MEDICARE OPEN ENROLLMENT ENDS DEC. 7 THIS YEAR

Posted by:  :  Category: Medicare

January 1-February 12 is the Disenrollment period. 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: kuczinskifinancial.com

Video: Medicare Part D (Formulary Conversion)

Health Related Articles Blog: Medicare Coverage And Providers

Taking the time to choose the most cost effective way to take advantage of the services can cut your out of pocket expenses dramatically. In some cases, services can be provided only at certain facilities. However, there are often several providers from which you can choose. Talk with your physician about your options so you can make informed choices when selecting where you receive health care services.
Source: blogspot.com

The super committee: “A bridge too far”

In theory at least, it had immense and unprecedented power.  If the select committee had been able to produce a consensus plan on deficit reduction, that legislation would have been guaranteed an up or down vote in the House and Senate — with no amendments allowed from the other duly elected members of either body.  No corner of the federal budget was beyond its potential reach.  It had the power to change tax laws, Social Security, Medicare, Medicaid and every other program too.  And once the committee settled on a deficit-cutting plan, the super committee’s recommendations would have been rushed to the House and Senate floors for votes, with just one month separating the deadline for committee action from the final votes in Congress.  That would have made it very difficult for opponents of the plan to get organized and stop it. In sum, the super committee was twelve members with the power to literally rewrite U.S. fiscal policy from top to bottom  — all in one piece of highly privileged legislation.
Source: theincidentaleconomist.com

Medicare Open Enrollment Ends Dec. 7

A summary of what you need to know. Presented by Jacob Warren Don’t wait until New Year’s to join a Medicare plan. The open enrollment period ends early this year, and many Medicare beneficiaries may not realize it. In fact, 97% of seniors in a recent poll conducted by UnitedHealthcare and the National Council on Aging could not specify this year’s earlier-than-usual deadline.1 Some key dates to remember. This fall and winter, there are three periods in which Medicare beneficiaries can either enroll or disenroll in forms of coverage: • Now through December 7: Open enrollment period. This is when you can elect to leave Original Medicare (Parts A and B) for a Medicare Advantage Plan (Part C) and change your prescription drug coverage (Part D). You can also elect to get out of a Part C plan and go back to Parts A and B during this period. • December 8: Annual enrollment period begins for 5-star plans. This is new: As you probably know, Part C and Part D plans are assigned ratings. Beginning December 8, a 365-day window opens for you to enroll in a 5-star Part C or Part D plan. You can do this once per 365 days. How do you find the 5-star plans? Visit www.medicare.gov/find-a-plan. • January 1-February 12: Disenrollment period. 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).2 What should you look for in a Part C or Part D plan? Be sure to take a look at a few key factors. • While premiums matter, overall plan expenses ultimately matter most; scrutinize the copays, the co-insurance and the yearly deductibles as well. Attractively low premiums might not tell you the whole story about the value of a Medicare Advantage plan. • How inclusive is the plan network? Assuming the plan has one, does it include the hospitals you would choose and the physicians that now treat you? • Regarding Part D, how wide-ranging is the prescription drug coverage? Look at the list of approved drugs (the formulary). If the drugs you want or need aren’t listed, you are probably going to have to open your wallet to pay for them. The frustrating thing about formularies is how they change; drugs on this year’s list may not always be on next year’s list. • One nice thing to note about Part D coverage for 2012: Medicare beneficiaries who enter the coverage gap for prescription drugs next year (sometimes referred to as “the doughnut hole”) will end up paying just 50% of the price of name-brand drugs and just 86% of generics. Some Part D plans may help you realize greater savings via discounts.1 Part B premiums are rising, but not drastically. They were expected to increase given the 2012 cost-of-living adjustment for Social Security benefits, but the hike isn’t as dramatic as some seniors feared it would be. Monthly Part B premiums are going up by $3.50 a month next year to $99.90, well under the $106.60 estimate projected earlier in 2011 by Medicare trustees.3 Medicare Advantage premiums may fall. The Department of Health and Human Services estimates that Part C premiums will be 4% cheaper in 2012 than in 2011. It also projects that Part D premiums will stay about the same in 2012.2 Jacob Warren Warren Wealth Management 111 West Port Plaza Drive, Ste 300, Saint Louis, MO 63146 (314) 682-2337 ——————————————————————————– Securities and Investment Advisory Services offered through Woodbury Financial Services, Inc., Member FINRA, SIPC, and Registered Investment Advisor. Warren Wealth Management and Woodbury Financial Services, Inc. are unaffiliated entities. Content provided by Peter Montoya, Inc. This material was prepared by MarketingLibrary.Net Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. Marketing Library.Net Inc. is not affiliated with any broker or brokerage firm that may be providing this information to you. All information is believed to be from reliable sources; however we make no representation as to its completeness or accuracy. Please note – investing involves risk, and past performance is no guarantee of future results. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is not a solicitation or a recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment. Citations 1 – www.mysanantonio.com/health/article/Medicare-s-enrollment-deadline-is-quickly-2272605.php [11/16/11] 2 – www.miamiherald.com/2011/10/07/2443864/medicare-open-enrollment-navigating.html [10/7/11] 3 – www.freep.com/article/20111028/NEWS07/110280392/Medicare-premiums-go-up-not-high-expected [10/28/11]
Source: warrenwealth.com

medicare supplemental insurance comparison: it is medicare formulary finder

Nobody can be no healthy problem in his life. Ill condition infulences the charge a lot. So far, people are insterested in medical treatment insurance. A long time ,people hesitate go or not go to hospital ,but now ,they don’t,cause they have medical treatment insurance. Look ,the medical has no shortage, only is good for all the people.. i like medical insurance because it could give us more happyness and safety once you get sick you can ask your insurance company for part of your money expense or even all your medical expense. you know unexpected emergencies happen like car accidents, unexpected injuries and serious dieases. the medical could save most part of the money and help people give them a hand. medical insurance plays a key rule for the old people who has no children and give them free treatment. The health care insurance coverage that beared with the place out division has benefited most males and females in most countries. We choose commercial health insurace companies to get more services. There are many notes we should follow. The company is legally registered or not. It is very important weather the company has enough money to pay for accident insurance or not. Does the company has a high integrity? By the way, both the company’s health insurance products and insurance costs are taken into think. According to the survey ,it’s about 90% of Americans are enjoying the new medical insurance that the government adopted in 2010. The introduction of the new medicare insurance benefit for most Americans, and increased the confidencethe index of people living. Finland has also just adopted a new medical insurance reform program. Good medical insurance is one of the government reliability standards which people evaluate their government.
Source: blogspot.com

Things To Consider When Choosing Medicare Coverage And Providers ~ Ex web blog

Taking the time to choose the most cost effective way to take advantage of the services can cut your out of pocket expenses dramatically. In some cases, services can be provided only at certain facilities. However, there are often several providers from which you can choose. Talking with your doctor about the available options will enable you to make an informed decision about where you get your health care services.
Source: blogspot.com

Turning 65? Critical Medicare Tips To Save You $$$

There’s the original government-run Medicare which comes with substantial deductibles and co-insurance (for example, an $1,100 deductible for a hospital stay and 20 percent of outpatient doctor visits). People who don’t have a secondary retiree plan from their employer usually buy a separate private Medigap policy to help with those deductibles and coinsurance. About one in four Medicare recipients opt for the newer Medicare Advantage plans. These are private plans—mostly HMOs—that take the place of original Medicare plus Medigap, and usually the Part D drug plan as well. While you’ll probably pay lower monthly premiums, bear in mind that you will not have Medigap to cover any deductibles and co-pays, which can vary from plan to plan. Thus, one of the downsides of an Advantage plan is potentially higher out-of-pocket costs if you get seriously ill.
Source: ctwatchdog.com

Sonora / Tuolumne News, Sports, & Weather, Angels Camp, Twain Harte, Jamestown

Posted by:  :  Category: Medicare

gutted bag by jason.odonnellThe Better Business Bureau has received several complaints over the past three weeks describing similar stories. The consumer advocacy group says people should never give out personal information over the telephone. Medicare does not make phone calls regarding health care coverage, and seniors can call 1-800-MEDICARE if they have questions.    
Source: uniondemocrat.com

Video: Sell Medicare By Phone

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

The first version of the scam uses an impostor Medicare employee. Victims are contacted by telephone and asked to verify their Medicare information by someone claiming to be representing Medicare. The caller sometimes claims that a new Medicare card needs to be issued, and claims that the victim has qualified for enhanced benefits. Often times the official sounding phone call intimidates unsuspecting people into giving out sensitive information over the phone to receive the enhanced benefits. Often times the thief will ask to verify identity using social security number or credit card information. This enables the scammer to steal this vital information for use in identity theft.
Source: isassoc.com

Medicare Phone Calls Linked To Scam

KMBC 9’s Peggy Breit tried calling the customer service number on the check. It is tied to a company named My Ben. The person on the other end of the line identified himself as Trevor and said he works for a different company, Third Party. He told Breit that unless she was a My Ben client, he couldn’t discuss anything.
Source: kmbc.com

Medicare Anthem Blue Bows Out of North Valley

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

Walter's Stretch The Rules

Private consultation can be provided absolutely free coupled with accessibility to the latest medicare insurance news in order to keep you abreast and up to date on all the new changes to medicare health insurance. Even if you are not new to medicare and want to see if you can gain from making modifications to your personal policy, these services could help you.
Source: stretchtherules.com

React & Act: Medicare, money and your hospital experience

Medicare pays hospitals based on the severity of the medical condition, which is determined by the patient’s primary diagnosis, surgical procedures and medical complications. These documents also inform Medicare whether conditions were “present on admission.” This is of interest to Medicare authorities who track whether a patient walked into a hospital with or without an infection or bedsore or other conditions that can arise during a hospital stay as a result of inadequate care.  Hospitals can lose funding in cases in which patients develop medical problems during a hospital stay.
Source: californiawatch.org

Medicare phone scam hits Ishpeming area

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Source: elder-gateway.com

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

Health care stamps. The efficiency of markets vis-à-vis centralized control is well documented wherever centralized control has been tried. But how do we transition from the current centrally controlled Medicare system to individual control. Perhaps we can learn something from how the food industry is treated. Supermarkets contain thousands of individual products all with prices attached. Since food consumption is a necessity, just as health care, how do we insure that food is available to all? Rather than having Foodcare, we subsidize low income individuals by selling them “dollar value food stamps” at discounted prices. These stamps are real money to the grocery stores and to the recipients. Since individuals consume more than their food stamp limit, on the margin they are spending a dollar for a dollar. However, if they choose to buy pricey steak instead of hamburger using food stamps dollars, they will have less to spend on other products. Source: healthaffairs.org
Source: medicaresupplementalco.com

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

The first version of the scam uses an impostor Medicare employee. Victims are contacted by called and inquire to verify their Medicare information by someone claiming to be representing Medicare. The caller sometimes claims that a new Medicare card needs to be issued, and claims that the victim has qualified for enhanced benefits. Often times the official sound phone call intimidates unsuspecting populating into bighearted out sensitive information over the ring to had the enhanced benefits. Often times the thief will enquire to checking identity using social security number or credit card information. This enables the scammer to steal this vital information for use in identity theft.
Source: online-credit-card-portal.com

Flap’s Dentistry Blog: California Dental Association Sues the California Department of Healthcare Services Over Medicaid Payments to Dentists

Posted by:  :  Category: Medicare

The California Dental Association has joined others including the California Medical Association (CMA), the California Pharmacists Association (CPhA), and the National Association of Chain Drug Stores in a federal lawsuit. A coalition of medical professionals filed a lawsuit Monday against state and federal Medicaid administrators over the approval of broad cuts to the program known as Medi-Cal in California. Trade associations for medical professionals say the approved 10 percent cuts to reimbursement rates for Medi-Cal didn’t go through appropriate legal channels, according to a lawsuit filed in U.S. District Court. The cuts approved last month by the federal Centers for Medicare and Medicaid Services include a 10 percent reduction to payments for outpatient services for doctors, clinics, optometrists, dental services, medical equipment and pharmacies. The cuts would save the state’s general fund $623 million. Doctors and medical professionals say continued cuts will hurt the state’s already ailing Medi-Cal system, and it is already difficult for recipients to find doctors who still participate in the federal program. The state of California ended adult Medicaid services except for pregnant women and some emergencies in 2009. However, the Medicaid system called Deni-Cal in California does provide children’s services. California has one of America’s lowest compensation rates for dentists and other health providers. Dentists and physicians know that the California Medicaid system is on the verge of collapse since NOBODY is going to accept another 10 per cent cut in the fees they now charge. Providers will simply refuse to care for the poor, blind and disabled who qualify for Medicaid. The CDA believes this latest attack on the already inadequate Medi-Cal network of dental care will result in further hindrance of dentists’ ability to provide appropriate care. “The state’s elimination of adult dental services in 2009 was devastating to low-income Californians,” said Dan Davidson, DMD, president of the CDA. “More cuts to children’s services are unconscionable.” The information that CMS relied on to approve the state’s cuts do not measure whether and how patients’ access to care would be impacted or otherwise take into consideration, as required by law, the costs to provide the care, according to the CDA. In fact, a recent poll and independent studies show that access to care is already unequal, making the recent cuts illegal by federal standards. Because California Medi-Cal rates are already extremely low, many providers cannot afford to participate. Kaiser State Health Facts lists California as the lowest reimbursed state in the nation. The co-payments and arbitrary limits on services will create additional barriers for sick, vulnerable patients seeking care and, ultimately, they will be forced to delay care or use emergency rooms for basic health services, according to the CDA. CMA, CPhA, and CDA successfully sued in the past to enjoin prior Medi-Cal cuts and expect to demonstrate once again that federal law, which ensures that Medi-Cal patients have equal access to healthcare, was not followed. If anything, there will be continued uncertainty in treating the poor. Previously, the state has asked clinics and providers who were paid while an appeal of a previous cut was made, to reimburse the state when the appeal was denied. This was many months later. Of course, these providers and clinics did not have the money to pay the state back. So, here we go again. How can a dentist be expected to provide services and then find out in six months that the money they thought they were receiving is now actually 10 per cent less and you owe California a check for the difference. Who in their right mind would participate in such a system?
Source: flapsblog.net

Video: Lowest Rates Of Michigan Medicare Supplement Providers

How can I get dental coverage

About affordable article Benefits best Business Care Companies compare comparison Cost costs Coverage dental drug Family financial find from Good great Guide Health home Insurance launches Life Medicaid Medicare much News Nursing online Plan Plans Private Quotes Report Secrets Security Self Social Student Supplemental Trends
Source: healthinsuranceandmedicareupdate.com

California Providers Sue Over Medicaid Rates; Texas Weighs Steep Cuts For Medicaid Rehab

The Fort Worth Star-Telegram/McClatchy: Texas Might Cut Medicaid Reimbursements Therapy and physician groups in Texas are alarmed about proposed cuts in government healthcare reimbursement rates that they say would hurt the sickest and poorest Texas patients … The average reduction for home health providers, for example, would be 35 percent. … The reductions vary by service and provider type. The average reduction would be 54 percent for comprehensive outpatient rehabilitation facilities and outpatient physical therapy and speech pathology facilities (Barbee, 11/21).
Source: kaiserhealthnews.org

CA medical groups seek to block Medicaid cuts

The California Medical Association    , California Dental Association    , California Pharmacists Association and the National Association of Chain Drug Stores banded together to sue Toby Douglas, director of California’s Department of Health Care Services, and Kathleen Sebelius, secretary of the U.S. Department of Health & Human Services    .
Source: capoliticalnews.com

Medicare Dental and Vision Positive aspects

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Source: namthemovie.com

Provider groups file lawsuit to battle Medi

“In late September, the Centers for Medicare and Medicaid Services asked DHCS for more information that would substantiate its state plan amendments for cuts in the Medi-Cal program. Without receiving that information, CMS went ahead and approved the cuts before them,” stated Francisco J. Silva, CMA general counsel and VP. “It is clear that CMS did not follow protocol and applied the wrong legal standard. The approval of the SPAs will have dramatic affects on access to health care for the poorest, most vulnerable Californians.”
Source: drugstorenews.com

Health Related Articles Blog: Medicare Coverage And Providers

Taking the time to choose the most cost effective way to take advantage of the services can cut your out of pocket expenses dramatically. In some cases, services can be provided only at certain facilities. However, there are often several providers from which you can choose. Talk with your physician about your options so you can make informed choices when selecting where you receive health care services.
Source: blogspot.com

Humana Medicare Dental Plans

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Source: medicareadvantagesupplementplans.com

Why is dental not covered under my health insurance?

Until the 1960s, dental services were virgin territory for insurance carriers. Increased enrollment in institutions of higher learning produced more and more dentists. Many War Veterans used their military experience and GI Bill education benefits to become medical practitioners and dentists. Suddenly there was a large supply of dentists, along with a new generation of citizens looking for help in covering the costs of the dental services; services that were becoming increasingly more important and necessary in their lives.
Source: lowcosthealthinsurance.com

modern 2010 Modernized Medicare Supplement Plans

Posted by:  :  Category: Medicare

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

Video: Medicare Supplement Plans – Changes for 2010

modern 2010 Modernized Medicare Supplement Plans

As it is well known that throughout Medicare product plans typically the supplementary insurance policies works simply because subsidiary that helps link typically the gap which is certainly left behind the Medicare protection. Actually the project relates to health insurance policies are utterly controlled from the private insurance plans, usually government is not go to interfere on this matter. There have different Medicare insurance plans available nowadays but the mandatory step ought to be taken after the person is actually purchas precisely the same insurance. He needs to understand the high grade rates belong to the insurance protection because until such time as and in the event he established fact about the software he cannot adopt this particular policy. If the retired human be is ready purchase the Medicare product policy for at first chance or in the event that anyone would like replace this exist protection with another person it really is possible. Now the software became easiest through the use of internet, through on the net we choose know the details related in order to insurance, insurance premiums. If anyone would like purchase the software through on the net he will receive a receive postal mail and soon after gett quite simply for him to determine which would work Medicare insurance policies. In this particular respect quite a few guidelines can be utilised such simply because agent. They tend to make the many people understand regard can the policy and share with their full be an aid to the disadvantaged person. Source: rocksite.pl
Source: medicaresupplementalco.com

Kevin’s View: Choosing The Right Medicare Supplement

This year, in fact March 1, 2012, my wife will become eligible for Medicare. The initial Medicare insurance and Part B is provided automatically. It is the Medicare Supplemental Insurance and prescription drug (part D) plans that one needs to shop around and find the best plan. For example if you chose the wrong one, then you could have a doughnut hole in your Part D plan, which means some prescriptions would have to paid completely 100% out of your pocket. Part D and the supplemental are provided through private insurance companies and are not a part of the government insurance. Don’t get me wrong they are not the same either. Part D as I said before is prescription drug coverage and Medicare Supplemental Insurance covers what the so called Part A and B don’t cover. Think about it this way, parts A and B would be more compatible to your traditional insurance.  Covering 80% of your doctor visits and hospitalization. Medicare Supplemental Insurance covers the other 20%. Basically it covers deductibles, co-pays,  and a lot of the little surprise expenses that you and I might not think about. Over all it is a lot to consider, because once you chose a plan you are stuck with until the next open enrollment. I am lucky, that my wife worked in this field a few years back, so she knows the questions to ask.Much more so then me. If you are in the market for Medicare this year, do your homework and chose the right plans for you.  I am confident my wife will chose the right one for her.  ———- My name is Kevin, and that’s what I think. What do you think? Agree? Disagree? follow us on Twitter
Source: kevinsview.com

Medicare Supplement Coverage Options After June 2010

As of June 2010, you will no longer be able to purchase Plans J, E, H, and I. They are being phased out and will no longer be for sale by any insurance company as mandated by the Centers for Medicare and Medicaid Services. If you have enrolled in one of these four plans prior to June 1st, then you can keep it if you wish. However, all insurance companies will  allow you to convert  to  any of the  new Medicare supplements  they offer  – like Plan F for instance.
Source: ohioinsureplan.com

New Medicare Supplement policies climb in 2010

According to Debra Donahue of Mark Farrah Associates, new Medicare Supplement memberships are on the rise, with new policies (those issued in the last three years) increasing by almost 6 percent in 2010, compared to a 1.3 percent increase in 2009. Donahue says the surge in memberships result from the ending of Medicare Advantage private-fee-for-services plans in many parts of the country and new options offered for Plans N and M.
Source: lifehealthpro.com

Choose your Medigap plans carefully and get the best benefits

However, there are certain factors that should always be kept in mind while dealing with the Medicare Supplement Plans. The first and the foremost thing to consider is that the Medicare Supplement Plans are only supplementary insurance plans to the original Medicare and therefore cannot be sold or purchased independently. If you want to enroll for the Medicare Supplement Plans you must be a beneficiary of the Original Medicare Part A and B first. Other than that it should also be kept in mind that if you switch over to any other plan other than the original Medicare, say for example to the Medicare Advantage plans you can no longer use the benefits of the Medicare Supplement Plans unless you switch back to the original Medicare. Other than these there are also certain other things that should also be kept in mind in this respect as well.
Source: articlejadeo.com

Joel Skousen: GOP WARMONGERS EMERGE IN CNBC DEBATES

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98Gingrich takes a hard line on expanding foreign policy in line with his globalist background and policy advisors. As pointed out on Jim Lobe’s blog, “Former House Speaker and GOP presidential hopeful Newt Gingrich announced his national security team last night, ahead of tonight’s CNN national security debate. David Wurmser: a fellow at the American Enterprise Institute [a neocon think tank where Gingrich is a former senior fellow], Wurmser served on the staffs of two top Bush administration hawks, former U.N. ambassador John Bolton and Vice President Dick Cheney (where Stephen Yates, another Gingrich adviser, also served). In 2007, a U.N. official called Wurmser one of the ‘new crazies’ who wanted to attack Iran. In 1996, Wurmser co-authored a paper from a right-wing pro-Israel group advocating the removal of Saddam Hussein from power.
Source: wordpress.com

Video: Zurvita Review: The Real Deal Or A Scam?

Best, and worst, N.J. healthcare plans

The lowest score went to Horizon Blue Cross Blue Shield of New Jersey. Despite its above-average ratings for consumer satisfaction and treatment, its overall score was 68. But the plan is not accredited by the NCQA, which — according to Consumer Reports — could add 15 points to the score. So perhaps its score, if accredited, would have been 83 – in the same ballpark as other New Jersey HMOs.
Source: newjerseynewsroom.com

Letters from a Farmer in Ohio: Medicare Part D

Bruce Bartlett highlights how Newt Gingrich added $16 trillion to the Federal Debt.  I’m not one to defend Newt, or Medicare Part D, but technically, that is the long-term cost of the program.  We don’t even want to consider how much traditional Medicare will cost long-term.  He is right though that Gingrich lobbied on behalf of a very expensive program with no funding mechanism to raise revenues.  Also, the Bush administration low-balled the program cost by a significant factor at the time the program was debated.  I agree with Bartlett’s point that Newt is a jackass who claims to do things totally different than he actually did.  Some historian!
Source: blogspot.com

Union Bankers Health Insurance Company Review

, provides users with detailed information about Universal’s many Medicare contract program options. Each distinct plan has its own website, tools, information, and forms. Available plans and options vary from state to state so it is important to enter a current zip code so you will see the plan details and options for your city and state.
Source: healthinsuranceproviders.com

Bay Area Medicare Advantage Plans Provider, AdvoCare Insurance Services Discusses Long

A possible solution is for them to purchase a life insurance policy with a long-term care rider which has guaranteed ?living benefits? for life. Some life insurance companies are offering long-term care benefits combined with their life insurance products. These are called ?linked-benefit? life insurance products which add a long-term care rider usually to a universal life insurance policy. The major advantages of these products are they pay no matter what the buyer?s life situation becomes ? a long-term care benefit if needed, or a death benefit if long-term care is not needed. Further, these policies provide substantial leverage for every insurance dollar invested ? usually about 2 to 1 for the death benefit and 4 to 1 for the long-term care benefit. The buyer will need to determine whether this is a better solution than separate long-term care and life insurance policies.
Source: rcpattern.net

Mutko Insurance Services Opens Office in Willoughby

“Insurance choices, especially health insurances for older adults are becoming increasingly complex. My clients can count on me to help them select the insurance plan that best covers their particular doctors, their prescriptions, their hospitals and fits with their financial situation. We provide insurance for all ages and stages of life. And, as their local agent, seniors can count on me to be around when they need me in the future.”
Source: bestlongtermcare.org

All You Need To Know About Whole Life Insurance

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Source: lifeinsurancequotespro.com

BrothersJudd Blog: OUR BATTLES ARE SO BITTERLY PARTISAN PRECISELY BECAUSE NOTHING DIVIDES US ON THE ISSUES:

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SSSupport Builds for a Plan to Rein In Medicare Costs (ROBERT PEAR, 11/25/11, NY Times) Though it reached no agreement, the special Congressional committee on deficit reduction built a case for major structural changes in Medicare that would limit the government’s open-ended financial commitment to the program, lawmakers and health policy experts say. Members of both parties told the panel that Medicare should offer a fixed amount of money to each beneficiary to buy coverage from competing private plans, whose costs and benefits would be tightly regulated by the government. […] Mr. Obama’s health care law provides “premium support” for people below age 65. The government will offer subsidies, in the form of tax credits, to help people buy coverage marketed by private carriers on an insurance exchange. If this approach works for commercial insurance under the new law, it could allay concerns about similar changes to Medicare. Competition among private insurers has already driven down costs for prescription drug coverage under Medicare. Medicare’s drug benefit is delivered entirely by private insurers. In addition, one-fourth of the 48 million Medicare beneficiaries are in private Medicare Advantage plans, offered by companies like UnitedHealth and Humana, which cover a wide range of doctors’ services and hospital care. The new health care law is cutting payments to Medicare Advantage plans. Republican lawmakers predicted that the cuts would lead insurers to increase premiums, reduce benefits or pull out of the program. But so far the dire predictions have not been borne out. On average, the Obama administration said recently, Medicare Advantage premiums will be 4 percent lower in 2012 than in 2011, and insurers expect their Medicare enrollment to increase by 10 percent.  Everyone knows how we’ll reform entitlements and make the budget “crisis” disappear, we’re just reluctant to join hands with the other party to achieve it.  After all, if my party agrees with their party then what’s the point of all my political passion?
Source: brothersjuddblog.com

Video: Pinellas County: Medicare Advantage Plans Florida- Zero premium

Medicare Advantage 2012 Spotlight: Plan Availability and Premiums

This brief highlights trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2012, premium levels and other plan characteristics. The brief was authored by researchers at Mathematica Policy Research and the Kaiser Family Foundation.
Source: kff.org

MEDICARE OPEN ENROLLMENT ENDS DEC. 7 THIS YEAR

January 1-February 12 is the Disenrollment period. 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: kuczinskifinancial.com

Medicare Advantage Premiums To Fall 4% Next Year

The plans were targeted by Democrats who complained that the government pays more per capita for beneficiaries in the private plans than it spends on those in traditional Medicare. The billions of dollars cut from the plans were used to help the Obama administration pay for the cost of expanding coverage to 32 million Americans through expanded Medicaid eligibility and subsidies for people buying coverage in new insurance exchanges starting in 2014.
Source: kaiserhealthnews.org

Support Builds for Premium Support Plan for Medicare

Alice M. Rivlin, who was budget director for President Bill Clinton, had urged the deficit panel to establish an insurance exchange for Medicare beneficiaries. Private plans would compete with the traditional Medicare program and would have to provide at least the same benefits. The federal contribution in each region would be based on the cost of the second-cheapest option, whether that was a private plan or traditional Medicare.
Source: peacepowerlove.com

Support Builds for a Plan to Rein In Medicare Costs

Competition among private insurers has already driven down costs for medication drug coverage underneath Medicare. Medicare’s drug advantage is delivered wholly by private insurers. In addition, one-fourth of a 48 million Medicare beneficiaries are in private Medicare Advantage plans, offering by companies like UnitedHealth and Humana, that cover a far-reaching operation of doctors’ services and sanatorium care.
Source: 4-liability.com

Medicare Open Enrollment Ends Dec. 7

A summary of what you need to know. Presented by Jacob Warren Don’t wait until New Year’s to join a Medicare plan. The open enrollment period ends early this year, and many Medicare beneficiaries may not realize it. In fact, 97% of seniors in a recent poll conducted by UnitedHealthcare and the National Council on Aging could not specify this year’s earlier-than-usual deadline.1 Some key dates to remember. This fall and winter, there are three periods in which Medicare beneficiaries can either enroll or disenroll in forms of coverage: • Now through December 7: Open enrollment period. This is when you can elect to leave Original Medicare (Parts A and B) for a Medicare Advantage Plan (Part C) and change your prescription drug coverage (Part D). You can also elect to get out of a Part C plan and go back to Parts A and B during this period. • December 8: Annual enrollment period begins for 5-star plans. This is new: As you probably know, Part C and Part D plans are assigned ratings. Beginning December 8, a 365-day window opens for you to enroll in a 5-star Part C or Part D plan. You can do this once per 365 days. How do you find the 5-star plans? Visit www.medicare.gov/find-a-plan. • January 1-February 12: Disenrollment period. 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).2 What should you look for in a Part C or Part D plan? Be sure to take a look at a few key factors. • While premiums matter, overall plan expenses ultimately matter most; scrutinize the copays, the co-insurance and the yearly deductibles as well. Attractively low premiums might not tell you the whole story about the value of a Medicare Advantage plan. • How inclusive is the plan network? Assuming the plan has one, does it include the hospitals you would choose and the physicians that now treat you? • Regarding Part D, how wide-ranging is the prescription drug coverage? Look at the list of approved drugs (the formulary). If the drugs you want or need aren’t listed, you are probably going to have to open your wallet to pay for them. The frustrating thing about formularies is how they change; drugs on this year’s list may not always be on next year’s list. • One nice thing to note about Part D coverage for 2012: Medicare beneficiaries who enter the coverage gap for prescription drugs next year (sometimes referred to as “the doughnut hole”) will end up paying just 50% of the price of name-brand drugs and just 86% of generics. Some Part D plans may help you realize greater savings via discounts.1 Part B premiums are rising, but not drastically. They were expected to increase given the 2012 cost-of-living adjustment for Social Security benefits, but the hike isn’t as dramatic as some seniors feared it would be. Monthly Part B premiums are going up by $3.50 a month next year to $99.90, well under the $106.60 estimate projected earlier in 2011 by Medicare trustees.3 Medicare Advantage premiums may fall. The Department of Health and Human Services estimates that Part C premiums will be 4% cheaper in 2012 than in 2011. It also projects that Part D premiums will stay about the same in 2012.2 Jacob Warren Warren Wealth Management 111 West Port Plaza Drive, Ste 300, Saint Louis, MO 63146 (314) 682-2337 ——————————————————————————– Securities and Investment Advisory Services offered through Woodbury Financial Services, Inc., Member FINRA, SIPC, and Registered Investment Advisor. Warren Wealth Management and Woodbury Financial Services, Inc. are unaffiliated entities. Content provided by Peter Montoya, Inc. This material was prepared by MarketingLibrary.Net Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. Marketing Library.Net Inc. is not affiliated with any broker or brokerage firm that may be providing this information to you. All information is believed to be from reliable sources; however we make no representation as to its completeness or accuracy. Please note – investing involves risk, and past performance is no guarantee of future results. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is not a solicitation or a recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment. Citations 1 – www.mysanantonio.com/health/article/Medicare-s-enrollment-deadline-is-quickly-2272605.php [11/16/11] 2 – www.miamiherald.com/2011/10/07/2443864/medicare-open-enrollment-navigating.html [10/7/11] 3 – www.freep.com/article/20111028/NEWS07/110280392/Medicare-premiums-go-up-not-high-expected [10/28/11]
Source: warrenwealth.com

Medicare Advantage Premiums Falling 4% In 2012

Then, in a policy shift last fall, HHS decided to lower the bar for bonuses. Average-quality plans garnering just three or three-and-a-half stars would also get bonuses, although at a lower percentage than top-tier plans. The HHS decision means more than 90 percent of Medicare Advantage enrollees are in plans now eligible for a bonus. Under the tougher approach Congress took in the health law, only about 33 percent would have been in plans getting the extra payments.
Source: kaiserhealthnews.org

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

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

Medicare Advantage premiums to fall in 2011

The average premiums paid by individuals for private Medicare Advantage plans, which insure about one-fourth of all beneficiaries, will decline slightly next year, even as insurers provide more benefits as required by the new health care law. However, commercial insurance premiums for many people under 65 and many small businesses are increasing 10 percent to 25 percent or more. Insurers can begin marketing to beneficiaries on Oct. 1 for Medicare coverage that starts Jan. 1. Medicare officials say they held down premiums and co-payments by negotiating with insurers, which sponsor the Medicare Advantage plans. About 11.3 million of the 46 million Medicare beneficiaries are in private Medicare Advantage plans, which offer comprehensive care in return for monthly premiums. While premiums for some plans in a particular county may increase next year, beneficiaries may be able to find other plans offering a better deal.
Source: dailyfinance.com

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

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

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

National Family Caregiver Month

Posted by:  :  Category: Medicare

OBAMACARE WATCH:....THE PUSH IS ON, ........THEY WILL CONTROL WHAT YOUR DOCTOR KNOWS AS WELL AS WHAT HE OR SHE TREATS by SS&SSLooking for assistance and information? We can help. Ask Medicare has tips sheets, videos and practical information for caregivers, including tips on what every caregiver should know and answers to your Medicare questions. As a caregiver we know you’re juggling a lot, so we put it all in one place to save you time.
Source: medicare.gov

Video: The Medicare Learning Network (MLN): Official CMS Information for Fee-For-Service Providers

Viewpoints: Romney’s Critical Missing Information On Medicare; Anti

Minneapolis Star Tribune: Romney Falls Short On Medicare Reform Republican presidential candidate Mitt Romney conveniently left out key facts when he ripped a new health care cost-control measure – the Independent Payment Advisory Board. . The Affordable Care Act also specifically limits the board’s powers. It cannot ration care, reduce benefits, raise premiums or other cost-sharing such as copays. As part of that, it cannot raise Medicare’s eligibility age, as Romney himself has proposed (Jill Burcum, 11/8). The Wall Street Journal: ObamaCare: Flawed Policy, Flawed Law  Republicans should be doing everything they can to explain their proposals: a better set of incentives that will encourage—not require—people to purchase health insurance by offering targeted assistance and creating a broader, more competitive marketplace where consumers can purchase affordable, portable health insurance of their choice (Grace-Marie Turner, 11/9).
Source: kaiserhealthnews.org

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

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

Understanding Medicare Glossary and Managing your Health Information Online

The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services. A benefit period begins the day you are admitted as an inpatient in a hospital or skilled nursing facility. The benefit period ends when you have received any inpatient hospital care (or skilled care in a SNF) for 60 days in a row. If you go into a hospital or a skilled nursing facility after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods.
Source: indoamerican-news.com

Medicare and You! Important information from EUTF and ERS

 Those who are soon to be receiving Medicare, the State/EUTF will reimburse you and your spouse (or domestic partner) for your Medicare Part B premiums.  The EUTF must receive the following documents from you to begin the Part B reimbursement:  1) a copy of your Medicare card, 2) a completed Direct Deposit Agreement Form along with a voided check, and 3) a copy of the letter you receive from the Social Security Administration informing you what your monthly Medicare Part B premium will cost.  
Source: wordpress.com

InsureBlog: Frustrating Carrier Tricks: Medicare vs Group

I did hear back from customer service who confirmed we do not have something like this. You are correct that there would be too many variances with how the claims will process. We will need to see the Medicare EOB & then determine which policy is the primary. The claims area will then key the claim into the system … they will input the information from Medicare. All of this information is taken into account, while viewing the members benefits. I hope this helps
Source: blogspot.com

Board on Aging publishes Health Care Choices booklet for seniors

The primary purpose of the governor-appointed Minnesota Board on Aging is to ensure that older Minnesotans and their families are effectively served by state and local policies and programs in order to age well and live well. Partnering with area agencies on aging and others, the MBA administers and oversees the use of the Older Americans Act funds as well as state funds to support older Minnesotans. In addition, the MBA provides objective information and data to the Minnesota Legislature, the governor and state agencies to shape policies that reflect the needs and interests of older Minnesotans.
Source: echopress.com

Medicare Pricing and Information #79471

Your Annual Enrollment Period is Coming Up. Get your Me.dicare Advantage Pricing now. Click: http://cmfiction.com/1987442e94y2405250 To unsubscribe, please visit: http://cmfiction.com/1987443e94y2405250 or write: Annual-Enrollment-Period PO Box 7022 New York NY 10116 to remove yourself http://cmfiction.com/unsub.php or write Please Follow here to manager your online status. All requests are handled promptly and privately. Or Write: PO Box 18484 San Jose Ave City Of Industry, CA, 91748, US
Source: bubble.ro

Medicare changes explained in forum

Medicare is a federally funded insurance program for people 65 or older and anyone who is on Social Security and disability for 24 months or longer. Her company, which is funded through grants through Centers for Medicare/Medicaid Services, provides information and education on Medicare. Landreth said that the two biggest aspects of her presentation were to help people learn about assistance programs they may qualify for and to help them understand Medicare better.
Source: agentnavigator.com

The Official Medicare Set Aside Blog And Information Resource: MSP free agents switching teams

Comment: Tom is now listed as an independent sales professional on his linked-in page. Word from those in the know is that he is a great account manager but could not close enough new business for G&L to satisfy their private equity investors (remember that ABRY Partners bought them with the expectation that they would grow the business from $30M to 90M in five years.) This should not reflect poorly on Tom who, in my opinion, had one of the best reputations of any G&L employee from the John Williams era. After all, I couldn’t sell bottled spring water from the Fukushima nuclear plant either. Besides, doesn’t G&L already have every domestic and international company anyway? They need to focus on keeping the clients that have rather than hard selling new ones.
Source: medicaresetasideblog.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

Which Health Insurers Will Gain Most From Consolidation Trend

Posted by:  :  Category: Medicare

From what we can see now, many of the acquisitions are small, tuck-in types that augment the larger acquirer’s participation in a particular market or geographic region. As such, these small acquisitions do not, in themselves, create a change in market dynamics. However, in aggregate, they do change the landscape. For example, Texas, the fastest growing state also has the smallest insured population. This factor creates a fabulous opportunity for a company such as Amerigroup which is already the largest Medicaid provider in Texas. A Wall Street Journal article dated October 30, 2011, listed several companies they thought might be likely targets. This list includes Amerigroup, Coventry Health Care, among others.
Source: seekingalpha.com

Video: GBMC Primary Care – Debbie Jones, CRNP

Business Analyst Principal I / Amerigroup / Chesapeake, VA

1. Perform detailed requirements gathering, analysis, design, configuration, and process and data flow diagramming for processes of high complexity. Understand and consider the relationship between processes and business policies. 2. Function as a liaison between business, health plans, operational areas, and ITS. 3. Identify risks and multiple solutions. 4. Recommend and implements improvements to existing procedures. Influence others to follow existing procedures. 5. Lead all system/application testing for implementations, conversions, upgrades and updates including individual claim and batch testing. Ensure all application updates are implemented timely. 6. Develop and adhere to existing configuration management procedures. Recommend improvements to existing procedures. 7. Read and interpret design document conceptual, logical, and physical models to include context diagrams, data flow diagrams, process flow diagrams, data dictionaries and logical flow charts. 8. Develop complex queries and reports. Perform database updates. 9. Write, revise, and verify test plans for multiple complex systems in a software application. Provide leadership and guidance to other analysts in the creation of system test plans. 10. Evaluate and test complex new/modified programs, applications and/or operating systems. Monitor system functionality and performance to ensure standards are met. Document and track product defects. Coordinate problem resolution with development and/or product vendors. 11. Validate proposed contracts meet requirements taking into consideration financial arrangements and impacts as they apply to the budget as applicable in functional area of responsibility. 12. Make technical and functional business recommendations based on evolving technologies and evolving application trends to include infrastructure, software, database, and networks. 13. Address business challenges to improve efficiency and decision making, reduce redundancy, and ultimately enhance business results. 14. Manage multiple priorities and projects. 15. Lead and mentor functional area team members and other Business Analysts. 16. Manage project related budgets as applicable in functional area of responsibility. 17. Perform other duties as assigned.
Source: webbyslist.com

Has anybody heard any good or bad things about Amerigroup health insurance?

Also, plans will vary greatly between states and even between counties, which means one plan may be better for him in one state while the other plan may be better in another state. That being said, if the agent your father is working with is independent and representing all of the major companies then go ahead and listen to the agent. If the agent is only with Amerigroup you may want to find another agent that represents more options.
Source: bestlongtermcare.org

Medicare Jobs Careers Vacancies at Amerigroup, USA

PRIMARY RESPONSIBILITIES: 1. Implements programs to develop relationships with community-based organizations to build community coalitions and promotes awareness of AGP’s Medicare Advantage products. 2. Builds and manages relationships with local and regional community/charitable organizations that support seniors and people with disabilities; Develops and implements approved community marketing strategies that may include events, community partnerships, and sponsorships. 3. Networks with local associations, organizations and clubs that will provide additional marketing exposure. 4. Oversees execution of strategically integrated community relations plan (Headquarters / Health Plans) that support local sales representatives. 5. Manages involvement in high visibility local and regional charitable events. 6. Supports local Sales Directors in the ROI evaluation of various event sponsorships and community events 7. Builds internal partnerships with SOO and field sales and marketing resources to create new business opportunities. 8. Identify various local media channels that could be used to optimize the effectiveness of Medicare marketing campaigns. 9. Works to raise the community profile of AGP’s Medicare Advantage products through regular social and professional contact with grass-roots community leaders and organizers. 10. Responsible for monitoring marketing materials used for mail outs, flyers, ads and all other materials used to ensure all materials are current to ensure CMS compliance. 11. Create a calendar of events on a monthly basis and provide market reports to compliance officer and Sales Director. 12. Tracks activities of health industry competitors, makes recommendations in accordance with sales strategy, and reports activity to management. 13. Conducts research to identify appropriate venues for distribution of materials in conjunction with goals of driving appointment and sales activities. 14. Identifies and collects educational material on community networks and advocacy groups to develop resources so that Amerigroup is the subject matter expert for the communities we serve. 15. Represents Amerigroup by participating on Boards and/or committees of significant community organizations to increase awareness of health plan benefits. 16. Other duties as assigned.
Source: newjobscorner.com

State Roundup: Another Medi

The Associated Press/Times-Picayune: Louisiana Doctors Continue To Work While Under Investigation Four Louisiana physicians wrote hundreds of bogus prescriptions that powered multimillion-dollar health-care frauds in the Baton Rouge area, according to evidence amassed by the nearly two-year-old local Medicare Fraud Strike Force. Yet, all four physicians remain licensed to practice medicine … Officials of the Louisiana State Board of Medical Examiners declined to comment on the targeted physicians — three of whom or were placed on probation or their licenses were suspended for questionable prescription practices before being charged in the Medicare fraud cases (11/22).
Source: kaiserhealthnews.org

MEDICARE OPEN ENROLLMENT ENDS DEC. 7 THIS YEAR

Posted by:  :  Category: Medicare

William D. Novelli by Center for American ProgressJanuary 1-February 12 is the Disenrollment period. 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: kuczinskifinancial.com

Video: Medicare Drug Coverage – Part D Plans

Kevin’s View: Choosing The Right Medicare Supplement

This year, in fact March 1, 2012, my wife will become eligible for Medicare. The initial Medicare insurance and Part B is provided automatically. It is the Medicare Supplemental Insurance and prescription drug (part D) plans that one needs to shop around and find the best plan. For example if you chose the wrong one, then you could have a doughnut hole in your Part D plan, which means some prescriptions would have to paid completely 100% out of your pocket. Part D and the supplemental are provided through private insurance companies and are not a part of the government insurance. Don’t get me wrong they are not the same either. Part D as I said before is prescription drug coverage and Medicare Supplemental Insurance covers what the so called Part A and B don’t cover. Think about it this way, parts A and B would be more compatible to your traditional insurance.  Covering 80% of your doctor visits and hospitalization. Medicare Supplemental Insurance covers the other 20%. Basically it covers deductibles, co-pays,  and a lot of the little surprise expenses that you and I might not think about. Over all it is a lot to consider, because once you chose a plan you are stuck with until the next open enrollment. I am lucky, that my wife worked in this field a few years back, so she knows the questions to ask.Much more so then me. If you are in the market for Medicare this year, do your homework and chose the right plans for you.  I am confident my wife will chose the right one for her.  ———- My name is Kevin, and that’s what I think. What do you think? Agree? Disagree? follow us on Twitter
Source: kevinsview.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

Medicare Part D Prescription Drug Benefit

Enrollment Generally, there are three periods of time when individuals can sign up for Medicare prescription drug coverage. The IEP is 7 months long, starting 3 months before the month of becoming entitled to Medicare. Second, there is an annual coordinated election period from November 15 through December 31 each year. During the annual coordinated election period, individuals who are not enrolled in a Medicare drug plan may enroll, and individuals who are already in a Medicare drug plan may drop or switch plans. The change will be effective from January 1 of the following year. Third, there are special situations that entitle individuals to a special enrollment period, such as an involuntary loss of creditable prescription drug coverage or a change of permanent residence out of the plan’s service area.
Source: whatisencyclopedia.com

Comparing Medicare Part D Plans

Comparing plans that offer Medicare Part D coverage is essential if you want to make sure that the plan you would be getting would suit your needs and your budget. To help you get started, here is a guide on how to compare Medicare Part D plans that you can use. The first thing you need to do would be to make a list of the medications that you are taking and how much you are spending on them every year. This is important, as this would help you in determining how much coverage you need to get with the plan. You should then look for providers of Medicare Part D plans. The best way to do this would be to go online, as many Medicare Part D Prescription Drug Plan providers have websites where they are able to offer information about how Medicare Part D works and the plans that they have. Make sure that as you go through the different providers, you would also be conducting a background research on each of them so that you can be certain that the ones you would be considering to get a plan from are reputable, established and have had a lot of experience in providing individuals like yourself with the prescription drug coverage and the assistance you may need later on.
Source: worldhealthtalk.net

Medicare Open Enrollment Ends Dec. 7

A summary of what you need to know. Presented by Jacob Warren Don’t wait until New Year’s to join a Medicare plan. The open enrollment period ends early this year, and many Medicare beneficiaries may not realize it. In fact, 97% of seniors in a recent poll conducted by UnitedHealthcare and the National Council on Aging could not specify this year’s earlier-than-usual deadline.1 Some key dates to remember. This fall and winter, there are three periods in which Medicare beneficiaries can either enroll or disenroll in forms of coverage: • Now through December 7: Open enrollment period. This is when you can elect to leave Original Medicare (Parts A and B) for a Medicare Advantage Plan (Part C) and change your prescription drug coverage (Part D). You can also elect to get out of a Part C plan and go back to Parts A and B during this period. • December 8: Annual enrollment period begins for 5-star plans. This is new: As you probably know, Part C and Part D plans are assigned ratings. Beginning December 8, a 365-day window opens for you to enroll in a 5-star Part C or Part D plan. You can do this once per 365 days. How do you find the 5-star plans? Visit www.medicare.gov/find-a-plan. • January 1-February 12: Disenrollment period. 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).2 What should you look for in a Part C or Part D plan? Be sure to take a look at a few key factors. • While premiums matter, overall plan expenses ultimately matter most; scrutinize the copays, the co-insurance and the yearly deductibles as well. Attractively low premiums might not tell you the whole story about the value of a Medicare Advantage plan. • How inclusive is the plan network? Assuming the plan has one, does it include the hospitals you would choose and the physicians that now treat you? • Regarding Part D, how wide-ranging is the prescription drug coverage? Look at the list of approved drugs (the formulary). If the drugs you want or need aren’t listed, you are probably going to have to open your wallet to pay for them. The frustrating thing about formularies is how they change; drugs on this year’s list may not always be on next year’s list. • One nice thing to note about Part D coverage for 2012: Medicare beneficiaries who enter the coverage gap for prescription drugs next year (sometimes referred to as “the doughnut hole”) will end up paying just 50% of the price of name-brand drugs and just 86% of generics. Some Part D plans may help you realize greater savings via discounts.1 Part B premiums are rising, but not drastically. They were expected to increase given the 2012 cost-of-living adjustment for Social Security benefits, but the hike isn’t as dramatic as some seniors feared it would be. Monthly Part B premiums are going up by $3.50 a month next year to $99.90, well under the $106.60 estimate projected earlier in 2011 by Medicare trustees.3 Medicare Advantage premiums may fall. The Department of Health and Human Services estimates that Part C premiums will be 4% cheaper in 2012 than in 2011. It also projects that Part D premiums will stay about the same in 2012.2 Jacob Warren Warren Wealth Management 111 West Port Plaza Drive, Ste 300, Saint Louis, MO 63146 (314) 682-2337 ——————————————————————————– Securities and Investment Advisory Services offered through Woodbury Financial Services, Inc., Member FINRA, SIPC, and Registered Investment Advisor. Warren Wealth Management and Woodbury Financial Services, Inc. are unaffiliated entities. Content provided by Peter Montoya, Inc. This material was prepared by MarketingLibrary.Net Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. Marketing Library.Net Inc. is not affiliated with any broker or brokerage firm that may be providing this information to you. All information is believed to be from reliable sources; however we make no representation as to its completeness or accuracy. Please note – investing involves risk, and past performance is no guarantee of future results. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is not a solicitation or a recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment. Citations 1 – www.mysanantonio.com/health/article/Medicare-s-enrollment-deadline-is-quickly-2272605.php [11/16/11] 2 – www.miamiherald.com/2011/10/07/2443864/medicare-open-enrollment-navigating.html [10/7/11] 3 – www.freep.com/article/20111028/NEWS07/110280392/Medicare-premiums-go-up-not-high-expected [10/28/11]
Source: warrenwealth.com

Medicare Part D Plan Ratings and Reviews Posted on MedicareDrugPlans.com to Help Seniors During Open Enrollment

“To choose the best Medicare Part D plan, it’s important to look at how satisfied others are with that plan, in addition to checking plan costs and benefits,” said Tod Cooperman, M.D., President of PharmacyChecker.com, which runs the MedicareDrugPlans.com website. MedicareDrugPlans.com shows how satisfied plan members are with the overall plan and with key aspects: customer service, the choice of drugs (formulary), plan costs, the ease of using the plan, and information provided by the plan.
Source: laurenambrose.org

What Is Medicare Advantage, Exceptionally Florida Medicare

After retiring and contemplating accessible health advantages, many individuals wonder what is Medicare advantage. Medicare is often referred to as the government sponsored health insurance coverage plan for many who have retired or over the age of 65. Nonetheless, most individuals don’t perceive that throughout the Florida Medicare program, there are several several types of Medicare plans and kinds of coverage available. The different types of Florida Medicare plans indicate varying levels of coverage that ranges from hospital visits, emergency services, and different kinds of healthcare insurance. For those who are questioning what is Medicare advantage, it is necessary to first perceive that Medicare is break up into a number of different types of plans and that the total comprehensiveness of Medicare advantage depends upon the plan.
Source: nasdaqreportnews.com

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

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

New Software Tool Offers Relief for Mental Health Providers with Smaller Budgets

Posted by:  :  Category: Medicare

OBAMAS DEATH PANEL------ GUESS WHAT FOLKS IT'S ALIVE AND WELL---"CRAZY PALIN" NOT SO CRAZY NOW by SS&SSCTIS browser-based electronic clinical records software for the Mental/Behavioral Health (MBH) community, will be offered for the first time beginning May 15, 2008. The cost will be under $ 6,000 for up to 10 users. Faced with historical limits on private insurance reimbursements and Medicare paying 28% less than two years ago, many MBH organizations need an inexpensive way to improve HIPAA compliance and operating efficiency, without spending $ 80,000 or more on typical MBH software. CTIS software was developed over a period of three years, with the experience gained from working with three MBH organizations in Houston, including The Menninger Clinic.
Source: bestlongtermcare.org

Video: Medicare RAC Baseline Auditors Are Comming. www.PaymentAutomation.net

Medicare Providers Application Made Easy

Mail the completed application accompanied with all the required documents to a Medicare fee-for-service contractor, who is also termed as National Supplier Clearinghouse, Medicare Administrative Contractor, Fiscal Intermediary or Carrier working for your geographic location or state. Do not mail your application to the Center for Medicare and Medicaid Services at Baltimore, Maryland as it will delay the processing. If you have registered in Medicare, but haven’t submitted CMS-855 since 2003, you will need to send a complete enrollment application. Once you submit Medicare providers application, your enrollment will be recorded in PECOS, if you are a supplier or physician provider. If you are a non physician practitioner or physician, your National Provider Identifier and name will be recorded to the referring and ordering report during the next update cycle.
Source: canadiandrugsaver.com

Medicare Enrollment Revalidation and the Revised CMS 855 Forms : Healthcare Integration Advisors : New York Attorneys & Lawyers for Health Care Providers, Hospitals, Insurers : Iseman, Cunningham, Riester & Hyde LLP

In July of this year, CMS published revised Medicare enrollment forms for all provider and supplier types.  CMS revised the enrollment forms in an effort to implement a more rigorous program of integrity standards.  CMS’s theory is that by keeping bad people out of the Medicare system, most of the fraudulent activity that has plagued federal health care programs can be halted before it even begins.  The most substantial revisions were made to the Form 855A for institutional providers and the new Form 855O, which is for physicians and non-physician practitioners who enroll in Medicare for the sole purpose of ordering or referring items for Medicare beneficiaries.
Source: healthcareintegrationadvisors.com

Medicare Provider Enrollment Revalidation

Providers and suppliers should submit revalidation only after receiving the request from their MAC to do so. Providers and suppliers will have 60 days from the date of the letter to submit the required completed enrollment forms. Failure to submit enrollment forms as requested may result in the deactivation of Medicare billing privileges. Revalidation can be completed through the Internet-based Provider Enrollment Chain and Ownership System (PECOS) or a paper application; currently, federally qualified health centers only may submit paper enrollment applications. Please note: CMS forms 855A, 855B, 855I, 855O, 855R and 855S all have been revised as of July 1, 2011, and should be used for the provider enrollment revalidation. The new forms can be found by searching “855” on the CMS website.
Source: healthcarereforminsights.com

ANTITRUST AGENCIES ADOPT POLICY STATEMENT ON MEDICARE ACCOUNTABLE CARE ORGANIZATIONS : Health Care Law Matters

The agencies provide assurance that they would not challenge ACOs that come within the ACO-specific safety zone.  The safety zone focuses on the ACO’s shares of “common services” in the “PSA” of each ACO participant.  “Services” are divided into three categories:  physician specialties; major diagnostic categories for hospital inpatient services; and outpatient services defined by CMS.  A “common service” is one of the services that more than one ACO participant provides.  The “PSA” is the smallest group of zip codes from which an individual participant draws 75 percent or more of its patients for each service (for example, an inpatient hospital will have separate PSAs for inpatient services, outpatient services and employed-physician specialty services).  To fit within the safety zone, ACO participants providing a common service must have a combined share no greater than 30 percent of that service in
Source: healthcarelawmatters.com

Online Medicare Forms: Appeal, Payment, Disclosure, Application

Medicare insurance forms for parts A, B, C and D are accessible online for electronic filings and mail in. Online forms include an application for Medicare, claim forms for patients requesting payments and Medicare appeal forms. Older Americans can apply for Medicare even if not planning to retire, as long as the person is close to 65 years old. Even when a person has been denied Medicare, appeal forms can be submitted online requesting a hearing or case review.
Source: suite101.com

Keep away from Delays inside your Medicare Software by Performing Forms Accurately

Medical supplementation insurance is definitely the health insurance policies that occurs in Medicare health insurance insurance. It facilitates the Medicare health insurance insurance by spending money on costs which are not understood by Medicare health insurance. It allows you to decrease this charges in amount, which is to be paid in the health plan in addition to helps to pay more for gaps which might be related medigap expenditure as well as compensations from the Medicare insurance policies. Nowadays Medicare health insurance supplement insurance coverages are developing up almost all countries from the world. There are numerous healths insurance agencies who tend to be providing this particular service even so the coverages tend to be same via company for you to company just thing is how the premiums that will varies since the device depends within the particular company which is to be chosen. Some private insurance agencies are there who sadly are providing this policy that will fills this gap on coverage. Some seniors who tend to be financially definitely not sound as well as struggling to their life to them the Medicare health insurance insurance becomes an essential factor to produce them calmness. Usually the seniors those tend to be financially low number of strong they believe the insurance coverages would be extremely expensive but this premiums can be affordable in line with their capacity. So here it is rather beneficial Medicare Supplemental Insurance. ?
Source: forthegoodofthecity.com

Recent Changes to Medicare Part A Enrollment Forms

Consistent with the Paperwork Reduction Act of 1995, CMS published an Agency Information Collection Activities Notice, on May 20, 2011, consisting of a summary of the proposed revisions to the enrollment forms, with public comments due by June 20, 2011.[4] The final, revised forms became effective July 1, 2011.[5] The revised CMS 855A now explicitly requires disclosure of any entity whose mortgage, deed of trust, or other security interest in the Part A provider is equal to five percent (5%) or more of the total property and assets of the Part A provider.[6] This includes investment funds, holding companies, banks and financial institutions, and charitable and religious organizations.[7] The Part A provider must report the entity’s name, address, tax identification number, type of organization, percentage of interest in the provider, and an organizational chart identifying all of the owning or controlling entities and their relationship to each other and the provider. Dates of birth and social security numbers are additionally required for individuals who hold security interests.
Source: ebglaw.com

Overview of Medicare Appeal, Claim, Disclosure and Application Forms

In case you didn’t already know there are several types of Medicare insurance forms, and they are available online so you can file them electronically or mail them in. “Medicare has made the process of completing and submitting forms easy,” notes Alan Weinstock, insurance broker at MedicareSupplementPlans.com, “by offering the Medicare application, claim forms for patients requesting payments and Medicare appeal forms all online. Even if your claim has been denied by Medicare, appeal forms can be submitted online requesting a hearing or case review.” There are four online Medicare forms available for your use: 1. Medical Authorization to Disclose Personal Health Information 2. Online Medicare Application 3. Patient’s Request for Medical Payment 4. Medicare Appeals Form The Authorization form allows the Center for Medicare and Medicaid Services (CMS) to disclose personal health information to persons or organizations that you designate. The Medicare application is to be used to sign up for Medicare if you are at least 64 years and 8 months old. The other two forms are discussed below. Online Forms for Appealing a Medicare Insurance Denial There are five forms used to appeal an unfavorable Medicare decision. Each of these forms should be used when escalating an appeal for Medicare denial. The appropriate form depends on the situation and the stage of the appeal. If you were denied Medicare, you can appeal using an attorney who specializes in disability and Medicare rules. However, you can appeal directly as well. There are Medicare appeal forms to: 1. Appoint someone (such as an attorney) to represent you (CMS 1696) 2. Transfer your appeal rights to your provider or supplier (CMS 20031) 3. Request a hearing (CMS 20027) 4. Ask for a case review when you’re dissatisfied with the results of a hearing (CMS 20033) 5. Request a final review if dissatisfied with the case review (CMS 20034 A/B) Online Medicare Insurance Claim Forms One of the benefits of online Medicare forms is that you can directly submit a request for payment of medical expenses. If you see a health care provider who is not enrolled as a Medicare provider or who refuses to submit claims, use form CMS 1490S to request payment from Medicare directly. You need to do this within one year from the time of service. To submit a claim form you should: 1. Print the form from the Medicare.gov site 2. Fill in the form and submit it along with copies of your bills or other documentation (hang onto your originals for your files) 3. If you want Medicare to give your personal health information to someone other than you, submit a completed Authorization to Disclose Personal Health Information form 4. Explain why the bill is being submitted (i.e. “provider refused to submit bill”) 5. Mail in the form to the state address where services were provided 6. Allow 60 days for Medicare to complete payment process By the way, if you are unable to find the National Provider Identifier (NPI) number, the Medicare contractor will look this up when processing your claim form. All forms are accessible for view, print, download and submission from the CMS forms catalog or can be requested from Medicare by telephone at (800) 633-4227. Medigap insurance can give what the original Medicare Supplement cannot and this is a very effective advantage of the Medigap insurance California.
Source: articleswide.com