My Disability Blog: Social Security Disability, Cobra, and Medicare Eligibility

Posted by:  :  Category: Medicare

The following question was submitted recently in a comment: “On Social Security disability my cobra has been canceled and I am not Medicare age yet will I become eligible for Medicare?” If you are receiving Social Security disability benefits, you will become eligible for Medicare insurance benefits two years after the month you became entitled to your monthly disability benefits. You will be eligible for Medicare part A and B, as well as, part C and D at that time. Medicare part A is free, while part B, C, and D are pay insurance coverage. Medicare coverage can be difficult to understand, if you do not understand your Medicare benefits call 1-800-Medicare. They can provide assistance or refer you to other agencies that can help you chose the right Medicare coverage for you. Additional information on Social Security Disability at www.ssdrc.com Return to the Social Security Disability SSI Benefits Blog
Source: blogspot.com

Video: Continued Medicare Eligibility and Work Incentives

Income at Risk: Unemployment Rates Rise Sharply for People with Disabilities, Allsup Finds

The Allsup Disability Research: Cash flow at Danger reveals that 737,468 men and women with disabilities applied for SSDI throughout the 3rd quarter of 2011, down 3 percent from the preceding quarter. Yr-to-date, almost 2.22 million folks have submitted disability promises, in contrast with nearly two.23 million applicants by the exact same time final yr. Because the fourth quarter of 2007, when the economic downturn started, more than 10.8 million folks have applied for SSDI. Virtually 1.8 million SSDI statements are pending with an average cumulative wait time of much more than 800 days, based mostly on Allsup’s evaluation of the Social Protection disability backlog.
Source: be-a-sugar-baby.com

Medicare Drug Get advantages Gaining Thousands and thousands Of Enrollees

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Source: articlessupport.com

The Federal MediCare Insurance policy Rewards

Custodial nursing house care Most outpatient prescription drugs Routine bodily examinations Routine eye examinations and eyeglasses Hearing examinations and listening to aids Routine dental providers Routine foot care and orthopedic footwear Most immunizations Personalized convenience things Cosmetic surgical procedure
Source: householdsensors.org

Raising Medicare Eligibility Age to 67 is a huge, indirect Cut to Social Security

WASHINGTON, D.C. Nov. 3, 2011 – On Tuesday, Erskine Bowles, co-chair of the president’s deficit commission recommended that the Super committee raise Medicare’s earliest age of eligibility to 67. If Congress were to follow this advice, out-of-pocket health care costs’ could consume as much as 45 percent of the Social Security checks of 65 and 66 year olds, according to a new analysis which builds on a Kaiser Family Foundation report. According to that report, 3.3 million people aged 65 and 66 would pay more out-of-pocket for health care if they were no longer eligible for Medicare. “Erskine Bowles is proposing to take billions of dollars right out of the pockets of the nation’s seniors and their families and billions more out of local communities,” said Eric Kingson, co-chair of the Strengthen Social Security Campaign. “Americans overwhelmingly disagree with cuts to Social Security, Medicare and Medicaid. They know that these programs didn’t cause the deficit and they are sick of the 99 percent being asked to pay for the failures of the one percent. The 99 percent cannot afford these cuts, neither can the communities where they live.” Existing Social Security beneficiaries, aged 67 and older would also see their out-of-pocket health care costs increase, and consequently, their Social Security benefits reduced because on average, the healthiest, least expensive members of the Medicare risk pool, those aged 65 and 66, would be removed. It is estimated that Part B premiums, which are automatically deducted from Social Security checks, would increase by 3 percent in 2014 on top of increases produced by rapidly rising health care costs. “The so-called Super committee appears unwilling to force the 1 percent to sacrifice even a small amount. In contrast, both Democratic and Republican members of the Super committee have proposed tremendous sacrifices by the 99 percent, including by seniors who have spent their lifetimes, often in physically demanding jobs, contributing to our country. Both the Democrats and Republicans have offered plans which reportedly cut Social Security and increase the out-fo-pocket health care costs of seniors, people with disabilities and others who depend on Social Security and Medicare. If they decide to follow the advice of Wall Street multi-millionaire Erskine Bowles, and increase Medicare’s eligibility age to 67, they will shift costs to those least able to afford it – the sickest and the oldest among us,” said Nancy Altman, co-director of Social Security Works. “At a time when the 99 percent are already struggling, the Super committee seems poised to compound their hardship.” Costs to Social Security beneficiaries could also be substantially higher than estimated. The Kaiser Family Foundation report assumes the health insurance exchanges and subsidies enacted under the 2010 Patient Protection and Affordable Care Act (ACA) will be fully implemented by 2014. If any or all of four key provisions of the ACA are scaled back or repealed the increase in out-of-pocket health care costs due to raising the Medicare eligibility age would be significantly higher and consume a much greater proportion of Social Security benefits. Below are specific dollar amounts seniors would lose through Medicare cuts: · Out-of-pocket health care costs would increase, on average, by $4,300 in 2014 for 960,000 people aged 65 and 66 who purchase coverage through a health insurance exchange and have incomes exceeding 400 percent of the federal poverty level ($43,560), making them ineligible for subsidies available to exchange participants with lower incomes. · Out-of-pocket costs would increase, on average, by $1,200 for 240,000 people aged 65 and 66 who purchase coverage through a health insurance exchange and have incomes between 300 and 400 percent of the federal poverty level ($32,670-$43,560). · Out-of-pocket costs would increase, on average, by $2,200 for 1.1 million retirees with employer-sponsored retiree health plans if the increased cost to employers did not cause them to terminate these plans. · Out-of-pocket costs would increase, on average, by $500 for 1 million retirees with employer-sponsored health plans if the increased cost to employers did not cause them to terminate these plans. The Strengthen Social Security Campaign is comprised of more than 320 national and state organizations representing more than 50 million Americans from many of the nation’s leading aging, labor, disability, women’s, children, consumer, civil rights and equality organizations. www.strengthensocialsecurity.org
Source: yubanet.com

Medicaid: Health Care Insurance Program for Senior Citizens1

These rules and regulations will still vary depending on your state or the eligibility group you belong in. There are also special rules for senior citizens who are currently living in nursing homes and for parents who have children with disabilities who are living at home. For senior citizens who have a limited source of income, they may still be qualified to have financial support from Medicaid. You can always ask help from a qualified caseworker in your area to help you complete the application process. Again, depending on the policies and the rules of your state, you may still be liable to pay for a small portion of the total of your medical expenses, but in most cases, Medicaid helps pay for most of these, including the payments for nursing home care.
Source: 1800homecare.com

Medicare Drug Get advantages Gaining Tens of millions Of Enrollees

By: In step with a recent file from the Division of Well being and Human Services and products (HHS), Medicare’s new prescription drug benefit now covers 25 million American citizens, with an ordinary of 250,000 new enrollees being added every week. In a promising sign of the program’s enlargement, HHS’ progress file showed that the number of beneficiaries rose greater than 2.6 million in a month. “It is important for seniors and folks living with disabilities to be mindful their choices with Medicare’s new prescription drug receive advantages,” stated Senator Bob Dole, former presidential candidate, who’s best an ongoing, nationwide tour to advertise the new drug receive advantages to seniors. “Any person eligible for Medicare in need of dependable drug coverage can join a Medicare-approved plan and potentially store a significant sum of money on their medications.” HHS says there are advantages to enrolling in a Medicare drug plan at first of any given month. Consistent with HHS, signing up early within the month manner enrollees will most likely have their prescriptions crammed directly and lets them get the best worth out in their drug protection from the primary day it goes into effect. More importantly, any person who desires to benefit from the convenience this yr must join via May 15, 2006-the final day of 2006′s open enrollment period. Seniors who have Medicare’s new prescription drug coverage are experiencing decrease costs and are spending much less on their medications than ever before. So as to maximize savings, seniors must examine the new Medicare options with their current coverage to decide which choice is best possible for them. Eligible seniors and other folks with disabilities may wish to discuss with family members to assist them take note the brand new benefit. Advocacy companies representing greater than eight million Americans are aiding Dole’s speaking tour. Any person recently enrolled in or eligible for the brand new receive advantages can log on to Dole’s Internet web page that is up to date often with important knowledge for seniors and their households If you want extra knowledge with respect to medicare part a, stop by Julissa Q Budnick’s internet site right away. Article Courtesy of Article Submission Directories
Source: articlestoeditors.com

Learn About Social Security Disability Requirements

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Source: home-care-assistance.com

Medicare Open Enrollment and Eligibility

Consumers who discontinue a Medicare Advantage plan within one year of acceptance can purchase a supplemental policy. Due to the complexity of Advantage plans, government mandates allow consumers one year to opt out and return to traditional Medicare and Medigap coverage. If the insured has participated in the coverage for longer than a year, then medical underwriting may be necessary for plan purchase.
Source: ohioinsureplan.com

GOP Members of Debt Panel Call for Medicare Reforms, Tax Revenue

Posted by:  :  Category: Medicare

Congressman Brad Sherman, California’s 27th District (D) by cliff1066™Democrats and Republicans on the debt panel have had a long-standing impasse over the GOP’s refusal to accept tax increases and Democrats’ insistence against cutting entitlement programs. The GOP proposal marks the first time Republicans have considered actual tax increases as part of deficit-reduction strategies.
Source: californiahealthline.org

Video: California Medicare Supplements

Choosing the Best Plan is very Important

The people who are just turning sixty five are sure to find their lives changing at a very fast pace for the worst and in some cases even for the better. Seniors in almost all countries are eligible for a number of benefits and among so many benefits available to the seniors all over the main is Medicare. It is one such federally funded health insurance program that is very instrumental in solving the health related problems of the seniors and pays for all their health needs including surgeries, prescription drugs, checkups, treatments, and items and accessories that make life easier such as wheelchairs and canes. Beside several advantages of the Medicare policy, it is not untouched by a single problem and that is it does not cover all of an individual’s needs. This is the reason why Medigap or Medicare Supplemental Insurance has been brought into the forefront by the federal government. The individuals who approach the age where they qualify for Medicare, they begin to wonder about the medigap costs. It is nothing but a supplement policy that pays off a portion of the medical bills that are not covered by the original Medicare.
Source: articlesark.com

Medicare Meeting in La Honda

Christina Kahn, Community Outreach Coordinator for the Health Insurance Counseling and Advocacy Program (HICAP) will meet with individuals from the La Honda and Pescadero communities to discuss the upcoming changes in Medicare coverage in 2012.  She will also present comparisons and other information about current supplemental health insurance options (please note that if  you wish to change your Medicare coverage in any way, you can do so between October 15 and December 7, 2011).  The meeting will take place at the Puente Office in Downtown La Honda and is sponsored by the La Honda 55+ Program.  HICAP, an information and counseling service, is supported by the local Agency on Aging.  They do not represent or advocate for particular insurance or healthcare entities and appointments with HICAP Counselors are typically made through senior centers.
Source: pescadero-california.com

California Medical Association calls on Centers for Medicare & Medicaid Services to address access problem

SACRAMENTO, Calif. Oct. 26, 2011 – The California Medical Association (CMA) has submitted an official request to the Centers for Medicare and Medicaid Services (CMS), asking CMS to take corrective action to address California’s unacceptably low provider fee rates. The request is separate from and independent of the review of the state plan amendment proposals currently pending before CMS and the U.S. Department of Health and Human Services. “What we’re seeing from independent research recently conducted is that patients are already having a hard time getting access. Regardless, the Department of Health Care Services (DHCS) has submitted state plan amendments (SPAs) that would further reduce Medi-Cal reimbursements, which already are substantially lower than what it costs the physician to see the patient” CMA president James T. Hay, M.D., said. “We believe that California’s historically low rates have caught up with the state and are now having a significant and adverse impact on access to care.” Medi-Cal is intended to provide a comprehensive set of essential health care services to many of the poorest and most vulnerable Californians, i.e. low-income seniors, pregnant women, children and people with disabilities. The reality is, however, that Medi-Cal has become a second-class system in which enrollees are often unable to access consistent quality health care. Historically low provider reimbursement rates are a key reason for this tragic reality. According to research by the Urban Institute, Medi-Cal reimburses providers at 56 percent of the Medicare rate for the same service. For primary care services, Medi-Cal pays less than half of Medicare rates. “California is one of the most expensive states in which to practice medicine. For many physicians, the low rates paid by Medi-Cal make it economically unfeasible to participate fully or to participate at all in Medi-Cal. In a time when health care reform is adding new patients to the Medi-Cal program, we shouldn’t be cutting resources and limiting physician accessibility,” Dr. Hay added. CMA firmly believes that California’s current Medi-Cal physician fees fail to satisfy the Section 30(A) requirements that rates “are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area.” The organization representing 35,000 physicians in California is asking CMS to take corrective action and examine current reimbursement rates before considering the current SPAs submitted by DHCS.
Source: yubanet.com

Kaiser Medicare plans in California receive top ratings

This year’s Impact Sonoma conference focused on Sonoma County’s economic future, featuring the businesses and decision makers who are making a difference. Download presentations by keynote speaker Barry Schuler, chairman and founder of Raydiance of Petaluma, the world’s leading developer of ultrafast laser technology, and panelists Tom Scott, general manager of Oliver’s Market; Honore Comfort, executive director of Sonoma County Vintners; Bob Whitlock, general manager of Small Precision Tools; Tom Duryea, president and CEO of Summit State Bank; Efren Carrillo, chair of Sonoma County Board of Supervisors from the Fifth District; John Sawyer, councilman with the City of Santa Rosa, and Brian Sobel, political consultant.
Source: northbaybusinessjournal.com

Prime Healthcare's treatment of rare ailments stands out

Joseph Ingrande, Doty and Fedeli’s supervisor, said the meeting spurred him to leave. He sent a resignation letter just a few days afterward to hospital executives: “To stay and be part of these practices would give the appearance I approve and validate these procedures,” he wrote. “I cannot with good (conscience) be part of these activities which could potentially put me in legal jeopardy with (Medicare).”
Source: californiawatch.org

Medicare Premium Increase To Be Less Than Expected

Monthly premiums for Medicare Part B, which covers physician visits and outpatient procedures, will rise by $3.50 next year to $99.90. Earlier this year, Medicare trustees projected that premiums would increase by $10.20. Obama administration officials attributed the lower rates in part to cost-cutting provisions under the federal health reform law and beneficiaries’ lower use of services.
Source: californiahealthline.org

NEWS: Rep. Karen Bass Joins SEIU

“I oppose denying people the basic human right to healthcare, yet Republicans in Congress propose that we cut benefits for millions of seniors, people with disabilities and children who need lifesaving care. Eliminating essential care to our nation’s most vulnerable populations would not only jeopardize the health of our country, but also potentially millions of jobs that we cannot afford to lose at this crucial time,” said Rep. Bass.
Source: seiu-uhw.org

Medicare Supplement Plans California serves the people better

For skilled nursing home costs it is true that the Original Medicare pays all for the first 20 days of each benefit period. But from the day 21 you need to share a part of the bill. In that case Medigap plans C through J pay your share of the bill from day 21 till day 100. There is another Medicare supplemental insurance company available exclusively for the people of California which is called Medigap Insurance California. Cal-cobra is another attraction. Though the plan is a bit expensive from the mode of its premium payment it is even attractive than the group Medicare plans. However, it is cheaper than the individual plan. It includes some couples of former employees and along with that it covers the retirees, spouses, former spouses and also dependent children in a temporary continuation which is designed in a manner as same as the group Medicare insurance plan. The plan may cover two to nineteen employees at a time and also covers half of the percentage of the working days. The company as an individual authority is responsible here to pay the premium and not the employees themselves is another charming offer that is proposed by the plan.
Source: girls-fitness.com

New Medicare Innovation Advisors Program Announced | CPHA

The program will select and develop as many as 200 individuals from across the nation in its first year. The first group of Innovation Advisors will start their six-month intensive orientation and applied research period in December 2011. Innovation Advisors will be expected to commit up to ten hours per week to the Innovation Advisor Program during the initial six months of their fellowships, with part of that time devoted to seminars and instruction. The rest of that time will be devoted to implementing the improvement project they propose in their initial application.
Source: cphan.org

California Anthem Users Facing Medicare Changes

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Source: doctorsexpresstricity.com

Medicare Anthem Blue Bows Out of North Valley

Rachelle Parker was born in Oakland, California and raised in the Bay Area. Her grandmother moved to Oroville in 1960, resulting in Rachelle spending many summers and holidays in the area. Rachelle eventually followed her grandmother’s lead and moved to Oroville in 2003. A graduate of UC Berkeley with a degree in Sociology, Rachelle is a winner of the Judith Stronach Prize for prose, and contributed a story to The New City magazine in 1999 under the tutelage of Clay Felker. Rachelle has worked off and on as both a print and broadcast journalist since 1980, and is happy to bring her love of writing and her concern for her community to the task of being a citizen correspondent for KQED’s Health Dialogues.
Source: kqed.org

Democrats’ New Super Committee Proposal Includes $400 Billion In Medicare And Medicaid Cuts http://t.co/F0fdtwyb [ThinkProgress]

Posted by:  :  Category: Medicare

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Source: fearandvoting.com

Video: Medicare and You — 50% Off Brand-Name Prescriptions in the Donut Hole

Medicare, Medicaid Still Paying for Blood Drugs Despite FDA Warnings

Amgen and Johnson & Johnson have made billions in sales of the drugs. When the FDA issued its warning this summer, both companies issued detailed statements, including comments from their respective medical experts, on how the new information would help inform physicians. But sales are down, and Amgen last month announced a tentative $780 million settlement with the federal government over its sales and marketing practices for the anemia drugs, including doctor payments. The company said at the time that “if the ongoing settlement discussions are successfully concluded, Amgen expects that the proposed settlement will resolve the federal investigations, the related state Medicaid claims and the claims” in a major court case.
Source: thedailybeast.com

Romney Unveils Plan To Revamp Medicare, Medicaid

The Wall Street Journal: Romney Proposes Voucher Option For Medicare Plan The Romney Medicare plan could become a hallmark of the presidential campaign of 2012 should he win the Republican nomination. Democrats had already planned to make the Ryan Medicare plan, which they call privatization, a centerpiece of their efforts to unseat Republicans in Congress. Now Mr. Romney has thrust the future of Medicare more directly into the presidential race. Ben LaBolt, a spokesman for the Obama re-election campaign, charged that Mr. Romney’s budget proposal “would leave millions of older Americans to fend for themselves” under a privatized Medicare. Romney campaign aides reject the term “privatization” to describe their approach (Weisman and O’Connor, 11/5).
Source: kaiserhealthnews.org

Colors of Lupus Urges Congress to Shield Medicare, Medicaid

Medicare Element D, for case in point, lessens federal shelling out by $ twelve billion by covering medications that are presently trying to keep seniors out of the emergency space. Medicare Component D provides far more than 29 million Americans access to prescription medication at costs they can manage. Ahead of the development of Medicare Part D in 2006, a lot of therapies had been also expensive for as much as a 3rd of the elderly population. With no Medicare Element D, a lot of seniors would have forego such prescription drugs, in which scenario it?s only a matter of time before they conclude up in the hospital, driving charges up for taxpayers.
Source: route3construction.com

Health Care Reform Update: Where Are We, and What’s Up for 2012? 

[1]As referenced in previous Alerts, Health Care Reform consists of two separate laws, the Patient Protection and Affordability Care Act of 2010 (PPACA), Pub.L. 111-148 (March 23, 2010), and the Health Care and Education Reconciliation Act of 2010 (HCERA), Pub. L. 111-152 (March 30, 2010). The laws often are collectively referred to as the Affordable Care Act (ACA). [2] The Urban Institute, "America Under the Affordable Care Act" at http://www.urban.org/publications/412267.html (site visited Oct. 25, 2011). [3] Kaiser Family Foundation Health Reform Source Implementation Timeline at http://healthreform.kff.org/timeline.aspx (site visited Oct. 25, 2011). [4] See, e.g., MedPAC Report to Congress: Medicare Payment Policy (March 2010) noting that in 2010, overall payments to plans average an estimated 113 percent of original Medicare fee-for-service (
Source: medicareadvocacy.org

Colors of Lupus Urges Congress to Protect Medicare, Medicaid

“Those of us advocating on behalf of those victimized by this silent killer, lupus, and other debilitating autoimmune diseases, thank Senator Reid for his efforts to protect our vital access to treatment and for the medicines critical to sustaining quality lives and saving lives of those most vulnerable,” Ang said. “Without access or means for affordable treatments as provided by Medicare Part D, there is no hope, and without hope those afflicted and suffering from grossly debilitating diseases such as lupus are, and will continue, to be cast aside, alone, defeated and scared.”
Source: find-me-sugar-daddy.com

Daily Kos: No Cuts to Social Security, Medicare and Medicaid

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Source: dailykos.com

The American Spectator : The Spectacle Blog : Pushback on Romney’s Medicare Strategy

Not that Romney’s plan is necessarily bad: depending on the details, one could even argue that a reform that gave seniors a choice between private plans and traditional Medicare could prove to be a better solution than the Paul Ryan premium-support model. Romney, however, hasn’t spelled out those details. There’s no reason to praise him, or even think that he’s not just leading conservatives on, until he commits to some specifics. 
Source: spectator.org

New Poll: New Mexicans Overwhelmingly Support Medicare, Medicaid

The poll, which was conducted by Research and Polling, Inc., for six advocacy groups, shows that the vast majority of voters (83 percent) believe Medicaid is important to residents in New Mexico with 66 percent saying Medicaid is very important. Medicaid is the health program for the disabled, seniors in nursing homes, low-income children, and impoverished families. The majority (59 percent) of voters do not believe there should be any reductions in Medicaid spending as a way to reduce the federal debt.
Source: nmvoices.org

Super Committee Dems Again Offer to Cut Medicare Benefits

Instead, Democrats chose to totally throw away this potential political advantage. In the 2012 election the American people will now choose between two parties that want to cut your Medicare benefits. The fact that one claims to want to cut your Medicare benefits slightly less will be little comfort and make little difference to many regular voters.
Source: firedoglake.com

Healthcare Bulletin: Medicare Premium, Coinsurance, and Deductible Rates for 2012

This site and its content are provided for your convenience and use by Frost, Ruttenberg and Rothblatt, PC (FR&R). By gaining access to content contained in this web site, you are also confirming your identity for purposes of authentication. You are responsible for your username and password, and are responsible for their confidentiality. FR&R is not responsible for lost or stolen usernames and/or passwords that are used to gain access to this site. Failure to comply may result in termination of your access to content contained in this web site.
Source: frronline.com

Medicare Annual Enrollment: A Chance for Beneficiaries to Make Changes to Their 2012 Medicare Plans

Posted by:  :  Category: Medicare

Self Portrait Day 37 by HopkinsiiIn late September, Medicare beneficiaries received in the mail the handbook, “Medicare & You,” which contains useful information for seniors wishing to enroll in Medicare or change their coverage. Medicare beneficiaries who are already enrolled in a Medicare Advantage plan should have also received their Annual Notice of Change, a document that explains how their plan’s benefits and costs will change next year. Assess Your Current Needs Take time to accurately and completely determine your current medical requirements. Pay specific attention to any changes that have occurred in the last year. Have any of the medications you take changed? Were you diagnosed with a new medical condition? Have you moved? Any of these changes could impact which plan is best for you. Shop and Compare Information for the 2012 Medicare plans is available online at www.medicare.gov. This begins your opportunity to shop and compare available plans to determine which option is best suited for you.  In addition to your health care needs, there are other facts to consider: 
Source: patch.com

Video: Do I need to enroll in Medicare part B if I have VA benefits

Possible Enrollment Delays for Medicare for New Providers

Following is a notice from one of the MAC websites: Beginning November 1, 2011, all new providers submitting through an existing submitter ID (including billing services and clearinghouses) will be required to enroll/link using HIPAA version 5010. If the existing submitter ID is not certified for the version 5010 format, any enrollment requests to link new providers will be rejected and returned. This notice is in accordance with CMS Technical Direction Letter (TDL) 12035.
Source: wordpress.com

Who cannot get Medicare Cover and why?

In addition, there is a period called ‘open enrolment’ when eligible candidates may register themselves. It is during this time that someone may escape the strict condition’s noose if they miss or lack some of the requirements such as releasing all medical history records to the registrar and also the condition of having been working at a governmental position for more than six months prior to enrolment.
Source: oagnepal.com

DRX Trends: 10 Million+ Beneficiaries Have Been Enrolled in Medicare Plans Using DRX Tools

DRX’s Medicare plan comparison and enrollment tools—which are found on Medicare.gov and on the web portals of America’s largest health plans, Fortune 500 employers, brokers, agents, and other organizations that license these exchange products—not only facilitate enrollments, but also reduce costs for all involved, ultimately benefiting the overall Medicare system.
Source: drugtrendstoday.com

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

Common Medicare Questions and Answers

3. Can Medicare program consider a service to be unnecessary? Yes. If a doctor or physicians find it necessary to perform a certain medical operation or service which is not covered by the patient’s current Plan Policy benefits, they are supposed to notify or advice the patient in writing about the process and that Medicare will not cover the expenses. And if the service charges are estimated to exceed a level at which Medicare can cover, they are also supposed to notify the patient with them in writing. It is done in writing and the customer approves of the service by signing against the given notice.
Source: frontagecode.com

eMedicareSupplements Raises Awareness of New Enrollment Deadline

As a subsidiary of Affordable Insurance, Inc., eMedicareSupplements has made it a priority to help average people with the inner workings of a complex system. The website eMedicareSupplements.com features articles covering many different Medicare-related topics and questions. eMedicareSupplements agents are always available to help seniors, using their time and expertise to answer specific or difficult questions and help people get the coverage they need.
Source: release-news.com

Understanding the Medicare Benefits for Senior Citizens1

What does the Part D cover? The Medicare Prescription Drug Coverage is a type of health insurance program that are being run by insurance companies or other private companies that have been approved by the Medicare program. The two ways for you to get this coverage is through the Medicare Prescription Drug Plans and through Medicare Advantage Plans. The Medicare Prescription Drug Plans help immensely by adding coverage of drug prescriptions to the Original Medicare plans. The Medicare Advantage Plans also covers the Part D aside from covering both Parts A and B of your Medicare plan.
Source: 1800homecare.com

Medicare beneficiaries on a Medicare Supplement plan who wish to change their Medicare Part D coverage in 2012 do so during the AEP. / eHealth

About eHealth eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, the nation’s leading online source of health insurance for individuals, families and small businesses. Through the company’s website,www.eHealthInsurance.com, consumers can get quotes from leading health insurance carriers, compare plans side by side, and apply for and purchase health insurance. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 180 of the nation’s leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia, making it the ideal model of a successful, high-functioning health insurance exchange. Through eHealth’s technology solutions (www.eHealthTechnology.com), eHealth is also a leading provider of health insurance exchange technology. eHealth provides a suite of hosted e-commerce solutions that enable health plan providers, resellers and government entities to market and distribute products online. eHealth, Inc. also provides online tools to help seniors navigate Medicare health insurance options through PlanPrescriber.com (www.planprescriber.com) and eHealthMedicare (www.eHealthMedicare.com).
Source: ehealthinsurance.com

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

A way to remain tension free – medicare supplement leads

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSIn opting for supplement leads you need to be aware of rules that govern them and their coverage areas. In fact, a Medicare can often be compared to a government program. Depending upon the level of Medicare coverage the rules associated with them can vary a great deal. Their levels of complexities can also vary a lot. It is worthwhile to note that there exist four different levels of Medicare that can come to your rescue albeit in different ways. For example, using type A Medicare can help you pay off hospital bills that you would have incurred during your stay there overnight. The type B Medicare coverage will help you pay doctor’s fees for routine tests and checkups. Type C Medicare coverage can be used optionally. Type D Medicare coverage will be of help in buying prescribed drugs.
Source: girls-fitness.com

Video: 090129 EMG Postal

Exclusive Medicare Supplement Leads Will Boost Your Conversion Rates

The Medicare supplement market is really hopping these days. Why not invest in buying exclusive Medicare supplement leads as they will pay off for you? You want potential Medicare supplement leads that convert, right? Of course you do, or you would not be in the insurance business in the first place. This is why benepath.net has something you will not be able to pass up – solid, real-time, exclusive Medicare supplement leads.
Source: benepath.net

ParasolLeads Reports Record Medicare Supplement Insurance Leads Sales

For insurance agents wanting to take their pursuit of success to the next level, few things are more valuable than Medicare supplement leads. In a difficult economy, every advantage helps, and the right leads give agents a competitive advantage. ParasolLeads understands the importance of staying one step ahead of the competition and takes the danger of scam artists and lead generation services that offer deep discounts but deliver low quality leads out of the picture.
Source: travelnets.info

Improving Your Health by Medicare Supplement Leads

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Source: apssupplements.com

How To Best Keep from Collapse Through Medicare Supplemental Plans

You should remember that one reason health insurance is so complex is to dissuade you against doing your own research in the field. Insurance companies make more money off of ignorant clients. You can aluminum foil their intentions as well as improve the treatment you receive from them by looking at the valuable information available on medicare insurance.
Source: selling-medicare-supplements.com

All about Medicare supplement plans.

Websites are now using link building tips to increase their page rank with search engines. The internet is inundated with so many websites dealing with various issues. The websites are owned by countries, organizations and individuals. Creating a website is a good way of creating revenue if the website is well performing. Websites create their revenue, [...]
Source: wateriskey.org

Medicare Supplement Leads: Internet, Direct mail, Referrals

Shared leads are the cheaper of the two options. They are sold to multiple agents so you will most likely experience competition in prospecting with them. Seniors you speak to may be frustrated by the volume of agents they have spoken to regarding their supplemental insurance needs and you will have to distinguish yourself from the others. Exclusive leads are just what they sound like, exclusive to one person. They are a higher upfront cost; however, you will be able to close the business faster and have a higher close ratio due to the prospect only hearing from one agent.
Source: carsandinsurance.info

MWG Insurance Mall Announces Beta Launch of Online Quoting Tool for Medicare Supplements : e Yugoslavia

“By offering this new tool to senior citizens, MWG Insurance Mall is able to provide our customers Medicare supplement health insurance coverage to help pay expenses that Medicare doesn’t cover,” said David White, president and CEO of Morgan-White Group, Inc., parent company Morgan White, Ltd. “Our new tool makes it simple for seniors to see various quotes without the hassle of speaking to multiple insurance carriers or completing numerous forms.”
Source: eyugoslavia.com

Medicare supplement leads to Boost your Business

The Medicare supplement leads from Senior Marketing are exclusive. By exclusive it means that the leads are not shared. The leads that you get are only yours. You may work on them and do the needful in converting them to sales. Shared leads hardly have any potential to be converted to sales. So, if you are looking for sure shot results; they are a big no-no. The leads that you get from this company are also very affordable. This company generates leads in all the 50 states of U.S and benefits millions of insurance agents and mortgage brokers like you. The leads from this company are screened regularly so that you know that the leads you come across are valid.
Source: wordpress.com

Nevada Supreme Court Rules Common Law Doctrine of Unconscionability Preempted By Medicare Advantage Law

Posted by:  :  Category: Medicare

HERES YOUR TOP TEN by SS&SSThe Court then addressed whether the arbitration provision was enforceable or whether the state common law doctrine of unconscionability was preempted by the Medicare Act.  The express Medicare preemption statute provides that federal “standards” established under the Medicare Act supersede “any State law or regulation” with respect to MA plans.  42 U.S.C. §  1395w-26(b)(3).  Citing Uhm v. Humana, Inc., 630 F.3d 1134 (9th Cir. 2010), the Court determined that the arbitration provision was encompassed by the preemption statute because it constituted marketing materials due to its placement in the Evidence of Coverage and because CMS’ regulations governing marketing materials can be considered “standards” for purposes of the preemption statute.  See Opinion, at pp. 9-10.  The Court further ruled that Medicare preemption of “any State law or regulation” extends to generally applicable common law, in light of the preemption statute’s legislative history and the Uhm decision.  See Opinion, at p. 10.  Thus, because the common law doctrine of unconscionability would specifically regulate the MA plan in this case, the Court determined that it was encompassed by the preemption statute.  In reaching this decision, the Court noted that allowing a state court to review a Medicare contract and possibly find it unconscionable, despite the fact that CMS approved the same contract as part of its review of a plan’s marketing materials, is an unacceptable result under the Uhm decision.  See Opinion, at p. 11. 
Source: crowell.com

Video: Nevada Medicare Advantage Plans

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

Colors of Lupus Urges Congress to Shield Medicare, Medicaid

Medicare Element D, for case in point, lessens federal shelling out by $ twelve billion by covering medications that are presently trying to keep seniors out of the emergency space. Medicare Component D provides far more than 29 million Americans access to prescription medication at costs they can manage. Ahead of the development of Medicare Part D in 2006, a lot of therapies had been also expensive for as much as a 3rd of the elderly population. With no Medicare Element D, a lot of seniors would have forego such prescription drugs, in which scenario it?s only a matter of time before they conclude up in the hospital, driving charges up for taxpayers.
Source: route3construction.com

Nevada Medicare Advantage Plans

www.medicareplansofamerica.com Nevada Seniors get more protection with medicare advantage plans. Get an online medicare insurance plan quote today. Medicare enrollment is open to Seniors 65 and up for the most part in Nevada. Learn more about new medicare options in NV. Additional Nevada Medicare Supplement sites: www.2011medicareadvantageplans.com www.trinitymedcare.com Video Rating: 0 / 5
Source: nevadachatta.com

Colors of Lupus Urges Congress to Protect Medicare, Medicaid

“Those of us advocating on behalf of those victimized by this silent killer, lupus, and other debilitating autoimmune diseases, thank Senator Reid for his efforts to protect our vital access to treatment and for the medicines critical to sustaining quality lives and saving lives of those most vulnerable,” Ang said. “Without access or means for affordable treatments as provided by Medicare Part D, there is no hope, and without hope those afflicted and suffering from grossly debilitating diseases such as lupus are, and will continue, to be cast aside, alone, defeated and scared.”
Source: bloginteract.com

Colors of Lupus Urges Congress to Protect Medicare, Medicaid

“Those of us advocating on behalf of those victimized by this silent killer, lupus, and other debilitating autoimmune diseases, thank Senator Reid for his efforts to protect our vital access to treatment and for the medicines critical to sustaining quality lives and saving lives of those most vulnerable,” Ang said. “Without access or means for affordable treatments as provided by Medicare Part D, there is no hope, and without hope those afflicted and suffering from grossly debilitating diseases such as lupus are, and will continue, to be cast aside, alone, defeated and scared.”
Source: find-me-sugar-daddy.com

Medicare Complement Ideas In Nevada, Colorado, and Utah

Typically the healthier the state the reduced the rates. All of these states boast a really great well being rating. When a Medicare Supplement Organization has lower health claims they also have reduce fees which they typically pass alongside to the buyer as lower premiums for there plans. Truly these companies are in a position to seem in years previous to consider to figure out there future charges for statements, when they see that in a long time earlier claims charges have been comparably lower than other states they are capable to retain prices decrease simply because of that. These rocky mountain location states therefore are benefiting from a nutritious lifestyle style, All of these states have plenty of outdoor activities which aide in preserving a excellent wellness rating.
Source: wp7development.org

Medicare Supplement Ideas In Nevada, Colorado, and Utah

Usually the healthier the state the reduced the charges. All of these states boast a extremely excellent wellbeing rating. When a Medicare Supplement Business has decrease wellbeing statements they also have decrease expenses which they normally pass along to the buyer as reduce prices for there programs. Actually these companies are ready to look in a long time earlier to try to determine there potential fees for claims, when they see that in a long time prior claims expenses have been comparably lower than other states they are able to preserve rates reduce simply because of that. These rocky mountain place states thus are benefiting from a healthy life design, All of these states have plenty of out of doors routines which aide in preserving a excellent wellness rating.
Source: watchmygear.com

Ga Medicare Designs ? Greatest Prescription Narcotic Plans, Identify Who For you to Trust

Posted by:  :  Category: Medicare

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Source: thewallstreetcloner.com

Video: Georgia retirees celebrate Medicare, Social Security Birthday

Bobbie Paul: Cut Missiles, Not Medicare

Bobbie Paul serves as Executive Director of Georgia WAND. She has spent almost 25 years supporting the vision of WAND’s founder – Dr. Helen Caldicott – to gradually rid the world of nuclear weapons. She has helped the Georgia chapter define its three areas of concentration across the state and Southeast region:  Peace in Action, Environmental Justice and Empowering People to Act Politically. Paul has watch-dogged Savannah River Site (SRS) for over fifteen years and led campaigns to successfully restore Department of Energy (DOE) environmental monitoring of SRS in Georgia. Paul is a former theatre professional and the co-founder of a regional theatre company in St. Petersburg, Florida (now known as American Stage Company). She has worked for the US Department of State as a theatre specialist in Egypt and Jordan.
Source: gawand.org

Medicare Supplement Plans GA: Stop Overpaying. Find The Best Plan Value

Medicare Supplement Plans GA, Stop Overpaying, Find the Best Value was written by Bob Vineyard, CLU. We are your number one resource for complete information on Medicare benefits and supplement plans. We serve senior clients on Medicare all over Georgia, and have the lowest priced Medigap plans in the state. Your needs come first, not our own. To assist you best, we tell it like it really is. Visit Georgia Medicare Plans at http://georgia-medicareplans.com
Source: 93705.info

Medicare on Main Street: Satisfaction with Part D Rx Coverage; Competition Works

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Source: conservativega.com

Target waste and fraud, not Medicare patients

Although a home health co-pay would be intended to generate Medicare savings, it could actually drive costs up, both for seniors and for the government. Research shows that requiring co-pays could shift costs of care from Medicare to Medicaid, and it could drive up Medicare costs by forcing patients to seek costlier inpatient services. Some beneficiaries, when faced with a high co-pay, might simply try to do without the home health care they need. That, in turn, could cause them to suffer worse medical problems, and they would wind up requiring treatment in a more expensive institutional setting.
Source: georgiahealthnews.com

GA medicare supplemental insurance for disability

There are many supplemental insurance providers who provide discounts throughout begin enrollment. In some cases, the applicant’s achieve reduction can be as broad as 15%. This savings will carry more than into subsequent years helping to have premiums lower as the insured grows older. Additionally, some insurance businesses will require underwriting for common supplements, like concept J, if the applicant is more than 3 months past their 65th birthday. If applying during originate enrollment, health underwriting will not be required for understanding J.
Source: carinsurancesaga.com

Medicare Changes GA and Adds GX Modifier for ABNs

The analysis of any medical billing or coding question is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies (as well as coding itself) are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly.
Source: capturebilling.com

“The Basics” Chiropractic Medicare: Chiropractic Medicare

When billing for the Chiropractic adjustment and non-covered services, modifiers are a must.  When billing 98940, 98941 and 98942, the “AT” modifier is necessary to tell the Medicare carrier – this is “active treatment” and to consider payment for this service.  This does not mean they will automatically pay. If the doctor, after making an assessment of the patient each and every visit, believes Medicare may not pay for this covered service he may ask the patient to sign an ABN. All payable services 98940, 98941 or 98942 will be followed by “AT” and “GA” modifiers. The lack of “AT” modifier after a payable service means the doctor is asking the Medicare Carrier to consider this service as a nonpayable service and telling the carrier NOT to pay. That is usually a mistake because the adjustment to correct a subluxation is the only thing Medicare reimburses. The doctor also needs to learn to document so the covered services in Medicare are reimbursed. The “GX” modifier is only used when non-covered services are billed to Medicare. This is done to receive a denial EOB for supplemental insurance.
Source: blogspot.com

Atlanta doctor sentenced for Medicare, Medicaid fraud

But law enforcement officials contended that he did not provide all the services for which he was billing. An investigation by the FBI and Georgia’s Medicaid Fraud Control unit allegedly showed that many of the doctor’s reported patients were actually deceased or were not in a nursing home setting. Prosecutors argued that it would have not been possible for the doctor to have actually provided all of the services for which he submitted claims.
Source: atlantafederalcriminaldefenseattorney.com

Man Pleads to Medicare Fraud in Brunswick Georgia

An Armenian man pled guilty moments before a jury was to be selected in his federal court case in Brunswick Georgia yesterday. Medicare fraud prosecutions are becoming more prevalent around the country as additional resources are being used by Secret Service and the FBI to combat Medicare Fraud. For a full recap of this story, read the Florida Times Union article here.
Source: criminalattorneyjacksonvilleflorida.com

Romney Unveils Plan To Revamp Medicare, Medicaid

Posted by:  :  Category: Medicare

Sign at Occupy St Pete: "Hands Off Social Security, Medicaid Medicare"  "www.SayNoCuts.org" by Fifth World ArtThe Wall Street Journal: Romney Proposes Voucher Option For Medicare Plan The Romney Medicare plan could become a hallmark of the presidential campaign of 2012 should he win the Republican nomination. Democrats had already planned to make the Ryan Medicare plan, which they call privatization, a centerpiece of their efforts to unseat Republicans in Congress. Now Mr. Romney has thrust the future of Medicare more directly into the presidential race. Ben LaBolt, a spokesman for the Obama re-election campaign, charged that Mr. Romney’s budget proposal “would leave millions of older Americans to fend for themselves” under a privatized Medicare. Romney campaign aides reject the term “privatization” to describe their approach (Weisman and O’Connor, 11/5).
Source: kaiserhealthnews.org

Video: Medicare and Medicaid: What’s it all mean?

Medicare, Medicaid Still Paying for Blood Drugs Despite FDA Warnings

Amgen and Johnson & Johnson have made billions in sales of the drugs. When the FDA issued its warning this summer, both companies issued detailed statements, including comments from their respective medical experts, on how the new information would help inform physicians. But sales are down, and Amgen last month announced a tentative $780 million settlement with the federal government over its sales and marketing practices for the anemia drugs, including doctor payments. The company said at the time that “if the ongoing settlement discussions are successfully concluded, Amgen expects that the proposed settlement will resolve the federal investigations, the related state Medicaid claims and the claims” in a major court case.
Source: thedailybeast.com

Colors of Lupus Urges Congress to Shield Medicare, Medicaid

Medicare Element D, for case in point, lessens federal shelling out by $ twelve billion by covering medications that are presently trying to keep seniors out of the emergency space. Medicare Component D provides far more than 29 million Americans access to prescription medication at costs they can manage. Ahead of the development of Medicare Part D in 2006, a lot of therapies had been also expensive for as much as a 3rd of the elderly population. With no Medicare Element D, a lot of seniors would have forego such prescription drugs, in which scenario it?s only a matter of time before they conclude up in the hospital, driving charges up for taxpayers.
Source: route3construction.com

Colors of Lupus Urges Congress to Protect Medicare, Medicaid

“Those of us advocating on behalf of those victimized by this silent killer, lupus, and other debilitating autoimmune diseases, thank Senator Reid for his efforts to protect our vital access to treatment and for the medicines critical to sustaining quality lives and saving lives of those most vulnerable,” Ang said. “Without access or means for affordable treatments as provided by Medicare Part D, there is no hope, and without hope those afflicted and suffering from grossly debilitating diseases such as lupus are, and will continue, to be cast aside, alone, defeated and scared.”
Source: find-me-sugar-daddy.com

New Poll: New Mexicans Overwhelmingly Support Medicare, Medicaid

The poll, which was conducted by Research and Polling, Inc., for six advocacy groups, shows that the vast majority of voters (83 percent) believe Medicaid is important to residents in New Mexico with 66 percent saying Medicaid is very important. Medicaid is the health program for the disabled, seniors in nursing homes, low-income children, and impoverished families. The majority (59 percent) of voters do not believe there should be any reductions in Medicaid spending as a way to reduce the federal debt.
Source: nmvoices.org

Colors of Lupus Urges Congress to Protect Medicare, Medicaid

“Those of us advocating on behalf of those victimized by this silent killer, lupus, and other debilitating autoimmune diseases, thank Senator Reid for his efforts to protect our vital access to treatment and for the medicines critical to sustaining quality lives and saving lives of those most vulnerable,” Ang said. “Without access or means for affordable treatments as provided by Medicare Part D, there is no hope, and without hope those afflicted and suffering from grossly debilitating diseases such as lupus are, and will continue, to be cast aside, alone, defeated and scared.”
Source: bloginteract.com

Disadvantages of Medicaid

Although Medicaid plans tend to be more inexpensive than supplemental policies they have a number of restrictions and limitations for the users.  Medicaid plans are only accepted by a small number of participating providers.  Any doctor that is not participating in the group can reject giving treatment to any person on a medicaid plan.  Medicaid may also suddenly stop covering an area.  Those individuals within that geographic region can then look into getting a supplemental health care plan but their medicaid plan will be gone for good.
Source: medigapbuyersguide.com

Daily Kos: No Cuts to Social Security, Medicare and Medicaid

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Source: dailykos.com

Medicare Supplement Insurance Companies

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSA ton of recipients of Medicare are just not certain about how they ought to go about handling the things that imply the most to them. For all those of us that are concerned about our health, we already know that as soon as we hit the age of 65, we will be eligible for Medicare, however what we may not know is if this is likely to be good enough to keep us healthy. Essentially, health care is really expensive for the majority of people and especially with regard to seniors and Medicare is no where near sufficient. While Medicaid is available to those in certain circumstances, you may want to consider the value that good Medicare supplemental insurance can offer you. Medigap is the best method for solving this problem as you can see doctors at practically no cost and it floods up all those spaces that Original Medicare offers. This is one way that a lot of People in america are investing in their own health long before they need any kind of treatment. By taking a more proactive role towards their they keep on their own from having to worry about what they might perform if they wind up in a situation where they are facing something that they never expected in terms of a threat to their own health:
Source: autoinsurance-california.com

Video: Understanding Medicare Supplements, Medicare Supplement Insurance

Medigap Health Insurance coverage

Medigap supplement Quotes are really important for those people who are just turning 65 or signing up for Medigap health insurance the very first time. There are several methods people use to obtain Medicare supplement Quotes, however the easiest and a lot effective way to obtain supplement insurance facts are to contact an insurance coverage broker (like us) who focuses primarily on Medigap supplement insurance. We are able to give a Medicare supplement Quote from multiple insurance firms and can provide valuable comprehension of upcoming changes that could affect Medigap supplement Plans plus your current supplemental insurance policy.
Source: carinsurance-florida.org

Medicare Supplement Insurance Rates

To get Medicare Supplement Insurance Rates when using a service, you simply need to fill out a basic questionnaire.  You will get a number of different insurance policies from different providers to review the prices and policy figures from all the different providers.  Then you can pick out the insurance plans that provide what you want and that are affordable.
Source: my-insnet.com

A Vision of the Changing Times In Future

Medicare Supplemental Insurance Plans are also known as Medigap Insurance. The main purpose of these plans is to fill in the gaps that are left behind by the regular Medicare coverage. These plans are standardized by the government and are very instrumental in putting an end to the health related problems of an individual. There are many health insurance companies who are the extreme providers of these plans but in the presence of so many companies it becomes difficult for the common man to make a comparison and decide on which plan to choose. There are many aspects that make one company different from the other and there are many factors that determine which company an individual would want to get Medicare insurance from. There are various factors that determine the cost of the insurance that is being taken. The most important of all is the place factor.
Source: ezinemark.com

Medicare Advantage & Medicare Supplement Info: Medigap Supplemental Insurance

Medicare Part A- This is the portion of Medicare that you automatically receive from working 10 years or more at a job in the United States. Medicare Part A covers the hospital portion of any medically necessary situation. Medicare Part A has some large gaps in it however, as of 2011 there is a $1132 deductible associated with Medicare Part A, this deductible is a per benefit period deductible meaning that it needs to be paid for every separate accident or illness that may occur. If you have an accident or illness that you are going back into the hospital for within 60 day of the first occurrence of the accident or illness you will not have to pay the deductible twice, only if you are going outside of that 60 day window. I know that this may sound confusing but think of it like this the great majority of the time that you go into the hospital you will be responsible for a $1132 (2011) deductible. You will also be responsible for co-insurance or co-pays to the hospital that Medicare does not cover. This is one of the main reasons why we see so many people that are starting Medicare choose to have a Medigap type of plan. There is also another large gap in Medicare, this is Medicare Part B.
Source: blogspot.com

Supplement Insurance For Medicare

A few senior may have a month-to-month pension but many are dependent upon on some type of package they received from their previous company. These things plus more need to all be looked at very carefully as an eagle hunting for its victim. Know your options with benefits of Medicare advantage. This will reduce any unneeded pressures the insurance company may bring on you when you delay to remit your premiums according to their expectations.
Source: carinsurance-texas.org

Medicare Supplement Insurance

By finding a broker, who deals in health insurance and specifically one who specializes in Texas Medicare supplemental insurance you will have someone who can encourage you accumulate sense of all the options and changes that have been made. In addition, they can wait on you in deciding what you really need and then helping you to reach by it at the best possible effect. carry out ranges vary to such a degree that you need someone who will review options for all the major companies like Blue inappropriate Blue Shield of Texas, United of Omaha or even Gerber Life and so many more. This can be a grand relief to someone who is already in a stressful plot due to health issues. It can also be expedient to those who do not have the time or inclination to exercise the time learning all the ins and outs of this type of insurance.
Source: medicaresupplementalinsurances.org

Arizona Medicare Advantage Plans or Medicare Supplemental Insurance

medicare advantage plans ct, medicare supplemental illinois 2012 rates, medicare deductibles oklahoma, medicare supplement/advantage plans in sc, 2012 medigap rates maryland, 2012 premium comparison of medicare b supplemental plans in arizona, wi medicare supplement 2012, which is better medicare supplemental or advantage in massachusetts, 2012 medigap plans mississippi, colorado medicare supplement plans 2012, medicare advantage plans ct 2012, medigap plans in colorado for 2012, va 2012 supplemental insurane costs, zero premium medicare advantage plans idaho, medicaresupplementadvantageplans com, edicare part c south carolina, unable to pay medicare gap michigan, 2012 medicare supplement plans for maryland, medicare supplemental insurance nevada premiums 2012, Massachusetts Medicare Advantage Plans
Source: medicaresupplementadvantageplans.com

Texas Medicare Part D Drug Plans

In Texas, there are only two ways to get Medicare drug coverage- through a Medicare Prescription Drug Plan (PDP) or through a Texas Medicare Advantage Plan. Medicare Prescription Drug Plans, or Part D, are offered to everyone with Medicare and sold through private insurance companies. Basically, Part D is prescription drug coverage that is added to your Original Medicare. Understanding these plans can be a bit tricky and many Texans just like you are confused as to eligibility, enrollment, costs and coverage. Take the time to learn a few in’s and out’s of Texas Medicare Part D and make the right decisions concerning your health care coverage.
Source: medicareinsurancetexas.com

Most sage advice For people Attempting to find Medicare Supplemental Plans

Evaluate the claims process before selecting a health insurance policy. A few carriers work with healthcare offices to streamline and simplify the claims process. Other people require you to pay for treatment out of your pocket as well as submit claims for reimbursement. Depending on your individual preferences and healthcare needs, the claims process may be an important consideration when selecting health insurance coverage.
Source: iulren.com

Plan F High Deductible Medicare Supplement Quotes

Someone who was once in good health, but later finds that the $2,000 + deductible must be met each year as his or her health has changed might not prefer the coverage any longer. The issue then would be that it is can be difficult to change plans if the insured is in poor health. Medicare beneficiaries cannot change coverages without undergoing medical underwriting with most providers in most states.
Source: ohioinsureplan.com

United Healthcare Oxford Medicare Advantage Denies Coverage

Posted by:  :  Category: Medicare

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Source: www-privatehealthcare.com

Video: United Healthcare Oxford Medicare Advantage Denies Coverage

Missives From Missouri: Oxford: Ending The Recession: What If This Is The Approach That Would Work?

Friends, With almost three-quarters of a billion dollars going to tax credit programs in MO annually, our unemployment rate is still high, and many of our neighbors suffer foreclosure, hunger, and the chaos of poverty. The gap between the top one percent and the 99% that we hear so much about these days continues to grow. About six centuries before the Common Era, the Hebrew prophet Isaiah wrote a recipe for how to produce a vibrant society in a bold series of “If……then” statements: If we share our bread with the hungry……         If we bring the homeless poor into our homes……                 If we clothe those who are naked…… …..Then our light will break forth like the dawn.         …..Then our healing will come quickly.                 …..Then we will be like a watered garden.
Source: blogspot.com

Associations of patient demographic characteristics and regional physician density with early physician follow

Abstract Early physician follow-up after a heart failure (HF) hospitalization is associated with lower risk of readmission. However, factors associated with early physician follow-up are not well understood. We identified 30,136 patients with HF ?65 years at 225 hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE) registry or the Get With The Guidelines-Heart Failure (GWTG-HF) registry from January 1, 2003 through December 31, 2006. We linked these clinical data to Medicare claims data for longitudinal follow-up. Using logistic regression models with site-level random effects, we identified predictors of physician follow-up within 7 days of hospital discharge. Overall 11,420 patients (37.9%) had early physician follow-up. Patients residing in hospital referral regions with higher physician concentration were significantly more likely to have early follow-up (odds ratio 1.29, 95% confidence interval 1.12 to 1.48, for highest vs lowest quartile). Patients in rural areas (0.84, 0.78 to 0.91) and patients with lower socioeconomic status (0.79, 0.74 to 0.85) were less likely to have early follow-up. Women (0.87, 0.83 to 0.91) and black patients (0.84, 0.77 to 0.92) were less likely to receive early follow-up. Patients with greater co-morbidity were less likely to receive early follow-up. In conclusion, physician follow-up within 7 days after discharge from a HF hospitalization varied according to regional physician density, rural location, socioeconomic status, gender, race, and co-morbid conditions. Strategies are needed to ensure access among vulnerable populations to this supply-sensitive resource.
Source: beckerinfo.net

Affordability And Convenience: New Jersey Health Insurance

As far as regular new jersey health insurance providers or carriers are concerned, the leading names are Horizon, Oxford and AmeriHealth. The more expensive ones comprise Health Net and Aetna as they do not sell products individually, but are required to do so according to the requirements of the state. The most popular as well as well priced plan includes the Oxford PPO as it falls within the Oxford Liberty network. Hence, in case you decide to purchase a Liberty medical insurance plan, you need to make sure that your pharmacists and physicians are covered within the network. In case you are looking for quotes for policies on an individual basis, you need to offer your information for getting the free quotes.
Source: preservation-academy.us