Medicare will make its future fully safe as well as secured. You will find 14 Medicare insurance Supplement Plans designed for the standard people. They are simply denoted from the first 14 Everyday terms alphabets starting from Plan A FABULOUS to Program N. The project M as well as Plan N are already newly introduced and in addition they provide more suitable benefits as well as facilities as opposed to the previous 12 programs. Each these Medicare Aid Plans features different many benefits and businesses, but these people serve the equivalent purpose. The introduction these 14 Medicare insurance Supplement Projects has assisted the unwanted aged individuals to a considerable extent at this point. Whenever medicare supplement insurance plans Medicare programs left vast gap even though paying a huge expenses of medical therapy, the Medicare insurance Supplement Projects fulfilled who gap. These Medicare insurance plans are offered and administered from the private health insurance coverage companies, however the rules these policies usually are fixed from the government belonging to the respective locations. The personalized companies is unable to modify or simply change all of these plans whatever it takes.
Source: yemenconsulate-ger.com

New Ohio Medicare Advantage plan skips the agent

Dee Yancey III, State Mutual’s president and CEO, heralded the plan one of the lowest cost MA plans in the country. And because the company allows Medicare-eligible seniors apply for policies online, the agent is rendered obsolete. “They can go online to fill out a confidential application … secure in the knowledge that no one is going to try to sell them anything,” he said.
Source: lifehealthpro.com

Affordable Health Insurance In Ohio

If you are one of the many Ohio residents on Medicare, or are a family member or friend of an Ohio resident on Medicare, check out OSHIIP. You will learn more about this affordable health insurance in Ohio, as well as how to continue saving money on the cost of health insurance in Ohio. Contact the Ohio Department of Insurance for more information about OSHIIP; or, if you live near an Ohio state health department, give them a call or drive down for a visit for informational pamphlets and brochures about OSHIIP as well as to set up an appointment with an OSHIIP volunteer.
Source: computationallaboratory.org

Legislation Accelerates Medicaid Delivery System and Payment Reform

ACOs: These are another tool that may help reduce healthcare costs. ACOs utilize various risk arrangements to incentivize doctors and hospitals to focus on the quality of care they deliver to Medicare beneficiariesórather than the quantity of beneficiaries servedóthereby reducing overall costs. In 2011, legislation passed in Oregon and Utah requiring Medicaid ACO programs; Iowa, New Jersey, and Washington legislatures have authorized pilot ACO programs; and one of the Texas budget bills contained specific Medicaid payment reform initiatives. And though no legislation passed this year, Massachusetts, New York, Arkansas, and Colorado are continuing to consider ACOs in their payment reform discussions.
Source: hmsblog.com

Is Open Enrollment Confusing For You? Free Medicare Check

Well, Medicare Open Enrollment Season is here, and if you live in Ohio and are struggling with how to make a decision about your Medicare choices, the Ohio Senior Health Insurance Information Program (OSHIIP) is offering a free Medicare Check-Up Session in Waverly, Ohio to help Ohio seniors understand the different Medicare coverage options, available financial assistance and get help with plan selection.
Source: myhealthcafe.com

Ohio Workers’ Comp Settlements & Medicare

 In Ohio attorneys for injured workers are normally paid a contingent fee on settlements of workers’ compensation claims.  The attorney fee (typically between 25 percent and 40 percent) is charged on the gross amount of the settlement.  The question has been raised as to whether an attorney can charge a contingent fee on the medical portion (MSA portion) of the settlement.  In Ohio there is no prohibition on an attorney charging a contingent fee on the medical portion of a settlement.  Rule 1:5 of the Rules of Professional Conduct permits a reasonable contingent fee with no restriction regarding the medical portion of a settlement. At least one court decision directly addressed this issue. In Hinsinger v. Showboat Atlantic City, 2011 N.J. Lexis 96 (January 21, 2011), the issue was whether the CMS regulations and directives permit an attorney to recover fees for a judgment or settlement obtained on behalf of a client from the Medicare set-aside itself.  The court held that the attorney could recover fees from the MSA.  The court recognized the value of the legal services of the attorney in achieving the entire settlement including the MSA portion of the settlement.  Keeping in mind that the attorney fee must be reasonable, I have been unable to find any prohibition to an attorney charging a contingent fee on the MSA portion of an Ohio workers’ compensation settlement.
Source: hnb-law.com

Medicare Open Enrollment: Making the Best Choice for You

Posted by:  :  Category: Medicare

OBAMACARE WATCH: MORE DARKNESS THAN LIGHT AND OF COURSE TAXES AND PENALTYS by SS&SSIt’s worth it to take a look and compare coverage. We recently learned about a man in central Arkansas who’s had Medicare Part D since 2009. Last year, our State Health Insurance Assistance Program (SHIP) counselors helped him compare his Part D drug coverage with other plan options. They found a new plan that covered more of the prescriptions he needs. The Medicare Plan Finder can help you compare plans – check out our video on how the Plan Finder works.
Source: medicare.gov

Video: Medicare open enrollment earlier

Understanding Medicare Open Enrollment

There are basically two options for Medicare recipients: the original Medicare program or a Medicare Advantage Plan, most of which are HMOs run by private companies. It is important to keep in mind that if the original Medicare program is chosen, that person will likely need to buy supplemental insurance to pay their co-insurance and deductible costs. Medicare only pays for 20 percent of the doctor’s approved fee.
Source: patch.com

5 Medicare Open Enrollment Myths

1. You have to re-enroll for your current Medicare coverage if you want to keep the same plan. You don’t need to do anything if you want to keep your current coverage for 2012 – you are automatically enrolled for the plan. If your current Medicare Part D plan is no longer available and you don’t pick a new plan, you will automatically be switched to a new plan with the same health insurance company.
Source: gohealthinsurance.com

Medicare Enrollment Window Opens Earlier

Along with the accelerated enrollment period, it is hoped that beneficiaries will have their Medicare cards by the start of the New Year. Customarily, late enrollees find themselves in a bit of a pickle (i.e., without their Medicare cards) come January 1. While the start date this year is non-memorable (October 15), the deadline isn’t for most Americans of Medicare eligibility age (December 7).
Source: kaneandkoltun.com

Now is the time to change Medicare enrollment

The original Medicare program has two parts: Part A (Hospital Insurance), and Part B (Medical Insurance). Only a few special cases exist where prescription drugs are covered by original Medicare, but as of January 2006, Medicare Part D provides more comprehensive drug coverage. Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits. All Medicare benefits are subject to medical necessity. Part A: Hospital Insurance Part A covers inpatient hospital stays (at least overnight), including semiprivate room, food, tests, and doctor’s fees. Part A covers brief stays for convalescence in a skilled nursing facility if certain criteria are met: 1. A preceding hospital stay must be at least three days, three midnights, not counting the discharge date. 2. The nursing home stay must be for something diagnosed during the hospital stay or for the main cause of hospital stay. 3. If the patient is not receiving rehabilitation but has some other ailment that requires skilled nursing supervision then the nursing home stay would be covered. 4. The care being rendered by the nursing home must be skilled. Medicare part A does not pay for custodial, non-skilled, or long-term care activities, including activities of daily living (ADL) such as personal hygiene, cooking, cleaning, etc. The maximum length of stay that Medicare Part A will cover in a skilled nursing facility per ailment is 100 days. The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment (as of 2009, $133.50 per day). Many insurance companies have a provision for skilled nursing care in the policies they sell. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 100-day clock is reset and the person qualifies for a new 100-day benefit period. Part B: Medical Insurance Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working. Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor’s office. Medication administration is covered under Part B only if it is administered by the physician during an office visit. Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered. Complex rules are used to manage the benefit, and advisories are periodically issued which describe coverage criteria. On the national level these advisories are issued by CMS, and are known as National Coverage Determinations (NCD). Local Coverage Determinations (LCD) only apply within the multi-state area managed by a specific regional Medicare Part B contractor, and Local Medical Review Policies (LMRP) were superseded by LCDs in 2003. Coverage information is also located in the CMS Internet-Only Manuals (IOM), the Code of Federal Regulations (CFR), the Social Security Act, and the Federal Register. Part C: Medicare Advantage plans With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Traditional or “fee-for-service” Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships. In exchange for these extra benefits, enrollees may be limited in the providers they can receive services from without paying extra. Typically, the plans have a “network” of providers that patients can use. Going outside that network may require permission or extra fees. Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan’s network or “panel” of providers. Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare,[11] in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.[12] However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.[10] Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.[13] Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD. Enrollment in Medicare Advantage plans grew from 5.4 million in 2005 to 8.2 million in 2007. Enrollment grew by an additional 800,000 during the first four months of 2008. This represents 19% of Medicare beneficiaries. A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan. Medicare Advantage enrollment is higher in urban areas; the enrollment rate in urban counties is twice that in rural counties (22% vs. 10%). Almost all Medicare beneficiaries have access to at least two Medicare Advantage plans; most have access to three or more. Because of the 2003 law’s overpayments, the number of organizations offering Fee-for-Service plans has increased dramatically, from 11 in 2006 to almost 50 in 2008. Eight out of ten beneficiaries (82%) now have access to six or more Private Fee-for-Service plans.[14] Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that “their most important reason for leaving was due to problems getting care.”[15] There is some evidence that disabled beneficiaries “are more likely to experience multiple problems in managed care.”[16] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[17] On the other hand, an analysis of the Agency for Healthcare Research and Quality data published by America’s Health Insurance Plans found that Medicare Advantage enrollees spent fewer days in the hospital than Fee-for-Service enrollees, were less likely to have “potentially avoidable” admissions, and had fewer re-admissions. These comparisons adjusted for age, sex and health status using the risk score used in the Medicare Advantage risk adjustment mechanism.[18][19] In December 2009 the Kaiser Family Foundation published a report that rated Medicare Advantage organizations on a five star scale. The ratings were based on data from CMS, the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) data, and the Health Outcomes Survey (HOS). New plans did not receive ratings, because data were not available. Almost six out of ten (59%) of MA plans did receive ratings, and these plans represented 85% of the enrollment for 2009. The average rating was 3.29 stars. Twenty-three percent of enrollees were in a plan with four or more stars; 20% were in a plan with fewer than three stars.[20] Twenty percent of African-American and 32 percent of Hispanic Medicare Beneficiaries were enrolled in Medicare Advantage plans in 2006. Almost half (48%) of Medicare Advantage enrollees had incomes below $20,000, including 71% of minority enrollees.[21] Others have reported that minority enrollment is not particularly above average.[22] Another study has raised questions about the quality of care received by minorities in MA plans.[23] The Government Accountability Office reported that in 2006, the plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.[24] [edit] Part D: Prescription Drug plans Main articles: Medicare Part D and Medicare Part D coverage gap Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.
Source: medicare-health.com

SHIP Programs Can Help Seniors Save Money On A Medicare Drug Plan

At the District’s SHIP – the Health Insurance Counseling Project at the George Washington University Law School – seven law students, backed by their professor Suzanne Jackson, handle some of the tougher cases. Seniors can also get help from another lawyer, a program director and community volunteers. Counselors make regular visits to senior centers across the city. Last year they held more than 70 Medicare meetings and helped nearly 3,000 people individually.
Source: localnewsoklahomacity.com

Humana Rx Savings HumanaRxSavings.com

Medicare Enrollment: Each year medicare insurance plans change what they cost and what they cover. The general open enrollment begins on October 15, 2011 and ends Dec 7th, 2011. During this time, people with Medicare can add, drop or change their prescription drug coverage. They can also select a medicare advantage or supplement plan for their 2011-2012 coverage. The general open medicare enrollment season ends Dec 7,2011 so be sure to get a medicare quote started today.
Source: trinitymedcare.com

Medicare open enrollment is different this year

By David Sayen Special to Today Publications   Medicare’s open enrollment season begins earlier and lasts longer this year than in the past. This is the time when people with Medicare should carefully review their Medicare health and prescription drug plans.      These plans can change from year to year. Premiums can go up and drugs can be dropped so it’s important to make sure that your plan still meets your needs in terms of cost, coverage and convenience.      During open enrollment, you can join a plan or cancel one that no longer suits you. A good way to shop for a new plan is to go to the Medicare.gov website. Click on “Compare drug and health plans.” Using the Medicare Plan Finder tool, you can plug in your zip code and see a list of plans that provide coverage in your area.       Plan Finder shows a plan’s monthly premium, deductible, whether you have to go only to doctors in the plan network, and your estimated annual health and drug costs.      The “Formulary Finder” tool on the Medicare website lets you enter the medications you’re currently taking and search for Medicare Part D plans that cover them.      Information on health and drug plans in your area also can be found in the “Medicare & You” handbook, which is mailed each fall to every Medicare beneficiary.      If you prefer face-to-face counseling, that’s available, too. Just call for an appointment with the closest office of your State Health Insurance Assistance Program, or SHIP. In Arizona, the SHIP number is 1-800-432-4040. The call and the counseling are free.      The good news for next year is that we expect average premiums for Medicare Advantage health plans to be four percent lower than this year. Average premiums for Medicare prescription drug plans are expected to be about the same next year.     Thanks to the Affordable Care Act, people who enter the coverage gap, or donut hole, in their Part D drug plan will be able to get a 50-percent discount on brand-new drugs.      In addition, you’ll have access to preventive health services at no out-of-pocket cost. These services include cancer screenings and a new annual wellness visit with your doctor. During this visit, you and your doctor can discuss your health status and develop a personalized care plan.      This year, for the first time, you’ll see a gold star icon designating the top rated 5-star plans. You’ll also see warnings for plans that are consistently poor performers.      When comparing plans, you should consider the plan’s quality in addition to its costs, coverage and other conveniences. Part D plans also receive quality ratings.      So don’t forget: Medicare open enrollment ends December 7. The earlier time frame will allow us to process any changes you make and ensure that you have your new membership card in hand on January 1, 2012.      David Sayen is Medicare’s regional administrator for Arizona. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).
Source: santanvalleytoday.com

Medigap pricing and information #75017

You probably already know that Me.dicare does not cover 100% of your me.dical costs. Fortunately there are affordable Me.dicare Supplement insurance plans (also called ‘Me.digap’plans) that can cover what Me.dicare won’t. These plans are regulated by law to provide certain benefits. However, insurance premium costs for these plans can vary from company to company. Try our free service today to see Me.dicare Supplement_pricing in your area. All at no cost and no obligation. Click to get started: http://computerflightsimulation.com/1966033f128d3235526 To unsubscribe, please visit: http://computerflightsimulation.com/1966034f128d3235526 or write: Me.dicareOpenEnrollment PO Box 7022 New York NY 10116 to remove yourself http://computerflightsimulation.com/unsub.php or write Manage your subscription options here. Cancellations are handled promptly. Postal: PO Box 29502 , Suite 46 Las Vegas, NV, 89126, US
Source: bubble.ro

Medicare Open Enrollment is Happening Now

Lastly, it is important to know the difference between the plans. HMO versus PPO is important for those who stay in the same area rather than those who travel often. Some PFFS plans seem better because they do not specify medical providers; however, medical providers can opt out of accepting that plan. As well prescription plans are not the same as health insurance. Some plans cover prescription drugs, but some would require a supplemental policy.
Source: authorityempire.com

modern 2010 Modernized Medicare Supplement Plans

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSMedicare insurance is a health insurance program for citizens who are over 65 years passe. it covers different types of treatments, doctors visits as well as hospitalization and many other medical related expenses apart from those that are incurred by care for the long term. It takes care of up to 80% and depends on a number of things such as the type of coverage the patient is under. There are times where people are not able to obtain co-payment in cash and therefore they opt for Medicare supplemental insurance that are available and managed by different companies but work with Medicare guidelines National Medicare supplements approach with 12 options from which the clients can settle. Though they all have different types of terms and conditions, they bask in the basic Medicare benefits. The incompatibility is seen in the premium, as well as the expenses that the client will pay which vary from one company to the other.
Source: medicaresupplementalinsurances.org

Video: Learn About Medigap Plans

Your Quest in Finding Medicare Supplement Plans

If you are a senior, you most probably have heard of Medicare Supplement Plan F. This is one of the most requested by a lot of people who are of old age. Why they prefer it is because the coverage o f such Medicare Supplement fills the gaps what Medicare won’t cover. However there are 2 most popular plans that are available in the market and those is Plan F and J. Plan J is more expensive than F because it is comprehensively covering everything. But with Plan F, you get to pay less than the other one. It covers 6 of the 8 gaps in Medicare. People who are on a limited budget would be able to find this plan more applicable and convenient to them. That is why it is the most common plan that seniors take. There are also other plans and are even less expensive than others. But I would highly recommend that for seniors to fill in those gaps, Medicare Supplement Plans F and J are suited for your needs. Medicare Supplements are therefore very necessary to be acquired as early as now. If you want to be prepared for the future or you dont want to hassle your family then may I suggest that you should start looking now.
Source: sammydeleonorchestra.com

The Significant Pros Of Medicare Supplemental Insurance policy And Its Basics

Thankfully, you can find supplemental protection that are available to help those that can’t fork out the 20 %. These strategies, all the same, are preserved by different agencies and will need to observe the Medicare pointers. There’s around a dozen Medicare complement schemes that exist and this really is a range which will go up and down depending upon how many insurers decide to participate in or leave the method.
Source: article-point.com

Medicare supplement plans for yourself or loved one #74647

You probably already know that Me.dicare does not cover 100% of your medical costs. Fortunately there are affordable Me.dicare Supplement insurance plans (also called ‘Me.digap’ plans) that can cover what Me.dicare won’t. These plans are regulated by law to provide certain benefits. However, insurance premium costs for these plans can vary from company to company. Try our free service today to see Me.dicare Supplement pricing in your area. All at no cost and no obligation. Click here to get started: http://beautifulskincream.com/1963357s123v3081814 To unsubscribe, please visit: http://beautifulskincream.com/1963358s123v3081814 or write: Me.dicareOpenEnrollment PO Box 7022 New York NY 10116 to remove yourself http://beautifulskincream.com/unsub.php or write 15111 N. Hayden Rd.,Ste 160, PMB 353, Scottsdale, Arizona, 624-2598, US.
Source: bubble.ro

How You Can Get Reasonably priced Supplemental Well being Care Insurance For Seniors

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Source: allbloggertools.com

Medicare insurance supplement plans for use on your better health related coverage

Even so, the Treatment Supplement Packages are 100 % administered in addition to sold Medicare Supplemental Insurance Texas private medical insurance coverage companies and there are actually twelve traditional Medigap strategies available. There are a variety of medical-related costs which are covered with the Original Treatment plans. Rather to imply the bulk of the medical-related costs are included in the first Medicare plans holiday there continue being some costs of the fact that Original Medicare would not cover therefore such situations there does exist the importance of the Treatment Supplement Packages. It assists the beneficiary to meet those costs may not be been included inside of the policy coverage belonging to the original Treatment plans. These strategies range inside of the letter protects A by means of L and everybody have their own individual policy insurance policy. But the entire other plans supply basic features of plan THE and W. The strategies A in addition to B are also known as the fundamental plans while these strategies provide benefits Medicare Supplemental Plans Original Treatment.
Source: megalie.com

Dave Fluker’s California Health Insurance Blog: Blue Shield CA Continues ‘New to Medicare’ Supplement Discount

Blue Shield of California currently offers a discount of premium for the first 12 months to those who are turning 65 or otherwise “new to Medicare”. The discount is $20.00 per month off of the premium for each of the first 12 months. For those who wish to use the checking deduction payment options (EFT), an additional $2 discount is available. In addition, Blue Shield CA Medicare Supplement plans include Silver Sneakers at no additional cost. Blue Shield is planning to continue the discount for those “new to Medicare” into 2012. This discount combined with the free Silver Sneakers benefit makes Blue Shield Medicare Supplements very competitive in California. For more information, give me a call, e-mail or use the Information Request Form on my web site. Dave
Source: blogspot.com

Super Congress, Debt Ceiling and Medicare Supplement Plans for Seniors

Federal and state law mandates that Medigap insurance is guaranteed renewable. Guaranteed renewability ensures a stable market because seniors can keep their existing benefits by simply continuing to pay their premiums on time. An abrupt alteration of the Medigap cost-sharing benefits for in force policies will cause a major market disruption and cause serious confusion for seniors. Medigap policyholders will look to their state insurance regulators for assistance and to their congressional representatives for answers when they find out that the guaranteed renewability provisions of their Medigap policies have not been honored.
Source: aplaceformom.com

Selecting Medicare Supplement Health Insurance

The first step in choosing the best supplemental policy for your personal needs is to analyze your medical costs. This includes any regular bloodwork or other tests, necessary prescriptions, hospitalizations, and physician or specialist visits. Evaluating your current costs can get complicated when you toss into the mix the different coverage provided by Medicare Part A, Medicare Part B, and Medicare Part C. Be sure to include in your costs the premiums for your Medicare policy or policies.
Source: articles-digest.com

Medicare Colorado Announces Meetings in Colorado Springs, Pueblo, Canon City, and Falcon for the 2012 Open Enrollment Period

Posted by:  :  Category: Medicare

CENTRAL CITY, COLORADO 1968 by roberthuffstutterThe Medicare Open Enrollment Period is an annual event allowing beneficiaries to evaluate their Medicare Advantage and Part D Prescription Drug Plans. If a beneficiary is not happy with their current plan, this is the time to change to a plan that better fits their needs. Most Medicare beneficiaries qualify for Medicare when turning 65, but others may qualify through disability. The 2012 Open Enrollment Period is from October 15th to December 7th, with plan effective dates beginning January 1, 2012.
Source: aidiia.com

Video: Colorado Medicare Supplements

Romney proposal would privatize part of Medicare Colorado Springs Gazette

The Republican presidential hopeful and former Massachusetts governor has released a broad plan to transform Medicare, the popular health-insurance program for the elderly. He addressed the lightning-rod issue and other spending cuts during a fiscal policy speech before an afternoon gathering of conservative activists at the Washington Convention Center, where the tea party-allied group Americans for Prosperity is holding a two-day event.
Source: gazette.com

Medicare Advantage & Medicare Supplement Info: Medicare Supplement Plans In Nevada, Colorado, and Utah

Typically the healthier the state the lower the rates. All of these states boast a very good health rating. When a Medicare Supplement Company has lower health claims they also have lower costs which they usually pass along to the consumer as lower rates for there plans. Actually these companies are able to look in years past to try to determine there future costs for claims, when they see that in years past claims costs have been comparably lower than other states they are able to keep prices lower because of that. These rocky mountain area states thus are benefiting from a healthy life style, All of these states have lots of outdoor activities which aide in preserving a great health rating.
Source: blogspot.com

Colorado Medicare patients denied new cancer treatment

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Source: prostate8.com

Prostate Cancer Treatment Denied To Colorado Medicare Patients

If there is a treatment option available for a cancer patient that is more effective, cheaper, and poses fewer risks than other available treatments, common sense says to use it. However, Medicare in four states, including Colorado, is denying patients just that. Colorado’s 9 News reports that a treatment called Cyberknife, a fairly new form of radiation treatment available for men suffering from prostate cancer, is being denied to patients because of a supposed lack of research behind the procedure.
Source: mcdivittlaw.com

The Durango Herald 10/17/2011

Health plans change, so Medicare officials advise patients to review both their health and prescription drug coverage plans. One-on-one counseling is available for patients at Colorado

Medicare health insurance Supplements plus Medicare Benefits Plans Won’t be the same Thing

Posted by:  :  Category: Medicare

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Source: buildbydesignconst.com

Video: Whitehouse: Cuts to Social Security and Medicare Benefits Have No Place in Debt Talks

Medicare insurance Supplements and also Medicare Benefits Plans Won’t be the same Thing

Routinely, Medicare Advantages Plans were considered HMO strategies were a good insured person was mandated to use the seductive plan hospitals, clinical doctors, and various other medical providers to always be covered. Numerous Medicare Advantages Plans are usually HMO strategies. However, PPO Treatment Advantage strategies also be present. Fee for the purpose of Service Treatment Advantage Projects, or plans which will cover all medical carriers who consent to the insurance policy, are becoming marketed aggressively today.
Source: tahoeweddingbook.com

Medicare’s Future: Will Medicare benefits be cut?

If the Super Committee fails to reach an agreement, Medicare growth would still be curbed for the 2013 plan year because The Budget Control Act of 2011, the same law that created the Super Committee, requires specific budget cuts to be made if the Super Committee can’t reach a consensus and move a bill forward. The current law requires federal spending reductions beginning in 2013. Included in these cuts are a two percent (2%) reduction in Medicare payments to hospitals and other providers.   This is on top of the over $400 billion in ten year Medicare savings that were a part of the 2010 health care reform legislation.
Source: ehealthinsurance.com

modern 2010 Modernized Medicare Supplement Plans

Medicare insurance is a health insurance program for citizens who are over 65 years passe. it covers different types of treatments, doctors visits as well as hospitalization and many other medical related expenses apart from those that are incurred by care for the long term. It takes care of up to 80% and depends on a number of things such as the type of coverage the patient is under. There are times where people are not able to obtain co-payment in cash and therefore they opt for Medicare supplemental insurance that are available and managed by different companies but work with Medicare guidelines National Medicare supplements approach with 12 options from which the clients can settle. Though they all have different types of terms and conditions, they bask in the basic Medicare benefits. The incompatibility is seen in the premium, as well as the expenses that the client will pay which vary from one company to the other.
Source: medicaresupplementalinsurances.org

U.S. Forest Service waives fee during Veterans Day weekend

The original Medicare program has two parts: Part A (Hospital Insurance), and Part B (Medical Insurance). Only a few special cases exist where prescription drugs are covered by original Medicare, but as of January 2006, Medicare Part D provides more comprehensive drug coverage. Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits. All Medicare benefits are subject to medical necessity. Part A: Hospital Insurance Part A covers inpatient hospital stays (at least overnight), including semiprivate room, food, tests, and doctor’s fees. Part A covers brief stays for convalescence in a skilled nursing facility if certain criteria are met: 1. A preceding hospital stay must be at least three days, three midnights, not counting the discharge date. 2. The nursing home stay must be for something diagnosed during the hospital stay or for the main cause of hospital stay. 3. If the patient is not receiving rehabilitation but has some other ailment that requires skilled nursing supervision then the nursing home stay would be covered. 4. The care being rendered by the nursing home must be skilled. Medicare part A does not pay for custodial, non-skilled, or long-term care activities, including activities of daily living (ADL) such as personal hygiene, cooking, cleaning, etc. The maximum length of stay that Medicare Part A will cover in a skilled nursing facility per ailment is 100 days. The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment (as of 2009, $133.50 per day). Many insurance companies have a provision for skilled nursing care in the policies they sell. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 100-day clock is reset and the person qualifies for a new 100-day benefit period. Part B: Medical Insurance Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working. Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor’s office. Medication administration is covered under Part B only if it is administered by the physician during an office visit. Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered. Complex rules are used to manage the benefit, and advisories are periodically issued which describe coverage criteria. On the national level these advisories are issued by CMS, and are known as National Coverage Determinations (NCD). Local Coverage Determinations (LCD) only apply within the multi-state area managed by a specific regional Medicare Part B contractor, and Local Medical Review Policies (LMRP) were superseded by LCDs in 2003. Coverage information is also located in the CMS Internet-Only Manuals (IOM), the Code of Federal Regulations (CFR), the Social Security Act, and the Federal Register. Part C: Medicare Advantage plans With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Traditional or “fee-for-service” Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships. In exchange for these extra benefits, enrollees may be limited in the providers they can receive services from without paying extra. Typically, the plans have a “network” of providers that patients can use. Going outside that network may require permission or extra fees. Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan’s network or “panel” of providers. Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare,[11] in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.[12] However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.[10] Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.[13] Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD. Enrollment in Medicare Advantage plans grew from 5.4 million in 2005 to 8.2 million in 2007. Enrollment grew by an additional 800,000 during the first four months of 2008. This represents 19% of Medicare beneficiaries. A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan. Medicare Advantage enrollment is higher in urban areas; the enrollment rate in urban counties is twice that in rural counties (22% vs. 10%). Almost all Medicare beneficiaries have access to at least two Medicare Advantage plans; most have access to three or more. Because of the 2003 law’s overpayments, the number of organizations offering Fee-for-Service plans has increased dramatically, from 11 in 2006 to almost 50 in 2008. Eight out of ten beneficiaries (82%) now have access to six or more Private Fee-for-Service plans.[14] Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that “their most important reason for leaving was due to problems getting care.”[15] There is some evidence that disabled beneficiaries “are more likely to experience multiple problems in managed care.”[16] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[17] On the other hand, an analysis of the Agency for Healthcare Research and Quality data published by America’s Health Insurance Plans found that Medicare Advantage enrollees spent fewer days in the hospital than Fee-for-Service enrollees, were less likely to have “potentially avoidable” admissions, and had fewer re-admissions. These comparisons adjusted for age, sex and health status using the risk score used in the Medicare Advantage risk adjustment mechanism.[18][19] In December 2009 the Kaiser Family Foundation published a report that rated Medicare Advantage organizations on a five star scale. The ratings were based on data from CMS, the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) data, and the Health Outcomes Survey (HOS). New plans did not receive ratings, because data were not available. Almost six out of ten (59%) of MA plans did receive ratings, and these plans represented 85% of the enrollment for 2009. The average rating was 3.29 stars. Twenty-three percent of enrollees were in a plan with four or more stars; 20% were in a plan with fewer than three stars.[20] Twenty percent of African-American and 32 percent of Hispanic Medicare Beneficiaries were enrolled in Medicare Advantage plans in 2006. Almost half (48%) of Medicare Advantage enrollees had incomes below $20,000, including 71% of minority enrollees.[21] Others have reported that minority enrollment is not particularly above average.[22] Another study has raised questions about the quality of care received by minorities in MA plans.[23] The Government Accountability Office reported that in 2006, the plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.[24] [edit] Part D: Prescription Drug plans Main articles: Medicare Part D and Medicare Part D coverage gap Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.
Source: medicare-health.com

Vigilant Counsel News Blog

Can an employer reduce or eliminate benefits for a current employee when the employee becomes eligible for Medicare? No, because doing so is probably a violation of the federal Age Discrimination in Employment Act (ADEA) and also a violation of the Medicare rules, according to a recently released informal discussion letter from the federal Equal Employment Opportunity Commission (EEOC) (ADEA: Coordinating Medicare with Current Employees’ Benefits, August 2, 2011). In the discussion letter, the EEOC reminds employers that the ADEA exemption that allows employers to drop employer-sponsored health coverage upon Medicare eligibility applies only to retiree coverage, not to current employees. And, because dropping coverage for current employees upon Medicare eligibility is an age-based action, the employer must meet the ADEA’s “equal benefit or equal cost” defense to pass muster under the ADEA, meaning that the employer must provide older employees the same benefits as are provided to younger employees, or else they must incur the same cost to provide benefits, even if the benefits that may be purchased for that cost are less than what may be purchased for younger employees. Finally, the EEOC noted, the Medicare program itself requires employers to offer current employees, who are Medicare-eligible the same benefits under the same conditions as those employees who are not Medicare-eligible.
Source: vigilantcounsel.org

Report: Super Committee Democrats Caving On Medicare Benefits Cuts

The sweet Jesus lovin’ Republicans once again have pushed the weak-spine Demos, inspired by Captain Crap Out the Capitulator (you might know him as Hopie-Changie), into causing mass death and pain among senior citizens. Praise the Lord, for the Republicans follow Jesus’ example with love: – Raise your rifles and fire to the heavens, for the Lord’s got a smiley paint ball with holy water aimed at your temple! – Blessed are the rich and whoa to the poor: let me reiterate, it is easier for a camel to pass through the eye of a needle, than for a poor man to enter heaven. – “When I was stuff from my $700 dinner, you gave me more when your health care premiums increased; when I whined about my Porsche, you accepted stagnant wages; when Hopie-Changie had no courage to raise my taxes a microscosim, you fought against your own personal interests and ordered his ass to stay put.” – The world is flat! The bible says so! Remember, farts, the health care your parents receive should be the same care you’ll desire when you’re old and kaput. If our current senior citizens suffer, than we’ll deserve no different upon retirement.
Source: businessinsider.com

Survey shows Medicare benefits not fully understood by many

Another factor that came out from the survey was that many of those taking the survey felt they knew a good deal about health care cost management when, in fact, they did not. Some 78 percent said they believed they were knowledgeable about Medicare benefits. But when asked what was covered in Medicare Part A, many could not answer. Also, more than 50 percent of those taking the survey said they did not have a strategy to pay for long-term care needs.
Source: connecticutelderlawblog.com

Earlier deadline for changing 2012 Medicare coverage?

You may have heard that there is a new, earlier deadline if you want to change your 2012 Medicare coverage. And you may be wondering how that applies to you and your coverage under traditional Medicare and its provision for Christian Science nursing in a religious non-medical healthcare institution (RNHCI) such as the Benevolent Association. Traditional or original Medicare benefits are covered under Medicare Part A and Part B. It is Part A that provides coverage in a RNHCI.
Source: chbenevolent.org

Medicare: What Family Caregivers Should Know

You may, for example, be caring for an aging parent who is enrolled in a Medicare Advantage plan and becomes hospitalized. After the hospital stay, he/she may need inpatient rehabilitation care at a Skilled Nursing Facility. However, the Medicare Advantage Plan may have limited skilled nursing facilities within the network and you may not be pleased with the options. In that situation, there is what is known as the OEPI (Open Enrollment Period for Institutionalized Individuals). Persons “institutionalized” (i.e. residing in or moving in and out of a skilled nursing facility and other eligible institutions) have a continual enrollment period. The person can disenroll from a Medicare Advantage plan while in the facility and return to regular Medicare (or a different MA if accepting enrollment) the beginning of the next month.
Source: agingwisely.com

Benefits of AARP Medicare

In most countries retired persons have special care and respect amongst the folks. Similarly, USA has announced so several luxuries and health facilities for these old age folks. AARP Medicare is great and most helpful insurance plan that delivers numerous benefits to all members. Medicare New Jersey supplies splendid supplement insurance policies for old aged people. AARP Medigap brings so several features and great merits, which serve members in outstanding style. Cost of these insurance applications is dissimilar to each other.
Source: haogao8.com

Unions speak out on PEIA co

Posted by:  :  Category: Medicare

Congressman Kendrick B. Meek by cliff1066™Pharmacy Option B would place a $8 co-pay on generics and a $16 co-pay for a 90-day supply of generics. The co-pay for preferred brand would be $50, with a 90-day supply costing $125. The co-pay for non-preferred brand would be $85, with a 90-day supply costing $212.50. Specialty drugs would cost $100. Pharmacy Option C would remove proton-pump inhibitor coverage and Pharmacy Plan D would eliminate coverage for $4 generic drugs.
Source: watchdog.org

Video: Medicare Advantage Plans 2011

Louisville Medicare Advantage Plan, KY, Change, Switch, Compare, Replace

Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist) and these rules can change each year.
Source: bradeninsurance.com

Compare Medicare Supplement Insurance to Medicare Advantage Coverage

Furthermore, you simply may not be able to switch back to a traditional supplement if you have certain preexisting conditions.   Most Medicare supplement providers require medical underwriting if you have been enrolled in an Advantage plan for over one or two years.   In other words, you can be declined coverage.   Additionally, it can be difficult to disenroll from a MA plan if it is not the correct time of year.
Source: ohioinsureplan.com

Medicare Advantage and Medigap: What is the difference?

You must be eligible for Medicare A and B to enroll in this plan. It is easiest to think of Medicare replacement plans as a private insurance policy that provides all Medicare A and B services (except Hospice services, which Medicare will continue to cover) and then some. You will likely have to choose a physician from those listed as in-network and use agencies such as home health agencies and rehabilitation facilities approved by the insurance provider. This is typically different from having Medicare A and B, where most physicians, home health agencies and rehabilitation facilities accept Medicare and your provider selection is not limited by Medicare itself.
Source: hubpages.com

2012 Medicare Deductibles and Premiums: Is This the Year You’ll Collect Deductibles at Time of Service?

The largest factor affecting the contingency margin for 2012 is the current law formula for physician fees, which will result in a payment reduction of about 29percent in 2012. For each year from 2003 through 2011, Congress has acted to prevent smaller physician fee reductions from occurring. The 2012 reduction is almost certain to be overridden by legislation enacted after Part B financing has been set for 2012. In recognition of the strong possibility of increases in Part B expenditures that would result from similar legislation to override the decrease in physician fees in 2012, it is appropriate to maintain a significantly larger PartB contingency reserve than would otherwise be necessary. The asset level projected for the end of 2012 is adequate to accommodate this contingenIn 2012, Social Security monthly payments to enrollees will increase by 3.6 percent. The dollar increase in benefit checks is expected to be large enough on average to cover the increase in the Part B premium of $3.50 that most beneficiaries will experience. For those who were paying the standard premium of $115.40, their benefits checks will only increase.
Source: managemypractice.com

Two Tips if Your Medicare Plan is Terminated

Each year some Medicare beneficiaries are forced to face finding a new Medicare health plan because their plan is terminated.  The reason the Medicare plan won’t be  available in the coming year may be because it was not approved by the government agency that runs Medicare (CMS) or the company may have decided to stop offering it.
Source: momentumtoday.com

A Bonus for Managed Medicare

Perceiving the potentially devastating impact the PPACA bill will have on MA plans (and likely with the 2012 elections in mind), CMS and the Obama announced in April 2011 a new star-rating bonus demonstration to include all plans rated 3-stars and higher in the bonus structure through the end of 2014. This now means that almost all plans (85% of plans received a star rating 3 or greater) will be included in the bonus plan for the next 3 years. The demonstration will end in 2015 at which time the plans receiving less than 4 stars will no longer receive a bonus. The demonstration will provide political cover during the phase-in of the new payment methodology, and will provide training wheels to plans that are endeavoring to achieve 4 star ratings, or better, by 2015. This updated table below illustrates the impact of the demonstration.
Source: leavittpartnersblog.com

What Medicare Beneficiaries Need to Know about Medicare Dental Services

Currently, Medicare does not cover routine dental care or most dental procedures such as cleanings, fillings, tooth extractions or dentures. Medicare only pays for dental services that are an integral part either of a covered procedure (e.g., reconstruction of the jaw following accidental injury) or for extractions done in preparation for radiation treatment for neoplastic diseases involving the jaw.
Source: projektgenerika.org

Medicare Enrollment Window Opens Earlier

Posted by:  :  Category: Medicare

George W. Bush by cliff1066™Along with the accelerated enrollment period, it is hoped that beneficiaries will have their Medicare cards by the start of the New Year. Customarily, late enrollees find themselves in a bit of a pickle (i.e., without their Medicare cards) come January 1. While the start date this year is non-memorable (October 15), the deadline isn’t for most Americans of Medicare eligibility age (December 7).
Source: kaneandkoltun.com

Video: Heat Exposure within Seniors of Florida Medicare and Ocala Medicare

Florida Medicare Advantage Plans

Florida has a large number of Medicare Advantage plans available.  One reason could be the large population of seniors that retire to the state.  The first thing to consider if you are looking for a Medicare Advantage plan in Florida is that the plans are NOT state specific.  The are in fact county specific.  Check here to look up Medicare Advantage plans by state for 2012.  Chances are you will find a company in South Florida that is not at all available in the Northern part of the state.  One exception to this is United Healthcare.  They offer a plan that is identical across the state.  This is probably because of the size of the company.  They also offer a large network across the state.
Source: medicare-plans.net

South Florida Seniors Paying Too Much for Medicare Drug Plans

Aetna Assurant Health Blue Cross Blue Shield Plans Celtic Insurance Company CIGNA Fairmont Specialty Group Golden Rule Group Health Cooperative Group Health Incorporated Health Net Health Partners Humana Intermountain Health Care Kaiser Permanente LifeWise Health Plans Medica Medical Mutual of Omaha Midwest Security Oxford Health Plans PacifiCare Security Life UNICARE United Wisconsin Life/American Medical Security Vista Health All Available Providers
Source: individual-health-plans.com

Medicare Supplemental Insurance in Naples Florida Part 3

Medicare Supplemental Insurance in Naples Florida Part 3 goes over the Medicare Supplement Plan that covers all 9 gaps original Parts A and B of Medicare leave behind for the consumer/Medicare beneficiary to pay. Most of the people currently buying Medigap insurance today buy Medicare Supplement Plan F to cover their hospital and doctor expenses at 100%. The only difference between the different companies who offer plan F is is price so log on to www.medicaresupplementsmadeeasy.com to receive your free quote today. http forum.medicaresupplementsmadeeasy.com Video Rating: 0 / 5
Source: coloradomedicaremedigap.com

Fiorella Insurance: Medicare In Florida

Out of the 18,000,000 residents of Florida, approximately 18% are enrolled in Medicare according to data from the Kaiser Family Foundation. These statistics mean that in Florida, Medicare is a subject of critical concern for nearly one out of five people. Most of these Medicare beneficiaries (63.8%) are age 70 or older and more than half of all Florida Medicare beneficiaries are women. Florida Medicare beneficiaries may enroll in stand-alone prescription drug plans, Medicare Advantage plans, or Medicare Supplement (Medigap) plans. However, many residents are often unclear regarding the differences among these types of plans and gravitate towards whatever plan has been marketed to them. Stand-alone Medicare prescription drug plans, sometimes referred to as PDPs, are private insurance plans approved to provide drug coverage to people enrolled in either Medicare Part A or Part B. There is no coverage for hospitalization or medical services in a stand-alone PDP, only drug coverage. Each PDP has a list of drugs that it covers. This list is known as a formulary. Medicare mandates that a formulary must cover AT LEAST two drugs from each therapeutic category approved by Medicare. Formularies also determine how much you pay for a drug covered by the PDP plan. PDPs can cover different drugs so it is vital that you confirm that your drugs are covered before enrolling in a PDP plan. Medicare Advantage plans are private health insurance plans available to people enrolled in Medicare Parts A and B. They provide hospitalization and medical benefits and, most often, include prescription drug coverage. However, as is the case with stand alone prescription drug plans, Medicare Advantage plans with drug coverage have formularies that determine which drugs they cover and which ones they do not cover. Always confirm your drugs are covered before enrolling in a Medicare Advantage plan. Some Medicare Advantage plans can be confusing because they offer a $0 monthly premium. Those insurance companies that offer this rate can do so because they receive a reimbursement rate from the government that enables them to remain profitable given their plan enrollees. Medicare Supplement plans intend to cover the out-of-pocket expenses, or “gaps,” associated with Medicare Parts A & B. In every state but Massachusetts, Minnesota, and Wisconsin, there are ten standard plan types from which to choose. Each of the plan types has a letter name: A, B, C, D, F, G, K, L, M, and N. Each plan covers different out-of-pocket expenses with plan F having the broadest coverage. Medicare Supplement plans do not include prescription drug coverage. However, you may enroll in a stand-alone prescription drug plan alongside a Medicare Supplement plan. According to statistics from 2010, 32% of Medicare beneficiaries in Florida were enrolled in stand-alone prescription drug plans as compared to 29% in Medicare Advantage plans with drug coverage and 27% had prescription drug coverage from another source such as an employer plan. United Healthcare’s 2010 statistics claimed that Florida had over 642,000 residents enrolled in a Medicare Supplement plan.
Source: blogspot.com

Top Medicare Health Plans in Florida

This entry was posted on Monday, September 12th, 2011 at 1:34 pm and is filed under AvMed, florida health insurance, Health First Health Plans, health insurance carriers, health insurance rankings, Health Plan Rankings, medicare, medicare advantage, Senior Health Insurance. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.
Source: healthinsurancesort.com

Florida Elder Law and Estate Planning: Medicare Open Enrollment Starts, Ends Earlier This Year

Alert to Medicare beneficiaries: The enrollment period starts and ends earlier this year! From Oct. 15 through Dec. 7 you have the opportunity to look at your Medicare coverage, examine any new options, and decide if you want to make changes in your coverage. The enrollment period has been adjusted to allow the government more time to process the changes, and ensure recipients have their new membership cards in hand by Jan. 1, 2012.
Source: blogspot.com

Florida Senior Medicare Patrol Program Receives National Award

In 2010, SMPs nationwide received additional funding from CMS to expand the capacity of the program to educate more older Americans on how to prevent, detect and report health care fraud. “CMS believes that the consumer education efforts of the SMP program at the grassroots level are an essential part of our national strategy to decrease waste, fraud and abuse in the Medicare system,” said Angela Brice-Smith, director of the Medicaid Integrity Group/Center for Program Integrity at CMS.  She presented the SMP awards along with Barbara Dieker, AoA, at the 2011 SMP National Conference.
Source: wordpress.com