Medicare Open Enrollment Ending for 2011

Posted by:  :  Category: Medicare

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

Video: Health Insurance Information : About Medicare Dental Benefits

Medicare Open Enrollment: Extra Benefits & Preventive Services

A full 99% of people with Medicare have access to Medicare Advantage Plans in 2012, and these plans often offer extra benefits that Original Medicare doesn’t cover. Medicare Advantage Plans may offer vision, hearing, or dental coverage, or extend coverage while you travel. Most Medicare Advantage Plans also include prescription drug coverage.
Source: medicare.gov

Dental Insurance: Dental Insurance Questions & Answers

More Dental Insurance quesions please visit : InsuranceQuotesFAQ.com Best dental insurance? I need dental insurance for my 5 year old son and conceivably myself also. Doe’s anyone know the best plan to go with? Thanks alot I would encourage a stop by to this website: www.healthsavings.ourperfectcard.com I signed up online over 5 years ago now and they have save me thousands of dollars $$$ since. From exams,… Best medicare insurance for dental ? I just became disabled and qualify for Medicare I hold been comparing plans ie Humana BlueCross and Aetna My question is… What possessor has the best coverage for dental. There are some than now bestow dental and curious if anyone has a great Medicare approved Insurance Agent in Utah Many Thanks Ali None, phone a… Best robustness and dental insurance for students contained by California? I’ve never purchased insurance before. I’m a 20 year old feminine. Currently my wisdom teeth are impacted and that has cause a few other dental issues. The wisdom teeth extraction procedure costs much more than I can afford and other dental work on top of that wishes to be done. My… Billing For Dental Insurance?(Narrative Perio)? I am Just recieved a denial back from the insurance company I am trying to help out the dr that I work for the E.O.B states that the is not an iota substancial boneloss on the x-rays and want a narrative for how we determined this pt has periodontal disease can any one please help… Both my wife and I enjoy insurance from work. can we both report claims for dental work? yes u can but make sure to be around the limit for that ask the human resources character what plan u got and she can actually explain it to you better. yes, but they will not wage more than the total owed. … Braces …is have insurance or dental insurance cheaper than going to a private orthodontist ? I want to have braces done i just wanr to know where on earth would it cost me less to have braces have dental insurance or just going to an orthodontis if u have experience surrounded by this field i would be really happy… Broken Wisdom Tooth and No Dental Insurance within Delaware? I was just sitting on the couch playing online after I put my kids to bed when adjectives of the sudden I noticed that something inside my mouth was poking the inside of my cheek. I feel with my tongue and discovered that the sharp thing be where one of my wisdom… Can a 23 year elderly grasp clothed Ortho coverage contained by their dental insurance? I know it is difficult to find ortho coverage when older than 19… I currently have a Blue Cross HMO plan that will cover me- but not much. And I am have a terrible time trying to find someone to accept this. Is nearby something… Can a 23 year hoary catch clothed Ortho coverage within their dental insurance? I know it is difficult to find ortho coverage when older than 19… I currently have a Blue Cross HMO plan that will cover me- but not much. And I am have a terrible time trying to find someone to accept this. Is in attendance something… Can a dental bureau submit claims to insurance LATER? I went to my dentist yeaterday. I supposed to have dental insurance trough my wife’s work (actually we rewarded for it), and HR ar her work told her that the insurance will kick in Nov 01/2007. Yes, but when I go to the office they checked with the insurance company and said… Can a dental department not submit claims to insurance by choice? I saw a dentist in 2004. I had dental insurance and provided this information to the dental bureau. I never heard anything after that but changed dentists due to location. I get a copy of my credit report second month and see there is a collection for this dentists… Can an hand hold robustness or dental Insurance through his/her spouce’s employer and also through his own? YES, IN THIS CASE DENTISTRY SHOULD COST YOU NOTHING OUT OF POCKET Yep its called primary and subsidiary insurance. But just use the one with the better coverage while you can. Yes, the insurance you have for yourself, through work, would be your… Can an individual enjoy more than one dental insurance policy to assist pay envelope for dental work? Yes, you will have to pay the deductable on respectively plan, then they two pans split the cost. Or at most minuscule what the plan says they pay for unshakable procedures. No. When one finds out about the other then they will of… Can any one recommend cheap dental insurance? If it matters, I’m in NJ and a moment ago looking for basic services… Thanks Most dental insurance is costly. If it is cheap you will get paid remarkably poor benefits and coverage. Source(s): A dentist The best place to compare dental plan rates is at Dental Plans Reviewed. They compare… Can anybody suggest individual inexpensive dental insurance? I have no dental insurance through my work and I went to the dentist today and call for some major work done but can’t afford it. You own four options with dental. 1. Visit a local dental institution. You can get many procedures done for a reduced price if you’re… Can anyone describe me if near is any dental insurance and prescription med abet for ppl below 55? I know a couple who have young children and both work. They net too much money to get any help from the command but not enough to carry dental insurance for it is road out of their budget. Does anyone know of any… Can anyone recommend a well-mannered dental insurance plan for implant? I need about 20k of work surrounded by implants and cannot afford it. I need to find a flawless dental insurance plan that would provide some coverage to help me pay for this. Hi my nickname is Jeffery M Salerno DDS Unfortunately, there are very few insurance plans which give… Can anyone within the US recommend a upright dental insurance? I need one that will allow pre-existing conditions. Thanks. I would encourage you to call in this great website: www.healthsavings.ourperfectcard.com I signed up online over 5 years ago when I was in college and they enjoy saved me thousands of dollars on all of my dental services since. From exams,… Can dental insurance (DPO and DMO) be used together to run down the copay? How does it work? ? Yes, a dual insurance can help reduce co-pays. It depends on which one is your primary though. DMO is kinda similar to a really good discount plan, a DMO doesn’t really pay your dentist for treatment but will… Can i acquire braces if my insurance doesn’t cover dental? My parents have a Chrysler insurance, and we got a sense in the mail that they will no longer cover dental and delirium starting July 1st 2009. I was planning on getting braces. If i get braces previously July 2009 since it’s not the dentist that work with braces will… Can I attain dental insurance to cover slice of a nightguard? I grind my teeth pretty bad at night, and since I’m going to be getting two crowns put on teeth I have root canals on, my dentist strongly reccomends I get a nightguard so I don’t do further disfavour to my teeth or to the crowns once they’re put in…. Can I be added to my bf’s health/dental insurance from work? Hi. I was wondering if I am actually competent to be added to my boyfriends benefits he gets from work. We live in Las Vegas, Nevada and he works at the Clark County Detention Center so its the County. My payrol hand at my work told me… Can i be denied a dental procedure that have be repeated more than twice near insurance? i have had 2 composite filling placed over the same chipped tooth with a week of eachother. when the tooth chipped, i be having breakfast. when the first composite filling broke, i be eating dinner. when the second composite filling broke, i be stressing about… Can I bring back dental insurance for myself if I am a dependent? I’m 19 and I live at home with my parents. I am still a dependent. We don’t have dental insurance and I required to know if I can buy dental insurance for myself. I am unemployed, will that make a difference? Yes you can, you’ll just have… Can i catch a crown replaced? will it be covered by dental insurance? i had a really bad tooth abscess develop on a tooth that i have a crown put on 2.5 years ago. Apparently, the filling was done and after a crown was applied but the bacteria kept multiplying. The crown be also a little loose i think… Can I catch dental insurance lacking getting trance and other stuff? I was wondering if its possible – id close to some dental insurance but i dont need vision or any other extras. Hey… haha. Karen – this is funny… I asked this request for information a few days ago. I tried a bunch of different sites that were recommended. … Can i catch individual dental insurance through the state somehow for my suitability teeth? I have impacted wisdom teeth and requirement them out by this summer at the latest. I don’t have any dental insurance and my strength insurance expired a few months ago… I’m 16 years old and I need to come up next to 2000 dollars somehow. Is there… Can I catch my own dental insurance? I need dental work done, and I want to buy dental insurance as it is not offered through my company. Can I do that? How much will it cost? What do they look at in writ to decide the cost? Where do I look for dental insurance? Sure you can, but they… Can I enjoy more than one dental insurance provider? I want to get braces, but I am looking at about $5000 to gain them. The dental insurance provider pays only up to $1000 total for orthodontic work. Is it legal for me to acquire 5 dental insurance providers so that I can have braces paid for? I numeral… Can I Get Dental Insurance? I have suffered from gum disease for most of my adult duration. I have a bridge for my front 2 teeth. Now I have an abscess contained by my lower jaw and lower front 4 teeth feel loose. There is plentifully of receding gum showing. I have (NHS) appointment next week. I am anticipating dentist will..
Source: blogspot.com

How Can Retired People Afford Dental Care?

Medicare only covers certain types of dental care. If you need routine dental care, you cannot count upon your Medicare benefits. You may need to purchase another type of plan in order to get senior dental discounts or dental insurance. Many people assume that Medicare will pay for dental services, but this is not usually true.
Source: drew-altizer.com

Dental News, CE, Forums, Buyers Guide

When private insurance policy falls short and public techniques fail, low cost dental programs can be a light at the conclude of the tunnel for lower-salary Us residents. For a low regular payment, individuals can attain entry to a network of dentists and experts who supply preventative, servicing, and emergency oral care to all members of the family members at personal savings of wherever from 20 to sixty % of the complete price tag. Remedy can get started immediately soon after patients signal up, with no waiting periods, yearly maximums, deductibles, or claim varieties to file. Though low cost strategies are not thought medicare dental coverage 2010 to be to be dental insurance policies in the traditional sense, they are proving to be a crucial hyperlink in the economical dental care safety net. We can only desire that they, in mix with other sources, will one particular day assure affordable and obtainable oral healthcare for each and every and each and every American. Source: voicesoftheheartland.com
Source: medicaresupplementalco.com

Medicare Open Enrollment Ending for 2011

Posted by:  :  Category: Medicare

Self Portrait Day 37 by HopkinsiiThe 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

Video: SHIIP Medicare Enrollment Basics.flv

Web Wealth: Enrolling or changing Medicare

At the government’s Medicare site, click on “compare drug and health plans” to begin a search for the providers in your area. You’ll be asked which prescription drugs you take, how much, and how often. You’ll even be asked which pharmacies you use. The process, invented by politicians and bureaucrats, is tedious and not engineered for easy use by our elders. However, the end result is a full list of available insurance plans, their costs, and the individual’s estimated total expenses for the year. Click “enroll” to apply for coverage.
Source: philly.com

Time to Compare Medicare Plans

 “Seniors and people with Medicare should act now, review their plan coverage and compare their current plan with other available options,” said CMS Administrator Donald M. Berwick, M.D.  “The important decisions you make now can help ensure that any changes made will be in place by January 2012 for seamless and uninterrupted access to your health care providers and medications at your chosen pharmacies.”  
Source: momentumtoday.com

Medicare Open Enrollment: Better Choices, Sooner

People with Medicare are also enjoying important new benefits. Every person is entitled to an Annual Wellness Visit with their doctor so that they can discuss their health and their health care needs. Prevention services like mammograms and other cancer screenings are now available with no cost-sharing. And people who reach the donut hole in their drug costs will get a 50% discount on covered brand name drugs and a 14 percent discount on generics. That puts money back in your pockets.
Source: medicare.gov

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

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

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

Increase Your Social Security Check

To take advantage of these programs and many others you need to call SSC or hop online to their website, answer a few questions for eligibility- and by the way all of your information is confidential, in fact the person you talk to will be your advocate for as long as you like, this mean that you are not transferred to someone new every time you call or have questions. Your advocate will ask you two simple questions to get you started: 1- Are you single with a monthly income less than $1,238 or, a couple with a monthly income less than $1659? 2- Are you single with savings of $4,000 or less, or a couple with savings of $6,000 or less? You advocate with this information will then determine the best plan for you to obtain all the benefits you qualify for.
Source: theguidetohomebusinesssuccess.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

frequently asked questions during the 2012 medicare annual enrollment period / eHealth

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

APPROACHING MEDICARE, AMERICAN BABY BOOMERS KEEP BOOMING, ACCORDING TO NEW, NATIONAL SURVEY FROM INDEPENDENCE BLUE CROSS

Posted by:  :  Category: Medicare

Nurse Alliance Action at RNC by SEIU International“Independence Blue Cross has provided comprehensive health care options since 1938, predating the post-war baby boom,” said Daniel J. Hilferty, president and CEO of IBC. “In so many ways, IBC has been with these individuals during every step of their lives. As this influential generation becomes Medicare eligible, we want and need to know them better, especially on the cusp of health care reform, which will change the nature of health care for everybody.  For IBC, this survey enabled us to learn more about this population, their daily lives, health habits, and activities as well as their plans for the future.  Health care needs to be a more personal business and this survey will help us provide plans that serve Boomers as well into retirement as we have served them through all other phases of their lives.”
Source: cisionwire.com

Video: Blue Cross Sit in for Medicare for All, Los Angeles CA, October 15

Psychologists fear Blue Cross payment changes will harm patientsThe state’s

Psychologists fear Blue Cross payment changes will harm patients The state’s biggest managed-care company is making changes many predict will jeopardize mental health care for thousands of Floridians. Blue Cross and Blue Shield of Florida Selects Omnicom Group Partnership Orion JACKSONVILLE, Fla., Nov. 29, 2011 /PRNewswire/ — Blue Cross and Blue Shield of Florida, Inc. (BCBSF) announced today that it is engaging a partnership of five Omnicom (NYSE: OMC) agencies to support its future brand and marketing communications efforts. (Logo:… Skate Through the Holiday Season at the Blue Cross RiverRink PHILADELPHIA, PA– – The Blue Cross RiverRink at Penn’s Landing, the only completely outdoor Olympic-size ice skating rink in Philadelphia, is the perfect place to spend the holidays. The Blue Cross RiverRink …
Source: medicare-news.com

Blue Hampshire: Politics ::: Charlie Bass: Pants on Fire

While Bass later claimed that his plan would “protect, preserve, and strengthen Medicare for our senior citizens,” he said at the time:  “We’re going to have to cut close to $1 trillion.  It’s going to require amendments to cut entitlement programs, Medicare and Medicaid.” (Congressional Record, One Minute Speech by Charles Bass, September 6, 1995; The Boston Globe, “House Rookies Return from the Fray,” by Bob Hohler, April 9, 1995)
Source: bluehampshire.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

determine Blue unfriendly Medicare Insurance opinion To bag Complete Coverage

People must become a section of Blue irascible Medicare insurance idea because the Medicare insurance plans that they have do not shroud the entire expense. The fact is Medicare will only screen about 80 percent of the medical expenses. The balance 20 percent must be financed by the person who is covered under the opinion. As most people under Medicare are seniors, who are above the age of 65, it often becomes difficult for them to afford even this 20 percent. Many of these people are not even obedient of working to rep money. Therefore, their income is not sufficient to camouflage for the allotment of the expenses they might have to hold.
Source: mexicoentucorazon.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

Blue Medicare – Blue Cross Blue Shield Medicare: A Guide to BCBS Medicare Advantage, Part D, and Supplemental Plans

Blue Medicare PPO – under this plan, beneficiaries have the freedom to either access the company’s network of health care providers or go outside of the network (though going outside the network incurs greater costs.) There are low copayments for primary care physicians and specialists, and monthly premiums are both predictable and affordable. The plan includes generic drug coverage at little-to-no cost and provides emergency nationwide coverage;
Source: suite101.com

10 Days Left in the Annual Medicare Advantage Enrollment Period

Especially here in Santa Monica and Brentwood, many policy holders had to switch there Medicare Advantage Plans. One reason was that Anthem Blue Cross discontinued their Freedom PPO Plan but offered a new local Medicare Advantage PPO plan, another reason for switching plans was that  policy holders on the  local Blue Shield Medicare Advantage HMO Plans cannot access UCLA doctor in 2012. If you need more information about individual plans do not hesitate to contact us at https://www. solidhealthinsurance.com.
Source: solidhealthinsurance.com

The Medicare Mom: Operation Black and Blue Friday

8:30 The crowd is increasing, notably the group milling around the 12 volt Barbie type cars and a new group around the Play Tyme Custom Kitchens just behind me. Strategies being planned. “Now be ready to go into action the minute it’s 10:00. People will push, shove, and bite but hang in there, stand your ground. Use your cell phone for backup but only if you are losing the battle.” I thought it was a security guard behind me talking on his walkie talkie but it was some Mom instructing her teenage daughter, a Black Friday novice. Several security guards are making a line of defense in front of the outside exit doors. The S.W.A.T team has arrived complete with flak jackets, walkie talkies on each hip and enough battery packs to power four mini TV’s. This is going to be big.
Source: blogspot.com

Medicare Open Enrollment Ending for 2011

Posted by:  :  Category: Medicare

Rogue Magazine - October 1964 - Volume 9 Number 5 - Water Balloons .....item 1..routinely use devious devices -- wears us down like rabid trial lawyers until we give in (August 15, 2011 / 15 Av 5771) ... by marsmet542The 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

Video: Senior Care Concierge Medicare 2011 part1

The Official Medicare Set Aside Blog And Information Resource: Changes to Maryland Workers’ Compensation Regulations Finalized

You may recall a September 2011 blog article that discussed proposed amendments to COMAR 14.09.01 and COMAR 14.09.19 adding specific requirements for workers’ compensation settlements involving Medicare beneficiaries. These amendments were finalized November 28, 2011 and officially adopted into Maryland Workers’ compensation law. The most noteworthy aspect of the new regulations is that the parties are permitted to forego CMS approval of a proposed settlement that meets CMS review thresholds provided that the settlement documents contain three elements: (1) an acknowledgement that the settlement is within the CMS review thresholds, (2) a statement that the parties voluntarily have elected not to submit the settlement and formal set-aside proposal to CMS for review and approval and (3) a statement that the parties are aware that CMS may refuse to pay for services related to the injury and may assert a recovery claim against any entity, including a claimant, provider, supplier, physician, attorney or private insurer. The previous version attempted to use state law as a means to mandate participation in CMS’ voluntary WCMSA review program, a move that was opposed by both claimant and defense attorneys equally.
Source: medicaresetasideblog.com

I’m an MS Activist: Deadline for Medicare Open Enrollment Nearing

If you are enrolled in a Medicare Prescription Drug (Part D) plan or a Medicare Advantage (Part C) plan and need to make changes to your coverage for 2012, you must do so December 7, 2011. This Open Enrollment period started in mid-October and ends earlier this year than usual. Unless you are able to qualify for a special enrollment opportunity, through December 7th is the only time you can make changes like the following: join a Medicare Prescription Drug plan; switch between Medicare Prescription Drug plans; drop your Medicare Prescription Drug plan; switch from original Medicare to Medicare Advantage (or vice versa); or switch between Medicare Advantage plans. 
Source: blogspot.com

Avail Maximum Benefits with Medicare Advantage

An introduction to Medicare Advantage Health plan member complaints and appeal: Medicare Advantage Plan includes how often members file a complaint against the plan. What is Medicare Advantage? This plan usually offers services not covered in original Medicare plans and some of them cover prescribed drugs. Plans that are marketed by private insurers and promoted by health maintenance organizations(HMO)or preferred provider plans(PPO)are Medicare Advantage plans. One of the changes in Medicare Advantage this year is about to happen. The enrolment period for seniors to join, switch or drop Medicare Advantage plans 2011 has been changed and will be from October 15 to December 7. The change has been made to give more time for enrollees to join a plan. Records of member complaints regarding drug plan and Medicare audit findings: Medicare Advantage Plans include details of how many times members file a complaint about any drug plan. They also keep findings from Medicare audit of drug plan. Health plan telephone customer service: Medicare Advantage Includes how well the plan handles calls from members. Ratings of health plan and health care: Medicare Advantage plan includes how members rate the plan based upon satisfactory level. Pricing of Drugs and Safety of the Patient: Medicare Advantage Plans provide information which is regularly updated on Medicare website. The website also provides drug plan prices for the prescriptions and records are kept on how many times members with certain medical conditions get prescription drugs. 3.Drug plan and experience of the member: Medicare Advantage Plans take care of the member’s reaction on the service. Quality of these health services covers topics in 5 different categories: Health Care : Medicare advantage plan involves keeping track of how often members get various screening tests, vaccines, and other check-ups that help them stay healthy. When enrolling in for Medicare Advantage, an enrollee gets a “welcome to Medicare” visit which involves a wellness physical. The co-pay and deductible for this physical have been dropped to encourage seniors not to avoid seeing a physician. Advantages of Medicare In return for a premium, Medicare Advantage plans share costs and cap out of pocket expenses. These plans are not Medicare Supplements, but take place of “Original Medicare”. Good quality healthcare services, provided as advantage for Medicare come from various sources that include: Surveys of individual members by Medicare; Information from Clinic owners; Information relevant to the Plans; Feedback from Medicare’s activities that are regularly monitored. For quality of drug services, advantage for Medicare comes from sources that include: Results from Medicare’s regular monitoring activities; reviews of billing and other information about plans submitted to Medicare; and member surveys done by Medicare. Main enrolment periods post the announcement about Medicare Advantage plans 2011 are : * Annual Enrolment Period(AEP): from November 15 to December 31* Open Enrolment Period(OEP): from January 1 to March 31
Source: articlesurge.com

Psychologists fear Blue Cross payment changes will harm patientsThe state’s

Psychologists fear Blue Cross payment changes will harm patients The state’s biggest managed-care company is making changes many predict will jeopardize mental health care for thousands of Floridians. Blue Cross and Blue Shield of Florida Selects Omnicom Group Partnership Orion JACKSONVILLE, Fla., Nov. 29, 2011 /PRNewswire/ — Blue Cross and Blue Shield of Florida, Inc. (BCBSF) announced today that it is engaging a partnership of five Omnicom (NYSE: OMC) agencies to support its future brand and marketing communications efforts. (Logo:… Skate Through the Holiday Season at the Blue Cross RiverRink PHILADELPHIA, PA– – The Blue Cross RiverRink at Penn’s Landing, the only completely outdoor Olympic-size ice skating rink in Philadelphia, is the perfect place to spend the holidays. The Blue Cross RiverRink …
Source: medicare-news.com

Medicare to Pay $4 Billion More to SNF in 2011, Must Take Action says OIG

Prior to FY 2011, CMS made changes to how skilled nursing facilities bill their time for concurrent therapy, with the expectation that they would see a decrease in billing for higher levels of therapy. CMS intended for the changes to be budget-neutral, but contrary to CMS’s expectations, skilled nursing facilities actually billed more for higher levels of therapy and for very little concurrent therapy during the first half of FY 2011.
Source: seniornews.com

AHL’S TOP STORY: Both Parties Back Medicare ‘Premium Support’; Could Lead to Future Program Changes

Republicans traditionally have supported premium support, which would give Medicare beneficiaries a fixed amount of money to purchase coverage from competing private plans. GOP presidential candidates Newt Gingrich and Mitt Romney in the last two weeks have endorsed variations of premium support in Medicare.
Source: ahlalerts.com

ACO Final Rule Changes: What They Mean for Medical Practices

CMS removed the requirement that 50% of primary care physicians in an ACO must be ‘meaningful users’ of electronic health records. However, CMS continues its strong support for the adoption and use of EHRs as a critical component to successful ACO care coordination by doubling the value of the EHR quality measure.
Source: himss.org

Health Beat: “Premium Support” Is Just Another Way To Privatize Medicare

If, as the Times reports, some Democrats are warming to the idea of premium support for Medicare, they are not embracing Ryan’s draconian voucher plan. Instead, they may be reconsidering the merits of a premium support plan championed by Alice Rivlin, director of the Office of Management and Budget during the Clinton administration and Pete Domenici, former chairman of the Senate Budget Committee. During the budget deficit negotiations, Rivlin urged the supercommittee members to consider an insurance exchange for Medicare beneficiaries—with a public option; “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,” the New York Times article explains. The idea of the Rivlin-Domenici plan is to move Medicare toward a premium support model, “without destroying the individual entitlement at the heart of the program.”
Source: healthbeatblog.com

Doctor Groups Seem Less Wary of Medicare Changes

Although the association didn’t specify in its letter what changes they like or provide further comment, other doctor groups like the AMA said the physician community is happy they will be able to participate without losing money in the first three years and the federal government will allow certain doctor groups access to $170 million in initial Medicare savings to help them form ACOs. In addition, doctors said they were encouraged that the number of quality measures that need to be met was cut in half, but there will still be more than 30 or so benchmarks.
Source: nytimes.com

2011 Medicare Open Enrollment Deadline

Use of an advocate, a friend or a family member’s help with these decisions work to the individual’s advantage, particularly for those easily overwhelmed by the amount of paperwork and other written communications. For those who are members of Senior Centers, this type of help is readily available in one-on-one sessions, through workshops and through small group consultations.
Source: assistedlivingfacilities.org

Senator Grassley on Medicare Open Enrollment 

For 2012, Medicare beneficiaries have plan options that offer enhanced coverage, including zero deductibles and coverage in the gap for generic drugs. In Iowa, there are 33 Medicare prescription drug plans available for 2012. These plans offer additional options, such as coverage in the standard benefit’s coverage gap and a deductible below the standard $310, including plans without a deductible. For 2012, the lowest Medicare prescription drug plan available in Iowa for 2012 is $15.10 per month. Overall, drug plans have seen a slight decrease in premiums for 2012. I co-authored the legislation that created the Medicare prescription drug program. Competition among insurers was built into the program design to keep costs low for enrollees, and the program has delivered consistently better-than-expected results in keeping premiums low and affordable. Beneficiary satisfaction also is high, with 95 percent of enrollees saying their Part D plan works well, and 94 percent saying it’s easy to use, in a survey conducted this year.
Source: belleplainenow.com

Pennsylvania AARP Members Delivering 57,000 Petitions to State Congressional Delegation

Posted by:  :  Category: Medicare

HERES YOUR TOP TEN by SS&SSPennsylvania AARP Members Delivering 57,000 Petitions to State Congressional Delegation Seniors Want Washington to Oppose Budget Deal that Cuts Social Security and Medicare Benefits HARRISBURG, Pa., Nov. 15, 2011 /PRNewswire-USNewswire/ — AARP Pennsylvania members and volunteers are delivering an additional 57,766 petitions this week to members of the state’s… Briefs for Nov. 28, 2011: AARP to meet this afternoon Craig AARP Chapter 1418 will meet at 2 p.m. today at Sunset Meadows I, 633 Ledford St. A pharmacist from Walgreens will present about Medicare Pharmacy D. For more information, call 824-5123.
Source: medicare-news.com

Video: State Takeover of Harrisburg, Medicare/Medicaid Funding [Pennsylvania Newsmakers]

Medicaid and additionally Medicare Health Help PENNSYLVANIA

Some one has Medicare supplement coverage may perhaps think they’re covered. You really well could look into that around yourself. Though there are quite a number of hospital rates that Medicare will in fact finance, there tend to be nevertheless several them which have been left in back of. To discover where Treatment has placed off, you should purchase within Medicare insurance plans TX presents. These tend to be straightforward additions to all your Medicare product medicare supplement intention of you may put about and modify a program to fit your needs. Whichever your health and wellbe needs may just be, there really should be a product these days for people. Browse of these selections so it will be possible to always visit Edwards plateau and various other TX attractions.
Source: glutenfreedietideas.com

Schwartz Presses Super Committee To Advance Her ‘Doc Fix’ Proposal

The Hill: Rep. Schwartz Urges Super Committee To Adopt Her Medicare ‘Doc Fix’ The proposal would prevent a scheduled 27.4 percent cut to doctor payments on Jan. 1 and put in place a six-year transition period with fixed payment updates. After that, the Department of Health and Human Services would be tasked with coming up with at least four payment systems physicians could choose from, based on their location, patient mix and other factors. A flat-out repeal of the SGR is estimated to cost about $300 billion over 10 years. [Rep. Allyson] Schwartz (D-Pa.) said she anticipates that her bill would save money compared to the temporary patches that lawmakers have regularly been adopting for years to prevent the scheduled cuts from going into effect (Pecquet, 11/16).
Source: kaiserhealthnews.org

How to Select and Buy Medicare Supplement Insurance

In states where Excess Charges are illegal (like in Pennsylvania), there is no reason to buy the more expensive Plan F – Plan C will suffice.  There is also no need to use Plan G – Plan D will suffice.  Since 99% of doctors accept Medicare assignments, the need to cover Excess Charges is very small even in states where Excess Charges are allowed.  Therefore, there is no reason to buy the more expensive Plan G  if Plan D  is available.  The same is true is true for plans F and C:   there is no reason to buy the more expensive Plan F if Plan C is available.
Source: medicare-pa-nj-de.com

DCCC to return to Medicare attacks against vulnerable Republicans

The DCCC’s target list largely reflects freshman Republicans in swing districts or those whose districts have or could be made more Democratic in redistricting. One member not on the list: Ryan himself, whom Democrats had made a target earlier this year. They now seem to have accepted he’ll be tough to beat in a Republican-leaning exurban Milwaukee district.
Source: thehill.com

Bill To Provide More Protection for EHR Users Faces Opposition

Marino, who is a member of the House Judiciary Committee, said offering the new legal protections to health care providers would promote greater use of EHRs and encourage Medicare and Medicaid providers to continue serving beneficiaries (iHealthBeat, 10/27).
Source: ihealthbeat.org

Disabilities: Saving Medicare billions: Trying too hard can get in the way

The Obama administration’s penny-wise-and-pound-foolish cutbacks on availability to durable medical equipment, rehabilitation services, and home health care are forcing residents of independent living facilities into the Centre Crests of this country. For example, the narrow focus is apparent in Medicare’s frequent citations of the Congressional Budget Office’s competitive bidding estimates of relatively insignificant savings for Medicare Part B ignoring the astronomical costs that will result to Part A when disabled individuals like me can no longer pick up the phone and call my local medical equipment provider. Instead, I must wait for a competitive bidding winner (several have unsavory reputations and some are based out of state) to provide a battery. Delays could easily force me into Centre Crest as a result of falls, problems getting to the bathroom, etc. Delays would rob me of the ability to work as an adviser on virtual reality models for construction of future aging in place housing–construction which will result in significant Medicare savings.
Source: blogspot.com

Time to Compare Medicare Plans

Posted by:  :  Category: Medicare

Healthcare in America: Who's Paying Who? And Who's Getting What? (g1a2d0014c1) by watchingfrogsboil “Seniors and people with Medicare should act now, review their plan coverage and compare their current plan with other available options,” said CMS Administrator Donald M. Berwick, M.D.  “The important decisions you make now can help ensure that any changes made will be in place by January 2012 for seamless and uninterrupted access to your health care providers and medications at your chosen pharmacies.”  
Source: momentumtoday.com

Video: Pete Mitchell’s When To Sign Up For Medicare by Pete Mitchell

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

Getting Through the Medicare Enrollment Maze

Congress decided to set up a mechanism to allow private insurers to join the Medicare party and provide coverage as an alternative to “Original Medicare.” Part C of Medicare provides for Medicare Advantage plans that are in lieu of Part A and Part B. The plans must provide all of the basic Medicare Part A and Part B services – but they can also offer other services that Original Medicare does not cover (perhaps dental, hearing aids, and other exotic benefits like gyms) – and they can (and do) charge various amounts for their plans. The federal government then pays the plans a fixed amount per plan participant. There are several delivery models to choose from (notably health maintenance organizations, preferred provider organizations, and private fee for service plans).
Source: masonlawpc.com

Tricare Help – When must I sign up for Medicare Part B?

Q. I am retired military, but an active state employee covered by the state health plan. Presently, Tricare is my secondary coverage. In August I will turn 65. I must sign up for Medicare. Because I am still covered by the state health plan, I have an option to sign up for Part A, maintain the state health plan as my primary coverage until I retire from the state, and then sign up for Part B upon that retirement without penalty or loss of coverage. My question comes in regard to Tricare for Life. There appears to be a similar Part B delay provision for anyone still on active duty when they turn 65 – they can delay signing up for Part B without penalty until they retire from the military. However, there does not seem to be any link between the two exceptions for military retirees. In other words, it appears I must sign up for Part B immediately before I retire from the state or lose my eligibility for Tricare for Life. Is that correct?
Source: militarytimes.com

Your guide to Medicare open enrollment for 2012

honeywell enroll 2012 avaya 2012 open enrollment ibm health benefits 2012 united airlines benefit center raytheon medicare plus plan 2012 ibm retiree medical 2012 ibm medical 2012 enrollment dates for lockheed retiree medical insurance 2012 ibm health plan 2012 2012 ibm retiree medical benefits lockheed martin open enrollment rockwell collins benefits open enrollment lockheed martin open enrolment 2012 Honeywell medical plan ibm retiree benefits enrollment 2012 raytheon medicare plus plan raytheon medicare plus honeywell 2012 benefits lockheed martin 2012 medical plan lockheed martin 2012 insurance rates INTERNATIONAL BUSINESS MACHINES OPEN ENROLLMENT lockheed martin 2012 employee healthcare costs lockheed martin 2012 open enrollment lockheed martin health insurance plan increase 2012 lockheed martin insurance 2012 lockheed medicare advantage plans 2011=2012 lockheed medicare lockheed medical retirement lockheed martin united healthcare medicare lockheed martin retiree medicare insurance options lockheed martin open enrolment schedule 2012 lockheed martin open enrolment 2011 lockheed martin open enrollment 2012 lockheed martin medicare advantage coverage 2012 Lockheed Martin Medicare 2012 lockheed martin medical retirement lockheed martin medical open enrollment lockheed martin medical enroll kaiser lockheed martin insurance late enrollment lockheed credit union helath plan open enrollment lockheed 2012 medical coverage lockeed retiree medical ibm retirement benefits and medicare phone number ibm retirement benefits 2012 enrollment contact information IBM Retirement Benefits 2012 ibm retirement 2012 health benefits ibm retirees medicare choices ibm retirees health insurance new options for 2012 ibm retiree medigap coverage ibm retiree medicare plan ibm retiree medicare choices ibm retiree medical options 2012 ibm retiree medical enrollment for 2012 ibm retiree medical benefits 2012 ibm retirement medical 2012 IBM Retriree 2012 health benefits ibm supplemental medicare lockeed open enrollment dates LM healt benefits 2012 kodak retiree healthcare kodak retiree health premiums for 2012 kodak medical insurance 2012 kodak health insurance 2012 kodak 2012 health benefits INCREASED RATES FOR MEDICARE B 2012ORIGINAL PREMIUMS IBM US Benefits 2012 ibm u s retiree medical costs for 2012 ibm supplemental medicare insurance ibm supplemental medicare benefits lm medicare medical plans why is rockwell collins dropping retirees medicare plans ual medical benefits 2012 retiree enrollment ual 2012 benefits enrollment the impact of changes in medicare rates for medicare advantage plans switching chevron retiree medical insurance considered part c state farm insurance retirees supplemental choices for 2012 state farm cancels retiree medical rockwell dropping health plans for seniors rockwell collins retiree open enrollment rockwell collins retiree medical rockwell collins open enrollment rockwell collins extend health medicare rockwell and open enrollment united airlines 2012 health insurance benefits United Airlines Benefits Center united airlines benefits center 2012 which ibm retiree medical plan for 2012 is best where does agilent technologies rate on medicares star when does bofa open enrollment 2012 close when do ibm retirees enroll in 2012 health insurance when are ibm 2012 health insurance elections due date what is the best ibm medicare medical plan for retirees what is ibm medical coverage medicare options wells fargo retirees blog united medicare supplement retirement wells fargo 2012 united airlines open enrollment for 2012 united airlines open enrollment 2012 united airlines medicare 2012 open enrollment reviewing ibms midical plans for 2012 retired ibm medicare plan
Source: ourbusinessnews.com

Happy Birthday October HappyBirthdayOctober.com Medicare

Perhaps you received a Happy Birthday October card from Humana Inc with the medicare site HappyBirthdayOctober.com listed. Humana Inc provides medicare plans for seniors from coast to coast. Having several different Humana plans to choose from is a great time to begin with medicare. With Humana you can upgrade from the original medicare plan to insurance plans that provide more health care in turn protecting your families assests. With the original medicare program at best there is an 80% reimbursement on your health care services. With private medicare plans you can cover some or all of the costs that medicare does not cover. No wonder companies like Humana are so popular. Compare Humana Medicare Plans in Your State.
Source: trinitymedcare.com

Medicare drug coverage gap shrinks

FILE – In this June 8, 2010 file photo, President Barack Obama listens as Health and Human Services Secretary Kathleen Sebelius speaks during a town hall meeting on the Affordable Care Act, at the Holiday Park Multipurpose Senior Center in Wheaton, Md. Medicare’s prescription coverage gap is getting noticeably smaller and easier to manage this year for millions of older and disabled people with high drug costs. The “doughnut hole”will shrink about 40 percent for those unlucky enough to land in it, according to new Medicare figures provided in response to a request from The Associated Press. (AP Photo/Alex Brandon, File)/AP
Source: goerie.com

When Should You Sign Up For Medicare to Geat all Your Health Care Benefits

 » Missouri  » Montana  » Nebraska  » Nevada  » New Hampshire  » New Jersey  » New Mexico  » New York  » North Carolina  » North Dakota  » Ohio  » Oklahoma  » Oregon  » Pennsylvania  » Rhode Island  » South Carolina  » South Dakota  » Tennessee  » Texas  » Utah  » Vermont  » Virginia  » Washington  » West Virginia  » Wisconsin  » Wyoming
Source: goodfinancialcents.com

Time to Compare Medicare Plans

Posted by:  :  Category: Medicare

 “Seniors and people with Medicare should act now, review their plan coverage and compare their current plan with other available options,” said CMS Administrator Donald M. Berwick, M.D.  “The important decisions you make now can help ensure that any changes made will be in place by January 2012 for seamless and uninterrupted access to your health care providers and medications at your chosen pharmacies.”  
Source: momentumtoday.com

Video: The Black Professionals News Covers NMA’s Installation of Dr. Cedric Bright

Did You Join The Right Medicare Plan?

The first mistake of joining a plan based on premium alone is normally the result of not knowing how to research plans. If you do not know how to sort through your available options or how to access plan documents you may need the help of a trusted agent. You can also consult with a representative from your local local Area Council on Aging and know that a recommendation is not limited by companies represented.
Source: affordablemedicareplan.com

YoUnGeStEr: About health insurance plan

formularies have CRESTOR on their preferred drug lists. (Fingertip Formulary. Data accessed: Percentage of covered lives – Commercial Plans. Accessed August 17, 2009. Defined as Tier 1 through Tier 7 on Medicare MA, Medicare PDP, and Medicare SN by Fingertip Formulary as of January 2009. Data include covered lives whose prescriptions may be subject to step therapy requirements. Fingertip Formulary. Data accessed: State Medicaid Plans. Accessed August 17, 2009.) It’s important to work with your doctor and ask questions about what therapy is best for both your medical and insurance needs. Prior Authorization: If your doctor thinks you need a certain medication not on your health insurance plan’s formulary, they may request an exception by contacting your insurance company. Sometimes, your doctor may not realize that a prior authorization is required. Pharmacies, along with insurance companies, cannot change therapies without consent from the prescribing physician. If you receive a different medication, you may want to ask your pharmacist if you could get the medication your doctor selected if you obtained a prior authorization. If the answer is yes, you may want to place a call to your doctor requesting that he or she submit the appropriate paperwork so you can receive the medication your doctor prefers. Consumer Savings Program: Consumer savings programs are offered by
Source: youngester.com

Medicare Part D, formularies, competition, pricing leverage and getting it all wrong

“Pradaxa’s high price was always going to prompt some resistance, but Pradaxa’s unfamiliar safety profile will also be feeding conservatism among cardiologists,” said Decision Resources’ Therapeutic Area Director Nikhil Mehta. “Many cardiologists are taking a wait-and-see approach before prescribing Pradaxa widely, preferring the devil they know, even when that devil is warfarin.” Approved for the U.S. market in October 2010, Pradaxa is the only currently available antithrombotic for atrial fibrillation that combines superior efficacy over warfarin and simple dosing that does not require frequent adjustment or monitoring. Three factor Xa inhibitors, Xarelto (Bayer/Janssen’s rivaroxaban), Eliquis and Lixiana (Daiichi Sankyo’s edoxaban), will likely launch in the next two years for the same indication resulting in direct competition with Pradaxa. “Pradaxa’s first-to-market status may give it an initial advantage over factor Xa inhibitors, but brands that achieve incremental improvements over Pradaxa may ultimately achieve greater success given the serious and costly clinical events associated with atrial fibrillation (stroke and systemic embolic events) and the risk of major bleeding with warfarin,” continued Mr. Mehta. Decision Resources market access analysis on the atrial fibrillation drug market includes key insights from primary and secondary research addressing different aspects of market access for atrial fibrillation. The analysis is informed by: Source: decisionresources.com
Source: medicaresupplementalco.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

Lack of Monitoring and Clinical Efficacy Key Drivers of Prerferred Formulary Placement for Pradaxa

“Pradaxa’s high price was always going to prompt some resistance, but Pradaxa’s unfamiliar safety profile will also be feeding conservatism among cardiologists,” said Decision Resources’ Therapeutic Area Director Nikhil Mehta. “Many cardiologists are taking a wait-and-see approach before prescribing Pradaxa widely, preferring the devil they know, even when that devil is warfarin.” Approved for the U.S. market in October 2010, Pradaxa is the only currently available antithrombotic for atrial fibrillation that combines superior efficacy over warfarin and simple dosing that does not require frequent adjustment or monitoring. Three factor Xa inhibitors, Xarelto (Bayer/Janssen’s rivaroxaban), Eliquis and Lixiana (Daiichi Sankyo’s edoxaban), will likely launch in the next two years for the same indication resulting in direct competition with Pradaxa. “Pradaxa’s first-to-market status may give it an initial advantage over factor Xa inhibitors, but brands that achieve incremental improvements over Pradaxa may ultimately achieve greater success given the serious and costly clinical events associated with atrial fibrillation (stroke and systemic embolic events) and the risk of major bleeding with warfarin,” continued Mr. Mehta. Decision Resources market access analysis on the atrial fibrillation drug market includes key insights from primary and secondary research addressing different aspects of market access for atrial fibrillation. The analysis is informed by:
Source: decisionresources.com

11 Things You Need to Know About Medicare Part D

Each Medicare drug plan has a formulary, which is a list of approved drugs that the plan will cover. A plan can make formulary changes throughout the year as long as the changes are approved by the Centers for Medicare and Medicaid Services (CMS) and are posted on the drug plan’s Web site at least 60 days before the change is effective. Those enrollees already taking a drug that is removed from the formulary may continue to have coverage for the drug through the end of the calendar year. Individuals should make sure their current prescription drugs are included on the formulary of any Medicare drug plan in which they are enrolling.
Source: lifehealthpro.com

Medicare Advantage Health Plans

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98There are some options available for you to opt for when you plan to enroll in Medicare health plans. Medicare health plan is the government-sponsored health insurance program that is specially offered for people of 65 years old and over. There are four options available for you to choose from. If you plan for hospitalization you should choose Part A. If you plan for doctor visits you should choose Part B. If you plan for prescription drugs you should choose Part D. If you don’t find one that suits your health care needs, you can choose alternative choice, a Medicare Advantage health plansthat is also known as Medicare Part C.
Source: healthplanscomparison.net

Video: Medicare Advantage Plan Comparison Tool Tutorial

frequently asked questions during the 2012 medicare annual enrollment period / eHealth

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

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 Advantage VS. Medicare Supplement in Texas?

There are other factors to consider. It’s important to compare benefits when comparing premium rates between the two options.  For instance, the premium for Medicare Advantage may be lower than for a Medigap plan, but when prescription drug coverage is added, the premium rate may increase considerably. In addition, with Medicare Advantage, it’s likely that your premium will rise over time. Medigap plans have locked premiums, meaning that they will not increase. Finally, because Medigap plans are guaranteed renewable, you don’t have to worry that your plan will be canceled, even if your health deteriorates. The same is not true with a Medicare Advantage plan. In fact, if your plan discontinues, you will be faced with finding a new plan in your coverage area, or going back to Original Medicare. 
Source: medicareinsurancetexas.com

tufts health insurance private health insurance comparison wps health insurance

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Source: healthinsuranceandmedicareupdate.com

Compare Medicare Advantage Insurance Plans

But this does not warrant you to choose just any Medicare plan you come across. You need to   compare medical advantage plans with a high degree of scrutiny so that you can find a tailor made solution for you. Generally you will need to consider the following details in every Medicare solution that you are offered: Does the plan take age into your account: Generally, age is a very big factor when it comes to choosing the very best Medicare insurance plans? This is because with age our bodies tend to become weaker and weaker. This then leads to you becoming more and more susceptible to diseases. The perfect Medicare plan needs to take this into account. The package that you will want to go with needs to have a special provision for your age. This provision does not have to raise the premiums that you are liable to pay. Basically the perfect Medicare insurance plan should have a blanket premium all over the age groups but this is not very practical. But there are Medicare plans that do not charge exorbitant premiums to the elderly.
Source: medicareinsuranceplans.com

Medicare Supplement or Medicare Advantage: Which Should I Sell?

Changes in funding Now, let’s look at the federal cost to provide Medicare Advantage benefits versus Original Medicare benefits. You may recall that during last year’s health care debate, President Obama cited a statistic that Medicare Advantage costs 14 percent more to the taxpayer than Original Medicare. This statistic came from MedPAC, an independent advisory committee to Congress. MedPAC performs an annual analysis to calculate this statistic, but although the citation was made in 2010, the statistic quoted was based on the 2009 Medicare Advantage plan year.
Source: lifehealthpro.com

Surcharges for the rich to fall as Medicare premiums rise less than expected

Posted by:  :  Category: Medicare

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Source: cjr-cambodia.org

Video: SHIIP Medicare Premiums.flv

Health Beat: “Premium Support” Is Just Another Way To Privatize Medicare

If, as the Times reports, some Democrats are warming to the idea of premium support for Medicare, they are not embracing Ryan’s draconian voucher plan. Instead, they may be reconsidering the merits of a premium support plan championed by Alice Rivlin, director of the Office of Management and Budget during the Clinton administration and Pete Domenici, former chairman of the Senate Budget Committee. During the budget deficit negotiations, Rivlin urged the supercommittee members to consider an insurance exchange for Medicare beneficiaries—with a public option; “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,” the New York Times article explains. The idea of the Rivlin-Domenici plan is to move Medicare toward a premium support model, “without destroying the individual entitlement at the heart of the program.”
Source: healthbeatblog.com

Affluent Seniors Could Take A Hit On Medicare

Democrats have warmed to the idea because they don’t want to cut benefits for more typical Medicare beneficiaries, which includes seniors and disabled younger people, said Robert Blendon, professor of health policy and political analysis at the Harvard School of Public Health. “I think they are so worried about cutting benefits for the mainstream people, in their mind it’s much more important to have the upper-income pay more to keep the program going as it is than it is to start cutting benefits and having more and more people feel that Medicare is not adequate for them.”
Source: kaiserhealthnews.org

Medicare Part B Premiums to See a Change 

New Medicare enrollees on the other hand are not protected by the said provision. It means that those who enrolled in the year 2010 had to shoulder a higher premium rate per month to pay for Part B, while those who enrolled within the year have been paying a higher rate. Sources say that their premiums will drop to the standardized $99.90.
Source: southerndailypress.com

Medicare Premiums and Deductibles for 2012

[…] […] […] With a Cost of Living Adjustment (COLA) of 3.6% for Social Security income in 2012 which averages $43 more in monthly income, these Medicare cost changes will not be as painful as anticipated. The COLA allowed the cost to be distributed across all Medicare beneficiaries, not just the ones who will be new to Medicare in 2012 (as in the past 2 years when new premiums were $115.40 and $110.50). Also, surprisingly, the numbers include lower-than-expected use of medical care and spending growth in the Medicare program. Hopefully the Super Committee will notice.Source: retirementeducationplus.com […]Source: retirementeducationplus.com […]Source: retirementeducationplus.com […]
Source: retirementeducationplus.com

Medicare changes explained in forum

During her program, Landreth covered the four basic parts of Medicare — A (hospitalization and inpatient services), B (medical insurance such as primary care, specialists, outpatient services, medical supplies and preventative screenings), C (Medicare Advantage Plans which replace Medicare A and B such as HMOs and PPOs), and D (prescription drug insurance). She also discussed supplemental insurance programs, which will pick up the 20 percent Medicare doesn’t cover depending on a customer’s level of coverage and two assistance programs (The Medicare Savings Program and The Extra Help Program) that people may qualify for based on income that will pay for Medicare Part B premiums and prescription drug costs. Landreth said that the major change for the upcoming year is the monthly premiums people pay.
Source: co.uk

Is Medicare in Good Shape for the Future?

In 1965, Medicare was signed into law to provide health care for people over 65 and the physically-disabled under 65. In the early years, Medicare was fully funded by Federal Insurance Contributions Act (FICA) taxes, interest earned on trust fund investments, and premiums on people not eligible for Medicare. In 2011, due to people living longer and higher health care costs, most of the funding for Medicare comes from the general budget.
Source: financebuzzonline.com

2012 Medicare Premiums, Deductibles and Co

Medicare beneficiaries will have a lot to smile about in 2012, on average for those that are healthy they can possibly save an extra few hundred dollars, while for physicians and hospitals they will see things get bundled going forward.
Source: hvsfinancial.com

High premiums prevent benefits recipients from collecting "raise"

Late last month, we reported on a cost-of-living adjustment planned for disability benefits recipients, but it now seems that some of the residents with disabilities in Charleston may not get to use much of that “raise” because the insurance premiums for Medicare Part B are expected to rise, as well. For anyone living with a disability, the upcoming COLA is the first since 2009, but with Medicare premiums expected to use up at least one-quarter of the COLA, people receiving disability benefits are getting substantially less money than they originally accounted for.
Source: wvsocialsecuritydisabilityblog.com

Medicare to Take Smaller Bite of Social Security

The high-income premiums are paid by individuals with $85,000 or more in annual income, and joint filers with income over $170,000, and they scale upwards through four income brackets. Currently, the high-income surcharges affect just 5 percent of seniors, but they’re on track to hit 14 percent by 2019 due to the new health care reform law. The income threshold previously was indexed to inflation, but the Affordable Care Act froze the threshold at 2010 levels through 2019, starting this year.
Source: secondact.com

Medicare Premiums and Deductibles Lower Than Expected for 2012

The premium for new retirees in 2011 was $115.40; this group of retirees will now pay the standard premium of $99.90 per month, for a reduction of $15.50 in their monthly premium. New and prior retirees will receive a net increase in their Social Security check, given the recently announced cost-of-living increase (COLA) for 2012of 3.6 percent. The 2012 COLA will increase Social Security monthly checks by an average of $43 per month, more than offsetting the modest Part B premium increase for prior retirees.
Source: agentnavigator.com

Medicare Premiums, Deductibles & Coinsurance: Rates for 2011

Because of the zero COLA increase in 2011, some Medicare beneficiaries will not pay more for coverage. If your premium is deducted from your Social Security check and your income is $85,000 or less ($170,000 if you file a joint tax return), then you won’t have to pay more. Your monthly premium will stay at either $96.40 or $110.50.
Source: suite101.com

Seniors Require Medicare Supplements

Posted by:  :  Category: Medicare

Choose Love Over Fear by elycefelizA community rated plan, for example, will charge each of its participants the same rate each year. However, the cost will change for each member as inflation increases. An attained age plan, on the other hand, will increase in cost as you age, while also adjusting for inflation. Lastly, an issue age plan will base your premium on the age you were when you began participating in the plan. It will also adjust the premium each year in accordance with the current rate of inflation.
Source: wordpress.com

Video: Medicare Supplement Plan G

Victoria’s Voice: Medicare Part D Consumer Guide

We were recently visiting my in-laws over Thanksgiving.  While there the topic came up about Medicare and and how hard it is to either understand how it works or how to keep up with the changes. It can all become very confusing.  The Baby Boomer generation is coming up on retirement and more and more questions are being asked about how Medicare will work for them.  What about your prescriptions?  How are they handled?  
Source: blogspot.com