Raising the Medicare Eligibility Age Is Almost Surely a Bad Idea…

Posted by:  :  Category: Medicare

Some Democrats and advocates for the elderly say the idea of raising the age may sound like a smart fiscal move but that it has more drawbacks than appear at first glance. They say it would shift costs to older Americans and to government programs other than Medicare, and have ripple effects that can boost people’s out-of-pocket costs in the private insurance market.
Source: typepad.com

Video: Medicare Part 1: Eligibility and Enrollment

Don’t hike eligibility age for Medicare recipients

Good point Anonymous EE student. I am a 2002 grad of Electrical Engineering and Computer Science from a prominent top-rated university. Graduating in admist the tech bust, tech firms were doing no hiring and were laying off massive numbers of people. When hiring finally came back circa 2005-2006, most of the new hires were foreigners on the H-1B visa program, not US citizen applicants who were hitting the resume queues in droves. My resume was summarily thrown in the trash. Tech salaries have dropped preciptiously in real terms, and the anecdote you describe, of 100 applicants for 1 actual job is very common.
Source: centralfloridafuture.com

Raising the Medicare Eligibility Age Costs Money

The fundamental purpose of deficit reduction is to strengthen the economy over the long term. The relentless rise in health care costs is the key driver of projected long-term deficits that policy­makers must address. But reducing federal health care costs by raising state and private-sector health care costs even more makes little sense, as it only increases the burden that health care costs place on the economy as a whole. The goal should be to slow the growth of health care costs system-wide, while extending coverage to all Americans. This proposal does just the opposite on both fronts — raising costs system-wide and increasing the ranks of the uninsured.
Source: firedoglake.com

Healthcare CEOs want raised Medicare eligibility age to curb costs

In the Healthcare Leadership Council’s (HLC) proposal, it urged the bipartisan committee tasked with trimming at least $1.22 trillion from the national budget over the next decade to gradually increase the Medicare eligibility age by two months each year, until it reaches 67, reports Bloomberg.
Source: fiercehealthcare.com

Monkeying with the medicare eligibility age

ACA will offer very large subsidies to individuals with low or moderate incomes who buy insurance through the exchanges.  People with incomes below 133% of the poverty level will qualify for Medicaid.  People with incomes between 133 and 400% of poverty will qualify for premium subsidies.  At 133% of poverty, they only have to pay 3% of income (about $600 per year for a couple at 2011 income levels).  At 300% of poverty, they’d have to pay 8.05% of income (or about $3,550 for a couple with income of $44,000).  A lot of lower-income seniors will face lower premiums through the subsidized exchanges than they’d pay in Part B and Part D (prescription drug) premiums for Medicare.  (A full comparison of costs including copays and deductibles as well as premiums is beyond me, but maybe a health expert will weigh in with more information.)
Source: theincidentaleconomist.com

Raising Medicare Eligibility Age: Who Gets Hurt?

In addition, there are components to Medicare that need to be evaluated separately for each has its own characteristics: Hospital Insurance (HI) or Part A and Supplementary Medical Insurance (SMI) which includes Part B (e.g doctor visits), Part C (private plans that contract with Medicare to provide Parts A and B) and Part D (drugs).  Much attention has been already given to economies and efficiencies in Part A and many changes are in progress; Part B is an area that needs additional attention given the rapid increases in costs; Part C, such as the Advantage Plans are expensive and should be given additional scrutiny; and Part D is a great way to achieve big gains through drug purchases in the same way as the VA.  And, of course, persistent efforts to root out fraud.  
Source: talkleft.com

Romney Unveils Plan To Revamp Medicare, Medicaid

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

Daily Kos: Hospitals lobby for Medicare eligibility age hike

Consider if one or more of these tags fits your diary: Civil Rights, community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don’t fit in any of these tags. Don’t worry if yours doesn’t.
Source: dailykos.com

United Healthcare Medicare Solutions

Posted by:  :  Category: Medicare

Jobs in Portland OR: Due to market expansion, we have immediate openings in our Senior Health Insurance Products Division. This is a career agent position, and requires a State Health Insurance License. United Healthcare is a 55 Billion Dollar company, with over 73,000 employees, and over 70 million customers. Named by Fortune Magazine as the most admired Health Insurance Company in the World, United Healthcare truly has a lot to offer. We provide year round marketing and training support, specific to your market. We provide personalized lead support, dedicated training, and ongoing coaching. We also offer a full agent contract, no assignment of commissions, no separate contract to sign, you would be directly appointed with United Healthcare. This means that you own your own book of business. Our exclusive and proprietary marketing campaign is ongoing, and generates leads throughout the year. We do not charge for leads, and we do not charge for supplies. We are exclusive to United Healthcare for Medicare Products. In order to receive our leads, you would need to be exclusive to United Healthcare for these products also. If you are contracted with a competitor, we can still work with you, but we cannot provide leads to you. We are looking for either career agents, who are interested in a year round career opportunity, with leads and ongoing support and resources, or those who are interested in helping their current clients, on a very part time/occasional basis, and who would not want/need lead support as a result. We are open to any reasonable combination of these opportunities as well. Full training is provided, as well as personalized coaching, individual strategy planning, etc. If you don’t currently have e&o insurance, ask us about our complimentary e&o program (no cost). Here are some highlights of the products we offer: – 0 Premium Product – $400 average first year commissions per sale – 12 month advance – 10 year payment cycle (1st year + 9 yr renewals) – No cost lead support – Local training and resources – Local & National Support – Direct Company Appointment – Commissions paid twice weekly – Year Round Opportunity – Ongoing Marketing Support – No Assignment of Commissions – You Own Your Own Book – Agency Opportunities – General Agent Opportunities – Ask us about our Complimentary E&O program This means that if you average 5 sales per week, you can earn up to $100,000 first year in commissions, and $48,000 per year in renewals. At 7 sales per week, you can earn up to $140,000 first year commissions, and $70,000 per year in renewals. After a few years, your renewals could easily exceed your first year commissions, and the good news is that there is no time frame requirement to become vested, and you own your own book of business. We are in the midst of a major marketing campaign, including a variety of ongoing strategic efforts. This is an exciting time for us, and the good news is that if you would like to be part of our success, there is still time to contract. This contract would include AARP Medicare Complete, AARP RX Saver, Secure Horizons, and Evercare Products, as well as the AARP Medicare Supplement Products (including the new modernized plans). This is for a direct appointment, with a full agent contract, and is intended as a career opportunity. Please let us know if you are interested, by email, and we can discuss the opportunity further. Time is of the essence, since contracting and becoming certified to offer these great products takes approximately two weeks, and the busiest season of the year is fast approaching. We are busy year round as well, but we are currently in immediate need of dedicated agents to help us service opportunities during this exceptionally busy time. We are filing limited slots. For immediate consideration, reply to this posting and please include your phone number, and a summary of your experience. We will respond to qualified candidates promptly. If you are primarily interested in marketing to your current clients, and/or professional networking, we can provide ongoing support for your efforts as well. For highly qualified candidates, General Agent opportunities may be available in specific markets. Thank you for your interest in United Healthcare Medicare Solutions, and Secure Horizons. Location: Statewide Compensation: 50,000 to 130,000 First Year Commissions + Renewals Principals only. Recruiters, please don’t contact this job poster. Please, no phone calls about this job! Please do not contact job poster about other services, products or commercial interests.
Source: inportland.info

Video: united-healthcare-insurance.mp4

Court Ruled Against CIGNA & UHC UCR Class Actions by Out

On Sep. 23, 2011, the federal District Court in New Jersey dismissed all out-of-network provider plaintiffs UCR class action claims against CIGNA and UnitedHealthcare solely based on the poor and limited ERISA Assignment of Benefits. Franco v. Connecticut General Life Ins. Co. (Case 2:07-cv-06039-SRC–PS) was filed in federal court, District of New Jersey, as one of the largest UCR class actions after the UnitedHealthcare UCR settlement, by several patients, numerous out-of-network providers, several provider State Associations and the American Medical Association (AMA), alleging violations of the ERISA for wrongful UCR denials and reimbursement. ERISAclaim.com offers new webinars to examine the profound impact of this federal court ruling on ERISA requirements for Assignment of Benefits, and to discuss on how to secure valid ERISA and PPACA Assignment of Benefits, in order to prevail on all provider appeals and judicial reviews.
Source: ezgibutikotelkonaklari.com

United Healthcare and Saint Joseph Regional Sign Agreement

Saint Joseph Regional Medical Center  is a not-for-profit, multi-hospital health care system in North Central Indiana providing a wide variety of medical programs and care for people from all walks of life. A ministry organization of Trinity Health Saint Joseph Regional Medical Center has a 125-year history of offering faith-based, personalized care in a diverse and team-oriented environment. HealthGrades, the nation’s leading healthcare ratings company, has rated Saint Joseph Regional Medical Center among the top 5% in the nation for joint replacement and orthopedic surgery six years in a row (2004-2009), and among the top 5% for spine surgery in 2008. SJRMC also received a five-star rating from HealthGrades for treatment of stroke in 2009, and was rated the number one hospital in Indiana for orthopedics in 2009. Most recently, HealthGrades ranked SJRMC among the top 5% U.S. hospitals for women’s health for 2009/10.
Source: womenillhealth.com

UHC ICA Bad Experience in Bay Area, CA

Hello, I wanted to share my experiences with the UHC ICA system. I have been an agent for 10 years, selling LTC & annuities. Maybe this will help other agents considering the same thing and maybe I can acquire more ideas on how to best make more money by adding senior health products. A Sales Manager at UHC under the ICA system advertises on Craig

Medicare tax scare: Should you sell your home soon?

Posted by:  :  Category: Medicare

Bubbles? Take something like 'Not I! .....item 1..Wakulla Republicans Protest Against Taxes in the County (September 06, 2011) ... by marsmet552Here’s the whole story: Under the 2010 health care legislation, you must pay a 3.8% Medicare tax starting in 2013 on the lesser of net investment income or the excess of modified adjusted gross income (MAGI) over a $250,000 threshold ($200,000 for single filers). For this purpose, net investment income includes interest, dividends, royalties, rents, gains from dispositions of property and income from passive activities.  
Source: businessmanagementdaily.com

Video: Cut Medicare, SS & Taxes For Rich – Gang of Six

GOP: Charge Wealthy More For Medicare To Offset Payroll Tax Break

The New York Times: GOP And Democrats On How To Prevent Social Security Payroll Tax Increase Senate Republican leaders introduced a bill that would keep the payroll tax rate at its current level for another year. The cost is roughly $120 billion. Senate Republicans would offset most of the cost by freezing the pay of federal employees through 2015 and gradually reducing the federal work force by 10 percent. In addition, Senate Republican leaders would go after “millionaires and billionaires,” not by raising their taxes but by making them ineligible for unemployment compensation and food stamps and increasing their Medicare premiums. Democrats said that this part of the Republican proposal was not serious, pointing out that high earners were already ineligible to receive food stamps (Pear and Steinhauer, 11/30).
Source: kaiserhealthnews.org

Social Security: Congress and the President Manipulate Workers' Earnings

Okay – you’re right – all politicians obfuscate and pander. However, what the President is not telling the American worker is that their taxes will go up – substantially.  The President, Congress and most Americans know that Social Security and Medicare are broke – bankrupt, in fact.  Guess who is going to get an enormous tax increase to pay for Social Security and Medicare?   YOU!   The burden won’t be on the immoral manipulators – Presidents and Members of Congress.  No.  It will be on working Americans.
Source: freedomworks.org

Heller Payroll Tax Bill Protects Millionaire Tax Breaks, Slashes Medicare

“Dean Heller’s legislation is nothing more than another assault on Medicare,” said Nevada State Democratic Party spokesperson Zach Hudson.  “After saying he was proud to be the only member of Congress to vote twice to kill Medicare by turning it over to private insurance companies, Heller is now continuing his attack on the program by again introducing legislation that slashes seniors’ healthcare.  Nevadans have a clear choice between Shelley Berkley’s commitment to creating jobs and protecting seniors, and Dean Heller who wants to slash Medicare to protect tax breaks for billionaires and Wall St. bankers.”
Source: wordpress.com

‘Tis the Season to Be Weary…of Jobless Numbers

While 120,000 jobs were added last month, 315,000 people gave up looking for work.  Now the labor force participation rate (LFPR) is 64 percent, so far the second lowest monthly rate in 2011 and more than 3 percentage points lower than it was 10 years ago.  The declining LFPR does not bode well for a government reluctant to reform entitlement programs.  Social Security and Medicare depend heavily on payroll taxes to continue their obligations to seniors.  With fewer people working, fewer tax revenues are coming in to pay Social Security and Medicare benefits.
Source: ncpa.org

Doc Fix, Health Program Extenders Still On Congressional Agenda

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

The FairTax Series: America’s Road To Prosperity Part 2

There have been some in Congress, along with the “tax the rich more” crowd, who have suggested a Value Added Tax or VAT. This would be a national sales tax added on to the cost of everything we buy today. This tax, proposed to begin at about 2%, would eventually be up in the 16% or higher range as it is now in some European countries. THE FAIRTAX IS NOT THE SAME PLAN. Those who do not want to see the FairTax implemented deliberately confuse the two plans to scare people like me, and you, away from the FairTax. This worked for quite some time as I was not knowledgeable enough to discern the difference. Be assured that when you hear VAT used in the same sentence as the FairTax it is a red herring designed to put you off the most intelligent proposal I have heard in my 61 years, The FairTax. Now to the costs associated with our current system. In the debate about income and employment taxes we seldom hear of the costs involved. I am a simple man with a high school education so it doesn’t take very long for the tax structure to get the best of me. I haven’t been able to find any concrete numbers but the federal income tax code has somewhere between 67,000 pages, as stated in the 2nd FairTax book published in 2008, and 86,000 that I heard a politician mention a little while back. I can’t remember which politician or exactly when he gave that number but I do remember 86,000 pages being mentioned. I really don’t care which number is right, both are absurd. My wife has a college degree in accounting in which she achieved a 4.0 grade point average. She is a very smart lady and extremely good with accounting but even she can’t keep up with yearly changes and the odd nuances of the ever changing tax codes. As a result we have our taxes done by a local Certified Public Accountant who is very good and keeps up with all of the changes from year to year.Let me describe the differences very simply here before I go on to the main subject of this article. The FairTax is instead of, not in addition to, income taxes, employment (Social Security/Medicare) taxes, inheritance (death) taxes, gift taxes, etc. The Value Added Tax (VAT) is in addition to, not instead of, these other taxes. This is a huge difference when it comes to deciding whether to support the FairTax or not. Once I understood the difference in the two plans I could plainly see that the FairTax is a plan that is in my best financial interest.
Source: conservativedailynews.com

How to Choose the Medicare Supplement That’s Right For You

Posted by:  :  Category: Medicare

DAMN!! -- I THINK WE'RE F*%KED by SS&SSWhich is better, Medicare Supplement (Medigap) or Medicare Advantage? This is a question that many people turning 65 will be asking themselves. In my opinion, all things considered equal Medicare Supplement Plan F would be the best option. Plan F covers the Part A and Part B co-insurance and Part A and Part B deductibles. Therefore, most if not all out-of-pocket costs will be paid by Original Medicare and Medicare Supplement Plan F. However, Plan F will probably be the plan with the highest…
Source: blogspot.com

Video: Switching To Medicare Supplement Plan F

Medicare Supplement Plan F

This entry was posted in 2012 Medicare Supplement Insurance, Medicare supplement insurance, Medicare supplement Quotes, Medicare Supplemental Insurance and tagged Medicare, medicare coverage, Medicare insurance, Medicare supplement, medicare supplement coverage, Medicare supplement insurance, Medicare Supplement Plans, Medicare supplement Quotes, medicare supplement rates, Medigap, medigap coverage, medigap insurance, medigap plans, medigap quotes, medigap rates. Bookmark the permalink.
Source: gomedigap.com

OOiZiT — Events — All About Getting The Greatest Medicare Plan N

Before availing ofMedicare Plan N, you need to get Unique Medicare first. You could have Authentic Medicare when you have Medicare Half A and Medicare Half B. Plan N is meant to supplement the Authentic Plan. The pricing of this package can also be determined by deductibles and out-of-pocket costs. Medicare Part B can be referred to as the Medical Insurance. This covers providers not out there in Half A, akin to outpatient care and visits to the doctor. Medicare Part B also contains home well being care, preventive services, and physical and occupational therapy. Identical to Half A, there are deductibles concerned in Part B.
Source: ooizit.com

If I buy a medicare part F plan, why do I still need Long term care insurance?

Medicare F is the most inclusive supplemental plan but it does NOT pay for residential or long term skilled nursing care. Supplemental insurance does not cover you beyond the 100 days that Medicare covers you. Supplemental insurance is intended to pay for the 20% of charges that Medicare does not. It covers the same services as Medicare does. Plan F covers your health care while traveling plus any excess Part B costs that Medicare may not cover. Long term care insurance is for your nursing or rehab care which extends beyond the 100 days that Medicare covers. Long term care covers you for as long as you live in a skilled nursing facility.
Source: insurancep.com

Treatment Advantage AGAINST Medicare Medigap Providers

In 1965, Congress answer and adjust concerns related to increased health reform costs Medicare Supplement Plans older individuals passed some sort of amendment towards Social Security measure Act of which created Treatment. The conduct yourself created only two benefits, Medicare Section A of which covered hospitalization and also Medicare Section B of which provided insurance to protect other clinical costs. Legislation creat Treatment was brought in by Web design manager Lyndon Manley on This summer 30, 1965, for the sign wedd former Web design manager Truman appeared to be issued the earliest Medicare cartomancy.
Source: icopa-xi.org

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

Why Don’t You Have Medicare Plan F? Find Tips For The Best Coverage.

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Source: profitableonlinehomebusiness.com

Illinois Medicare Supplement Plan F

Like most Illinois residents, you understand the importance of securing dependable, reliable health insurance. While Medicare helps significantly, it doesn’t cover all of your health care needs. Supplement insurance helps you pay for the gaps in coverage that Original Medicare doesn’t cover. Illinois Medicare Supplement Plan F offers the best coverage by providing comprehensive benefits, affordable premiums and completely eliminates all out-of-pocket expenses. Consider a Medicare Supplement Plan F from the most trusted name in insurance- Blue Cross Blue Shield of Illinois- and get the peace of mind that comes from knowing that you are well taken care of.
Source: ssiinsure.com

tufts health insurance private health insurance comparison wps health insurance

Posted by:  :  Category: Medicare

inexpensive-health-insurance.info health insurance providers private health insurance health insurance plans health insurance benefits public health insurance health insurance coverage Video Rating: 0 / 5 inexpensive-health-insurance.info tufts health insurance discount health insurance low cost health insurance national health insurance secondary health …
Source: healthinsuranceandmedicareupdate.com

Video: How Tufts Medicare Preferred Works Video

Tufts Medical Center and its doctors may stop accepting Blue

Tufts Medical Center and its doctors may stop accepting Blue Cross insurance in Jan. Blue Cross Blue Shield of Massachusetts has started sending letters to about 55,000 employers and other customers notifying them that Tufts Medical Center and its doctors group is ending its contract with the state’s largest health insurer, effective Jan. 17. AD: Grainger covers your electrical needs. If you need conduit, relays, or complete wire management solutions, think Grainger. We stock … Health insurance impasse could affect 10,000 Blue Cross patients More than 10,000 patients seeing MetroWest Medical Center doctors could have to switch providers if a contract impasse with the state’s largest health insurer continues, the hospital’s CEO said yesterday.
Source: medicare-news.com

4mv3: Roundup: Fla. Medicare HMO closed; Tufts and BCBS resume talks

Quality Health Plans, a Medicare HMO with 10000 Florida members, has been ordered into liquidation after failing to come up with the cash reserves the state says were needed. Its members will be moved to another — still unnamed — plan by Dec. … Roundup: Fla. Medicare HMO closed; Tufts and BCBS resume talks
Source: blogspot.com

Tufts Medicare Advantage?

For a company Ive never heard of they sure do have a lot of Med Advantages in your state. Tufts Medicare Preferred HMO Basic $16.00 Tufts Medicare Preferred HMO Basic $0 Tufts Medicare Preferred HMO Basic Rx $38.00 Tufts Medicare Preferred HMO Basic Rx $22.00 Tufts Medicare Preferred HMO Basic Rx Plus $48.00 Tufts Medicare Preferred HMO Basic Rx Plus $32.00 Tufts Medicare Preferred HMO Prime $96.00 Tufts Medicare Preferred HMO Prime $72.00 Tufts Medicare Preferred HMO Prime Rx $118.00 Tufts Medicare Preferred HMO Prime Rx $94.00 Tufts Medicare Preferred HMO Prime Rx Plus $128.00 Tufts Medicare Preferred HMO Prime Rx Plus $104.00 Tufts Medicare Preferred HMO Value $58.00 Tufts Medicare Preferred HMO Value $42.00 Tufts Medicare Preferred HMO Value Rx $80.00 Tufts Medicare Preferred HMO Value Rx $64.00 Tufts Medicare Preferred HMO Value Rx Plus $90.00 Tufts Medicare Preferred HMO Value Rx Plus $74.00 Tufts Medicare Preferred PFFS Basic $50.00 Tufts Medicare Preferred PFFS Basic $45.00 Tufts Medicare Preferred PFFS Basic Rx $72.00 Tufts Medicare Preferred PFFS Basic Rx $67.00 Tufts Medicare Preferred PFFS Basic RxPlus $82.00 Tufts Medicare Preferred PFFS Basic RxPlus $77.00 Tufts Medicare Preferred PFFS Prime $111.00 Tufts Medicare Preferred PFFS Prime $92.00 Tufts Medicare Preferred PFFS Prime Rx $133.00 Tufts Medicare Preferred PFFS Prime Rx $114.00 Tufts Medicare Preferred PFFS Prime RxPlus $143.00 Tufts Medicare Preferred PFFS Prime RxPlus $124.00 Tufts Medicare Preferred PPO $87.00 Tufts Medicare Preferred PPO $82.00 Tufts Medicare Preferred PPO Rx $109.00 Tufts Medicare Preferred PPO Rx $104.00
Source: insurance-forums.net

HeyErin.com : work & ramblings of interactive designer Erin Bowman

As a frequent client of H&G, Tufts Health Plan approached us with the desire to redesign their Medicare Preferred experience. The existing site was poorly organized and difficult to use, so our task began not with design, but with an analysis of existing content and focusing on UX. I handled the sitemap and wireframes and established a look and feel through collaboration with my Creative Director, Michelle Sinclair. I was responsible for blowing out nearly all of the following pages, which carried through that look and feel.
Source: heyerin.com

preferred medical health plan care health individual insurance

People who reach senior citizen age do have health insurance options available to them, but these options will be less limited if planned for in advance and will provide the senior with more freedom in choosing policy coverage and physicans. Seniors that plan for their future in advance will face less financial and emotional stress and will be better equipped and more prepared than they will be by putting off important issues and dealing with them once retirement occurs. There are many experts who will help people to plan for their retirement years. This will include looking over health insurance policy options, retirement savings fund options, and a budget for living off of retirement income. Senior citizens face a daunting time as they age and reach their retirement years. This time in a person’s life brings about many changes and these changes can place physical, mental, and financial stress upon the senior citizen. Going through these changes and dealing with an aging body requires a great deal of care and attention. Two of the most common things that senior citizens worry about are financial security and health insurance. While many seniors may qualify for Medicare, this government sponsored health insurance only covers necessities and often does not provide treatment and options for many medical needs. Reaching retirement age and being left without health insurance coverage can be avoided by speaking to insurance companies years in advance. Many companies will offer long-term coverage plans which will include affordable rates for the person once they reach senior citizen age. Taking the time to plan for this coverage and for these years will be a great benefit to the senior when he or she reaches retirement and does not have the option of having health insurance through their place of employment. Seniors who are dependent upon Medicare often do not have the privilege of choosing their own doctor or dentist and discover that they have to change family doctors to follow the guidelines of Medicare policies. Having a health insurance plan in place for a senior citizen is important to ensure that the senior’s medical needs are fully met and that he or she has as many options as possible when it comes to getting necessary treatment, choosing a preferred physician, and having access to physical therapy and prescription coverage. Planning ahead for health insurance policies is necessary and will help to provide a senior citizen with as much coverage as possible and will also help to ensure that he or she receives the treatment wanted, and not just having to accept only very basic medical needs being met. Many seniors are on a limited budget once they reach retirement years. Loss of health insurance through place of employment occurs after retirement happens and this makes it necessary to plan for the future to ensure that the needs of the senior are met and that he or she has as many options as possible.
Source: healthskills.info

Free Guided Care Training and Tools Available

Founded in 1929, the John A. Hartford Foundation is a committed champion of training, research and service system innovations that promote the health and independence of America’s older adults. Through its grantmaking, the Foundation seeks to strengthen the nation’s capacity to provide effective, affordable care to this rapidly increasing older population by educating “aging-prepared” health professionals (physicians, nurses, social workers), and developing innovations that improve and better integrate health and supportive services. The Foundation was established by John A. Hartford. Mr. Hartford and his brother, George L. Hartford, both former chief executives of the Great Atlantic and Pacific Tea Company, left the bulk of their estates to the Foundation upon their deaths in the 1950s. Additional information about the Foundation and its programs is available at www.jhartfound.org.
Source: jhsph.edu

caprock home health services

Many a times it happens that a person is not able to gain a lot of money in life owing to the poor condition of his business or due to the fact that he does not have the capability to earn a lot of money so that he can spend some amount of money for his future. Therefore a situation arrives in his life when he does not have enough money that he can spend for the unforeseen expenses that may arise any time in his life. In these circumstances getting a mediclaim is very important to remain aloof from the expenses that may be incurred on the health of an individual. There are several occasions in a human beings life when there are situations that are not able to be handled by the human being itself. There are circumstances when a person can get in contact with some kind of an expense that cannot be avoided by him at any cost. The major one being the health of a person. A human being can never compromise with his health and it is because of this health that he has to suffer a lot of financial stress on himself. To remain ready for such health blunders in life it is very important to get Medicare Supplement Plans. It is not necessary that the Medicare has to be taken only at a certain age in life. It can be taken at an early age in life and has to be regularly paid for getting the advantages of the Medicare thus taken. The choice of Medicare also depends upon the premiums that need to be paid for availing the Medicare. Medicare Supplement is nothing but a way out of your medical expenses that will have to be paid in the absence of the Medicare supplement plans. It is a plan that gives the advantage of paying off those bills and those medical charges of an individual which are not covered under the original Medicare. They are huge advantage for an individual as they bear up with most of the major expenses that are hard to be met up by a common man in this world. Medicare Supplemental Plans are very important and mandatory for a human being because of their usefulness and their contribution in the medical expenses of a human being. These plans are meant to give a very soothing effect to the health conditions of a human being by the mere contribution that they make in the expenses that are incurred in getting their health up to the mark once again. These plans serve as a medium in meeting the expenses that are incurred on the health conditions of a person. They are the ones that help the people get out of the trouble of paying all their medical bills at one go. There are Medicare plans that meet up the health requirements of a human being but the Medicare supplemental plans meet up those expenses or those expenditures on health that are not covered by the original Medicare. Hence they serve as a medium of getting through the medical expenses of an individual.
Source: healthskills.info

Why Wait? Use MyMedicare.gov

Posted by:  :  Category: Medicare

Do you balance your checkbook and review the charges on your credit cards, looking for charges you didn’t make? Reviewing your Medicare claims is another way you can protect yourself from fraud. Use MyMedicare.gov to check your claims online – they’re usually available within a day of processing.
Source: medicare.gov

Video: Two Useful (but frustrating) Websites: MyMedicare.gov and Missouri Case.net

Millions of Seniors Saving Money on Prescription Drugs, Thanks to the Affordable Care Act

Over the weekend, a report by the Associated Press detailed how the Affordable Care Act is dramatically reducing drug costs for seniors who hit the prescription drug coverage gap known as the donut hole. This year, seniors are benefiting from a 50 percent discount on brand-name drugs in the donut hole. And the discount and other provisions in the law are saving money for seniors. As the AP reported:
Source: cms.gov

Ask The Experts: Retirement

Q: I just turned 65 and started paying my Medicare premium on a quarterly basis. I am still working federal civil service and not drawing Social Security so I have to pay my Medicare premiums separately from my pay deduction. However, Medicare deductions are still taken from my civil service pay. It seems I am having to pay twice for the same coverage. If I was not working civil service I would not have the deduction and I would still receive the same coverage since I am 65 and paying the premiums for parts A and B.  Shouldn’t the pay deduction cease when a worker turns 65 since I am paying premiums directly now?
Source: federaltimes.com

Claims Information Now Available on My.Medicare.gov! NEW! My.Medicare.gov

Claims Information Now Available on My.Medicare.gov! NEW! My.Medicare.gov – the Medicare Beneficiary Portal is an internet portal allowing registered beneficiaries the ability to view eligibility and entitlement information, enrollment information including prescription drug plans, deductible and address of record information. Additionally, it provides beneficiaries with the ability to order replacement Medicare cards, access to online forms and publications, preventive service information and the option for web chat assistance for any technical questions. Now, My.Medicare.gov and the Centers for Medicare & Medicaid Services (CMS) are pleased to announce that adjudicated claims information is available online to all registered users through My.Medicare.gov! As a user of this site, you may now access and view the status of your adjudicated claims as well as search for a specific claim.
Source: medicare-news.com

What Is New In Medicare 2012?

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Source: medicareadvantagesupplementplans.com

“My son broke my ribs”…children physically abusing parents a growing problem across Victoria

“Many parents live in fear. They are at their wits’ end and don’t know how to stop the violence. Young people themselves may be dealing with a range of issues including mental health issues, school drop out and substance use. Many have experienced family violence themselves. Some become homeless as a result of their violence. Parents report high levels of violence including broken bones and injuries requiring hospital admissions.”
Source: org.au

***AUDIO: Thompson Reminds Medicare Beneficiaries of Upcoming Open Annual Enrollment Period Deadline***

Washington, D.C. – U.S. Representative Glenn ‘GT’ Thompson today during a radio address reminded Medicare beneficiaries of the upcoming December 7th, 2011, deadline for the 2012 Medicare Open Annual Enrollment Period. An audio recording and the full text of Thompson’s remarks, which includes additional Medicare beneficiary enrollment information, are provided below.   
Source: house.gov

If my dad gets health insurance from the VA and Medicare am I covered until age 26 too?

Posted by:  :  Category: Medicare

Healthcare in America: Who's Paying Who? And Who's Getting What? (g1a2d0014c1) by watchingfrogsboilabout anyone best clothes Clothing computer conditioning dietary Failure… find from good guidelines Health heater heaters Help home know machine machines much need question refrigerator refrigerators shirt should show some speaker speakers style supplement supplements system there this travel unit washing water wear work Would
Source: familyencyclopedia.net

Video: Chief Medicare Actuary Foster Gets Myers Award

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: clarionledger.com

Obama’s Medicare nominee gets GOP leader’s support
(AP)

Anthony Weiner Arne Duncan Arnold Schwarzenegger Barney Frank Bill Clinton Capitol Hill Citizens United Congress Debbie Wasserman Schultz Donald Trump Eric Cantor gay marriage Grover Norquist gun control Haley Barbour Harry Reid Herman Cain Hillary Clinton Hillary Rodham Clinton Joe Biden John Boehner John Edwards John Kerry Jon Huntsman Jr. Michael Vick Michele Bachmann Mike Huckabee Mitch McConnell Mitt Romney Nancy Pelosi Newt Gingrich Obamacare Rep. Gabrielle Giffords Rep. Weiner Rick Perry Rick Santorum Ron Paul Rush Limbaugh Sarah Palin Sen. John McCain Tea Party Tim Pawlenty Tucker Carlson Weinergate
Source: politicalparades.com

Medicare’s 50th Anniversary: Medicare gets a rough ride in Regina (CBC 1962)

CBC Broadcast Date: July 11, 1962 On July 11, the doctors strike peaks. Media reports talk of possible violence and leaders on both sides call for calm. Medicare opponents from around Saskatchewan gather at the provincial legislature in Regina, including some with lynched effigies of Premier Lloyd and Tommy Douglas. Crowd estimates vary from 10,000, as claimed by the rally’s organizers, to one government official’s claim that he could get more people out to a picnic. Police put the number at around 4,000. Click HERE to view.  Select video 6. 
Source: blogspot.com

Raising Medicare Eligibility Age: Who Gets Hurt?

In addition, there are components to Medicare that need to be evaluated separately for each has its own characteristics: Hospital Insurance (HI) or Part A and Supplementary Medical Insurance (SMI) which includes Part B (e.g doctor visits), Part C (private plans that contract with Medicare to provide Parts A and B) and Part D (drugs).  Much attention has been already given to economies and efficiencies in Part A and many changes are in progress; Part B is an area that needs additional attention given the rapid increases in costs; Part C, such as the Advantage Plans are expensive and should be given additional scrutiny; and Part D is a great way to achieve big gains through drug purchases in the same way as the VA.  And, of course, persistent efforts to root out fraud.  
Source: talkleft.com

Patient Satisfaction Gets Renewed Focus with Medicare Changes

As doctors, we are very opinionated about the need to reform the healthcare system for the better. But a critical element that seems to be missing from these many conversations is how we are actually going to improve patient satisfaction. We like to focus on issues such as access and cost and use terms such as “patient-centered” care. In reality though, we need a simple set of tools to help us focus on what truly matters to patients. Again, if a patient feels betrayed or not listened to or just plain unhappy with her care, she can lower the amount of reimbursement money coming back to a hospital regardless of her outcome.
Source: physicianspractice.com

Medicare Advantage Plan Star Ratings and Bonus Payments in 2012

Posted by:  :  Category: Medicare

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

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

Medicare’s Star Quality Ratings helps Hoosiers make best decisions for 2012 coverage

• Scope of coverage – Are the services you need covered? Do you want coverage for wellness benefits like vision and dental? • Other coverage – If you have other health coverage, how will it coordinate with Medicare? • Cost – How much are the plan’s premiums, deductibles and other costs? • Doctor and hospital choice – Are the doctors and hospitals you prefer part of the plan? • Prescription drugs – Do you need to join a plan with Medicare drug coverage? Does the plan you are considering offer Medicare drug coverage for the medications you are taking? • Convenience – Does the plan have local customer service and convenient doctors and pharmacies? • Travel – Will the plan cover you if you travel outside the country?
Source: iuhealth.org

Group Health Cooperative earns top Medicare 5

“Our five-star rating reflects our efforts to make quality, convenient care a reality,” said Group Health President and CEO Scott Armstrong. “We have reduced unnecessary hospital readmission by spending more time with our patients and making sure each patient is getting the right follow-up care. Innovations like these make a difference in the lives of our patients and their families.”
Source: ghcnews.org

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 Plans See Dollars In The Stars

The Obama administration has argued that the private plans, originally devised as a way to reduce Medicare costs, have long been overpaid. They cost the government as much as 114 percent of the cost of traditional Medicare patients, without producing better health outcomes for enrollees. The federal government announced in November that it would increase the bonuses. The program is part of a push for quality, led by Medicare administrator Dr. Donald Berwick, that is meant to boost results even as the cuts kick in.
Source: kaiserhealthnews.org

Kaiser Permanente CO earns Medicare 5

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

Health plans “score” with Medicare’s 5

This year health plans are paying much closer attention to their ratings because they stand to make more money if they score higher on Medicare’s 5-star quality rating system. The bonuses could be substantial, even for insurers that only make small increases in their ratings. Carriers with well-rated plans hope that the droves of baby boomers becoming eligible for Medicare will pay attention to the star ratings and choose their plans.
Source: wordpress.com

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

CMS established the star rating system to give Medicare patients a single summary score for each health plan to make it easier to compare different plans based on quality and overall performance. Plans are ranked on a scale of one to five stars. The overall score is based on more than 50 separate measures that rank member satisfaction, access to appropriate care, and managing chronic conditions.
Source: eyugoslavia.com

Quality, Schmuality: Rating the (Medicare Plan) Stars

While the measures are far from perfect indicators of high quality care, they do seem to tell us one thing — care is not top-notch for almost all of the quality measures, particularly for some that are of interest to older people. For example, the average star rating for improving bladder control is only 1.83 stars; pain screening 2.72; improving or maintaining mental health 2.15; and managing women who have had a fracture 2.06. When it came to monitoring physical activity, a key determinant of health for the elderly, the average star rating was only 1.91. Are plans really concerned about that?  
Source: reportingonhealth.org

Register Now for Nov. 15th ACO Medicare Shared Savings National Provider Call

Posted by:  :  Category: Medicare

San Diego, CA by Oggie DogA Notice of Intent to Apply (NOI) memo is currently available on the Shared Savings Program Application page at in the “Downloads” section. Submitting the NOI is the first step in the application process. A copy of the Shared Savings Program application will be posted to this website prior to the National Provider Call. CMS will send out an announcement when the application is available on the website. Call participants are encouraged to review the application prior to the call.
Source: wordpress.com

Video: EHR: Medicare and Medicaid Incentive Program Registration Webinar for Eligible Hospitals

Tavenner Nomination Finds Support From Health Care Stakeholders

CNN Money: Medicare In America: ‘It Has To Get Better’ As administrator of Medicare and Medicaid, Donald Berwick has been in charge of paying for the health care of nearly one in three Americans. He has also had an important role in implementing last year’s health reform law, which uses the Medicare system as a big lever to change how doctors and hospitals do business, in hopes of containing costs. Before taking the job — which he’ll leave in early December — the Harvard-trained pediatrician was a leading advocate for quality and patient safety, and often a blunt critic of our health system. Berwick’s nomination faced opposition from conservatives who focused on, among other things, his praise of government-run British health care. Instead of being confirmed by the Senate, Berwick was given a temporary “recess” appointment by President Obama, which was scheduled to run out this year (Gengler, 11/29).
Source: kaiserhealthnews.org

What you must be aware of when registering for Medicare.

If you have reached retirement age, or if you are in need of certain health care backing, chances are you have thought about signing up for Medicare. The U.S. government backs the Medicare program, and it is accessible to U.S. citizens or permanent residents who are 65 and older and who have worked for at least a decade through a Medicare-covered employer. People who are handicapped or who are in end-stage renal failure might also be eligible for Medicare. Two tiers are available through Medicare; Plan A and Plan B. Medicare Part A covers hospital stays, while Medicare Part B covers medical costs. Once you are familiar with the steps, signing up for Medicare is an easy process.
Source: risecooker.net

Seeing Doctor Before Registering With Medicare : British Expat Discussion Forum

The UK health card is crappy little cardboard thing that you take to your UK doctor when you register with the GP practice. I’m not sure where you get them from but my mum had ours for years! But I don’t think anyone would want to see one of them here. When my mum fell ill over here she just showed her UK passport and they didn’t charge her for her hospital stay. They did however charge her over $500 for an ambulance so that’s something to be cautious of if anyone needs to use an ambulance in QLD whilst on holiday.
Source: britishexpats.com

Health groups back Tavenner for top post at CMS : The Nursing Home Monitor

24-7 Press Realease reports: “We trust assisted living care facilities and nursing homes to care for our most vulnerable loved ones, those who have become unable to care for themselves. We expect that the medical professionals who run these facilities will provide the necessary support and care.” Read More…>> Unfortunately, when the facilities fail to meet their obligations, the consequences can be tragic. Moreover, it can be difficult to recognize that the facilities are not providing proper care, as elderly residents may be unable or unwilling to speak up.”
Source: nhmonitor.com

Registration for EHR Incentives is Now Open

These health professionals have to show they have adopted certified electronic health record technology and successfully demonstrate “meaningful use” of electronic health records in ways that improve quality, safety and effectiveness of patient care. Eligible professionals can receive up to $44,000 over a five-year period through the Medicare incentive program and up to $63,750 over a six-year period through the Medicaid incentive program. HHSC has made available an online tool health professionals can use to help determine which incentive program — Medicare or Medicaid — they might be eligible for.
Source: torchnet.org

Registration Opens for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs

While the Medicare EHR Incentive Program is administered by CMS, the Medicaid EHR Incentive Program is voluntarily offered and administered by the states. California, Missouri, and North Dakota are expected to open registration for the Medicaid Incentive Program in February 2011, with other states likely to offer the program during the spring and summer of 2011. Registration marks a major step for providers in the process of obtaining incentive payments under the EHR Incentive Programs. Under these programs, Medicare and Medicaid incentive payments totaling as much as $27 billion from 2011 to 2021 will be available for payment to eligible professionals (EPs) and eligible hospitals for the “meaningful use of certified EHR technology.” Providers are encouraged by CMS to register and participate early to obtain the maximum incentive payments.
Source: lexisnexis.com

Helpful tips towards the Medicare insurance Type.

three.  Online medicare insurance software ??? This really is an internet type which you fill on the internet which entitles you to definitely sign up for as well as sign-up for any medicare insurance strategy. Just like the typical procedure with regard to registering for the medicare insurance advantages strategy, you will find specifications which have to be achieved in the past. Maintain this particular in your mind if you are using whether or not on the internet associated with personally.
Source: traumainsurances.com

Federal Government Has Distributed $653M in EHR Incentive Pay

Of the $653 million distributed under the meaningful use program, CMS paid $389 million through the Medicaid incentive program and $264 million through the Medicare incentive program. The Medicare program has more stringent eligibility requirements, Modern Healthcare reports.
Source: ihealthbeat.org

RT @executivebiz: New post: CGI Selected for Colorado Medicaid Recovery Audit Contractor Program http://t.co/tUYjjQm6

Posted by:  :  Category: Medicare

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Source: northernvirginiabusinessnews.com

Video: Exploding Medicaid Costs in Colorado

Medicaid caseload threatens Colorado state budget

We can blame our  elected officials who voted for the Affordable Care Act (Obamacare) BEFORE ever reading it.They are guilty of rank legislative malpractice. Had they read the bill before voting for it, and listened to their constituents instead of their party leaders, the state would not be facing this financial Medicaid dilemma. Place this problem at the feet of Udall, Bennet, Perlmutter. and DeGette. Markey and John Salazar have already been held accountable.
Source: denverpost.com

Medicaid: Colo. Gov. Dismisses GOP Call For Waivers; Fla. Sanctions Docs

ProPublica: Florida Sanctions Top Medicaid Prescribers — But Only After A Shove At Dr. Huberto Merayo’s bustling psychiatry practice in Coral Gables, Fla., hundreds of poor patients on Medicaid walked away each year with prescriptions for powerful antipsychotic drugs. … Merayo’s situation is one of at least three in which Florida allowed physicians to keep treating and prescribing drugs to the poor amid clear signs of possible misconduct. … Medicaid programs across the country have long had evidence that physicians have been prescribing risky drugs in excess and perhaps to the wrong patients (Ornstein and Weber, 11/17).
Source: kaiserhealthnews.org

The Handiest Girlie Of All

House Bill 1293 was estimated to generate about $1.2 billion for Medicaid programs when fully phased in, and the measure called for expanding eligibility levels. A new eligibility class was created for adults without dependent children and whose income was up to 100 percent of the federal poverty level, or $10,890 per year for an individual.
Source: typepad.com

Consortium of Foundation Libraries: Colorado scaling back Medicaid program after understimating cost

The state has now found that the number of people eligible for coverage is close to three times as high and the cost of insuring them is almost nine times the first estimated numbers. Original projections were for an additional 49,200 to join the program at a cost of $197.4 million per year, with annual cost per person to be $292 per month. New estimates show that the costs may be $900 per month per individual. The Department of Health Care and Financing will
Source: blogspot.com

Colorado Medicaid Doctor Prescribes a Whopping $1.1 Million of Antipsychotic Drugs in Just 2008 and 2009 Alone

With Colorado already facing what the governor’s office estimates as  a $262 million general-fund shortfall for the current 2010-11 budget and facing another $1 billion shortfall in the 2011-12 budget year, details of the number and cost of prescriptions for antipsychotic and other psychiatric in the publicly-funded Medicaid program over the past 10 years should be made public, with a special focus on the increase in the number and cost of prescriptions written on antipsychotics for children.
Source: psychiatricfraud.org

Colorado to Reduce Medicaid After Underestimating Impact of Expansion

According to the report, lawmakers passed healthcare legislation in 2009 that allowed the state to impose a fee on hospitals while using the additional matching federal money to expand Medicaid coverage. The legislation was expected to produce roughly $1.2 billion for the programs and help cover childless adults who have historically been ineligible for Medicaid.
Source: randbsolutions.com

Colorado Cutting Back on Medicaid Coverage

Colorado is cutting back on Medicaid coverage for poor adults without children because the estimated number of people has tripled.  State program manager Joanne Zahora told the Daily Sentinel that the program has been based on 2 year old estimates which are basically outdated today.  The state originally estimated there would be just over 49 thousand people eligible for the program at a cost of about $200 million a year.  But since then the number of people eligible is over 140 thousand with an estimated cost of $1.7 billion…. Source: Daily Sentinel
Source: coloradoradio.com

Is Colorado Lagging in Health Care Fraud Recoveries?

Total Health Care Fraud recoveries nationwide are way up, but recoveries of stolen funds are not the same throughout the country. The Office of Inspector General recently released updated figures for Medicare and Medicaid fraud recoveries. A total of more than $1.84 billion was recovered in fiscal year 2010. States leading the way include New York, Texas, Florida and California. It is probably no coincidence that those states have strong state False Claims Act statutes and well-funded state and federal resources to combat health care fraud. States with weaker laws and less concentration on health care fraud enforcement do not fare as well. The Office of Inspector General for Health and Human Services has issued an interactive map which shows recoveries by state. Though Colorado was certainly not the worst in amounts recovered from fraudsters ($6.45 million), it lags behind many other states, such as Missouri ($49 million), Utah ($29 million), Tennessee ($71 million) South Carolina ($30 million) and Massachusetts ($65 million).
Source: crossbennett.com