Windsor Health Plan, Inc. Launches Enrollment for Medicare Advantage Products in 28 Total States

Posted by:  :  Category: Medicare

Amp Board Of Directors Ceo Chattanooga Tenn Common Stock Conference Call Firstcall Fourth Quarter Health Systems Infiniti International Paper Jude Children Knoxville Tenn Launch Llc Logo Marketwire Memphis Tenn Memphis Tn Nasdaq Nashville Tenn Nashville Tn Nationwide Nissan Nissan America Nissan North America Nissan North America Inc Nna North America Inc Nyse Partnership Photos Pinksheets Pinnacle Airlines Corp Prnewswire Shareholders St Jude Subsidiary Tenn Tennessee Tennessee Valley Authority Today Announced That Tva United States Usnewswire
Source: tennesseenewswire.org

Video: Windsor Medicare Extra – about to turn 65.mp4

Windsor Medicare Extra Bought by Sterling

The acquisition should be good for all of us. We need more large Medicare Advantage companies to stay in the market. Smaller companies that don

Medicare Supplement Quote Engine

Posted by:  :  Category: Medicare

Medicare National announced the release of their new Medicare Supplement Quote Engine in order to power online sales of Medicare Supplement products through its own e-commerce site for agents in 16 states. Advisers answer questions about Medicare, Medicare Supplements, Medicare Advantage, Medicare prescription drug plans, long term care and other health insurance concerns.
Source: tonyhawkexperience.com

Video: Medicare Supplement Quote

Medicare insurance Supplemental Insurance

Medicare Portion D is offered to hav it. original Medicare insurance (Parts A NEW and B), allow it to help cover the values of medicines. You must understand this coverage by way of a private insurance underwriter approved as a result of Medicare. Assum you have a Medicare supplemental health insurance policy, exactly like supplemental Medicare insurance insurance, it might already cover the values of meds. But if very easy, you are usually allowed to obtain a Medicare Medication Drug Plan within Medicare Portion D, but should alert your insurance underwriter if you so. Its not all supplemental Medicare insurance plans will give you drug fees, so it is essential to make sure texas medicare supplement you decide upon offers the follow benefit. If very easy, just remember that anyone can still acquire drug coverage by way of a Medicare System.
Source: lugtagzcustom.com

Medicare Supplement Quote Engine

Medicare National announced the release of their new Medicare Supplement Quote Engine in order to power online sales of Medicare Supplement products through its own e-commerce site for agents in 16 states. Advisers answer questions about Medicare, Medicare Supplements, Medicare Advantage, Medicare prescription drug plans, long term care and other health insurance concerns.
Source: mexbox360.com

Treatment Supplemental Plans

Medicare Aspect D can be purchased to hav it. original Medicare insurance (Parts A NEW and B), that will help cover the charges of prescription medications. You must understand this coverage by hav a private insurance corporation approved by way of Medicare. If you have had a Medicare supplement policy, simillar to supplemental Medicare insurance insurance, it may well already cover the charges of drug treatments. But if quite simple, you are usually allowed for any Medicare Pharmaceutical drug Drug Plan for Medicare Aspect D, but should alert your insurance corporation if you undertake so. There were supplemental Medicare insurance plans will take care of drug expenses, so it is very important make sure texas medicare supplement you decide offers the benefit. If quite simple, just remember which you could still get hold of drug coverage by hav a Medicare Schedule.
Source: nanovornews.com

Medicare Supplement Quote in Texas

Most people in Texas don’t know that all the Medicare Supplement plans available in the state are standardized. This means that regardless of who sells it, a Plan F from one company must provide the exact same benefits as a Plan F from another company. While this is great news for comparison shopping, it makes it even more important to stay with trusted names that you know will provide credible, dependable coverage. While all insurance companies must offer the same coverage, they are not the same in terms of reliability and dependability. Choose well-known, established companies like Blue Cross Blue Shield of Texas or United Health Care who have earned the respect and trust of Texans through years of dependable coverage.
Source: medicareinsurancetexas.com

Plan F High Deductible Medicare Supplement Quotes

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

Know The Differences Between Medigap And Medicare Supplement Insurance And How Things Work To Your Advantage

Monthly Premiums. Medicare supplement insurance quote by way of Medigap are actually higher, when contrasted with Medicare Advantage. Medigap asks for monthly premiums, while Medicare Advantage does not always require them, and if it does, at a slightly more affordable price. Medicare Advantage can be cheaper, but Medicare supplement insurance quote from Medigap tend to be more consistent. Medicare Advantage can raise its rates, while Medigap has a more stable premium, especially as policy holders can choose plans that have locked premiums.
Source: articlestem.com

Medicare Supplement Quote Engine

Medicare National announced the release of their new Medicare Supplement Quote Engine in order to power online sales of Medicare Supplement products through its own e-commerce site for agents in 16 states. Advisers answer questions about Medicare, Medicare Supplements, Medicare Advantage, Medicare prescription drug plans, long term care and other health insurance concerns.
Source: twinks-for-cash1.com

Medicare Supplement Quote Engine

Medicare National announced the release of their new Medicare Supplement Quote Engine in order to power online sales of Medicare Supplement products through its own e-commerce site for agents in 16 states. Advisers answer questions about Medicare, Medicare Supplements, Medicare Advantage, Medicare prescription drug plans, long term care and other health insurance concerns.
Source: thehoneybeeconservancy.com

Deadline for Medicare Drug Plan Coverage is December 7, 2011 ACT NOW!

Posted by:  :  Category: Medicare

Senate Dems Protest Medicare Cuts by TalkMediaNewsAbout ABCD: ABCD is the Boston-area antipoverty and community action agency serving more than 94,000 low-income residents annually. Now in its 50th year, ABCD’s critical services and innovative programs empower individuals, families, and communities, providing them with the tools to overcome poverty, live with dignity, and achieve their full potential.
Source: fenwaynews.org

Video: Understanding Medicare Advantage Plans

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

Democrats to oppose GOP Medicare plan

The Los Angeles Times (12/1, Mascaro) reports, “As the Senate prepares to vote on extending President Obama’s payroll tax holiday, the GOP has offered an alternative proposal that would not tax millionaires to pay for it, but instead require those earning beyond $1 million to pay full price for Medicare.” The Times notes, “Democrats are likely to reject the GOP approach, as they oppose cutting Medicare or other government programs unless they are part of broader efforts at federal deficit reduction.”
Source: drpauldorio.com

SilverSneakers Medicare Programs

So, what exactly is SilverSneakers?  SilverSneakers is essentially a gym membership or fitness club membership to participating centers across the country.  You can find participating gyms by going to www.silversneakers.com and typing in your zip code.  You can find out if your Medicare plan offers Silver Sneakers by calling 1-888-423-4632.  Here are some of the features offered by SilverSneakers.
Source: medicare-plans.net

UnitedHealth Buying Medicare Advantage Plan With Chronically Ill Specialty

Bloomberg: UnitedHealth Agrees To Acquire Medicare Managed-Care Insurer XLHealth UnitedHealth Group Inc. (UNH), the largest U.S. health insurer by sales, said it will buy XLHealth Corp., a provider of managed care for chronically ill Medicare members, to strengthen a growth area likely to gain increasing support from the U.S. government as it trims costs. The purchase price was about $2 billion, according to a person familiar with the deal who asked not to be identified because the price wasn’t disclosed. … The purchase of XLHealth, with 111,000 members, is the seventh since Jan. 1 involving companies that manage Medicare coverage (Wechsler, 11/22).
Source: kaiserhealthnews.org

Choosing a Medicare Advantage Plan: Flat Fee Vs. Percentage for Outpatient Surgery

Medicare Advantage plans tell agents and brokers that a patient who goes into the hospital will pay only the in-hospital co-pay (which is $295 per day in Ralph’s plan). So I would have thought his bill would be $590. But because the bill says he was in an “observation room”, Ralph had to pay a lot more.
Source: ourparents.com

Patient Resources for Medicare Choices

ACHD ACO Apparel Awards BULLETIN CME CMS Donations Education EHR Female Physicians Flu Foundation Gala Healthcare Power of Attorney Health Care Reform Highmark HIPAA HITECH Insurance In the News Legislators Living Will MCare Medical Records Medical Supplies Medicare Member Benefit Members Only Mentoring Needleless News OSHA Photo Contest PHP PMS PRHI Products Residents SGR Smoking Social Tech FYI UPMC WPAHS ACMS Foundation (12) Benefits (41) BULLETIN (26) CME (8) Education (11) EHR (8) Employment (6) H1N1 (Swine Flu) (22) HIPAA (8) HITECH (4) Insurance (16) Legal (28) Legislation (40) Medical Students (6) Medicare (22) Membership (35) News (100) Patient Resources (60) Physician Resources (189) Practice Management (16) Uncategorized (8)
Source: acms.org

Four Things To Remember Before the Dec. 7 Medicare Enrollment Deadline 

Is your doctor still contracted with your Medicare Plan? Senior citizens need to check if their primary care doctor is still contracted with their Medicare plan. If the doctor is not, you will be assigned to a new doctor by the health plan. If you are seeing a specialist who serves a unique section of medicine, for example diabetic care, you need to make sure that your doctor is still accepting your Medicare plan. You do not want to be in a situation where your doctor does not accept your Medicare plan, and you have to look for another specialized doctor who does.  Most doctors contract with multiple Medicare plans, so keeping your doctor can be as easy as switching to a new Medicare plan.
Source: inlandempire.us

Medicare Open Enrollment Deadline Is Almost Here

Qualified applicants still have three methods to figure out what plan works for them: physical brochure, hotline, or via the Plan Finder found at medicare.gov. The annual “Medicare and You” handbook is sent to every eligible Medicare recipient. It’s custom tailored to the location where the beneficiary lives and lists all of the different plan options.
Source: wobm.com

Medicare’s Open Enrollment Deadline Coming Soon

Face-to-face: At Open Enrollment events across the country, Medicare has been working closely with its partners across the nation to provide counseling opportunities for people with Medicare in their home communities. More than a thousand events with Medicare beneficiaries have been held across the country – and thousands of SHIP counseling sessions have been conducted. CMS and its partners have shared unbiased drug and health plan information at senior activity centers, through education-oriented media partnerships and phone banks and with other advocacy partners in unique local venues and faith-based communities. These events also highlight Medicare’s preventive services, including flu and pneumococcal shots and health screenings. For more information contact your local Area Agency on Aging, State Health Insurance Program or other unbiased senior advocacy organizations. Contact information for local telephone or face-to-face enrollment resources and year round assistance can be found on the back pages of your Medicare & You handbook.
Source: newhorizonsilc.org

About Supplemental Health Insurance

Posted by:  :  Category: Medicare

HHS-DSC_0104 by USDAgovGenerally, the majority of supplemental health insurance plans will pay anywhere from 40% to 80% of the cost of healthcare service needs such as vision, dental, hearing aids, psychologists, certain medical equipment, chiropractors, podiatrists, and even health care if traveling out of the country. When looking at health plans, find out about such issues as: family coverage that include children costs, individual coverage costs, limitations, what the plan covers, coverage regarding emergencies, pre-existing condition issues, coverage for specialists, how a claim is paid out and how much is paid out, the amount of the deductible, monthly cost of the plan, type of prescription drug coverage, does missing a payment mean cancellation of the policy?, does the plan cover dental and vision?, etc.
Source: 888jeffcline.com

Video: Health Insurance : How to Get Supplemental Dental Insurance if Your Employer’s Plan Is Not Enough

Supplemental Health Insurance

Many policies will have different benefits so it is advised that you should thoroughly examine any policy you’re offered, try not to take one just because it’s cheaper as doing this could lead to an unexpected bill because you don’t have the right medical cover. Supplemental health insurance is very strongly geared towards people and families who would not be able to afford the medical costs if something serious was to happen. This can include self employed people, low income families and a lot of people working in civil defense positions ie, soldiers and air force recruits.
Source: insurancefounder.com

What Supplemental Health Insurance Entails

Statistically, chances of developing cancer increases with age with over 77% of cases occurring to those over the age of 55. Also, it is more prevalent in men with a chance of 1 in 2 as compared to 1 in 3 for women. This makes cancer insurance premiums higher in those brackets but with the ongoing sensitization we hope to see a change in the statistics in coming years pushing the ages of prevalence further down. Having cancer insurance seems to be related early detection or screening such as mammograms. Twice as many people who have been screened have insurance. Poor access to cancer insurance has also been noted to be caused by racial disparity. Not having insurance means increased risk of death within 5 years by 1.6 times more than those who are insured. The insurance premium figures change yearly and even with the budgetary constraints in the wake of the recovering economy cancer insurance policies are being outlined more and more in favor of cancer victims.
Source: articlesalive.net

Supplemental Insurance Coverage

When using a website to get Supplemental Insurance Coverage, you simply need to fill out basic information on a form.  Quotes from various providers will be gathered and you will be able to review the policy figures and all prices from the different health insurance providers.  In the end you can choose the insurance policies that provide what you need and that are financially sound.
Source: danasfields.org

Medicare Supplemental Health Insurance

Medicare Supplement insurance comparability is that there are many companies that make this company as a way to attract new customers. Comparison is made between a company and another. This is because competitors in the market and it looks like a race, who would sell insurance to cover all the customers. The Medicare Supplement Insurance comparability can be achieved by taking surveys of buyers and sellers, how they cope and how they treated him to run. This method of comparison of Medicare supplement insurance coverage may be terminated by the trade name of the TV or through the words in the mouth immediately ask the number of insurance issues. The comparability of Medicare supplement insurance in many aspects, such as only benefit the customers considered. He has to examine whether Medicare Supplement plan is good or bad out there, and if he feels that it changes, then we the citizens can approach her and make adjustments so that the customer wants in the market. Medicare Supplement Insurance Health care is something that simply rely on the health and ensuring that the interest comes ahead of the best in another company to him and buy button. The plans are likely to encourage many health insurance companies and among them is a Medicare Supplement plan to select him, and this could be due to changes in customer behavior, tastes and preferences are. The head of the company will decide a plan and consult with others and that directed the Medicare Supplement plan and do things in a business perspective, since they would earn more revenue and less productivity and less capital. Medigap plans are totally different, where the company into what people do with low income and I think as a result of the recession because people consider lowering the rate.
Source: psientology.com

Supplemental Family Heath Insurance

More families are choosing to acquire Supplemental Family Health Insurance. If you are starting a family or have small children, you want to make sure that have the coverage you need for a range of health issue needs. Whether you have a government plan or health insurance plan from an employer, you may not have the coverage you require for you and your family. Before an emergency happens, it is important to review your current health insurance plan to see if you are lacking coverage in certain health services areas. By doing so, you can then determine which types of supplemental family health insurance you need.
Source: nextlevelarticles.com

Supplemental health insurance

Cancer treatment is expensive and most times the normal insurance cover cannot meet all the costs involved. This covers ensure that if ever one is faced with such a predicament, they won’t have to dig dipper into their pockets to pay for the extra expenses. Most of these plans also take into the account the time one may have to leave work to receive treatment. Cancer cases keep rising, and recent statistics conducted in America indicate that 1 out of every three women and 1 in two men are likely to be diagnosed with cancer at one point in their life. This should be a wakeup call to many people as the costs associated with treating cancer are very high, and it’s important to get a
Source: pinehurstinvitational.com

Advantages Of Choosing Medicare Supplemental Insurance

With the rising cost of health care many seniors and disabled people are finding out the benefits of having Medicare supplemental insurance to cover the gaps in their regular health plan. It provides coverage beyond what you would get solely from Medicare itself.One advantage of having this type of insurance is the cost savings. Expenses you would normally have to pay out of pocket are covered with the supplemental health plan. In case you have an extended hospital stay, need in home health care services or prescription drug coverage, you will have peace of mind in knowing you are provided for by having supplemental insurance coverage.There are many extended health plans to choose from and the best way to find a plan or policy to fit your needs is to do your homework. Research each and every plan available and learn what is covered and what is not and how much your monthly premiums will be compared across the board.This will be a huge benefit to you because you will see many different types of plans and be able to make an informed decision about your health care coverage. Knowledge is power and this power gives you the ability to make the best choice available. Know what you are looking for and what you need and find out about the different plans available today that offer that extra coverage you need.Another benefit of many extended plans is that when you become disabled you will be able to get the services you need and the policy may include a cash benefit payable to you to cover your living expenses. Many of the plans available that cover the gaps in your regular health plan are indemnity plans that pay a cash benefit to help pay for your medical expenses. This cash benefit can be the entire medical bill or a percentage of it depending on the type of plan you select.Of the many advantages that are available you will most appreciate the extended coverage you get that would otherwise be unavailable to you with single policy coverage alone. These extended benefits can include hospital indemnity benefits, low cost prescription drugs which can save you money and all your medical bills paid for by the plan with minimal to no out-of-pocket costs to you.When selecting a plan for your needs make sure you take into consideration your future needs and anticipate any and all changes that may occur during your lifetime. There are even cancer benefit plans available and long-term plans that cover you if you become severely ill or must stay in a facility.Medicare has changed over the years and does not cover what they used to, that is why an extended coverage plan is needed to cover the gaps in a Medicare plan. You have many options from which to choose and it all depends on your individual needs and what you can afford to pay at the time. It is to your advantage to have something to back you up financially because your future depends on it.
Source: 411insurance.com

Choosing Supplemental Health Insurance For Senior Citizens

Premiums increase to adjust to inflation and due to the methods obsolete to calculate them. On the first day of January, Medicare benefits are adjusted to sustain up with inflation. Because all these insurance benefits are coordinated with Medicare, premiums for supplemental plans will change accordingly.The three different methods used to site premiums are exercise the attained age, pronounce age and community rate outrageous. The attained age set premiums rise as you earn older. These increases are in addition to those due to the annual adjustments to inflation. The deny age premiums are based on the age at time of indulge in. They will not increase with age; but, they will rise to accommodate inflation adjustments. Community rate premiums are the same for those residing in the same geographic dwelling. The optimal policy choice taking this into represent would be deciding the support combination most aesthetic, then purchasing by looking at the policy with the lowest premium using the issue-age or community-rate space of calculating the premium.
Source: medicaresupplementalinsurances.org

Medicare Supplement Insurance for 2012 : legal

Learning about Medicare supplemental plans, is essential for those purposes. Part A: This handles your hospitalisation costs. You can also use this for house nursing or hospice, in the event that directly related for your condition. Part B: This particular relates to the actual Outpatient costs. You are to pay premiums right here. Part D: Deals with health insurance programs. They are being offered by private insurance agencies in 2012, as approved by the Government to provide such services. Part D: Covers prescription drugs. If the medicines are covered here, this can be used program to fix it.
Source: legal-marketing-center.com

Medical Insurance and Supplemental Insurance (paying for pregnancy)?

Okay, my husband and I would LIKE to start trying to conceive 3-6 months from now. We do not have medical insurance provided through his work so we need to explore other options. Also, we are both full time college student however, school does not provide student medical insurance. I have found some student insurance policies but they really only cover emergency room visits.
Source: satelec2003.com

Completed My CEEAA Course

Posted by:  :  Category: Medicare

I wish to thank Ms. Franko for her assistance in teaching me about billing for physical therapy. I have recently been assisted in the appropriate coding for speech. There are so many nuances that are not covered in the Medicare material. Ms. Franko is a genius in letting us know how to maximize the appropriate coding and billing techniques. I not only appreciate her knowledge, I appreciate her ability to break it down for the small clinics and persons like me who have minor knowledge of billing.
Source: encompassmedicare.com

Video: Fresh Perspectives: MEDICARE

A Look at Berwick's Tenure as Medicare Chief

As Dr. Donald M. Berwick prepares to step down later this week as administrator for the Centers for Medicare and Medicaid Services, there remains plenty of controversy over whether he was the best choice for the job. As my colleague Robert Pear noted in an article about his resignation, Dr. Berwick “became a symbol of all that Republicans dislike in President Obama’s health care policies.”
Source: nytimes.com

Medicare Sets Sights on Obesity Prevention

“It’s important for Medicare patients to enjoy access to appropriate screening and preventive services,” he said.      The service will teach those who qualify how to eat healthier and lose weight. Counseling will take place every week for one month and every other week for the following five months.      If a patient is losing weight, the sessions can continue for an additional six months.
Source: cbn.com

Medicare to cover obesity counseling, screening

Medicare patients who lose at least 6.6 pounds (3 kilograms) during the first six months of counseling would be eligible to receive addition face-to-face counseling once a month for an additional six months for up to a total of 12 months of counseling, the agency said.
Source: megasimplediet.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

Medicare Expands Competitive Bidding Program (DMEPOS)

Under the program, DMEPOS suppliers compete to become Medicare contract suppliers by submitting bids to provide certain items in competitive bidding areas (CBAs). The new, lower payment amounts resulting from the competition replace the fee schedule amounts for the bid items in these areas. The first phase of the program was successfully implemented for nine product categories in nine areas of the country on Jan. 1, 2011. To date, CMS monitoring data have shown a successful implementation with no changes in beneficiary health status. Today, CMS released the detailed schedule for Round 2 bidding. Registration will begin on December 5, and the 60-day supplier bidding period will begin in late January of 2012. Round 2 expands the program to 91 additional metropolitan areas, and the new prices are expected to take effect on July 1, 2013. A National Mail Order Competition to help bring down prices for mail order diabetic supplies will coincide with the Round 2 timeline. The bidder education program launched today is designed to guide suppliers through the competitive bidding process and will feature numerous enhancements such as improved Request for Bids instructions, updated fact sheets, and a series of webcasts that suppliers will be able to view at their convenience. Information and materials may be found at www.dmecompetitivebid.comand a toll-free help line (1-877-577-5331) is available to assist bidders with questions and concerns.
Source: myedutrax.com

How much you’ll pay for Medicare in 2012

Posted by:  :  Category: Medicare

If you’re a high-income beneficiary and your income has fallen since 2010 (the tax year used to determine your 2012 premiums) you may be able to reduce or eliminate your Medicare Part B premium surcharge. To qualify, your income loss must be tied to a life-changing event such as a marriage or divorce, a job loss or reduced work hours (including retirement), loss of income from income-producing property, or cuts in pension benefits. To learn more, see ssa.gov/pubs/10536.html.
Source: pomeradonews.com

Video: HHS Secretary Sebelius Introduces the New Medicare.gov

Medicare Open Enrollment: 3 C’s for Thanksgiving Dinner

       2.    Coverage:  While health care needs can be hard to predict, looking backward can help.  Think about the past year of health – does your loved one have new or different health concerns that may require different services and benefits in the coming year?   Look for plans with a 5‑star performance rating — the right expertise and care may help speed your recovery and improve your outcomes.  Rest assured that no matter what plan you pick, the Affordable Care Act provides access to a variety of preventive services and screenings, at no cost.
Source: medicare.gov

Medicare Open Enrollment 2011

These are really two different questions. First, we are currently in the AEP (Annual Election Period). It runs from Oct. 15th through Dec. 7th. This is when you are able to make changes to your current Medicare plans whether it is prescription drugs or medical plans. What I think you are talking about is called the General Elecion Period. If you didn

VIVA MEDICARE Plus Earns Highest Quality Rating Score in Alabama for Second …

Posted by:  :  Category: Medicare

Aamir Khan Akshay Kumar Amar Upadhyay Amitabh Bachchan Argentina Baggers Bites Big Boss Bigg Boss Celebrity Gossip Cheryl Cole Delhi Belly Frankie Cocozza Hrithik Roshan Imran Khan India Ka Jhatka Kareena Kapoor Katrina Kaif Kaun Banega Crorepati KBC Lady Gaga London Mark Wright Mumbai NDTV Pooja Misrra Priyanka Chopra RA Ranbir Kapoor Salman Khan Sanjay Dutt Shah Rukh Shah Rukh Khan Shahrukh Khan Shakti Kapoor Simon Cowell SRK Star Plus Sunny Leone Total Wipeout TOWIE TV US Zor Ka Zor Ka Jhatka
Source: zorkajhatka.org

Video: AARP Presents: Mayte Prida’s Story (English Version)

VIVA MEDICARE Plus Earns Highest Quality Rating Score in Alabama for Second Year in a Row

[…] • Visiting medicare.gov, where they can get a personalized comparison of costs and coverage of the plans available in their area. The popular Medicare Plan Finder tool has been enhanced for an efficient review of plan choices. Spanish Open Enrollment information is available. • Calling 1-800-MEDICARE (1-800-633-4227) for around-the-clock assistance to find out more about coverage options. TTY users should call 1-877-486-2048. Multilingual counseling is available. • Reviewing the 2012 Medicare and You handbook. It is also accessible online at: medicare.gov/publications/pubs/pdf/10050.pdf —  and it has been mailed to the homes of people with Medicare. • Getting one-on-one counseling assistance from the local State Health Insurance Assistance Program (SHIP). Local SHIP contact information can be found at medicare.gov/contacts/organization-search-criteria.aspx, on the back of the 2011 Medicare and You handbook, by calling Medicare or through a listing of national stand-alone prescription drug plans and state specific fact sheets that can be found at cms.hhs.gov/center/openenrollment.asp.Source: mtdemocrat.com […] Source: mtdemocrat.com
Source: medicaresupplementalco.com

How to Protect Money Against Inflation

Eduardo J. Ramos, head of Freedom Advisory, based in San Juan and Chicago, agrees. "There are forces at work that will create inflation, such as the rising demand for commodities. But there are also forces working in the opposite direction, such as the import of much-lower-priced goods from China and from other emerging countries." And oil? "Oil prices go up, and down, and up again —  but always with an upward-trend bias," he says.
Source: aarp.org

Fewer Children Are Uninsured with Health Insurance According to US Study

Posted by:  :  Category: Medicare

With two state funded programs, Medicaid and CHIP (Children’s Health Insurance Program) parents are more easily able to apply for these programs due to streamlining in application processes that were one of the results of President Obama’s signing an extension for CHIP and giving $87 billion dollars in funding to help states pay for Medicaid programs. With easier application methods, such as applying online, when previously, only in person applying was allowed, parents are finding it easier to apply, and that leads to decreases in the number of children without health insurance.
Source: z6mag.com

Video: How to Apply For Medicaid in Florida Online

Ohio Benefit Bank Mobile Express: Blood From a Stone

So I did what I could to fix it. I helped them fill out the SNAP/Medicaid application. Having been on SNAP, they were familiar with the questions I was asking. I asked them to call their caseworker since only one household member was on their SNAP case. For PIPP Plus, if that goes through, their electric bill will go down from over $100 per month to $10. That’s 90 more dollars monthly in pocket. Heck, these guys were eligible for OWF Cash Assistance too. We are talking about over $500 in monthly benefits. Selling blood to give your child a sense of normalcy should never have to happen. Nor should a six-year-old go without health insurance. I was so happy that this family, with a sugared up six-year-old in tow, was willing to spend 45 minutes with us going through all of these applications. They left happy and I felt as satisfied as I ever have working with low income clientele. I wish this were a perfect world where the need wasn’t so great, but we all know this isn’t that world. It should be noted that Erin and I helped other clients in less extreme circumstances apply for benefits. A few SNAP applications, lots of HEAP this time of year. And some voter registrations. But more on voter registrations tomorrow…
Source: blogspot.com

Medicaid Application Details

As you complete your Medicaid application, be sure to include accurate information. Additionally, provide any documentation that is requested. This may include: birth certificate; proof of citizenship; recent paystubs; proof of other income; proof of where you live; and an insurance card if you currently have coverage.
Source: retireeasy.com

CMS Announces $523 Medicare, Medicaid, & CHIP Enrollment Application Fee for 2012 : Health Industry Washington Watch

2012 application fee for institutional providers (excluding physicians and nonphysician practitioners) enrolling in Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) will be $523 – up from $505 in 2011. CMS uses a broad definition of institutional entities subject to the application fee; it applies to “any provider or supplier that submits a paper Medicare enrollment application using the CMS-855A, CMS-855B (not including physician and non-physician practitioner organizations), CMS-855S or associated Internet-based PECOS enrollment application.” As authorized under CMS’s February 2011 final Medicare/Medicaid/CHIP provider screening rule, institutional providers must pay the application fee when initially enrolling in the Medicare or Medicaid programs or CHIP; revalidating their Medicare, Medicaid or CHIP enrollment; or adding a new Medicare practice location (unless a hardship exemption applies).
Source: healthindustrywashingtonwatch.com

Connecticut: Connecticut Medicaid Application

Mystic Seaport and the connecticut medicaid application on the connecticut medicaid attorney to go out with your partner can picnic or go and see them in Connecticut beaches. Connecticut has to suffer a lot. This can lead to increased financial aid officer. The word match offends some financial aid forms and getting a financial aid that a good experience especially to get completely 100% out of a traditional Connecticut mortgage lenders would offer lower interest rates to Connecticut should include the connecticut medicaid attorney of Litchfield where you can join. You can also go to the connecticut medicaid program from parades to sea food festivals and everything that one could actually find Connecticut commercial real estate property at the connecticut medicaid program and Watch Museum. Just a little south in Waterbury is Time Expo, and a good deal of the connecticut medicaid waivers who frequent them. As you travel up the connecticut medicaid application from Manhattan, you’ll pass through the connecticut medicaid application of the connecticut medicaid application from Greenwich to Bridgeport, each with it’s own flavor and personality. The beaches and Harbors. For those people looking to invest in commercial real estate. This is what the dual diagnosis treatment centers for mental illnesses is the Civic Center which features sporting and cultural events, shops, restaurants, and luxury apartments in a certain order? Well let me tell you that after reviewing hundreds of thousands of visitors, enthusiasts, professionals, and tournament players year-round. This Connecticut casino industry thrives.
Source: blogspot.com

Medicaid Changes for December 2011

-          Medicaid recipients receiving Social Security as their only source of income will not need to renew their Medicaid cases, if their resources were below 85% of the Medicaid resource level at the last renewal or at application, whichever was later (the Medicaid resource level is $13,800 for a single person and $20,100 for a couple). SSI-related recipients should receive a notice informing them that their Medicaid coverage will continue unchanged and explaining that they do not need to respond to the mailing unless they have change to report in income, resources, health insurance or residence.
Source: specialneedsnewyork.com

The Importance of Pursuing Mental Health Integration

In summary, the reasons for integration are grounded in the desire to enhance access to both primary care and behavioral wellness services make sure that there are evidence-based practices as well as consistent communication and coordination of clinical activities (especially medication management-a key concern of customers) among the providers serving any single individual wed the skill sets of primary care physicians and BH clinicians in order to much better manage chronic wellness problems and, participate in and shape the public policy debate regarding how services ought to be organized, delivered and financed in methods that make sure that requirements of public sector SPMI/SED consumers and the broader community alike are met.
Source: riao2010.org

Health Care Innovation Challenge

The health care workforce of the future will be highly focused on prevention, care coordination, care process re-engineering, dissemination of best practices, team-based care, community-based care, continuous quality improvement, and the use of data to support new care delivery models. Training and educational experiences will be needed to help develop this knowledge and these skills. Current reimbursement payment policies do not necessarily support such workforce needs.  They can, for example, be prescriptive regarding the type of individuals providing care. Yet there are many care coordination models that utilize less expensive but potentially highly effective individuals who are trained to interact with patients in a focused way to address preventive health and chronic conditions (e.g., community health workers). There is a shortage of such individuals today, even as we are moving toward a health care system based on effective care coordination and prevention.  Additional examples could include but are not limited to: the use of personal and home care aides to help the elderly age at home; expanding the use of community-based paramedics to provide basic services to extend available primary care resources in rural communities; and the use of community-based nurse teams working with primary care practices to provide intensive care management for the most complex patients.
Source: cccblog.org

CMS creates a new Innovation Advisor program

“We seek to support and expand the number of health care leaders with the knowledge and the vision to find innovative ways to improve care for patients and use our healthcare dollars more wisely,” said CMS Administrator Don Berwick, M.D.  “The CMS Innovation Center is an ideal host for this network of experts. It will support their work on efforts that can strengthen public-private partnerships and ensure patients can spend more time with their doctor and get higher-quality care and lower costs.”
Source: jhconline.com

Analyzing the Effectiveness of Florida’s Medicaid Reform Pilot Program

The Reform Pilot showed the importance and impact of tracking patient satisfaction and health outcomes—something too few states do even now. Building on this, the Statewide Reform requires plans that are awarded contracts for each region to maintain those contracts, absent gross negligent behavior, for five years. This provides continuity for patients and encourages long-term provider contracting and better networks for patients. In addition, plans are required to increase reimbursement to physicians, matching Medicare rates, to expand access; host online the listing of the prescription drug formulary; accept prior authorization requests electronically; have adequacy standards for provider networks; publish quality data measures online; and host an up-to-date online service that shows patients the physicians, specialists, other health providers, and hospitals in their networks, as well as whether or not they are accepting new patients and their contact information and working hours.
Source: heritage.org

The American Legal Journal

The look-back period is the time preceding the person’s application for Medicaid during which asset transfers will be reviewed. The look-back period simply means that after a certain amount of time has passed, Medicaid doesn’t inquire whether the elderly person gave away property. However, a transfer within the look-back period will be questioned and, if something of equal value was not received in return, a penalty will be applied, which will prevent the person from receiving Medicaid long-term care benefits until that penalty period expires.
Source: americanlegaljournal.com

How much you’ll pay for Medicare in 2012

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SSIf you’re a high-income beneficiary and your income has fallen since 2010 (the tax year used to determine your 2012 premiums) you may be able to reduce or eliminate your Medicare Part B premium surcharge. To qualify, your income loss must be tied to a life-changing event such as a marriage or divorce, a job loss or reduced work hours (including retirement), loss of income from income-producing property, or cuts in pension benefits. To learn more, see ssa.gov/pubs/10536.html.
Source: pomeradonews.com

Video: Guide to Medicare Part A and Part B

Studying The Nature Of Change In Our Aging, Changing Brains

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

AffordableONE Insurance Wants Local Residents to Start the New Year Right With Florida Medicare Supplemental Insurance

Many people take time during the holiday season to stop and think about the things that are most important to them in life, including their family, friends and personal well-being. In addition, New Years resolutions are made in order to establish personal goals for the upcoming year. One common goal among older Americans is to save money whenever possible, and one of the biggest expenses for individuals in this age range is medical care. Thats why the team at AffordableONE Insurance wants local residents to take advantage of this time to purchase Florida Medicare supplemental insurance, which can help them save money on the health care expenses that Medicare Parts A and B do not cover.
Source: americanonews.com

Understanding Medicare and Medigap Insurance

Medigap insurance supplements are each unique and will want to be picked based upon the need of the individual. For instance, clients who need help with copayment and deductibles for basic benefits will want to choose Medigap plan A for those are the items that it helps cover. This plan is attractive for it is the least expensive plan available and is accepted by all doctors who accept Medicare. Drawbacks come with each and every plan available. The major drawback to plan A is that it covers basic necessities and not items such as long term care, skilled nursing, vision care amongst several other major areas of expense.
Source: articleslash.net

Four parts combined in Medicare coverage

• Medicare Advantage (Part C) skeleton generally cover many of a same advantages a Medigap process would cover, such as additional days in a sanatorium after we have used a series of days Medicare covers. People with Medicare Parts A and B can select to accept all of their health caring services by one of these provider organizations underneath Part C. There competence be additional premiums compulsory for some plans.
Source: 4-liability.com

Less Than Two Weeks to Stop 29.4% SGR Cuts to Medicare/Tricare January 2012

This situation impacts almost everyone because providers will simply increase their fees and those not on Medicare will pay more, insurance rates will increase to cover these additional costs.  It really will impact military retirees over age 65 because their Tricare For Life (TFL) requires their participation in Medicare Part B.  Thus the Broken Promise of “free life time health care” now typically requires annual payments in excess of $1000, per participant.  The current administration has proposed further cuts in Medicare/Tricare.
Source: boogai.net

Bill Aims To Help Rural Clinics Get Medicare EHR Incentive Pay

Posted by:  :  Category: Medicare

HELP ME HELP MYSELF! by eyewashHe said rural clinics “should not be discriminated against simply because they bill Medicare differently than hospitals or other health care practitioners who practice in rural areas” (Schock release, 11/17).
Source: ihealthbeat.org

Video: TMA Urges You to Help Stop the Medicare Meltdown!

Medicare Announces Timeline, Starts Bidder Education for the DMEPOS Competitive Bidding Program Round 2 and National Mail

Suppliers wishing to bid in Round 2 or the National Mail-Order competition should be taking steps to prepare for these competitions.  Suppliers interested in bidding are responsible for ensuring that certain key information in their enrollment files at the National Supplier Clearinghouse (NSC) is up-to-date and that they obtain all required state licenses for the items, and in the areas, for which they wish to bid.  Any enrollment updates or required licenses not already on file with the NSC should be submitted right away.  Suppliers interested in bidding for a product category for which they are not currently accredited must take action immediately to get accredited for that product category.  Only suppliers in good standing that have all required licenses and are properly accredited can be awarded a contract.
Source: thecre.com

National Family Caregiver Month

Looking for assistance and information? We can help. Ask Medicare has tips sheets, videos and practical information for caregivers, including tips on what every caregiver should know and answers to your Medicare questions. As a caregiver we know you’re juggling a lot, so we put it all in one place to save you time.
Source: medicare.gov

Obama’s Medicare nominee gets GOP leader’s support

Cantor said he is convinced that Tavenner is committed to preserving the role of the private sector in health care. Responsibility for health coverage in the U.S. is close to evenly split between federal and state programs like Medicare and Medicaid, and workplace and private insurance. Republicans charge that Obama is trying to engineer a complete takeover by government, while the president insists his way is the best approach for preserving a system of shared responsibility in the face of unsustainable cost increases and millions of uninsured.
Source: ktiv.com

Medicare's drug coverage gap shrinks, helping those with high costs

This year, the law provides a 50-percent discount on brand name drugs and 7 percent break on generics. Next year the discount on generics rises to 14 percent. When the changes are fully phased in, beneficiaries will still be responsible for their annual deductible and 25 percent of the cost of their medications until they reach catastrophic coverage.
Source: columbiamissourian.com

Medicare Extra Help Program

401k appliance savings auto insurance bad credit car car insurance car loan college savings conserve water coupon savings credit credit card debt credit cards credit report credit score fico flood insurance food savings gas grocery savings halloween savings health care Homeowners Insurance housing insurance interest interest rates investing ira life insurance loans mortgage phone bill pmi refinance refinancing mortgage retirement retirement accounts retirement plans retirement savings roth ira save money saving money stock market investing taxes
Source: moneysavingtips.org

How To Find Medicare insurance Supplemental Insurance And Obtain The Best Rates

Supplemental Insurance, you will find that you will find a couple of issues you will want to take into account when using for any new policy. Naturally, many people may stress over this, however, you should not because you will find plenty of distinct assets available on the market that will help you on the way. You will find 12 diverse intends to choose from so do not get overcome, we can help you understand them. When it comes to determining upon a insurance carrier, the procedure might end up being somewhat difficult. Listed here are a couple of recommendations for having the ability to feel the procedure for choosing a Medicare insurance Supplemental Insurance policy.
Source: pleadon.com

Find The Medicare Insurance Ideas That Can Help

Before any major procedures, confirm if you want to get pre-authorization from your insurance provider and make sure they check up on every aspect of your procedure. Stories about of individuals receiving large bills since the anesthesiologist was out of network, or that you simply needed to try a different medical option prior to going for a surgery. Save yourself the headache and get everything in writing before heading in to the hospital.
Source: group-travel-insurance.com

Medicare Part D: Vendors to Help Prevent Prescription Fraud

In response, the CMS is now requiring Medicaid Part D sponsors to confirm the validity of Drug Enforcement Administration numbers on drugs listed in schedules II through V or map National Provider Identifier numbers to the prescriber’s DEA number. It also requires that sponsors confirm that the controlled substance is within the prescriber’s scope of practice to prescribe and that all identifiers are valid and active.
Source: healthcaredatasolutions.com