Top 10 Things to do if You Lose Your Wallet or Purse

Posted by:  :  Category: Medicare

Deal 3, Table 7: Initiation enter Trick A~ contract taker leads King of Risks by KevinHutchins3146. Alert the fraud departments of the three major credit reporting companies. They will place a fraud alert on your name and Social Security number, and you can request that they alert you before opening a line of credit in your name. (Equifax: 1-800-525-6285; Experian: 1-888-397-3742; Trans Union:1-800-680-7289)
Source: rrea.com

Video: Tea Party (R) Plays Victim Card – No Apology To DNC Chair Schultz

Replacing Your Vital Documents

 – Go to the National Archives website for guidance on requesting personnel records for former federal civilian employees. Current federal workers can get personnel records from their human resources office.
Source: usa.gov

How to Replace a Lost Medicare Card

Medicare is a program funded by US government which provides affordable health care to citizens above the age of 65. A red, white and blue Medicare card wiil be given to citizens as a proof . Whenever you are seeking healthcare under medicare program, production of medicare card is a must.If your card has been destroyed, lost or stolen, you need to get a replacement card as early as possible. Here I will describe the process of getting a replacement medicare card.
Source: infobarrel.com

Things To Know About Your Medicare Card

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Source: cpaprotectplus.com

Medicare: Funded study finds dyslexia not tied to IQ

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Source: medicarecard.com

Top 10 Facts About Politifact’s Lie

Posted by:  :  Category: Medicare

House Republican Press Conference on Health Care Reform by House GOP LeaderSteve Bennen: “Medicare is a single-​payer health care system offering guaranteed benefits to seniors. The House Republican budget plan intended to privatize the existing system and replace it with something very different — a voucher scheme. It would still be called ‘Medicare,’ but it wouldn’t be Medicare​.It seems foolish to have to parse the meaning of the word ‘end,’ but if there’s a program, and it’s replaced with a different program, proponents brought an end to the original program. That’s what the verb means. I’ve been trying to think of the best analogy for this. How about this one: imagine someone owns a Ferrari. It’s expensive and drives beautifully, and the owner desperately wants to keep his car intact. Now imagine I took the car away, removed the metallic badge off the trunk that says ‘Ferrari,’ I stuck it on a golf cart, and I handed the owner the keys.“‘Where’s my Ferrari?’ the owner would ask.“‘It’s right here,’ I’d respond. ‘This has four wheels, a steering wheel, and pedals, and it says ‘Ferrari’ right there on the back.’”By PolitiFact’s reasoning, I haven’t actually replaced the car — and if you disagree, you’re a pants-​on-​fire liar.”
Source: thenewcivilrightsmovement.com

Video: AMA and AARP National Ad: Medicare Facts

5 Things To Know About California Medicare Insurance And California Medigap Get The Facts

2. Medigap plans are not offered by the government. Another important thing to be reminded of is that the government, itself, is not offering Medigap plans (unlike Original Medicare, which is a social insurance from the US government). This means that you would have to purchase this supplement to your California Medicare plan from a private health care provider. However, California Medigap plans and other Medigap plans in other states are regulated by the federal government so that policy holders would not have to fear from abuse or other unpleasant things from the private health insurance companies that offer them.
Source: articlesnaps.com

Politifact’s Shaky Command of Facts

Many premium support plans contain a spending cap meant to check the growth of Medicare. But whether this works depends upon a very technical — but essential — point: How fast will the amount of the premium support grow? Will it grow with inflation? With gross domestic product? With overall health care spending? When they say the “devil is in the details” this is what they mean. Under the Rivlin-Domenici plan, the value of the voucher would be capped at the rate of overall economic growth plus one percentage point — less than health care inflation has historically been. The Wyden-Ryan plan replaces the voucher cap with an overall cap on Medicare spending using the same target. Excess spending would prompt cuts to doctors and other providers, or an increase in payments by wealthier Medicare beneficiaries.
Source: politicsnotasusual.com

Medicare: Facts and Convictions

More importantly, I realized that the relevant economic facts were soft (relatively malleable). Even if they pointed in Obama’s direction, they did not decisively refute Ryan.  Economists with strong (relatively inflexible) convictions about the privileged role of markets and the dangers of government regulation could develop alternative interpretations of the facts that supported Ryan’s position.  Such strong convictions would be irrelevant if they were ungrounded prejudices.  But there is clearly a higher level of economic discussion on which the free-market economists as well as their opponents have developed what they see as a powerful historical and even philosophical case for their convictions.  Paul Ryan was, perhaps, gesturing to this level of conviction when he said, “This is not a budget; this is a cause.”
Source: nytimes.com

New Ryan Proposal Still Aims to Eliminate Medicare, Replace with Voucher Plan

In the current system if new medical device is introduced that costs more, but generates a higher margin for doctors and hospitals, you see its use go up – regardless of its relative effectiveness – even though it is more expensive. That’s because the doctors and hospitals make the decisions about its efficacy and use – not the ultimate consumer. There is a perverse incentive in the current system to use more expensive services that generate higher profits because the providers themselves make decisions for consumers – and they always will. Sick patients rely on experts to recommend therapies. It is good to involve patients in those decisions, but in the end patients must depend on Medical professionals to advise them.
Source: factsandarts.com

Defeating the Point of Fact

Explaining this decision, PolitiFact’s Bill Adair wrote that "We discussed each of the other finalists and concluded that while clearly false, they failed to be as significant as the Medicare claim." So when Republicans were set to come up with a "Lie of the Year" hat trick, the good people at PolitiFact intervened on an entirely arbitrary basis. How exactly is it a "fact" that the Medicare claim is "more significant" than Senator Jon Kyl’s (R-Ariz.) claim that abortion is "well over 90 percent of what Planned Parenthood does," or that "zero jobs" were created by the 2009 stimlus bill? It’s not a fact at all. It falls in the realm of "defensible argument," a fact-checking nether region that, as Jonathan Chait points out, at the very least includes the Democrats’ claim that privatizing Medicare changes the program so as to effectively "end it."
Source: motherjones.com

Democrat Party Whoppers of 2011 by:J.R

FactCheck.org has released a list of political whoppers for 2011.  I have listed the Democratic Party whoppers here but to be fair FactCheck lists Republican Party whoppers as well, however you’ll have to go to FactCheck.org to read those Democrats, I’m not doing your work for you. Republicans Would ‘End Medicare’ First the truth: The budget plan that Republicans pushed through the House in 2011 would have radically changed Medicare in the future — for workers now under age 55. Starting in the year 2022, the GOP plan called for new Medicare beneficiaries to purchase private insurance with the help of federal subsidies. But the plan would have continued the present Medicare system indefinitely for those now getting benefits, and also for all those who reach age 65 during the next decade. But the truth didn’t stop Democrats from misrepresenting the proposal shamelessly to scare senior citizens and win election votes. They tested this tactic in a May 26 special House election in New York state, running ads accusing the Republican candidate of endorsing a plan that would “essentially end Medicare” and amount to “cutting benefits for seniors,” claims that were far from the truth. The truth is that not all Democrats think that changing Medicare in the way Republicans proposed is tantamount to murdering grannie. In fact, Democratic Sen. Ron Wyden of Oregon joined Republican Rep. Paul Ryan of Wisconsin on Dec. 14 to offer a bipartisan plan that is a modified version of the GOP plan Ryan authored earlier. And the New York Times noted Nov. 28 that there is growing support among some Democrats for reining in Medicare costs through a “premium support” system similar to the GOP plan if accompanied by enough safeguards. Obama’s Dying Mother We also discovered in 2011 that one of President Barack Obama’s favorite personal anecdotes — which he had told any number of times to sell his health-care legislation to the public — was not true. The president told the story often during the 2008 presidential campaign and the many months before he signed the health care law. He said his mother, as she was dying, nearly was denied health insurance coverage due to the fact that her ovarian cancer was considered a preexisting condition. But in 2011, author Janny Scott published a biography, “A Singular Woman: The Untold Story of Barack Obama’s Mother.” And in it she wrote that Stanley Ann Dunham’s health insurance provider did, in fact, cover most of the medical expenses. The author had access to Dunham’s letters to her insurance company and reported that her fight was over disability coverage (which is not affected by the new health care law) and not over medical insurance. The White House did not dispute the account. This is not the first time Obama has been caught using an embellished anecdote to sell the massive new health care law. In 2009 — in a televised health care address to Congress and the nation, no less — he claimed an insurance company delayed covering an Illinois man’s chemotherapy and “he died because of it.” But as reporters later pointed out, the man’s coverage was reinstated. His treatment resumed, and however badly he was treated, he nevertheless survived another four years. In that case, Obama’s speechwriters relied on a mistaken news account and never bothered to check the facts, which had been aired in public hearings before Congress. Teachers Pay Higher Tax Rates Than Obama President Obama went overboard arguing for higher tax rates on high earnings, claiming that he pays a lower tax rate than a teacher making $50,000 a year. That’s not true. A single taxpayer with $50,000 of income would have paid less than half the effective rate paid by the Obamas in 2008, 2009 or 2010. And if the $50,000-a-year teacher was supporting a spouse and two children — like Obama — he or she would have paid no federal income taxes at all. Other Assorted Absurdities Vice President Joe Biden’s multiple whoppers about rapes in Flint, Mich., following police layoffs. He claimed variously that they went up 152 percent, tripled and even “quadrupled.” But FBI data show the number of rapes in Flint went down by 11 percent over two years. Michigan State Police figures, which include male victims, show a 9.8 percent reduction. The city supplied rape statistics to both the state and federal agencies. An exaggerated Democratic National Committee Web video accusing ex-Gov. Mitt Romney of far more flip-flopping than he really committed. It’s a preview of what the general election campaign will see should Romney win the GOP nomination. Democratic National Committee Chairwoman Debbie Wasserman Schultz wrongly claimed that the U.S. has begun to add “millions of jobs in manufacturing.” Read More Here: http://factcheck.org/2011/12/the-whoppers-of-2011/
Source: americanconservativedaily.com

Carlisle police warn of scam involving fake Medicare worker

Posted by:  :  Category: Medicare

"Citizenship is a tough occupation which obliges the citizen to make his own informed opinion and stand by it." ~ Martha Gellhorn  by eyewashA Carlisle woman told police a man called her Tuesday pretending to work for Medicare and asked for her bank account information. The call happened in the morning at a home in the 700 block of South West Street, police said. Police remind residents to never give their bank account information or Social Security number to anyone over the phone.
Source: pennlive.com

Video: EHR: Medicare, Medicaid EHR Incentive Program Webinar for Eligible Professionals

Medicare Open Enrollment Extension for Some

Today, December 7th, is the end of the open enrollment period for Medicare recipients.  Susan Jaffe from the KaiserHealthNews.org website reports that extensions are being offered to people who are unable to enroll due to wait times, but only by three days.  A spokesperson for the Centers for Medicare and Medicaid claims that extensions will only be available to seniors who contact the appropriate resources and are put on a call back list.
Source: healthinsurancesort.com

Medicare Fraud Bill Reintroduced By Florida Legislator

Medicare Fraud Enforcement & Prevention Act or H.R. 3735 provides for enhanced penalties to combat Medicare and Medicaid fraud, and a Medicare data-mining system and biometric technology pilot program to better assess the legitimacy of Medicare claims. It additionally creates a new criminal offense punishable with a 10 year mandatory minimum federal prison sentence for those who knowingly sell or distribute the ID numbers of Medicare beneficiaries.
Source: gryphon-blog.com

Beware of Scammers During Medicare Enrollment Periods

If a caller who claims to be from Medicare calls you, and offers you a Medicare refund for you to deposit, or offers you free medical supplies, hang up the phone. This person is a con artist who is trying to get you to tell him or her your important numbers. He or she will then use those numbers to steal your identity, your money, or both.
Source: families.com

Your guide to Medicare open enrollment for 2012

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Source: ourbusinessnews.com

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

ReversePhoneDirectory.com is a leading provider of reverse phone lookup services that enable consumers to simply search a number, including cell numbers (where available), landline numbers and VoIP to accurately find the owner of that number. In addition to phone number information, ReversePhoneDirectory.com has search portals for public records services and provides access to the most current information. ReversePhoneDirectory.com is committed to helping people live better during technologically advanced times, believing that information is a powerful currency and people across the country should have easy access to information about everything and everyone they come in contact with.
Source: bestlongtermcare.org

Can you be dropped from a Medicare supplement plan?

Posted by:  :  Category: Medicare

The short answer is, “no.” As long as you pay your monthly premiums, and did not knowingly lie on an application, the insurance company cannot “drop” your coverage. This is true of all health insurance policies and Health Reform legislation made it even more difficult for insurance companies to terminate a person’s policy except in instances of suspected fraud or for other reasons.
Source: ehealthinsurance.com

Video: Medicare Supplement Plans | Questions about Medicare Supplement Plans

Medicare And Medicare Supplement Insurance Is Not Just For Seniors

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Source: apssupplements.com

Medicare Supplement Quotes

Here is how to get the best Medicare Supplement Quote for your situation. 1. One Plan is the same as Every Other Plan Medicare supplement plans are regulated by each state, but every plan has to offer the same coverage as any other plan. What this means is that normally, price is the biggest consideration when comparing your quote for a Medicare Supplement policy. 2. How Long Have They Been in Business Some companies have come recently into the competitive space of Medigap insurance. Make sure that the company you do business with has a proven track record and will give you good service. 3. Use a Broker That Can Find What You Need A broker works for you, not the insurance companies. Brokers can normally help you get what you need at the lowest price.
Source: cleanupalbanynow.com

Two New Medigap Companies Driving Price Competition

New Era/Philadelphia American The New Era companies (New Era, New Era of the Midwest, and Philadelphia American) have been in business for over 25 years. However, just in the last couple of years, they have become a major player in the Medicare Supplement marketplace. In many states where the plans are offered, they currently are a price-leader with the most competitive rates available. Some of the states in which the New Era companies are most competitive are: NEW ERA/NEW ERA OF MIDWEST: Georgia, South Carolina, Pennsylvania, Texas, Louisiana PHILADELPHIA AMERICAN: Tennessee, Alabama, Mississippi, Ohio There are of course many other states in which their plans are offered, but the aforementioned states are ones where the plans are very competitively priced at this time.
Source: medicare-supplement.us

Medicare Supplement Comparability

Initially, it is best to carefully study what kind of Medicare insurance you presently have (if you have Medicare insurance already). Far too often, seniors assume that their employer insurance or Medicare Advantage plan is an actual Medicare Supplement. Supplements, nonetheless, are named for the letters A-J, so if your plan will not be named after one of these letters, it is probably not an actual Medicare Supplement plan. As soon as you understand which plan you could have presently, you can examine apples to apples by taking a look at like plans, with the belief that the identical letter plan might be equal coverage. Secondly, get quotes from as many plans as possible. Many people find it best to make use of a certified dealer to do that however you are able to do it on your own as well. However you do it, be sure you are vigilant in getting quotes from as many (or all) corporations as possible so you can be sure you will receive the lowest rates. Lastly, make a alternative based on all accessible quotes and firm status only. Do not allow different components to weigh into your resolution process. As beforehand discussed, supplements are standardized by the Federal Government. Coverage and claims fee is the same from firm to company. So, upon getting all of the data, choose from those plans based on value and firm reputation. Garrett Ball is a Medicare and Medicare Supplement specialist and broker. His firm, Secure Medicare Options, is a leading, unbiased resource for Medicare Supplement comparisons. On the location, you can get details about supplement plans, as well as having a custom-made price quote comparison emailed to you. Visit Medicare Supplement quote to get extra data and receive a custom-made price quote comparison.
Source: yourlupuslife.com

New York Anti Subrogation Law Trumps Medicare Advantage Plans Recovery “Right” Under Medicare Secondary Payer Law 

Posted by:  :  Category: Medicare

42 USC §1395y(b)(8) Allocation bad faith Centers for Medicare & Medicaid Services (CMS) Centers for Medicare and Medicaid Services CMS Franco Signor Franco Signor LLC Gary E. Seger et. al. vs. Tank Collection Hadden Hadden v. U.S. Jeffrey J. Signor Katie Fox Liability Medicare Set-aside Arrangement LMSA Mandatory Insurance Reporting Medicare Medicare & Medicaid Schip Extension Act of 2007 Medicare beneficiary Medicare reimbursement amount Medicare Secondary Payer Medicare Secondary Payer (“MSP”) Medicare Secondary Payer Act Medicare Secondary Payer Compliance Medicare Secondary Payer Compliance: How to Mitigate Exposure in the Medicare Beneficiary Personal Injury Case Medicare Secondary Payer Liability Medicare Secondary Payer Manual Medicare Secondary Payer Statute Medicare Trust Fund MMSEA MSP MSP compliance MSP private cause of action; Geer v. Amex Assuance Co. ORM Responsible Reporting Entity Roy A. Franco RRE SCHIP Extension SCHIP Extension Act Sebelius Section 111 Section 111 Mandatory Insurance Reporting Section 111 reporting User Guide wrongful death
Source: francosignor.com

Video: United Healthcare Oxford Medicare Advantage Denies Coverage

To keep high inflation from eroding the value of money, monetary authorities in the United States:?

NOTE TO EDITORS: The Insurance Research Council is a division of the American Institute For Chartered Property Casualty Underwriters (The Institutes). The Institutes are the leader in delivering proven knowledge solutions that drive powerful business results for the risk management and property-casualty insurance industry. Institutes knowledge solutions include the CPCU designation program; associate designation programs in areas such as claims, risk management, underwriting, and reinsurance; introductory and foundation programs; online courses; research; custom solutions; assessment tools; and continuing education (CE) courses for licensed insurance professionals and adjusters through its CEU.com business unit.
Source: insurance-online-news.com

United Healthcare Oxford Medicare Advantage Denies Coverage

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Source: paidinsurance.com

CMS Issues Last Minute Guidance on End of Annual Enrollment Period Medicare Advantage and Part D Application Submissions

Last night CMS issued some guidance for Medicare Advantage and Part D enrollments.  This guidance relates to this plan year only.  CMS told the plans that they can accept PAPER enrollments with a POSTMARK of December 8, 2011 or earlier, regardless when they are received by the plan.
Source: ritterim.com

Part C Supplement to Medicare Coverage

Posted by:  :  Category: Medicare

meds: it's obscene by fallsroadThe original Medicare program has two parts: Part A (Hospital Insurance), and Part B (Medical Insurance). Only a few special cases exist where prescription drugs are covered by original Medicare, but as of January 2006, Medicare Part D provides more comprehensive drug coverage. Medicare Advantage plans, also known as Medicare Part C, are another way for beneficiaries to receive their Part A, B and D benefits. All Medicare benefits are subject to medical necessity. Part A: Hospital Insurance Part A covers inpatient hospital stays (at least overnight), including semiprivate room, food, tests, and doctor’s fees. Part A covers brief stays for convalescence in a skilled nursing facility if certain criteria are met: 1. A preceding hospital stay must be at least three days, three midnights, not counting the discharge date. 2. The nursing home stay must be for something diagnosed during the hospital stay or for the main cause of hospital stay. 3. If the patient is not receiving rehabilitation but has some other ailment that requires skilled nursing supervision then the nursing home stay would be covered. 4. The care being rendered by the nursing home must be skilled. Medicare part A does not pay for custodial, non-skilled, or long-term care activities, including activities of daily living (ADL) such as personal hygiene, cooking, cleaning, etc. The maximum length of stay that Medicare Part A will cover in a skilled nursing facility per ailment is 100 days. The first 20 days would be paid for in full by Medicare with the remaining 80 days requiring a co-payment (as of 2009, $133.50 per day). Many insurance companies have a provision for skilled nursing care in the policies they sell. If a beneficiary uses some portion of their Part A benefit and then goes at least 60 days without receiving facility-based skilled services, the 100-day clock is reset and the person qualifies for a new 100-day benefit period. Part B: Medical Insurance Part B medical insurance helps pay for some services and products not covered by Part A, generally on an outpatient basis. Part B is optional and may be deferred if the beneficiary or their spouse is still actively working. There is a lifetime penalty (10% per year) imposed for not enrolling in Part B unless actively working. Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, immunosuppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as Lupron, and other outpatient medical treatments administered in a doctor’s office. Medication administration is covered under Part B only if it is administered by the physician during an office visit. Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prosthesis following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered. Complex rules are used to manage the benefit, and advisories are periodically issued which describe coverage criteria. On the national level these advisories are issued by CMS, and are known as National Coverage Determinations (NCD). Local Coverage Determinations (LCD) only apply within the multi-state area managed by a specific regional Medicare Part B contractor, and Local Medical Review Policies (LMRP) were superseded by LCDs in 2003. Coverage information is also located in the CMS Internet-Only Manuals (IOM), the Code of Federal Regulations (CFR), the Social Security Act, and the Federal Register. Part C: Medicare Advantage plans With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Traditional or “fee-for-service” Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships. In exchange for these extra benefits, enrollees may be limited in the providers they can receive services from without paying extra. Typically, the plans have a “network” of providers that patients can use. Going outside that network may require permission or extra fees. Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan’s network or “panel” of providers. Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare,[11] in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.[12] However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.[10] Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.[13] Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD. Enrollment in Medicare Advantage plans grew from 5.4 million in 2005 to 8.2 million in 2007. Enrollment grew by an additional 800,000 during the first four months of 2008. This represents 19% of Medicare beneficiaries. A third of beneficiaries with Part D coverage are enrolled in a Medicare Advantage plan. Medicare Advantage enrollment is higher in urban areas; the enrollment rate in urban counties is twice that in rural counties (22% vs. 10%). Almost all Medicare beneficiaries have access to at least two Medicare Advantage plans; most have access to three or more. Because of the 2003 law’s overpayments, the number of organizations offering Fee-for-Service plans has increased dramatically, from 11 in 2006 to almost 50 in 2008. Eight out of ten beneficiaries (82%) now have access to six or more Private Fee-for-Service plans.[14] Each year many individuals disenroll from MA plans. A recent study noted that about 20 percent of enrollees report that “their most important reason for leaving was due to problems getting care.”[15] There is some evidence that disabled beneficiaries “are more likely to experience multiple problems in managed care.”[16] Some studies have reported that the older, poorer, and sicker persons have been less satisfied with the care they have received in MA plans.[17] On the other hand, an analysis of the Agency for Healthcare Research and Quality data published by America’s Health Insurance Plans found that Medicare Advantage enrollees spent fewer days in the hospital than Fee-for-Service enrollees, were less likely to have “potentially avoidable” admissions, and had fewer re-admissions. These comparisons adjusted for age, sex and health status using the risk score used in the Medicare Advantage risk adjustment mechanism.[18][19] In December 2009 the Kaiser Family Foundation published a report that rated Medicare Advantage organizations on a five star scale. The ratings were based on data from CMS, the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS) data, and the Health Outcomes Survey (HOS). New plans did not receive ratings, because data were not available. Almost six out of ten (59%) of MA plans did receive ratings, and these plans represented 85% of the enrollment for 2009. The average rating was 3.29 stars. Twenty-three percent of enrollees were in a plan with four or more stars; 20% were in a plan with fewer than three stars.[20] Twenty percent of African-American and 32 percent of Hispanic Medicare Beneficiaries were enrolled in Medicare Advantage plans in 2006. Almost half (48%) of Medicare Advantage enrollees had incomes below $20,000, including 71% of minority enrollees.[21] Others have reported that minority enrollment is not particularly above average.[22] Another study has raised questions about the quality of care received by minorities in MA plans.[23] The Government Accountability Office reported that in 2006, the plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.[24] [edit] Part D: Prescription Drug plans Main articles: Medicare Part D and Medicare Part D coverage gap Medicare Part D went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. It was made possible by the passage of the Medicare Prescription Drug, Improvement, and Modernization Act. In order to receive this benefit, a person with Medicare must enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies. Unlike Original Medicare (Part A and B), Part D coverage is not standardized. Plans choose which drugs (or even classes of drugs) they wish to cover, at what level (or tier) they wish to cover it, and are free to choose not to cover some drugs at all. The exception to this is drugs that Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressant and barbiturates. Plans that cover excluded drugs are not allowed to pass those costs on to Medicare, and plans are required to repay CMS if they are found to have billed Medicare in these cases. It should be noted again for beneficiaries who are dual-eligible (Medicare and Medicaid eligible) Medicaid may pay for drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances.
Source: medicare-health.com

Video: What is Medicare Drug Prescription Coverage?

Filling the Medicare Donut Hole

The “doughnut hole,” as many know all-too-well, is the treacherous territory you fall into when you have spent too much of your Medicare Part D benefits to continue receiving full benefits (but not so much of your own money to qualify for “catastrophic coverage”).
Source: kaneandkoltun.com

what you should do if you miss medicare’s 2012 annual enrollment period / eHealth

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

Dubious Protection: New Medicare Drug Coverage Could Erode Retiree Perks

Initially, a U.S. District court ruled that employers are in violation of the Age Discrimination in Employment Act when they offer more generous benefits for employees who are younger than age 65 and, therefore, ineligible for Medicare. But, the Equal Employment Opportunity Commission stepped in with an exemption to the ADEA, and it allows employers to coordinate employer-sponsored health insurance benefits with public programs such as Medicare. This prompted a reversal of the original court decision that different benefits for pre- and post-age-65 retirees were discriminatory. But, the appeals process continues, and the case is still “lingering” in litigation, Horn explains. She adds that companies are “in a holding pattern right now until they see how the case turns out.”
Source: knowwpcarey.com

Medicare Benefit Plans To Value Much less In 2012

While all information is believed to be reliable, it is not guaranteed by us to be accurate. Individuals should assume that all information contained in our newsletter is not trustworthy unless verified by their own independent research. Also, because events and circumstances frequently do not occur as expected, there will likely be differences between the any predictions and actual results. Always consult a real licensed investment professional before making any investment decision. Be extremely careful, investing in securities carries a high degree of risk; you may likely lose some or all of the investment.
Source: beststockmarketresearch.com

As Open Enrollment Ends, People with Medicare save $1.5 billion on prescriptions

Thanks to the Affordable Care Act, the Medicare prescription drug coverage gap known as the donut hole is starting to close. Through the end of October, 2.65 million people with Medicare have received discounts on brand name drugs in the donut hole.  These discounts have saved seniors and people with disabilities a total of $1.5 billion on prescriptions – averaging about $569 per person.  For State-by-State information on the number of people who are benefiting from this discount in 2011, visit this page.
Source: medicare.gov

More Healthcare Choices With Highmark Medicare

Few folks possess sufficient income to cover medical expenditures when these folks get sick. In order to generate high quality medical care readily available to the majority, well being insurance coverage enjoy Medicare is devised by the the federal government as an assurance which individuals are protected from the fees incurred when availing one. The approach of well being insurance coverage follows a financial fee construct typically in the form of monthly top quality deductions by the insurance coverage websites to the salary of an individual. The savings which gather at the time of time from these rates are employed for paying medical care. Commonly, a well being insurance coverage has provisions to follow just before an insured individual can be eligible for coverage. In Medicare for instance, folks aged 65 or older, permanently unable to function well, or individuals with kidney failure, are entitled to use it so which their medical fees are a lot more affordable.
Source: linelit.org

What Does Medicare Cover Involve?

For some patients receiving benefits from Medicare, it is very important to know exactly what their Medicare cover involves and what it does not. Medicare is divided into four parts which are, Part A, B, C and Part D. Before learning about the different parts and what each part covers, you need to know that Medicare cover does not provide coverage for everything. For instance, it does not cover the entire cost for most medical supplies or covered services. The premium is based on the kind of Medicare plan that you opt for. Mentioned below are the different Medicare Parts and what the cover involves.
Source: easterndrugs.com

6 Things Every Caregiver Should Know

Many baby boomers need advice the first time they enroll in Medicare. And, many adult caregivers face the same challenges when they try to help family members review new or existing Medicare coverage, or understand changes from one year to the next. For baby boomers and caregivers, it’s becoming increasingly difficult to navigate the complexities of a system that isn’t getting any easier to understand. Finding your way through the Medicare maze can overwhelm anyone, especially with all of Medicare’s moving pieces. Medicare has four parts and ten supplemental coverage options. For example, Medicare Advantage plans include different benefits and provider networks, which should be compared. Prescription drug plans change each year to counteract rising drug costs, and each of the ten supplements has different coverage levels that should be evaluated.
Source: grandstrandboomers.com

Anthem medicare d prior authorization

Posted by:  :  Category: Medicare

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Source: posterous.com

Video: Anthem pulls switch on Medicare Advantage subscribers

Anthem Expands Medicare Advantage Offerings to Six New Counties in Missouri

Nationwide, more than 12 million seniors are enrolled in Medicare Advantage (MA) plans. Eighty-eight percent of them are satisfied with the quality of care they get, according to a 2008 survey from America’s Health Insurance Plans (AHIP). The plans combine Medicare Parts A (hospital) and Part B (medical coverage) into one convenient package run by a private insurance company. The plans can include additional benefits, and can be paired with a Part D plan to include drug coverage. They may include additional premiums.
Source: patch.com

Anthem medicare prior authorization form

Anthem Prior Authorization Forms: Find out everything there is to know about Anthem Prior Authorization Forms on Daymix.com! Images, videos, blog posts, news, tweets Anthem medicare prior authorization form .
Source: ablog.ro

Anthem Medicare Advantage Plans – Great Coverage

ABChealthplans.com is dedicated to providing you with all your health insurance needs. They offer the instant quote services for free without any obligation to buy into any of the policies that they provide quotes for. Shopping online has become very common place because it is so convenient. Comparing Medicare Advantage plans online is the easiest way to find plans and make an informed decision. You can compare quotes for Anthem Medicare Advantage plans any time of the day or night, whenever it is convenient for you. At ABChealthplans.com you are in the driver seat!
Source: abchealthplans.com

San Jose Medicare Supplements Insurance, Anthem,Medicare Advantage Senior Plans, San Jose, CA

sanjosemedicaresupplements.com Jose Medicare Supplements Insurance specializes in insurance for seniors aging into Medicare including Medicare supplement insurance and Medicare Advantage from Anthem Blue Cross, and Blue Shield. The senior years bring a major change in health insurance coverage as Medicare benefits will affect your health insurance options. San Jose, Santa Clara County, CA Video Rating: 0 / 5
Source: bestlongtermcare.org

Medicare Open Enrollment: Anthem Blue Cross Cancels Medicare Advantage Plans in California

If you are currently in the Anthem Blue Cross California Medicare Advantage plan, and you want to stay in Medicare Advantage, you must sign up for another Medicare Advantage plan by the end of Medicare Open Enrollment Season on December 7th. It does not necessarily have to another Anthem Blue Cross plan, but you do need to sign up by December 7th to keep on Medicare Advantage.
Source: myhealthcafe.com

Anthem Suddenly Changes Medicare Advantage Plan

Two weeks later, Anthem sent out a second letter, to the same customers. This one was labeled “Important Notice”, (two words you never want to hear from your insurance company). The letter explained “Your Medicare coverage is changing.” It went on to say that Anthem Blue Cross would no longer be offering the Medicare Advantage plan in 2012. So much for wanting to provide outstanding service “for years to come”!
Source: families.com

Anthem medicare rx prior authorization form // Dog ate 5mg adderall

Prior Authorization Forms by Customer. AHCCCS Prior Authorization Request Form; Citizens Choice Prior Authorization Request Form; GLHP Prior Authorization Request Form Blog, bitacora, weblog. Wellpoint prior authorization forms . Certification, also visit the attached. This anthem wellpoint medical policy; prior known as prior . Sheep Ovis aries are descended from the wild..Medicare Part D Pharmacy Prior Authorization and Determination Forms. If you need additional information regarding . Step Therapy / Prior Authorization Forms. Prime Therapeutics, our pharmacy benefit manager, conducts all Prior Authorization (PA) and Step Therapy (ST . Medicare Part D Pharmacy Prior Authorization and Determination Forms. If you need additional information regarding Medicare Part D prior authorization . Drug prior authorization forms Eliminate delays. We have to call for more information on 40% of all prior authorization and medical necessity drug request forms! Home > Doctors & Hospitals > Pharmacy Services original:
Source: freeblog.hu

California Anthem Users Facing Medicare Changes

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Source: doctorsexpresstricity.com

Medicare Supplement Companies Are Defrauded

Posted by:  :  Category: Medicare

HERES YOUR TOP TEN by SS&SSIn Colorado, many Colorado Medicare Supplement companies have been victims of fraud. A number of Colorado hospitals and health care providers have been putting down the wrong charges on their medicare claim forms. When they should have been reporting normal cases, they have been ordering many expensive tests that costs Medicare and Colorado Medicare Supplement companies millions of dollars.
Source: tonyhawkexperience.com

Video: Guaranteed Lowest Prices on CMS 1500 claim forms

Daily Digest for December 21: When Imbeciles Attack

Women Laid Off, Workers Sped Up: Konczal and Covert Uncover Clue to Gendered Recovery A World Upside Down? Ferguson and Johnson Take on Deficit Hysteria Democracy in Peril: Burnham Looks at Dangerous Voter Turnout Trends Deficit Reduction: Stiglitz Proposes Principles and Guidelines The Stagnating Labor Market: Jayadev and Konczal Discover Unsettling Unemployment Trends The Boom Not the Slump: Jayadev and Konczal Combat Flawed Deficit Logic Deficits and Social Security: Page and Jacobs Expose Deliberative Forum Pitfalls Midterm Storm Brewing: Ferguson and Chen Reveal Real Story of Massachusetts Upset
Source: newdeal20.org

Things to Know About Medicare Claims Processing

Nonetheless, there are several things you have to do if you really want to do the Medical claims processing yourself. For instance, you should check your MSN or Medicare Summary Notice in your mail or online. Every three months, you will receive a Medicare Summary Notice that lists all medical supplies and services that are billed to Medicare within the said time frame. If a particular supply or service does not appear on the Medicare Summary Notice, then such supplier or provider may not have filed a claim.
Source: healthinfotimes.com

How to Bill Endoscopic Procedures

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Source: abacusnt.com

Feds Fight Fraud by Withholding Medicare Reimbursements

BNA’s James Swann writes that the Medicare Fraud Strike Force, which consists of the Department of Justice and HHS personnel in nine U.S. cities, “brought cases involving more than $1 billion in fraudulent claims” last year. The new directive, says Sebelius, is designed to support “continuing efforts to move away from the existing pay-and-chase enforcement model to a model that would prevent improper payments in the first place.”
Source: firststreetonline.com

California Medicare Supplement Insurance coverage Info

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSThe finance analysis provides the investors with the ultimate investment products and tools for a successful stock market trading analysis. When researching stock in the stock market today, be sure to fully research all of your options for quality stock picks. Using the strength of a free stock screener may also be helpful. While all information is believed to be reliable, it is not guaranteed by us to be accurate. Individuals should assume that all information contained in our newsletter is not trustworthy unless verified by their own independent research. Also, because events and circumstances frequently do not occur as expected, there will likely be differences between the any predictions and actual results. Always consult a real licensed investment professional before making any investment decision. Be extremely careful, investing in securities carries a high degree of risk; you may likely lose some or all of the investment.
Source: eftanalysis.com

Video: How to Lower Your Health Insurance Premiums in Texas Brought to You by Family Financial Services

5 Things To Know About California Medicare Insurance And California Medigap Get The Facts

Posted by:  :  Category: Medicare

2. Medigap plans are not offered by the government. Another important thing to be reminded of is that the government, itself, is not offering Medigap plans (unlike Original Medicare, which is a social insurance from the US government). This means that you would have to purchase this supplement to your California Medicare plan from a private health care provider. However, California Medigap plans and other Medigap plans in other states are regulated by the federal government so that policy holders would not have to fear from abuse or other unpleasant things from the private health insurance companies that offer them.
Source: articlesnaps.com

Video: Learn About Medigap Plans

Medigap Plans Or Medicare Benefit Plans

The finance analysis provides the investors with the ultimate investment products and tools for a successful stock market trading analysis. When researching stock in the stock market today, be sure to fully research all of your options for quality stock picks. Using the strength of a free stock screener may also be helpful. While all information is believed to be reliable, it is not guaranteed by us to be accurate. Individuals should assume that all information contained in our newsletter is not trustworthy unless verified by their own independent research. Also, because events and circumstances frequently do not occur as expected, there will likely be differences between the any predictions and actual results. Always consult a real licensed investment professional before making any investment decision. Be extremely careful, investing in securities carries a high degree of risk; you may likely lose some or all of the investment.
Source: eftanalysis.com

What Retirees Need To Know About Medigap Plans And Medicare Advantage: How To Choose

Coverage by most types of plans is standardized by law. In any given state, Plan A offered by one insurer must match Plan A offered by any other insurer. But premiums vary widely even among the same plans by different insurers. For comparisons, check websites.
Source: investors.com

Overview Of Medicare Supplemental Insurance

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Source: apssupplements.com