Impose Medicare marketing and enrollment suspension for drug developers and health Three

Posted by:  :  Category: Medicare

meds: it's obscene by fallsroadProblems noted today, Health Net in Woodland Hills, California, is required to immediately suspend the marketing and beneficiaries enroll in their plans for new prescription drugs and Medicare Advantage. Intermediate sanctions were imposed on Medicare Advantage plans sponsored by Arcadian Management Services of Oakland, California, and Universal American Corporation of Houston, Texas. Marketing and suspension of registration for Arcadian and Universal American will be effective December 5. The sanctions remain in force until each of the three plans demonstrate to CMS that they have corrected the deficiencies and gaps related not likely to recur. CMS actions will have an impact on one million Medicare beneficiaries are currently enrolled in these health plans and three drugs in the country.
Source: unpayspournous.org

Video: Medicare Drug Coverage – Part D Plans

Higher copays seen for Medicare brand

“Seniors need to look beyond the premium to understand their drug benefit,” said Avalere CEO Dan Mendelson. “The more the cost burden gets shifted onto the patient who needs the medication, the more important it is for seniors to understand that next level.” Avalare is a data analysis firm serving the health care industry and government.
Source: starhq.com

DPHSS: Open Enrollment for Medicare Part "D" Underway, Ends December 7

Guam – The Department of Public Health and Social Services would like to announce that the annual enrollment period for Medicare’s prescription drug program, nationally known as Medicare Part D, is from October 15,  through December 7. During this period, beneficiaries may enroll in this voluntary prescription drug program or cancel their current plan if they are currently enrolled. For 2012, only the Preferred Plan sold by United HealthCare is available for Medicare beneficiaries living on Guam.  The monthly premium rate for the Preferred Plan is $11.20, with an effective date of January 1, 2012 provided the beneficiary enrolls before or by December 7, 2011.  A Medicare beneficiary currently enrolled in United HealthCare’s Enhanced Plan will be automatically terminated from this plan on December 31, 2011, and enrolled into the Preferred Plan, unless a Medicare beneficiary takes action to terminate them self from the Enhanced Plan. The Guam Medicare Assistance Program (Guam MAP) within the Division of Senior Citizens will be providing free informational presentations on the 2012 Part D Plan every Tuesday and Thursday at 9:00 a.m. and 2:00 p.m. from October 18, 2011 through December 6, 2011 at the Division of Senior Citizens office located at 130 University Drive, Suite 8, in Mangilao. Medicare beneficiaries and their families interested in obtaining more information are encouraged to contact the Division of Senior Citizens at 735-7421.
Source: pacificnewscenter.com

Hunting For A Prescription Drug Plan Is No Game

You can complete an easy-to-use online application for Extra Help at www.socialsecurity.gov. Go to the Medicare tab on the top of the page. Then go to “Apply For Extra Help With Medicare Prescription Plan Costs.” To apply for the Extra Help by phone or have an application mailed to you, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and ask for the Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020). And if you would like more information about the Medicare Part D Prescription Drug Program itself, visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048). So this open season (October 15 to December 7), after you track down the perfect prescription drug plan for you, hunt for something that could put about $4,000 in your pocket — bag the best Medicare prescription drug plan for you and see if you qualify for the Extra Help through Social Security. 
Source: hispanicallyspeakingnews.com

Innovative Healthcare Consultants

In addition to restructuring the timeframe for enrollment (during which existing members can also change prescriptions and health plans), Medicare is also initiating a quality rating system this year, as well as implementing reforms to the program’s infamous gaps in prescription drug coverage. According to Consumer Reports editor Nancy Metcalf, the rating system is “star-based,” with 4 or 5 star-rated health plans constituting those with the most funding as a reward for superior service. Members who can choose a 4 or 5-star plan will receive more benefits; but for those on lower-rated plans, there are still some new, guaranteed benefits across the board that seniors can look forward to in the coming year.
Source: delmartimes.net

Seniors In Oklahoma, Nationwide Face Important Medicare Deadline

Cindy Loftin with LIFE Senior Services has been educating Tulsa seniors about their options, and making sure they know about the deadline. Instead of having until the end of the year, seniors have until December 7 to sign up for a new plan or change their current plan.
Source: newson6.com

Time to Review Your Medicare Coverage

Disclosure: Any comments or posts in this blog should be considered opinions of the authors of such comments. This site nor any of its authors or commenters offer any investment, legal, insurance or tax advise. Please consult with a licensed professional for any such advise. All information contained within this site is the copyright material of the site owners and any copy, reproduction or use of any kind is prohibited by law and your honesty. Any post or comment is also the copyright material of the site owners. If you post or comment you are agreeing to transfer all rights to the site owners.
Source: kenhimmler.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: kaiserhealthnews.org

Medicare Advantage Insurance

Posted by:  :  Category: Medicare

By definition Medicare Advantage provides all of your Part A and Part B coverage. A Medicare supplement on the other hand, fills in the gaps of original Medicare and generally pays the hospital deductible and the 20% of Part B charges that would be your responsibility.
Source: affordablemedicareplan.com

Video: Herrest Harrison – 2010 Peoples Health Champion

Next Steps for Some Beneficiaries In Medicare Special Needs Plans 

Series on Special Needs Plans and Medicaid Programs:  Issue Brief No. 1 “Federal Authority for Medicare Special Needs Plans and their Relationship to State Medicaid Programs.”  June 2009 at http://www.communityplans.net/Portals/0/Events/2009%20CEO%20Summit/ASPE%20Federal%20Authority%20for%20SNPs.pdf (site visited Sept. 13, 2011).  This description of disproportionate share was codified at 42 C.F.R. § 422.4(a)(1)(iv) but that section has been amended since the law changed. [5] Marsha Gold, Gretchen Jacobson, Anthony Damico and Tricia Neuman, “Special Needs Plans:  Availability and Enrollment,” Kaiser Family Foundation Program on Medicare Policy, September 2011 available at http://www.kff.org/medicare/upload/8229.pdf (site visited Sept. 13, 2011) [6] Sec. 164 of Pub. L. 110-275 (July 15, 2008) [7] Sec. 3205, Pub. L.111-148 (Mar. 23, 2010) [8] Memorandum of June 17, 2011 to All Medicare Advantage (MA) Organizations, from Anthony Culotta, Director, Medicare Enrollment and Appeals Group, Subject:  Transition Guidance for Non-Special Needs Enrollees in MA Special Needs Plans Under the “Disproportionate Share” Policy, available at  http://www.medicareadvocacy.org/wp-content/uploads/2011/09/SNP_Transition_Guidance_6-16-11-FINAL-2.pdf (site visited Sept. 15, 2011). [9] Assistance with selecting supplemental Medicare policies, known as Medigap policies, is usually offered by State Health Insurance Assistance Programs (SHIPs).  Not all SHIPs operate out of State Health Insurance offices.  For information about your state’s SHIP, go to www.shiptalk.org (site visited Sept. 15, 2011) [10] Medicare Managed Care Manual, Ch. 2 § 50.2.5, available at  http://www.cms.gov/MedicareMangCareEligEnrol/Downloads/FINALMAEnrollmentandDisenrollmentGuidanceUpdateforCY2012August192011.pdf  (site visited Sept. 15, 2011).
Source: medicareadvocacy.org

The Official Medicare Set Aside Blog And Information Resource: Hadden v. US – Will the Supreme Court Take Cert?

The court again tries to rely too heavily upon the wording of the MSP and cites the definition of responsibility that it is using as: “under § 1395y(b)(2)(B)(ii) as amended, if a beneficiary makes a ‘claim against [a] primary plan[,]’ and later receives a ‘payment’ from the plan in return for a ‘release’ as to that claim, then the plan is deemed ‘responsib[le]’ for payment of the ‘items or services included in’ the claim.” Fine, pursuant to the MSP Pennyrile is responsible for purposes of this statute, but the statute does not expressly say responsible for payment in full, evidenced by Medicare’s routine practice of being satisfied by less than full reimbursement. The court goes on to conclude that thought with “and thus a beneficiary cannot tell a third party that it is responsible for all of his medical expenses, on the one hand, and later tell Medicare that the same party was responsible for only 10% of them, on the other.” And here is the fatal flaw in that logic: Mr. Hadden did not make a claim for only $165K – if I had to guess, it was probably more like a claim for $2 million. Since when do the damages alleged in a complaint equate to the reality of the value of the liability? And why would a court, well aware of that practice, try to spin that concept to make a point? Regardless of what items or services were “included in the claim,” the fact of the matter is that Pennyrile only paid for 10% of them because that is all it felt under Kentucky tort law it might be “responsible” for. The court goes on to criticize Mr. Hadded for demanding that Pennyrile compensate him for all of his medical expenses, stating that
Source: medicaresetasideblog.com

Providence Medicare Providence.org/php/newplan

So What are Medicare Advantage Plans anyway? By definition Medicare Advantage Plans are an “option to receive their Medicare benefits through private health insurance plans( like Providence Health Plan), instead of through the original Medicare plan (Parts A and B)”*. Introduced with the passage of the Balanced Budget Act of 1997 these optional Medicare Choice or Medicare Part C plans gave medicare recipients a choice in the government medicare system. Prescription Drugs Plans were added to these medicare plans with the introduction of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Medicare Advantage (MA) Plans today combine Medicare Parts A(Hospital),B(Medical Insurance) and D(RX Drugs Plans). Read more at What Are Medicare Advantage Plans?
Source: trinitymedcare.com

FAQ for HITECH Act by Shailen Patel M.D

CCHIT’s normal process is to begin work in July to establish certification requirements that are used for testing beginning the following July. If ONC publishes new requirements in December, it is unclear how CCHIT will be able to accommodate them in its 2010 testing program, which begins in July 2010. ONC is under pressure from a broad range of interest groups who are urging it to add additional requirements. As with CCHIT certification, as requirements for functionalities built into systems are expanded, fewer EHR vendors are able to meet the challenge of incorporating these requirements in a rapid timeframe. While vendors remain committed to meeting the requirements required by both CCHIT and ONC some vendors may not be able to qualify as a certified product.
Source: redpineservices.com

Defining Essential Health Benefits and Defining Away States’ Rights

But even with the potential waivers of the EHB, states would be limited in what they can mandate. The IOM recommends that waivers be granted only in cases where the state EHB variation is the “actuarial equivalent” to the federal EHB definition. In other words, the state list of covered benefits would have to cost the same as the federal list of covered benefits. But for states that want to cover additional benefits, the only way to make costs equal after adding such benefits is to remove other benefits.
Source: obamacarewatcher.org

Finding the Right Health Insurance Plan

The Administration last week issued favorable guidance with respect to student health coverage that will result in little disruption, if any, to this business until at least the 2012-2013 academic year. This guidance was announced in a Notice of Proposed Rule Making (rather than as an interim final regulation), which fortunately means that the rule is not effective immediately as has been the case with most regulations relating to PPACA reforms. The proposed student health rule would create a special class of individual coverage for student health pursuant to a set of factors, e.g., written contract between school and insurer, coverage only for students and dependents, health status may not be used as a condition of eligibility.  As Aetna has advocated, the impact would be delayed, as the rule (whenever finalized) would not be effective until policy years beginning on or after January 2012. Until then, student health is not subject to PPACA reforms.  And, when effective, student health would be excepted from the current guaranteed issue and renewability provisions of PPACA.  While it will be unclear for a while whether and how student health will be subject to the medical loss ratio (MLR) provisions of PPACA, we are encouraged by the fact that the proposed rule invites comments on whether student health should receive some sort of special accommodation (akin to the special rule for limited benefit plans) with respect to MLR, owing to the unique characteristics of the student health market.
Source: positivepathrecovery.com

The facts about Medicare premiums, medicare, care, year

Posted by:  :  Category: Medicare

Stella Johnson On The Impact Of Health Insurance Reform by Leader Nancy PelosiYou may have heard rumors lately that Medicare Part B premiums are shooting up – by as much as 200 percent. Those rumors are completely false, I’m happy to say. In fact, for most people with Medicare, the Part B premium will rise by $3.50 per month in 2012. That means the total monthly premium will be $99.90. Medicare is divided into four parts, A, B, C, and D. Part A pays for hospital inpatient care, skilled nursing care, hospice, and some home health care. Part B pays for doctor services, outpatient care, and some other types of home health. Part C, also known as Medicare Advantage, finances managed care plans, like HMOs and PPOs, operated by private companies approved by Medicare. And Part D is the Medicare prescription drug program. Only about 1 percent of people with Medicare pay Part A premiums, since they paid enough in Medicare taxes over their working lives to qualify for premium-free Part A. We expect Part C premiums to be 4 percent lower, on average, next year. And Part D premiums will be about the same next year as this year. People with Medicare pay 25 percent of their Part B premiums; the government picks up the rest. The actual amount of the premium is set each year based on expected care costs for all Medicare beneficiaries. The “standard” Part B premium of $96.40 – the amount paid by most beneficiaries – had stayed the same since 2008, under a law that prohibits increases in Part B premiums in years in which there’s no cost-of-living increase in Social Security payments. But retired workers will receive an average of $43 more each month in their Social Security checks next year. That will more than offset the $3.50 per month rise in standard Part B premiums. The Part B deductible for 2012 will be $140, a decrease of $22 from this year. The Part A deductible paid by beneficiaries when admitted as a hospital inpatient will be $1,156 in 2012, an increase of $24 from this year’s $1,132. This change is well below increases in previous years and general inflation. *** I also want to remind everyone with Medicare that the end of open enrollment season is drawing near. The deadline for choosing a new Medicare health or prescription drug plan is Dec. 7. People with Medicare should check their current plans to make sure they’re still a good fit. Can you still afford the premiums? Does your plan still cover the medical services and drugs you need? If you’d like help sorting through all the choices, take a look at the “Medicare & You” handbook that was mailed to you recently. It lists all the health and drug plans that offer coverage in your area. You also may want to check out Medicare’s online Plan Finder tool at www.Medicare.gov. Among other things, Plan Finder lets you enter the names of the medications you’re taking and find a plan that covers most or all of them. Beginning this year, Plan Finder also rates Medicare Advantage plans according to our Five-Star Rating System. A gold icon indicates plans that received five stars, the highest rating for quality of care and customer service. We encourage people with Medicare to enroll in plans with higher ratings — and we hope lower-rated plans will work hard to improve their care and service. I also wanted to let you know that, thanks to the Affordable Care Act, people who fall into the Part D “doughnut hole” will be eligible for 50 percent discounts on covered brand-name drugs next year. About 1.8 million Medicare beneficiaries have gotten cheaper drugs this year through the discount. Also thanks to the Affordable Care Act, Medicare preventive health benefits are now available for free. These services include cancer screenings and an annual wellness visit with your doctor. David Sayen is Medicare’s regional administrator for California, Arizona, Nevada, Hawaii, and the Pacific Trust Territories. Readers can always get answers to Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).
Source: yumasun.com

Video: The Early Show – Medicare premiums up less than expected

Government Announces Medicare Premiums And Deductibles Lowered

Many people on Medicare have paid $96.40 per month for coverage since 2008 because of a law that froze premiums in years where recipients did not receive a cost of living adjustment (COLA).  With 2012 bringing the first COLA to recipients in four years, most recipients can expect the $3.50 increase in premiums to be offset by the average $43 per month COLA. This means an extra $39.50 per month into the pocket of disabled and elderly individuals who depend on the program for survival. Part B deductibles will also decrease from $166 to $140.
Source: cartermario.com

Medicare Premiums and Deductibles for 2012 Mostly Sweet

However, some enrollees age 65 and over and certain persons with disabilities who have fewer than 30 “quarters of coverage” obtain Part A coverage by paying a monthly premium set according to a statutory formula. This premium will be $451 for 2012, an increase of $1 from 2011. Those who have between 30 and 39 “quarters of coverage” may buy into Part A at a reduced monthly premium rate which is $248 for 2012, the same amount as in 2011. The Part A deductible paid by a beneficiary when admitted as a hospital inpatient will be $1,156 in 2012, an increase of $24 from this year’s $1,132 deductible. The Part A deductible is the beneficiary’s cost for up to 60 days of Medicare covered inpatient hospital care in a benefit period. Beneficiaries must pay an additional $289 per day for days 61 through 90 in 2012, and $578 per day for hospital stays beyond the 90th day in a benefit period. For 2011, per day payment for days 61 through 90 was $283, and $566 for beyond 90 days.
Source: indoamerican-news.com

Medicare Premiums and Deductibles For 2012:Medicare Part D, Advantage Plans and Income Related Adjustment

“As required in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, beginning in 2007 the Part B premium a beneficiary pays each month is based on his or her annual income,” reported the CMS. “Specifically, if a beneficiary’s “modified adjusted gross income” is greater than the legislated threshold amounts ($85,000 in 2012 for a beneficiary filing an individual income tax return or married and filing a separate return, and $170,000 for a beneficiary filing a joint tax return) the beneficiary is responsible for a larger portion of the estimated total cost of Part B benefit coverage.”
Source: marshagoodmanattorney.com

Friday Reading: Rise in Medicare Premiums Lower Than Predicted

A variety of consumer-focused articles appears daily in The New York Times and online in our blogs. Each weekday morning, we gather them together here so you can quickly scan the news that could hit you in your wallet.
Source: nytimes.com

Medicare Premiums Rise Less than Predicted

Officials said Thursday the 2012 Part B for outpatient care will be $99.90 a month for 2012 instead of this year’s charge of $115.40.        Consequently, the three-fourths of Medicare recipients whose premiums have been frozen at the 2008 rate will keep more of next year’s Social Security increase.
Source: cbn.com

The facts about Medicare premiums

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Source: findrxpills.com

Remain Secure for the Future with Medicare Insurance

With old age begin many problems of a human being related to his health and also related to his dependency on others. A human life is prone to many troubles and many problems that may arise anytime in life and therefore it becomes very important for a human being to remain in full control of any situation that may be called as the unforeseen complexities. These problems are needed to be overcome in near future and have to be taken care of in order to remain secure in the future. The Medicare Supplemental Insurance plays a very vital role in getting a human being out of the problems that may arise due to the deteriorating health conditions of a person. It is something that is mandatory to be taken very early in life because of the fact that they serve as great advantage for a human being in times when the person faces any serious health issues that is related to incurring a lot of expenditure on the part of the individual. Many people do not have the capability and the affordability to take the medical expenses on their own because they are financially not very strong. It may happen because of the business or the service of a human being. This weakness on the part of the individual makes him helpless when faced with any problems in life. Therefore it becomes important for an individual to take the advantages of Medicare so that they do not have to be left helpless at the hands of fate anytime in their future. Medicare Insurance is also known as Medigap Insurance because of the fact that it covers up the maximum number of gaps that are uncovered by the Medicare insurance. The gaps that are left undone by the original Medicare are thus covered by the medigap insurance and the extra expenditure of an individual is maintained through the availing of the medigap insurance. There are many out of the pocket expenses that need to be maintained by an individual in case of a medical urgency these expenditures involve the tests and the diagnosis that need to be carried out, nursing home charges and so on. These expenditures are carried out by the Medicare Supplemental and are of great advantage for the people taking up the Medicare insurance facility. It is also very important to note that the original Medicare has some added and hidden charges that are made by the company giving the Medicare and the payment is also not received very easily but the supplemental insurance works in a very specific manner trying to give the services that it is meant for in the best way possible. It is advisable for an individual to compare the Medigap Premiums before making a choice of the supplemental plans that are best suited to the needs of an individual. Therefore an individual should always compare the premium rates that exist in the market of the different insurances that are available and then a make a definite choice regarding which plan to choose. For the best Medicare Supplemental Insurance Comparison for Medicare Supplemental its better to compare the Medigap premiums.
Source: articleswide.com

Medicare Open Enrollment Ends Early in 2011

Medicare Open Enrollmentends earlier this year. You have until December 7 to make sure your health and drug coverage still meets your needs. You do not need to take any action if you are happy with your current coverage. If you want to change plans, or if you need help choosing the right plan, visit the Medicare website and get personalized information about plans in your area.
Source: css-lawfirm.com

THE NYS PALLIATIVE CARE INFORMATION ACT

Posted by:  :  Category: Medicare

In providing this counseling, the primary care physician may also recommend or refer to a team of professionals, again determined by the patient’s need and the disease state or condition. The professionals may consist of social workers, nutritionists, mental health counselors, and even geneticists where appropriate. The goal is to provide care options appropriate to the patient, to prevent or relieve pain and suffering and to enhance the patient’s quality of life.
Source: wordpress.com

Video: Wii Bowling Games in Binghamton, NY – Sponsored by Touchstone Health

NY Pharmacists Busted for $3 Million Medicare Fraud (S U P R A S P I N A T U S)

Two New York State pharmacists were arrested Tuesday for allegedly defrauding Medicare of more than $3 million after billing the federal government for prescriptions they never filled. Read the full article (with video!) on the CBS website.
Source: nysbar.com

Medicare Advantage & NYS Anti

Under New York State General Obligations Law 5-335, also known as the New York State Anti-subrogation Law, it is “conclusively presumed” that a settlement between a plaintiff and defendant for personal injuries does not include compensation for medical expenses unless there is a statutory right of reimbursement.      A medical insurance plan does not have any rights against a settling party for medical expenses, and the law provides that any settlement by a plaintiff does not violate any insurance contract provisions between the plaintiff and an insurance company.
Source: doranandmurphy.com

Cuomo: Supercommittee Fail = Trouble For NYS

Days after sending a letter to New York’s Congressional delegation warning of fiscal dangers should Congress fail to act, Cuomo held a conference call with his outside economic and fiscal advisors and asked that they work with his administration to draw up an “expedited job creation and fiscal stabilization plan.”
Source: nydailynews.com

Why are union employees and others allowed to get medicare upon retirement? ? Answer, What, kathyisanurseBecause, Medicare, Best, This ? Retirement Overseas!

Question by grandma zaza: Why are union employees and others allowed to get medicare upon retirement? My mother is a retired (NYS) teacher, and she also has medicare. What one does not pick up the other does.
Source: 1289.de

URGENT — Take Action on Medical Malpractice Proposals Before NYS Legislature

Governor Cuomo, under the guise of Medicaid reform is attempting to curb the rights of victims of medical malpractice and close a budget gap by capping the recovery available to innocent injured individuals in the State of New York.
Source: lienresolutiongroup.com

“Retirees, elected officials to rally in support of Medicare.” August 10, 2011. NYSUT: A Union of Professionals. www.nysut.org

NYSUT, the state’s largest union, represents more than 600,000 teachers, school-related professionals, academic and professional faculty in higher education, professionals in education and health care and retirees. NYSUT is affiliated with the American Federation of Teachers, National Education Association and the AFL-CIO.
Source: nysut.org

2011 Ohio Medicare’s Open Enrollment Ending Soon!

Posted by:  :  Category: Medicare

BITCH..beautiful individual that causes hardons .....item 1..Allen West calls Wasserman Schultz ‘vile’ and ‘not a lady’  (7/20/2011) ... by marsmet522Have you shopped your Medicare Supplement lately? If you are 65 and older we can help you find the best priced supplement plan for you. You could save money, get better coverage, or both.  With the new health care law in Ohio, there are lower prescription costs when you are in the donut hole, annual wellness visits, and more preventive care services. Click here for more information on Medicare Costs in 2012.  Our guides sections also has much information that will help to answer any questions you may have. If you would like a quote from our Medicare Specialist click here.
Source: ohiomedigapinsurance.com

Video: Medicare Advantage Plans 2011

medicare private health plan

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

Romney’s Plan Would Fundamentally Change Medicare

Joe Baker, president of the Medicare Rights Center, a N.Y.-based consumer advocacy group, discounts Romney’s claims that having more seniors in private plans will save Medicare money. The Medicare Advantage program, he said, “has not brought down costs, so to think that there’s a new version that willy nilly by itself will bring down costs is a fantasy….It’s really cover for the real goal, and that is to end Medicare as we know it and by doing that, have more money come out of the pockets of consumers and save the federal government money.”
Source: kaiserhealthnews.org

united health care system wisconsin celtic health insurance company

There are many people who get original Medicare plans at a very early age so that they may remain secure in their future and also because they want to get the best benefits out of the insurance that they take for future. But these people are generally unaware of the fact that the original Medicare does not have the capability of paying off the expenses that are incurred on other medical aids such as vaccination or nursing costs. Therefore in order to get the best benefits out of the original Medicare plan it is very important to get enrolled for the Medicare Supplement plans. As we are all well aware of the point that Medicare supplement insurance also known as Medicare Supplemental is meant to fill in the gap that is left behind by the original Medicare plan. Along with this point it should also be kept in mind that supplemental insurance is not only meant to bridge up the gap left behind by original Medicare but is also very instrumental in reducing the Medicare premiums of an individual. The most important thing to note in this respect is that before going to choose a Medicare supplemental insurance plan it is essential to make a Medicare Supplemental Insurance Comparison in order to have a concrete idea about what a medigap health insurance plan is all about. The comparison is also very important in the respect of the premiums that are required to be paid. This payment of the premiums may differ from company to company and depend upon the rates set up by the private companies by their own whim. However there is appoint that is worth taken importance about and that is Medigap Plans California that rank among some of the best plans that are available to the people of the US nowadays. A statistical analysis confirms the point that there are more that forty five million in the people who are without insurance and the main reason behind this is the vagueness of the policies and the inability of the people to understand the details regarding the policies. The people failing to understand the policies fear expenses and try to stay out of insurance plans. This is the reason behind the great popularity of Medigap Plans California that serves the people to their optimum and ensures a great future to the people in the times to come. These plans are designed in such a way that they cover all the expenditures that a person may need to pay for his medical bills. These plans are basically created to support the original Medicare policy as there are always some gaps remaining after the usage of the policy. Though these plans are a complete private dealing but the upper hand is always governmental rules and authority which the private companies are bound to follow. The only difference is in the payment of the premiums which may differ from company to company. It is the sole discretion of an individual to decide which company to apply for as some may require big and some little.
Source: attentiontohealth.info

Baby Boomers U. S. (The Blog)

Do a quick check-up online, or get someone to help you: People tend to want to avoid a review of their Medicare coverage because it’s a hassle. But, there are a number of Internet sites that can reduce the hassle of reviewing your coverage. Sites like PlanPrescriber.com (owned by Plan Prescriber, Inc.), eHealthMedicare.com (owned by eHealthInsurance Services, Inc.) and Medicare.gov (the government website) make it easy for you to review plans and benefits side-by-side, and get a sense of what plan might work best for you. Or, if you don’t want to use the Internet, you can contact Medicare, your state department of insurance, the insurance company, or work with a licensed agent who represents several insurance companies, like eHealthInsurance.
Source: babyboomersus.net

Medicare Open Enrollment Ends December 7th!

January 1-February 12: Disenrollment. If you joined a Part C plan in late 2011 and want to reverse that decision, you can disenroll from that Medicare Advantage plan in this window of time and go back to Original Medicare with a stand-alone Prescription Drug Plan (Part D). Your Original Medicare coverage resumes on the first day of the month after the plan receives your enrollment form (either February 1 or March 1, 2012).
Source: billlosey.com

The American Spectator : The Spectacle Blog : Hensarling Pitches Romney Medicare Plan to Supercommittee

“The basic idea would be to introduce market forces into the insurance market for seniors by capping spending growth and allowing private plans to bid against traditional Medicare to offer insurance in a gven area.” – what a relief to hear something that actually make sense, not that the plan is great, but common sense is great to hear in this time of reformation; the current healthscare tax is deplorable – it’s full of mandates, and authority given to more agencies, rather than the people, who are paying for this intrusion – it’s not the same as forced car insurance – people that made the car insurance mandate were not progressive socialists, and character – does – matter. -redstate.com Obama Nominee Donald Berwick’s Radical Agenda May 12 2010 – “Any health care funding plan that is just equitable civilized and humane must, must redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional.” – **Donald Berwick (Obama administration nominee to run Medicare and Medicaid) –nypost-com O’s radical pick for Medicare O’s radical pick for Medicare June 16, 2010 – “Controversy is mounting over Dr. Donald Berwick, President Obama’s nominee to run Medicare and Medicaid — and for good reason. Berwick’s writings reveal that he would make radical changes — seniors beware…… in Berwick’s plan, many — perhaps most — primary-care providers would not be physicians…seniors have been able to call any doctor who takes Medicare, get treatment and have the federal government pay. Not in the future…He argues for a different focus, social justice…These subgroups — which can be defined by age, disease affliction or socio-economic status — should be the “unit of concern,” not the individual patient…A fervent ideologue, Berwick puts social engineering ahead of the individual patient’s needs. In contrast, most doctors understand that their duty is to heal each patient who comes to them.” Berwick loves socialism — he will fall right in line with the progressive socialistic/Marxist administration. PLEASE call your reps., and be critical — we are not experiencing politics as usual — the debate is not Democrat vs. Republican — the debate is capitalism/private enterprise vs. socialism/Marxism/totalitarian control. -ronpaul-com/Ron Paul: End Obama’s Corporatist Healthcare Mandate! April 18, 2010 HR 4995 “Last week I introduced a very important piece of legislation that I hope will gain as much or more support as my Audit the Fed bill. HR 4995, the End the Mandate Act will repeal provisions of the newly passed health insurance reform bill that give the government the power to force Americans to purchase government-approved health insurance…Second, the mandate is unlikely to remain “minimal” for long. The experience of states that allow their legislatures to mandate what benefits health insurance plans must cover has shown that politicizing health insurance inevitably makes it more expensive. As the cost of government-mandated health insurance rises, Congress will likely respond by increasing subsidies for more and more Americans, adding astronomically to our debt burden. An insurance mandate undermines the entire principle of what insurance is supposed to measure – risk…Instead of calling this socialized medicine, we should call it corporatized medicine, since the reform is to force us all into being customers of these corporations, whether we like it or not…”
Source: spectator.org

Forcing Dual Eligibles Into Private Health Plans is No Quick Fix 

[1] See, e.g. Melanie Bella and Lindsay Palmer, "Encouraging Integrated Care for Dual Eligibles," Center for Health Care Strategies, Inc., July 2009, found at http://www.chcs.org/usr_doc/Integrated_Care_Resource_Paper.pdf (site visited Nov. 19, 2011); James. M. Verdier, "Coordinating and Improving Care for Dual Eligibles in Nursing Facilities:  Current Obstacles and Pathways to Improvement," Mathematica Policy Research, Inc., March 2010, found at http://www.mathematica-mpr.com/publications/pdfs/health/nursing_facility_dualeligibles.pdf (site visited Nov. 19, 2011) [2] Id. [3] See, e.g., Affordable Care Act, Pub. L. 111-148, §§  2703, 3021, 3022, 3024 (March 23, 2010). [4] Medicare Payment Advisory Commission. "A Data Book:  Health Care Spending and Medicare Beneficiaries" Ch. 3, Dual-eligible beneficiaries (June 2011) at http://www.medpac.gov/chapters/Jun11DataBookSec3.pdf (site visited Nov. 21, 2011) [5] Kaiser Family Foundation Program on Medicare Policy, "Comparison of Medicare Provisions of Deficit and Debt Reduction Proposals," Sept. 23, 2011, at http://www.kff.org/medicare/upload/8124.pdf (site visited Nov. 20, 2011) [6] Much of the content of this Alert was a collaborative writing project shared among various advocacy organizations working on this issue.  The Alert is adapted from a Fact Sheet the organizations prepared to help Members of Congress understand the issues before them. [7] Kaiser Family Foundation Program on Medicare Policy, The Role of Medicare for the People Dually Eligible for Medicare and Medicaid (Menlo Park, CA: Kaiser Family Foundation, January 2011), available online at http://www.kff.org/medicare/upload/8138.pdf. [8] Private Medicare and Medicaid health plans are private plans that contract with either Medicare or Medicaid under a federal (and in the case of Medicaid plans, state) regulatory framework to provide benefits under each program that are otherwise provided in a fee-for-service like structure.  For each private plan, the public program pays a capitated (per member per month) amount for each enrollee, thus making the public costs predictable.  The private plan is at risk for providing the benefits within the payment it receives. [9] Medicare Payment Advisory Commission, Report to the Congress: Medicare and the Health Delivery System (Washington: MedPAC, June 2011), chapter 5. [10] MarkDuggan and Tamara Hayford, Has the Shift to Managed Care Reduced Medicaid Expenditures? Evidence from State and Local-Level Mandates, (Cambridge, MA: National Bureau of Economic Research, July 2011), available online at http://www.nber.org/papers/w17236. 
Source: medicareadvocacy.org

2011 Medicare Open Enrollment

Each year plans change what they cost and what they cover. Now is the time for people with Medicare to review the changes being made by their current plan and compare it to others to make sure it still meets their needs. Those who don’t have prescription drug coverage can also enroll in a drug plan during open enrollment.
Source: recorderonline.com

Argonneinsuranceagency.com

Posted by:  :  Category: Medicare

What's In My Bag... by Amy DiannaGIG HARBOR, WA ? A countdown widget has been created to help people keep track of the new Annual Enrollment Period for Medicare Advantage and Medicare prescription drug coverage, also known as Medicare Part C and Medicare Part D respectively. The new enrollment period began on Oct. 15 and ends on Dec. 7, a significant revision from the old period, which began on Nov. 15 and ended Dec. 31. The widget counts down the days, hours, minutes and seconds until the end of the new enrollment period for these plans. For seniors affected by the revision in the enrollment period, the widget was created as a way to spread awareness about the new dates. As more and more people enroll in Medicare yearly, the number and types of plans also change to accommodate the overall need. It is important to stay up-to-date on the enrollment period for individual Medicare options, especially popular options such as Medicare parts C and D. The countdown widget was created for you to download and embed on a webpage that seniors and their families might use with consistency, such as a blog or social media page. Any webpage that uses Flash or Java Script, however, can accommodate the widget, and it may prove valuable as a tool that keeps people aware of the upcoming end date for the new enrollment period. You may download the widget from one of the following two websites: [url=http://www.emedicaresupplements.com/medadvantage/changes/2011- annual- enrollment]http://www.emedicaresupplements.com/medadvantage/changes/2011- annual-enrollment[/url] [url=http://www.widgetbox.com/widget/countdown-pro/medicare- aep]http://www.widgetbox.com/widget/countdown-pro/medicare-aep[/url] Medicare is a complicated system, and navigating it can feel overwhelming. Seniors who would like assistance in sorting through their options and putting together the best Medicare health coverage possible may contact one of eMedicareSupplements? trained specialists at 1-877-275-2808. About eMedicareSupplements eMedicareSupplements was established as a subsidiary of Affordable Insurance, Inc., and its purpose is to make Medicare clearer and easier for the average person. The website offers dozens of articles explaining the many aspects of Medicare, from the different types of plans offered to the insurance companies that offer plans that work with Medicare. The companys well-trained and experienced agents are available by phone to help seniors with the more personal details and needs they may wish to talk over in their quest for the best health coverage. Source: yourfreepressrelease.net
Source: medicaresupplementalco.com

Video: Preserve Social Security & Medicare – AARP WA Speaks Out

RegenceMedicare.com Compare Regence Medicare

About 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

Aging Services: The Online Community for Senior Care and Services Providers: Compliance with Version 5010 January 1 FFS Deadline Requirement Still In Effect

As further confirmation of the deadline’s applicability to Medicare Fee For Service claims, CMS issued the following alert on 11/21/11: “You must comply with this important deadline to avoid delays in payments for Medicare Fee-For-Service (FFS) claims after December 31, 2011. You and your billing and software vendors must be ready to begin processing the Health Insurance Portability and Accountability Act (HIPAA), Versions 5010; D.0 production transactions by December 31, 2011. Beginning January 1, 2012, all electronic claims, eligibility and claim status inquiries, MUST use Versions 5010 or D.0. Version 4010/5.1 claims and related transactions will no longer be accepted.
Source: blogspot.com

Senior Care Bellevue WA: 8 ways for seniors to watch for Medicare …

Pacific NW Garage Doors sells, repairs, and installs garage doors and garage door openers and accessories. We have been proudly serving cities in the Puget Sound area, including Seattle, Tacoma, and Bellevue, for over two years. We are a licensed, bonded, and insured contractor who cares about our customers. We have built a solid reputation by consistently offering fair prices, superior workmanship, and high quality products. Every customer is important to us.
Source: garagedoorrepairbellevue.org

eMedicareSupplements Publishes Medicare Annual Enrollment Reminder by Emedicaresupplements

Tacoma, WA (1888PressRelease) November 12, 2011 – eMedicare Supplements has recently published a countdown widget for the new Medicare Annual Enrollment Period dates for Medicare Advantage and Medicare Part D prescription drug plans. The widget counts down by day, hour, minute and second to the expiration of the new enrollment period, which began on October 15 and ends on December 7. This is a substantial revision of the traditional enrollment period, which always began on November 15 and ended on December 31. People who are accustomed to the traditional enrollment period may want remind themselves and others of the important change in any way possible, including the countdown widget, which has been published for awareness purposes. The number of people enrolling in Medicare is always increasing. As more people are faced with putting together a Medicare health plan from the many coverage options available to them, it is important to be informed about the different enrollment periods Medicare offers for specific plans. Download the widget and embed it on any webpage, including a blog or a social media page, that will run JavaScript or Flash. It will keep track of the time you have until the expiration of the enrollment date, giving you an added safety net and a method of accountability. The widget is available to download from the following webpages: http://www.emedicaresupplements.com/medadvantage/changes/2011-annual-enrollment http://www.widgetbox.com/widget/countdown-pro/medicare-aep Sometimes it’s hard to decide whether Medicare Advantage or a Medicare supplement plan would be best for your health needs. Seniors looking for help in choosing the right Medicare plan may contact eMedicareSupplements at 1-877-275-2808. The trained specialists at eMedicareSupplements can help you work through the details, including the benefits and the drawbacks of the different options open to you. About eMedicareSupplements.com eMedicareSupplements is a subsidiary of Affordable Insurance, Inc. The eMedicareSupplements.com website provides answers to the many questions surrounding Medicare, seeking to offer simple explanations that are understandable to the average person. Agents at eMedicareSupplements have a wealth of experience in the Medicare and health insurance industry, and are ready to answer questions and to help people choose the best way to approach Medicare for their specific needs. ###
Source: 1888pressrelease.com

eMedicareSupplements Informs Seniors of New Enrollment Dates

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Source: free-pr-online.com

eMedicareSupplements Keeps Seniors Informed on Enrollment Changes

eMedicareSupplements seeks to make Medicare more understandable and accessible to the people who depend on it. A subsidiary of Affordable Insurance, Inc., eMedicareSupplements provides a website with many different articles containing up-to-date information on Medicare in simple terms. Agents are always available by phone to answer more specific and personal questions, and to help individuals navigate the Medicare world to their advantage.
Source: releasewire.org

The (Anything BUTT) Super Committee’s Epic Failure

What does this mean tax-wise? The Bush-era tax cuts are set to expire at the end of 2012 as part of the involuntary deficit reduction now set to occur. There could be other possible tax consequences as a result of the super committee’s failure. Unless Congress unexpectedly passes the President’s American Jobs Act, the payroll tax holiday will go away in 2012 (worth about $935 to the average worker, which some legislators wanted to make permanent). RBC Capital Markets analysts warn that taking the payroll tax back to 6.2% could shave 1% of U.S. GDP next year. For businesses, the current “bonus” depreciation write-offs for new capital equipment and the R&E tax credit could also become casualties. Additionally, when you do a broad cut to federal programs, you are impacting payments from Washington to state programs; state taxes could rise to compensate for that lost money. How about Medicare, the SSA & jobless benefits? While Medicare recipients won’t be bitten by the default deficit reduction, payments to Medicare providers could be shrunk by 2%. Long-term unemployment insurance would also dry up for 2.1 million Americans by February, according to the Department of Labor’s forecast; JPMorgan Chase economists think that development alone might hurt U.S. GDP by 0.75%.
Source: billlosey.com

WA Medicare Supplemental Insurance

There are specific limits or gaps in protection in the Medicare A or B insurance.  They do this to limit the expense to the state and local governments.  With a Washington supplemental Medicare insurance policy, you can fill in your coverage so that you are fully protected.  Call AAG insurance today, and speak with one of our knowledgeable agents.  They know the questions to ask you so that you can save money, and be properly cover all your Medicare Supplement Insurance in WA needs.
Source: aag-services.com

March from Occupy Wall Street Arrives in Washington DC Today

(This post is in response to a comment by Unicron 6 a couple of hours ago regarding the foreseeable failure of the “Super-Committee” (unconstitutional I add) and we must unite as the 99% and re-establish our Constitution-Democracy-and Government) The Republicans & Democratic Parties are one… There is no choice… Only “Good Cop – Bad Cop”… Good or Bad (Politicians) … there all the same. The Republicans taking the white house in 2012 only provides us with more of the same… The System is Broken… A long time hijacked and Broken… Google if you will Prescott Bush and find a man involved with Foreign Dictators in planning a “coup” of America through and by a Corporate Force of Fascism… Or look at who is in Herbert Hoovers Cabinet during the Stock Market Crash of 1929 and you’ll find Prescott Bush’s Daddy… Samuel Prescott Bush… who just happens to be in the “business” of selling Arms & Ammunition’s to Nations and Foreign Armies in and for War… supplying war munitions… Then of course there is George H. W. Bush and last(?) but not least… George W. Bush….Yet it was Bill Clinton who helped to push N.A.F.T.A. through Congress while the country was being focused by the Corporate Media on the Bill Clinton/Monica Lewinsky fiasco and impeachment “show”… So who do you think President Obama is involved/in-bed with??? Why he keeps signing off on Bush’s policies and wars and tax cuts for the wealthy?! …and I cannot help but to add this myself… Who was it that assassinated JFK & RFK and MLK??? If it walks like a Bush… Talks Like a Bush… Acts Like a Bush… it must be a BUSH! The Bush’s are at the head of the 1% and Our(so called) Congress is full of the same with the same allegiances to the 1%… So anyway… whether you vote for a republican or democratic candidate it won’t matter! The same thing that is going on today… right now… will only happen more and more and we the 99% will have less and less and then NOTHING and then EVEN LESS THAN NOTHING (we will end up slaves!) WE ARE THE 99%!!! and YES I mention a century of conspiracies here but it doesn’t matter because it all adds up to THE 1%… WE ARE THE 99% …on to D.C.!!!
Source: occupywallst.org

Supercommittee Deadlock is a Victory for Middle Class

Republicans insisted on not only extending, but expanding the Bush tax cuts for millionaires. Their plan would have made our deficit problems bigger, not smaller and would have further increased the gap between the middle class and the top 1%. Senator Murray refused to change the tax code in a way that gave further help to millionaires.
Source: washingtoncan.org

Medicare Advantage Plan Star Ratings and Bonus Payments in 2012

Posted by:  :  Category: Medicare

This report looks at the star ratings that have been used for many years to help consumers compare plans, and examines how Medicare Advantage quality scores will interact with plan payments, beginning in 2012.   To encourage Medicare Advantage plans to provide quality care, the 2010 health reform law authorized Medicare to pay plans bonuses beginning in 2012 if they receive four or five stars on the program’s five-star quality rating system, or are unrated.  Building on that provision, the Centers for Medicare and Medicaid Services subsequently launched a demonstration that allowed more plans to receive bonuses and increased the size of the bonuses to encourage plans to maintain or improve their rating.   Authored by Foundation researchers, the report is the fourth in a series looking at various aspects of the Medicare Advantage star ratings. Report (.pdf)
Source: kff.org

Video: Kaiser Permanente’s Medicare Plan in California Receives 5-Star Rating

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

Forcing Dual Eligibles Into Private Health Plans is No Quick Fix 

[1] See, e.g. Melanie Bella and Lindsay Palmer, "Encouraging Integrated Care for Dual Eligibles," Center for Health Care Strategies, Inc., July 2009, found at http://www.chcs.org/usr_doc/Integrated_Care_Resource_Paper.pdf (site visited Nov. 19, 2011); James. M. Verdier, "Coordinating and Improving Care for Dual Eligibles in Nursing Facilities:  Current Obstacles and Pathways to Improvement," Mathematica Policy Research, Inc., March 2010, found at http://www.mathematica-mpr.com/publications/pdfs/health/nursing_facility_dualeligibles.pdf (site visited Nov. 19, 2011) [2] Id. [3] See, e.g., Affordable Care Act, Pub. L. 111-148, §§  2703, 3021, 3022, 3024 (March 23, 2010). [4] Medicare Payment Advisory Commission. "A Data Book:  Health Care Spending and Medicare Beneficiaries" Ch. 3, Dual-eligible beneficiaries (June 2011) at http://www.medpac.gov/chapters/Jun11DataBookSec3.pdf (site visited Nov. 21, 2011) [5] Kaiser Family Foundation Program on Medicare Policy, "Comparison of Medicare Provisions of Deficit and Debt Reduction Proposals," Sept. 23, 2011, at http://www.kff.org/medicare/upload/8124.pdf (site visited Nov. 20, 2011) [6] Much of the content of this Alert was a collaborative writing project shared among various advocacy organizations working on this issue.  The Alert is adapted from a Fact Sheet the organizations prepared to help Members of Congress understand the issues before them. [7] Kaiser Family Foundation Program on Medicare Policy, The Role of Medicare for the People Dually Eligible for Medicare and Medicaid (Menlo Park, CA: Kaiser Family Foundation, January 2011), available online at http://www.kff.org/medicare/upload/8138.pdf. [8] Private Medicare and Medicaid health plans are private plans that contract with either Medicare or Medicaid under a federal (and in the case of Medicaid plans, state) regulatory framework to provide benefits under each program that are otherwise provided in a fee-for-service like structure.  For each private plan, the public program pays a capitated (per member per month) amount for each enrollee, thus making the public costs predictable.  The private plan is at risk for providing the benefits within the payment it receives. [9] Medicare Payment Advisory Commission, Report to the Congress: Medicare and the Health Delivery System (Washington: MedPAC, June 2011), chapter 5. [10] MarkDuggan and Tamara Hayford, Has the Shift to Managed Care Reduced Medicaid Expenditures? Evidence from State and Local-Level Mandates, (Cambridge, MA: National Bureau of Economic Research, July 2011), available online at http://www.nber.org/papers/w17236. 
Source: medicareadvocacy.org

Shopping Tips For Medicare Drug Plans

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Source: ehealthjournal.net

Top marks for Kaiser Permanente Hawaii’s Medicare plan

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Source: hawaii247.com

November Business Briefing

As Chief Executive Officer, Mirzabegian is responsible for operational effectiveness, strategic planning, business development, medical staff relations, financial management, and facility expansion plans. He currently oversees 2,500 employees, 450 physicians, and 400 volunteers, while successfully managing a $330 million annual operating budget. Mirzabegian was instrumental in the recent financial turnaround of AV Hospital and reduced the $18 million loss that had accumulated before he took over, to a $1.96 million loss at the end of fiscal year 2008. In fiscal year 2009, the hospital finished with almost $9 million profit.  The positive trend continued with $24.6 million profit at the end of fiscal year 2010.
Source: avbot.org

Kaiser Permanente CO earns Medicare 5

In addition to the high scores, Kaiser Permanente released survey findings revealing that consumers have a low awareness of the Medicare Star Quality Rating System. According to the survey conducted by Harris Interactive, only 18 percent of Medicare-eligible seniors said that they are familiar with the government’s rating system, and of those that are familiar, less than one-third have used the system to select their health plan. The survey also showed that only 2 percent of respondents know how their current health plan is rated.
Source: metrodenver.org

WASHINGTON: Romney's plan would change Medicare fundamentally

Joe Baker, the president of the Medicare Rights Center, a New York-based consumer advocacy group, discounts Romney’s claims that having more seniors in private plans will save Medicare money. The Medicare Advantage program, he said, “has not brought down costs, so to think that there’s a new version that willy-nilly by itself will bring down costs is a fantasy. … It’s really cover for the real goal, and that is to end Medicare as we know it and by doing that, have more money come out of the pockets of consumers and save the federal government money.”
Source: centredaily.com

medicare private health plan

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

Private Medicare Plans Defy Predictions, Growing Despite Health Law Cuts

The cuts have also been assuaged by another health law change. The law promised bonus payments to plans with good performance based on a five-star rating system used by the Medicare agency, the report said. Regulators increased the bonuses last year, further offsetting the cuts. A health plan executive told the report authors, “Unless some executive is asleep at the switchboard, I think everyone is paying attention to quality ratings and bonus payments.”
Source: kaiserhealthnews.org

How Kaiser Permanente Became a Continuous Learning Organization

About Kaiser Permanente Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We serve approximately 8.9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.
Source: justmeans.com

Make the Best Deal by Comparing Medicare Plans

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98Medigap Insurance Plans are always a better option available with the people who want to have a health care insurance which serves all well for his retired life. If a person takes up medical insurance it is always a wise decision made by him but many a times it is also seen that the original medical plan that is taken up by the individual does not serve everything well when comes to paying all the expenses that are made by the individual in his medical treatment. It is often seen that at last the person has to spend a lot of money form his own pocket since many medical services are not covered by the original medical policy. Therefore there is the presence of the Medicare Supplement Insurance which is introduced to bridge up the differences between the original payments that are needed to be spent by the individual and the insurance money that is given by the Medicare policy to the individual who has taken up by the individual. It is a very noble idea to have supplemental Medicare Insurance plan beside an original one in order to fill up the gap that exists by the original Medicare. It is very evident form the name itself that the medigap policy works clearly as its name implies. It is very important to have a medigap insurance plan with original Medicare policy to claim the whole amount of money that is needed for your treatment. The California Medigap Plans have a lot of hidden advantages part from the original Medicare Plan for which an individual needs to remain informed and educated. In order to get the advantages of the Medicare Supplementary Plans it is very important to remember that an individual has to enroll his name first for the original Medicare and only then can he get the supplementary Medicare plan. Without the original it is seer impossible to get enrolled for the later. It is not independent and the entire supplementary Medicare is controlled by various private companies and no government body is concern about the supplementary one. But all the private companies have to follow some specific rules and they are bound to follow those rules. It is also advisable for an individual to consult an insurance agent before deciding on taking insurance plans and also to decide the priority to book for a special one. It is very essential to book that particular plan that will give you the maximum benefits concerning your health issue and go for that definite plan. It is therefore very important to read the details and then go for the Medicare plans. Before choosing a particular Medigap insurance you can compare Medicare Plans and choose the Best Medicare Supplement Plan. Medicare Supplement Comparison will help you to find out the Best Medicare Supplement. It is important because it is a thing dealing with your future and health. Among all the available medigap insurance plans Medigap insurance California is one which is secured and good to pay attention. To cover the gap left behind by the original Medicare it is essential to get the Medicare Supplemental Plans and also to get the maximum benefits out of Medicare Supplement it is essential to learn the Medicare Insurance Rates.
Source: articleswide.com

Video: Medicare Advantage Plan Comparison Tool Tutorial

Medicare Supplemental Insurance Comparison

It really is critical to know if your physician accepts Medicare’s pre-accredited sum. Medical doctors might charge a lot more for a treatment than Medicare will pay. When Medicare handles eighty% of a pre-accredited amount, Medigap handles 20% of the same pre-approved sum. Your medical professional could charge a great deal much more than Medicare’s pre-authorized quantity and depart you to make up the difference. Medigap Program G pays for eighty% of any medical doctor charges above what Medicare will spend.
Source: syncop.org

united health care system wisconsin celtic health insurance company

There are many people who get original Medicare plans at a very early age so that they may remain secure in their future and also because they want to get the best benefits out of the insurance that they take for future. But these people are generally unaware of the fact that the original Medicare does not have the capability of paying off the expenses that are incurred on other medical aids such as vaccination or nursing costs. Therefore in order to get the best benefits out of the original Medicare plan it is very important to get enrolled for the Medicare Supplement plans. As we are all well aware of the point that Medicare supplement insurance also known as Medicare Supplemental is meant to fill in the gap that is left behind by the original Medicare plan. Along with this point it should also be kept in mind that supplemental insurance is not only meant to bridge up the gap left behind by original Medicare but is also very instrumental in reducing the Medicare premiums of an individual. The most important thing to note in this respect is that before going to choose a Medicare supplemental insurance plan it is essential to make a Medicare Supplemental Insurance Comparison in order to have a concrete idea about what a medigap health insurance plan is all about. The comparison is also very important in the respect of the premiums that are required to be paid. This payment of the premiums may differ from company to company and depend upon the rates set up by the private companies by their own whim. However there is appoint that is worth taken importance about and that is Medigap Plans California that rank among some of the best plans that are available to the people of the US nowadays. A statistical analysis confirms the point that there are more that forty five million in the people who are without insurance and the main reason behind this is the vagueness of the policies and the inability of the people to understand the details regarding the policies. The people failing to understand the policies fear expenses and try to stay out of insurance plans. This is the reason behind the great popularity of Medigap Plans California that serves the people to their optimum and ensures a great future to the people in the times to come. These plans are designed in such a way that they cover all the expenditures that a person may need to pay for his medical bills. These plans are basically created to support the original Medicare policy as there are always some gaps remaining after the usage of the policy. Though these plans are a complete private dealing but the upper hand is always governmental rules and authority which the private companies are bound to follow. The only difference is in the payment of the premiums which may differ from company to company. It is the sole discretion of an individual to decide which company to apply for as some may require big and some little.
Source: attentiontohealth.info

Safety and Security for a Lifetime

Medicare is a very important factor that plays a very crucial role in the lives of every human being. It is one such condition which helps a human being to get rid of many problems that occur during the last stages of his life. Many a times a person is not able to gauge out the weaknesses or the left-over’s in life that need to be filled up. These differences generally occur during the last stages of life when a person is unable to manage his health on his own and have to be dependent on a person. Medicare Plans in California are the best among so many plans available in the market. They are the ones that help people to get rid of their medical expenses in their old age and deliver a great soothing effect on the problems of the common man. Not only this, they are also available very easily and are always at par with the needs of the people. They are meant to give ultimate satisfactory service to the people and are hence always in demand by the people. It is due to the great popularity of these plans that they are also available at a very minimal cost.
Source: articlesark.com

Online Medicare Supplement Plan Comparison

The site is quite easy to search for with the use of the common search engines that people are usually using; because of the site’s easy availability, it is very convenient to all the people that are in search of it especially the people that are thinking of having a Medicare Insurance. The GoMedigap site is definitely a very convenient site that people can really go to in case they are they thinking of having a Medicare Supplement; the site can explain clearly everything that there is to know about the different kinds of insurance plans. With the help of the site, any person can easily make a Medicare supplement plan comparison and then decide as to which he or she will have to choose from the different plans that there are. However, it is quite obvious that the best plan would be the Medicare supplement Plan F, but it is still up to the person or the beneficiary, which he or she will have to choose.
Source: potomacclub.org

Medicare Advantage Health Plans

There are some options available for you to opt for when you plan to enroll in Medicare health plans. Medicare health plan is the government-sponsored health insurance program that is specially offered for people of 65 years old and over. There are four options available for you to choose from. If you plan for hospitalization you should choose Part A. If you plan for doctor visits you should choose Part B. If you plan for prescription drugs you should choose Part D. If you don’t find one that suits your health care needs, you can choose alternative choice, a Medicare Advantage health plansthat is also known as Medicare Part C.
Source: healthplanscomparison.net

The Effective Use of Medicare during Medical Urgency

These are the plans that cover the entire remaining part of the medical bills which are left undone by the original Medicare policy. These plans are under the sole discretion of the private companies who have the right to make changes in these plans. However a point to be noted in this respect is the fact that the private companies cannot modify any of the plans as they are fixed and strictly followed by the government. The government of the respective country has a strict supervision over the working and the administering of the insurance plans. The Best Medicare Supplement Insurance is the one that provides the maximum number of benefits and also covers the extra expenditure made by the individual for his health purpose and through these plans an individual is able to relax his future after the age of sixty five. These plans make it easy for a person to retire from work and enjoy post retirement life to the maximum. It allows an individual to remain independent and at the same time unhesitatingly leave all the tension about his health. Not only this, the plans are a resolution to almost every problem of a human being. However big a problem is but the solution is there with medigap.
Source: articlesblogs.info

Live and let live by the benevolence of Medicare plans

Renowned Medicare Supplement Insurance Companies always prepare to offer the best service and they are very punctual when it comes to the payment of medical bills. Smaller insurance companies are also trying to achieve their goals in terms of service. It is just a matter of performance of the company and the trust of the target audience who are coming to them with lots of expectation regarding their health care benefits which is the most precious thing for our elders as well as for us. In this present economic situation with the high pricing of daily commodities the health care industry also affected a lot. This is the reason why health services are becoming expensive. It is accepted that medical plans are available which are bounded to high medical costs. However, there are some health needs that these plans are unable to provide the customers. Supplemental insurance plans cover these shortfalls. They provide financial assistance for expenses not included in regular medical plans. Health insurance supplements are quite beneficial, especially for those on a budget, because they give more affordable health care financing options.
Source: articlejadeo.com

Comparing Cost Is Not Enough When Evaluating Medicare Part D Plans

5.    Do you have comprehensive and objective information on the plan? When evaluating plans, it’s important to ensure you have all the necessary details to make a fair comparison of Part D plans. Keep in mind that many Medicare plan selection services provided in the marketplace are designed to promote specific plans, including those provided by specific insurance providers. This can be true for Part D selection services offered online and by store pharmacies. Government resources also may not be the most current. These factors can limit your ability to make an informed choice and could mean you miss the opportunity to find a plan that better meets your needs.
Source: travelnets.info

Finding a Medicare Provider

  You can gain access to this tool by simply going online and by following instructions that would take you to your medical provider of choice.  You can also call their hotline number and inquire there by giving your area and the specialty of preference.   If you are holding a Medicare policy that covers only Part A and B of the plan, you can choose any of the doctors and medical facilities accredited by the Medicare.  However, if the plan that you have is that of a private insurance company or is a Medicare Advantage plan, your choice of provider is limited.  Why is this so?  This is because this kind of plan would only permit you to avail of the doctors and facilities that they recommend or accredit.  The best thing to do to prevent making unnecessary additional payments for services, is to ask for a list from your insurance company.  Only then, can you find out and choose the medical provider that you need.   It would be wise to have a checklist for looking for a Medicare provider that you prefer.  Include the area, the specialty, etc.  When you are done, check for the profile online.  Do not jump right in by contacting the medical provider immediately.  Check their profiles and compare.
Source: ezinemark.com

Baby Boomers U. S. (The Blog)

Do a quick check-up online, or get someone to help you: People tend to want to avoid a review of their Medicare coverage because it’s a hassle. But, there are a number of Internet sites that can reduce the hassle of reviewing your coverage. Sites like PlanPrescriber.com (owned by Plan Prescriber, Inc.), eHealthMedicare.com (owned by eHealthInsurance Services, Inc.) and Medicare.gov (the government website) make it easy for you to review plans and benefits side-by-side, and get a sense of what plan might work best for you. Or, if you don’t want to use the Internet, you can contact Medicare, your state department of insurance, the insurance company, or work with a licensed agent who represents several insurance companies, like eHealthInsurance.
Source: babyboomersus.net

Some information on Medicare Supplement Plans

As it is known the Medicare Supplement Plans are the supplementary insurance policies that help in bridging the gap that is left behind the original Medicare policy. Actually the fact is that the original Medicare policy covers almost all the medical costs that you may be in need of. But besides that there still remains some gap between their policy coverage and the original cost payable. Therefore there is the need of having a Medicare Supplement Plan, which would help you to get cleared of your medical bills completely. Actually the Medicare Supplement Plans are the health insurance plans that are completely administered and sold by the private insurance companies and the government doesn?t have much of say in it. But besides that the insurance companies are allowed to sell only 12 standard Medicare Supplement Plans under the letter cover hr support for small businesses s from A through L. All these plans provide different benefits and coverage. But along with that it should also be remembered the plans under the same letter cover is bound to provide the same benefits irrespective of whatever insurance companies may sell them. Though the cost of the premium may differ for different companies. Therefore it is always advised to go through the offer documents of all the plans from A through L before deciding to choose the one right for you.Now if you are interested to buy a Medicare Supplement Policy for the first time or if you want to replace your current policy with another one, it is really easy. You can also obtain the rates by simply completing an online quote on the Internet. And after receiving an email back with quote comparison you can decide the one most suitable for you with the help of your agent.
Source: thosepeabodys.com

Child health insurance is imperative

Posted by:  :  Category: Medicare

"The single best augury is to fight for one's country." ~ Homer (800 BC - 700 BC), The Iliad. by eyewashChild health insurancecompanies in India donot cover all kinds of ailments. They usually have a pre-determined list of ailments and health conditions to be covered under a policy. Almost all the medicare planand policies will cover hospitalization charges for the following ailments: •    Strokes •    Heart attacks •    Prolonged illnesses •    Loss of limb, eye, or other parts of the body due to accident •    Injuries •    Expensesfor maternity  care •    Medications
Source: forelia.com

Video: Medicare’s Orphans – Trailer 3

Paid Sick Days Would Decrease Emergency Room Visits, Study Says

The United States spends approximately $47 billion annually on emergency department services. IWPR findings show that, by shifting the treatment of some preventable illnesses from emergency departments to less expensive doctor’s offices, clinics, and hospital outpatient settings, access to paid sick days would save $1.1 billion annually. Currently, approximately $500 million of these costs are covered by taxpayer-funded public health care for children, the elderly, veterans, and low-income families, including Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), and Veterans Affairs services. The remainder of preventable emergency department costs are accrued to individuals who pay out of pocket for health care and to insurance companies and their customers.
Source: gsmlaborcouncil.org

The Delaware County Daily Times Blogs: The Delco Delivery: County council ratifies submission of grant

Delaware County Council ratified the submission of a grant application Tuesday in the amount of $20,000 to the Centers for Medicare and Medicaid Services for the Innovation Advisors Program. “We’re going after this grant,” said Delaware County Executive Director Marianne Grace during a county council agenda meeting Monday. “It will be great if we can get it, but we’ll have to see what happens.” Grace said that if the Centers for Medicare and Medicaid Services (CMS) awards the grant to Delco, Dr. George Avetian would be the county’s designated representative. Avetian, the county’s senior medical adviser, said he submitted the application to CMS last week. “The Innovation Advisors Program is designed to broadly help individuals refine, apply, and sustain managerial and technical skills necessary to drive delivery system reform for the benefit of Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries,” states a CMS fact sheet about the program. Back in October, CMS announced it was accepting applications for the Innovation Advisors Program. The Innovation Center was created through the federal Affordable Care Act.
Source: blogspot.com

Expansion of Publicly Funded Health Insurance in the United States: The Children’s Health Insurance Program and Its Implications

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Source: couponpromodiscount.biz

MPCA Staff Member Recognized for Excellence in Children’s Health Outreach

Under the Children’s Health Insurance Program Reauthorization Act (CHIPRA), CMS has awarded $90 million in outreach grants since 2009.  These grants are aimed at ensuring further improvements in reaching children who are eligible but unenrolled. An additional $40 million in funding will be made available under the Affordable Care Act for improving outreach and enrollment efforts. ECHOE honorees include past and current CHIPRA outreach and enrollment grantees, as well as groups working in partnership with grantees.  Their activities include using technology in innovative ways to enroll eligible children, enlisting schools in effective outreach, sponsoring a successful enrollment telethon and designing the systems needed to ensure that eligible children retain their health coverage for as long as they qualify.
Source: wordpress.com

How did you choose a family Doctor in Australia?

We realised we were missing a trick and started using the different Centre. When we made our initial appointment we weren’t given a choice of Doctors we just saw whoever was available. We have now been seen by most of the Doctors at the Centre and there’s no difference in the standard of service. The Centre itself appears to divide patients between Doctors wherever possible. It seems that one Doctor always sees the children and if Mum or Mr Mum’s gone 2 Aus need to see someone we get an appointment with whoever has seen us most frequently in the past. For immunisations, we take the children to their usual GP who gives them the once over before they see the nurse who, at our Centre, gives all childhood immunisations.
Source: mumsgone2aus.com

Arcadia Solutions Blog: CMS’ Center for Innovation posts $1 billion grant challenge

, awarding up to $1 billion in grants to applicants who will implement the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and CHIP, particularly those with the highest healthcare needs. This is an exciting opportunity for organizations to come together to test out new models of care delivery, and certainly one to keep an eye on.
Source: arcadiasolutionsblog.com

An absense of Wife and children Policy coverage Less Medicare insurance Vigor Hemorrhoid treatment Good care Options for One specific Much more youthful Wife or husband

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Source: bryanpalmernovogen.com

Facing Autism in New Brunswick: Medicare’s Orphans: The Fight for Healthcare for Children with Autism Disorders

In particular, I had the opportunity a few years ago to meet the Marinoiu family from Toronto. Their son Simon is very similar to my son Conor. I was deeply moved by my experience meeting this wonderful family. Simon’s life, his future, is very close to what can be expected for my son here in New Brunswick where our system of adult care for people with severe autism disorder challenges has been frozen by a non evidence based community cliche movement that prevents any serious discussion of adult care beyond the group homes that currently can’t handle the challenges presented by severe autism. The result is that severely autistic adults like my son live in a psychiatric hospital in northwestern New Brunswick.
Source: blogspot.com

The Private Health Insurance Rebate: What You Need to Know

The Private Health Insurance Rebate is available to many people. All those who are eligible for Medicare, and who have a Complying Health Insurance Product (CHIP) underwritten by a health insurer registered with the Private Health Insurance Administration Council (PHIAC), are eligible for the rebate. Most health insurance plans will qualify, but to make sure yours does, check out the list of insurers registered with PHIAC at www.privatehealth.gov.au. The Private Health Insurance Rebate is not based on family type or income, and is available on hospital cover, general treatment cover or combined cover. You can receive the rebate even if your employer pays your premium on your behalf, and you can receive the rebate if you are the policyholder but the policy doesn’t cover you, such as parents who hold a policy for their children.
Source: com.au

Aetna and Banner Health Poised to Become First Pioneer ACO

Following the unveiling of the proposed regulation for ACO in March, which received a chilly reception (such as the American Medical Group Association’s letter to Berwick), CMS rolled out the Pioneer Program. The hope was that high-performing healthcare organizations that are already doing what ACOs are intended to do — that is, provide high-quality care to Medicare beneficiaries while keeping costs down — would become advance models of ACOs. Kaiser Health News and Politico reported in September on the struggles to get Pioneer ACOs up and going, citing four leading health systems — the Mayo Clinic, the Cleveland Clinic, Geisinger Health System and Intermountain Healthcare — that were seen as excellent candidates to become Pioneer ACOs. All four chose to decline to apply to become Pioneer ACOs.
Source: beechtreepartners.com

Children’s Health is a National Priority

Recently, the Centers for Medicare and Medicaid Services (CMS) commissioned a survey by Lake Research Partners interviewing over 1,900 families at 250% of the federal poverty level or less. One-third of the families had children covered by Medicaid; a third were covered by CHIP; and a third received coverage through their employers.  The intent was to measure perceptions of these programs from families who are eligible for it; find what works and what doesn’t work about the program; and learn what strategies work best in terms of connecting kids to coverage.
Source: liveunited.org

Medicare To Cover Infusion Costs For Prostate Cancer Vaccine, Company Says

Posted by:  :  Category: Medicare

BITCH..beautiful individual that causes hardons .....item 1..Allen West calls Wasserman Schultz ‘vile’ and ‘not a lady’  (7/20/2011) ... by marsmet522CQ HealthBeat: Bill Would Give Rural Clinics Access To Medicare Health IT Payments Rural health clinics would become eligible to receive the higher Medicare payments available to providers that make effective use of health information technology, under a bill introduced by Republican Rep. Aaron Schock. “By making this change it will ensure seniors in rural areas can continue to rely on their local doctors for quality health care using up-to-date technology,” Schock, of Illinois, said in a news release (Reichard, 11/21).
Source: kaiserhealthnews.org

Video: Improving Medicare in 2011

Medicare Costs: More or Less?

1. Example: where do you get that I think any insurance pays 100%? I neither state that nor imply that. A few insurance plans still pay 100%, the majority do not and have not for a long time. Even so, Medicare coverage is inferior to the private coverage most people have. I already pointed out a couple of the Medicare features that are inferior