Medicare Privatization Plans

Posted by:  :  Category: Medicare

Bubbles? Take something like 'Not I! .....item 1..Wakulla Republicans Protest Against Taxes in the County (September 06, 2011) ... by marsmet552Overall, US healthcare could make a quantum improvement leap compared to today’s dysfunctional system. Instead, bipartisan complicity has worse in mind by cutting benefits, placing greater burdens on seniors and others, letting corporate predators game the system, and still leave millions uninsured, on their own and out of luck.
Source: uncommonthought.com

Video: Medicare Advantage Plans 2011

WHAT OTHERS SAY: Private Medicare plans have been a disaster

Then in 2003, a Republican-controlled Congress went to bat for private insurers again. Three years later, the resulting Medicare Advantage plans made $1.3 billion more in profits than they had expected to make, according to the Government Accountability Office. Lucky them. The unlucky American taxpayers pay at least 12 percent more for that program than they pay to cover seniors in traditional Medicare.
Source: columbiamissourian.com

Top 10 political blunders of 2011

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 Supplement Insurance Plans Comparability

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: investmentfinancialadvice.com

The Federal MediCare Insurance coverage Benefits

Posted by:  :  Category: Medicare

Press Conference on Benefits of Health Insurance Reform to Seniors by Leader Nancy PelosiCustodial nursing house treatment Most outpatient prescription medications Routine bodily examinations Routine eye examinations and eyeglasses Listening to examinations and hearing aids Routine dental solutions Routine foot treatment and orthopedic footwear Most immunizations Personalized usefulness products Cosmetic medical procedures
Source: theatreormpls.org

Video: Whitehouse: Cuts to Social Security and Medicare Benefits Have No Place in Debt Talks

Medicare Benefit Plans To Price 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: financemarkettoday.com

Innovative Medicare Advantages Plan Pricing you Capital

Medicare and additionally Medicare supplementation insurance will be two different things that will, while earning a living together fantastically, should not necessarily be confused against each other. Medicare insurance plan is made available from the government regarding 65 years old or elderly or regarding that medicare supplement as a result of disability. Users who are qualified to apply for Medicare all obtain same standard of benefits and additionally coverage. This routine has provided a lot of individuals while using health care them to need for prices them to would otherwise struggle to afford. The benefits associated with Medicare are actually valuable specifically those living about the fixed revenue.
Source: yarnstasher.com

What is Medicare Benefit?

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 Does Medicare Cover?

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: thestockexchangereport.com

Medicare Privatization Plans

Overall, US healthcare could make a quantum improvement leap compared to today’s dysfunctional system. Instead, bipartisan complicity has worse in mind by cutting benefits, placing greater burdens on seniors and others, letting corporate predators game the system, and still leave millions uninsured, on their own and out of luck.
Source: uncommonthought.com

Medicare Supplemental Insurance the best security for old age

A Medigap policy is often called “Medicare Supplement Insurance”. It is a private health insurance that is designed to supplement Original Medicare. So, it helps to pay some of the health care costs that Original Medicare doesn’t cover. If anyone has Original Medicare and a Medigap policy, Medicare will pay its share of the Medicare-approved amounts for covered health care costs. Then the Medigap policy pays its share. All Medigap policy and Medicare Advantage Plan (like an HMO or PPO) is different because those plans are ways to get Medicare benefits, while a Medigap policy only supplements of the Original Medicare benefits. But Medicare doesn’t pay any of the costs to get a Medigap policy. Medigap insurance is a health insurance and you have to buy this from a private insurance company. To protect the entire customer every medigap insurance plan has to follow federal as well as state laws. Medicare supplemental plan insurance companies can only sell you a “modernized” or “standardized” medigap plan identified by letters A through N. It does not matter which insurance company sells the plan but each and every modernized or standardized plan must have the basic benefits. The same plan sold by many different insurance company but the only difference is the cost. Health insurance companies set their medigap policies price by setting their own monthly premium.
Source: beneficialfunction.com

Secure Horizons Medicare Benefit

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Source: nasdaqtradingmarket.com

Changes Identified In The Brains Of Patients With Spinal Cord …

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

How to Apply for Social Security Retirement Benefits and Medicare : Pennsylvania Law Monitor

The earliest age at which you can receive Social Security Retirement Benfits is 62. You can start receiving Medicare Benefits at age 65. Within 4 months of the date you wish to start receiving benefits you should contact Social Security. The application process will require you to answer certain questions and provide some documents. If you have difficulty obtaining all the documents, Social Security will assist you in getting them. The documents required to prove your eligibility for retirement benefits include:
Source: stark-stark.com

Medicare Fraud in the U.S.: The Castro Connection

Posted by:  :  Category: Medicare

Charity Hospital, in disuse...at nite..all blurry..but kinda cool.. by JustUptownIt began like this: In 2005, Huarte and his co-conspirators formed or acquired control of six medical clinics in Florida, each with its own office. Patients were then recruited and paid kickbacks to periodically appear at the clinics or allow use of their Medicare numbers, according to a plea agreement signed by Huarte in October 2009. The clinics were shams – patients weren’t receiving legitimate treatment there. Later, when authorities caught on, Huarte created shell companies consisting of entirely fictional clinics — those that corresponded with mailbox stores, for instance.
Source: babalublog.com

Video: Los Angeles: Medicare Fraud Summit Law Enforcement Panel

Medicare Meeting in La Honda

Christina Kahn, Community Outreach Coordinator for the Health Insurance Counseling and Advocacy Program (HICAP) will meet with individuals from the La Honda and Pescadero communities to discuss the upcoming changes in Medicare coverage in 2012.  She will also present comparisons and other information about current supplemental health insurance options (please note that if  you wish to change your Medicare coverage in any way, you can do so between October 15 and December 7, 2011).  The meeting will take place at the Puente Office in Downtown La Honda and is sponsored by the La Honda 55+ Program.  HICAP, an information and counseling service, is supported by the local Agency on Aging.  They do not represent or advocate for particular insurance or healthcare entities and appointments with HICAP Counselors are typically made through senior centers.
Source: pescadero-california.com

Social Security Launches New Spanish Online Services

In addition to the new applications, Social Security has also recently made online estimates of retirement benefits available in Spanish.  People interested in planning for retirement can get an immediate, personalized estimate of their Social Security benefit by using the Retirement Estimator at www.segurosocial.gov/calculador.  Using people’s actual wages from their Social Security record, the Estimator gives a good idea of what to expect in retirement.  Workers can enter in different dates and future wage projections to get estimates for different retirement scenarios, which is why this service is one of the most highly rated electronic services in the public or private sector.
Source: us.com

CENTRAL La. POLITICS: MEDICARE AND MEDICAID FRAUD

A federal grand jury has indicted on Friday several people, including two elderly doctors, who allegedly netted more than $21 million in a phony Medicaid and Medicare billing scam. (See: “Doctors accused of scam”). “Prosecutors say unneeded neurology tests, pulmonary tests, echocardiograms and other exams were rampant in the scheme, which ran in 2009 and 2010, according to the 44-count, 78-page superseding indictment” and an “earlier indictment in April named nine defendants and placed the cost of the alleged scam at about $12 million”. id. “The defendants allegedly schemed to bill the government for thousands of tests that were never performed, and for others done unnecessarily, the indictment alleges.” id. Last year, CBS News reported that “Medicare fraud – estimated now to total about $60 billion a year – has become one of, if not the most profitable, crimes in America”. (See: “Medicare Fraud: A $60 Billion Crime”).
Source: blogspot.com

Lawyer’d Up: Medicare Fraud Bust in LA

The Los Angeles Times reports a physician, a pharmacist and 15 others have been charged with Healthcare Fraud in Federal Court in Los Angeles. Using stolen or illegally obtained Medicare beneficiary cards, members of the ring known as “runners” are accused of getting prescriptions for drugs from a Glendale doctor according to a criminal complaint unsealed Thursday in United States District Court in Los Angeles. The medications were commonly Seroquel and Zyprexa, for which Medicare pays pharmacies up to $2,800 a bottle. Fifteen alleged members of the ring were arrested Thursday and scheduled to appear in federal court in downtown LA. A 16th ring member already was in custody on a separate fraud case, and a 17th person remains at large. If you have been arrested for health care fraud in Los Angeles, contact the criminal attorneys with 80 years of combined experience in criminal law.
Source: lawyerdup.com

Locate Why Medicare health insurance Supplement Insurance Is

Another supplemental plan there to senior citizens is named Managed Consideration Plan. With this plan, several grouped doctors as well as hospitals obtain their payment from health insurance held through the client (and very much the same other clients). A lot of these hospitals as well as doctors, subsequently, take care medicare supplement plans senior individuals. Some occasions, these Succeeded Care Ideas are directly made available from supplemental Medicare insurance vendors. You only need to buy Medicare insurance insurance whereas other parts of succeeded care liability lies relating to the insurance business enterprise. You can easily, however, survey your doctors as well as hospitals included in the arrange. It is more preferable to evaluate these coverages since just about every scheme have a distinct network from doctors as well as hospitals doing work for them.
Source: stardancestudios.com

Feds Make Arrests in $18 Million Medicare And Medicaid Scam

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.
Source: kaiserhealthnews.org

People With Medicare Part D Prescription Plans Can Make Changes Earlier This Year — La Grange & La Grange Park news, photos and events — TribLocal.com

Insurance companies that offer Medicare Part D and Medicare Advantage plans were required to send Annual Notice of Change packets to their members by September 30. These packets explain changes to a plan’s benefits, drug list and costs for 2012. Some people were notified that their coverage will change in 2012 or that their plan has been discontinued. Others were told that they will automatically be moved into a different plan offered by the same company. For anyone who is not happy with their new plan, now is the time to make a change.
Source: triblocal.com

Eternity News Update: When Medicare Isn’t Medicare

Wendel Potter @ Common Dreams – Let’s say you have a Ford and decide to replace everything under the hood with Hyundai parts, including the engine and transmission. Could you still honestly market your car as a Ford? That question gets at the heart of the controversy over who is being more forthright about GOP Rep. Paul Ryan’s plan to “save” Medicare, Republicans or Democrats. If you overhaul the Medicare system like you did your Ford and tell the public it’s still Medicare, are you doing so honestly?  Read more.
Source: blogspot.com

Are You Looking For An Affordable Los Angeles Dentist?

A dentist, also known as a dental surgeon is a professional that treats, prevents and manages diseases affecting gums, teeth and mouth. Also, some experts that practice cosmetic dentistry work to enhance the aesthetic worth of your teeth. Although there are lots of qualified dental surgeons present all over the world still, people often opt for a Los Angeles dentist when it comes to dental implants or dental cosmetic surgery! Los Angeles is a convenient location in terms of service, cost, comfort and experience. Since most people of this city are beauty conscious hence, this area is jam-packed with lots of seasoned dental surgeons. The American Dentist’s Association recognizes 8 specialized areas related to dental surgery. The most important ones are: pedodontics (dentistry for children), orthodontics (oral dentistry), periodontics (dentistry for gums), endodontics (that deals with root canal therapy), prosthodontics (that focuses on making dentures or false teeth) and oral pathology (that deals with the treatment of oral diseases). Dental work can be very expensive at times, especially when you’re getting a cosmetic surgery done. Therefore, most people avoid visiting a dentist. Moreover, root canal treatments can be financially upsetting. In such circumstances, finding an affordable Los Angeles dentist is quite handy! In case you’re looking for an affordable Los Angeles dentist, you should follow the mentioned tips: Look for dentists that accept Medicare and Medicaid recognized patients. Medicaid and Medicare are American healthcare programs that are administered by the government for families and individuals that have low income. They introduce coverage policies and preventive dental care programs for children below 21 years of age and senior citizens that are 65 years old and above. These programs cover up oral pathology, dental surgery and other oral or dental problems. You can contact your local dental society for a quick reference. You may also check out the phone directory or browse through the online website of American Dental Association. You can contact a local call center for more information. You can visit a dental school or college. The graduates training in an institute administer free of cost dental care. Even if they charge you some amount, the overall bill is quite low! Lastly, you can speak to your acquaintances and friends for a recommendation. Take your time, be patient and find the best Los Angeles dentist for your teeth related problems!
Source: articlesxpert.com

Medicare Annual Enrollment Period: NEW Dates!! Tips for Choosing the Right Plan for You 

Other Medicare beneficiaries receive their health and sometimes their prescription drug coverage through a Medicare Advantage Plan. This alternative arrangement provides beneficiaries with their Medicare benefits through privately managed health insurance companies. Medicare Advantage Plans can be managed care provided by a health maintenance organization or a preferred provider organization or they can be private fee-for-service. Medicare beneficiaries who receive their Medicare benefits through an Advantage plan do have to make enrollment decisions during the annual enrollment period and it is an important time for Medicare beneficiaries to look at their health care needs and the options available. One very important consideration during this time is whether your provider is going to accept your health plan in 2012. Providers can and do change which insurance plans they will accept from year to year so if you do not want to switch providers, make sure your provider accepts the plan that you selected for enrollment. Again, the new dates for changing your Medicare Part D and Medicare Advantage plans will be Oct. 15 – Dec. 7, 2011 for plans to be effective January 1, 2012. You will not be able to change plans for the next year after December 7, therefore please plan accordingly.
Source: uwex.edu

Choosing Supplemental Health Insurance For Senior Residents

Posted by:  :  Category: Medicare

DAMN!! -- I THINK WE'RE F*%KED by SS&SSIn Plans B by means of J there is provision for a Half A deductible that covers the Half A deductible amount per benefit period. Accessible on plans C, F, and J is a Half B deductible that covers the amount. There may be full coverage in plans F, I, and J and 80 p.c coverage in Plan G for Half B excess physician prices for such charges that are limited to fifteen p.c above the Medicare standard. Nevertheless, if most of your docs take Medicare task, you might not need this coverage. Plans D, G, I, and J provide coverage for at-house restoration prices for short-term at-house assistance. That is limited to certain variety of visits by a provider who is certified and fee can be limited. Plans E and J cover preventive medical care deemed to be appropriate by your physician and beyond Medicare covered preventive providers to a certain amount. High deductibles are required for Plans F and J in trade for a lower premium. Word: along with the high deductible, there will likely be a deductible for international journey emergency.
Source: nasdaqtradingmarket.com

Video: Switching To Medicare Supplement Plan F

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

Pharmacies, Medical equipment Suppliers, STERLING HEIGHTS, MICHIGAN, (MI) USA

Posted by:  :  Category: Medicare

DM01-AUTOMATIC EXT DEFIBRILLATOR (AEDS) AND/OR SUPPLIES,  DM02-COMMODES,  URINALS,  BEDPANS,  DM03-CONTINUOUS PASSIVE MOTION (CPM) DEVICES,  DM05-BLOOD GLUCOSE MONITORS/SUPPLIES (NON-MAIL ORD),  DM06-BLOOD GLUCOSE MONITORS/SUPPLIES (MAIL ORDER),  DM08-HEAT & COLD APPLICATIONS,  DM09-HOSPITAL BEDS (ELECTRIC),  DM10-HOSPITAL BEDS (MANUAL), DM18-PNEUMATIC COMPRESSION DEVICES AND/OR SUPPLIES,  DM20-SUPPORT SURFACES: PRESSURE REDUCING BEDS/MATS/PADS,  DM21-TRACTION EQUIPMENT,  DM22- Transcutaneous Electrical Nerve Stimulation (TENS) AND/OR SUPPLIES,  DM23-ULTRAVIOLET LIGHT DEVICES AND/OR SUPPLIES,  M01-CANES AND/OR CRUTCHES,  M02-PATIENT LIFTS,  M03-POWER OPERATED VEHICLES (SCOOTERS),  M04-SEAT LIFT MECHANISMS,  M05-WALKERS,  M06-WHEELCHAIRS (STANDARD MANUAL & RELATED ACCESSORIES),  M07-WHEELCHAIRS (STANDARD POWER & RELATED ACCESSORIES),  M08-WHEELCHAIRS (COMPLEX REHABILITATIVE MANUAL & RELATED ACCESSORIES),  M09-WHEELCHAIRS (COMPLEX REHABILITATIVE POWER & RELATED ACCESSORIES),  M10-WHEELCHAIR SEATING/CUSHIONS,  OR01-ORTHOSES: CUSTOM FABRICATED,  OR02-ORTHOSES: PREFABRICATED (NON-CUSTOM FABRICATED),  OR03-ORTHOSES: OFF-THE-SHELF,  PD01-BREAST PROSTHESES AND/OR ACCESSORIES, PD06-OSTOMY SUPPLIES,  PD08-TRACHEOSTOMY SUPPLIES,  PD09-UROLOGICAL SUPPLIES, PE01-ENTERAL NUTRIENTS,  EQUIPMENT AND/OR SUPPLIES,  R01-CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICES & RESPIRATORY ASSIST DEVICES,  R03-INVASIVE MECHANICAL VENTILATION,  R07-NEBULIZER EQUIPMENT AND/OR SUPPLIES,  R08-OXYGEN EQUIPMENT AND/OR SUPPLIES,  R10-RESPIRATORY SUCTION PUMPS,  R12-VENTILATORS ACCESSORIES AND/OR SUPPLIES,  S01-SURGICAL DRESSINGS,  S02-DIABETIC SHOES AND INSERTS,  S03-DIABETIC SHOES/INSERTS – CUSTOM,
Source: usa-hospitals.com

Video: Medicare drug coverage changes

Sterling Medicare Supplemental Insurance Reviews

Sterling Option #1 is the first Medicare Advantage plan that allows holders to combine Medicare Supplemental Services and traditional Medicare. This ultimately translates into seeing your physician and allowing the bill to be sent to Sterling. Sterling will pay the bill and Medicaid will be notified of their portion, which then pays Sterling. This subsequently saves lots of time and headaches with filing claims with Medicaid and Sterling. Sterling basically handles everything while making the process as simple as possible for you. Your only concern will be paying the premiums for your Sterling Medicare Supplemental Insurance plan as well as for the Medicare Part B plan.
Source: ihealthcoalition.org

Sterling Medicare Supplement: Many Options From One Company

Sterling Option1 is a Medicare Advantage plan which allows you to combine your Medicare and Medicare supplement services. This means that you will see your doctor and his office will bill Sterling directly. Sterling will then pay the bill and notify Medicaid of their portion, who will then pay Sterling. This saves you the time and trouble of worrying about filing claim forms with both Medicaid and Sterling. Sterling will handle it all and simplify the process for you as much as possible. All you have to worry about is paying the premium of your Sterling Medicare supplement plan and the premium for your Medicare Part B plan.
Source: medicaresupplementinsurances.com

is the sterling medicare advantage insurance plan a hmo?

Medicare, and therefore any Medicare Advantage plans of all types, do not pay for nursing homes. They will pay for skilled nursing services in a Medicare certified skilled nursing facility up to 100 days and only if there is a possibility of improvement. For example, if after 10 days the doctor states that you will not get better and will need nursing services for a long period of time the plans will stop paying for the services even if you have not reached the 100 day mark.
Source: bestlongtermcare.org

The best way to Buy the right Office Wireless network Router

When AS I was investigating new buildings with my sister, one belonging to the things during my mind has been where We would put this wireless router. While that could be a bit extreme to most, it provides you with an ideal just the correct way important this is often. Many people search online for many different things. If a person plays online games, then it is recommended to have this router close video console. Some would prefer to even provide the video adventure system plugged in the router. At any rate, it has to be very at the router. Subsequently, if you may have an clinic, you do will possibly not want this router much from right now there. People include different demands significantly as internet velocity goes. Such as, I include my router downstairs not to mention my clinic upstairs and get on situation with the condition of speed which usually my internet set in my clinic. That says, I include FiOs the web, which can be internet which may be extremely swiftly.
Source: sterlinggraham.com

Medicare Supplemental Insurance Plans for 2012, Find Best Medigap Coverage from AARP, Sterling, Blue Cross Blue Shield, Colonial Penn and Others

Eligible senior Medicare recipients that are interested in finding the best Medicare supplement insurance plan or Medigap plan for 2012 will find many coverage offerings from a potpourri of insurance companies, all depending on the state and county in which they reside. Companies such as AARP, Blue Cross Blue Shield, Colonial Penn and Aetna all will be offering plans throughout the United States for 2012. Most plans will be available by October 15th, 2011, the start of the annual enrollment plan. The best plan will vary depending on the individual senior demographic data. For instance, women may find that their rates are generally lower for these plans, while smokers will definitely find that they will have to pay more for the best coverage. A quick glance at plans offered to a female, non-smoker aged 65 living in Palm Beach, FL shows that there are about 30 plan offerings, with premium prices ranging from 1100 dollars for the lowest priced plan, to about 3500 dollars for the most expensive plan. Price is, of course, not the only consideration, as many senior Medicare recipients might wish to have many choices for doctors or hospitals, and be willing to pay higher monthly premiums to keep out-of-pocket costs down. Keep these costs differences in mind.
Source: seniornewscoverage.com

Sterling Health Insurance Company Review

Sterling Life prides itself on providing high quality personalized service to all its clients. The company motto is “Real People, Wise Choices.” The Sterling website provides a testimonial page featuring comments by current customers. Sterling members have access to an excellent interactive portal where they may file a claim, make a premium payment, download information and forms, or shop for a new insurance plan. Plans are available to fit the needs of any individual wherever they might live in the US.
Source: healthinsuranceproviders.com

FAILED GOVERNMENT PROGRAMS THAT DESTROY INCENTIVES AND WASTE MONEY: SEARS MISMANAGEMENT SHOWN IN LACKLUSTER RETAILING EXPERIENCE AT CHRISTMAS

After 6 years of “management” by a hedge fund manager, and after their holding value has declined by some $10 billion,it may be time for Mr. Lampert to hire someone to run the stores like they should be. My own shopping experience tells the whole story. I needed to get a replacement filter for my Kenmore (SEARS Brand) winter air humidifier that needs new filters every 30 days. These humidifiers are sold by SEARS however, nobody has figured out that since they are sold there, they also need to sell the filters with the models that are sold! So, I have to call 2, 3 or 4 stores to see if they have the filters in stock, and of course they have but not for that model…I call some more and find a “close” one that I have to then buy since the filter is needed to disperse the humidity in the house. I drive to the store that has the “close” filter in stock, and there I discover that the store looks like it is out of the 80’s….same merchandise, and almost empty except for the people exchanging screwdriver sets, and surly cashiers. I wonder why their sales are not growing??? Sears Holdings Corp will close as many as 120 of its Kmart and Sears discount and department stores after its holiday sales slumped, sending its shares sliding more than 27 percent to their lowest level in three years. The retailer, which is controlled by its chairman, the hedge fund manager Edward Lampert, has seen sales decline every year since the $11 billion merger of the two chains in 2005, and likely faces further closings to cut expenses, preserve cash and push back against rivals such as Wal-Mart Stores Inc and Amazon.com Inc, analysts said. Sears also disclosed on Tuesday that it tapped its credit line to borrow cash and forecast that fourth-quarter earnings would fall by more than half. Under Lampert, the company, once one of the most successful U.S. retailers with a history going back to 1886, has let stores deteriorate, said analysts, who also faulted poor locations and ho-hum merchandise for its ongoing problems. “They’ve neglected this business for so long,” independent retail analyst Brian Sozzi said, adding that he expects more closings. “They are letting Kmart and Sears die on the vine.” In a memo to staff obtained by Reuters, Chief Executive Lou D’Ambrosio, who took the job in February, blamed the economy for some of Sears’ problems but acknowledged “we also did not execute with the consistency or speed necessary” in areas under Sears’ control. “We will do better,” he continued. But Credit Suisse analyst Gary Balter is not so sure. “We do not see how they dig out of these problems,” he wrote in a client note. Same-store sales at Kmart were down 4.4 percent in the eight weeks that ended Christmas Day, and down 6 percent at Sears’ U.S. stores. Overall, they were down 5.2 percent compared with the same period a year ago. The closings follow Sears’ announcement last quarter it would shut 10 stores. Kmart and Sears have a combined 2,177 big-box locations. A list of stores affected will be available at www.searsmedia.com once the retailer decides on the locations. The declines at Kmart were led by drops in electronics and clothing sales as the low-price chain, founded in 1962, faced stiff competition from a resurgent Wal-Mart which resumed its layaway program this year to make it easier for low income shoppers to make purchases by paying in installments. Kmart has found itself squeezed between Wal-Mart’s low prices and Target’s trendier offerings, while Sears has faced more intense competition for electronics and lower prices, and less demand for household appliances. Sears blamed electronics sales for more than half of the decline in its namesake chain’s domestic same-store holiday sales. Sears’ shares finished the day down 27.2 percent at $33.38, their lowest level since December 2008, and have fallen 65 percent since a 52-week high in February. At the current stock price, Sears Holdings — home to brands including Craftsman tools and Kenmore appliances — has a value of $3.57 billion. The value of Lampert and his hedge fund’s stake in the company has plunged nearly 75 percent to $2.25 billion since 2005, when his holdings were worth around $8.5 billion. The stake was worth as much as $12.7 billion in April 2007. The drop in shares is also a big blow for fund manager Bruce Berkowitz’s Fairholme Capital, Sears’ second-biggest shareholder with 15.2 percent. Fairholme’s stake was worth about $570 million on Tuesday, a potential loss of almost $180 million since the end of the third quarter. Sears’ problems also hit shares of appliance maker Whirlpool Corp, which last year derived 8 percent of sales through the retailer. Whirlpool shares fell 8.9 percent to close at $46.62. FALLING FURTHER BEHIND Sears’ empire was once so sprawling that it owned everything from a radio station (WLS in Chicago) to Allstate Insurance Co and Coldwell Banker Real Estate Group. But now the chain, founded in Chicago 125 years ago, acknowledges it has to downsize. Its standard practice in the past would have been to give weak stores time to improve, but the economy is too tough to do that this time, Sears said. Sozzi, the analyst, went to a Sears in Bayshore, New York, on Monday, one of the busiest days of the retail season, and said it was “deserted.” At the northern end of the state, in Plattsburgh, a Sears was similarly quiet. Wall Street analysts have long faulted Sears for letting its stores become stale, even as rivals ranging from Macy’s Inc and J.C. Penney Co Inc to Target Corp and Wal-Mart remodeled and spruced up their stores. Last fiscal year, Macy’s spent $505 million to improve its namesake and Bloomingdale’s stores, while Sears spent $441 million despite having more than three times as many stores. Sears is “effectively asking customers to pay for a poorer shopping environment”, Credit Suisse’s Balter said. Balter was also surprised that Sears would borrow money during the holidays, which are typically a peak cash flow period. Sears had $483 million of borrowings outstanding as of December 23, compared with zero a year earlier. As of October 29, Sears had cash and cash equivalents of $624 million, down from $790 million a year earlier. Sears Holdings said the lower sales and margin pressure would lead to adjusted fourth-quarter earnings before interest, debt and amortization of less than half of the year-ago quarter’s $933 million figure. The retailer expects to earn $140 million to $170 million by selling off inventory in affected stores and selling or subleasing store space. TIME TO MERGE, SELL OR CREATE VALUE,,,AT THIS PRESENT VALUE THE STORES PRESENT A BETTER VALUE AS A LIQUIDATION THAN AS A GOING CONCERN….FOR STOCKHOLDERS.
Source: blogspot.com

A New Type Of Filipino Real Estate Investment

As for health care, most U.Utes. Health Management Organizations purchase medical expenses incurred within the Philippines. Check with your The hmo. The Philippine Department associated with Foreign Matters presently has a task force headed by previous Secretary Roberto Romulo trying to have the U.S. government accredit a number of first class Philippine private hospitals for Medicare reimbursement. The actual Makati Medical Center, one of the nation?s best currently has such accreditation. Unbeknown to many is that for a long time, citizens of nearby countries such as Thailand, Nauru, Tonga, Indonesia, and Malaysia have flocked towards the Philippines with regard to medical care, especially sensitive surgical treatments. The quality of medical care at the much better Manila hospitals such as the Asian, Street. Luke?s, Medical city, Cardinal Santos, Filipino Heart Middle for Asia, National Kidney Institute, as well as Makati Medical Center meets international requirements, personalized return address labels.
Source: ginzacosme.com

Skiff Medical Center to Join the Advantra Network

Posted by:  :  Category: Medicare

Skiff Medical Center is a city-owned hospital in Newton, Iowa, providing services to Jasper County residents for all primary health services, including general and orthopedic surgery, radiology, obstetrics, emergency medicine, hospice, home care, laboratory, respiratory, audiology, and physical, occupational and speech therapy. Skiff Medical Center enjoys a close partnership with the physicians of Newton Clinic and other area providers; referrals to other specialists are coordinated when necessary. The Skiff Specialty Clinic hosts more than 20 physicians for routine and complex care specializing in cardiology, dermatology, ENT, gastroenterology, nephrology, neurology, oncology, ophthalmology, pulmonology and urology. Skiff also serves the nearby communities of Baxter, Colfax and Monroe through freestanding medical clinics. At Skiff, the best care is close to home.
Source: neishloss.com

Video: YouTube Videos matching query: advantra medicare advantage

Coventry Health Care Adds Cornerstone Health Care (P.A.) to their Advantra Medicare Advantage Provider Network in North Carolina.

Cornerstone Health Care has nearly 300 providers (including primary care and specialty physicians, and mid-level professionals) in more than 70 locations in High Point, Winston-Salem, Greensboro, Summerfield, Thomasville, Archdale, Trinity, Jamestown, Kernersville, Lexington, Asheboro, and Advance.
Source: agentpipeline.com

Advantra in Top 20 of U.S. Health Care Plans

The HealthAmerica and Advantra plans scored above the national average on 15 measures of patient satisfaction and medical services (e.g. treatment of certain diseases, health care access, preventative care, and prenatal care covered by maternity coverage). The HealthAmerica health care plans also scored higher than the Pennsylvania state average on 12 of those measures.
Source: healthinsurancesort.com

Will Your Medicare Advantage Plans Still Be Available In 2010

All plans must send you a notice of termination if there plan is terminating. When a plan terminates they do NOT enroll you in a part D plan. In some cases a plan may try to change you to another plan that they offer, however in they are still required to notify you in writing and give you the full details and you still have the option of changing plans if you are not satisfied with the benefits offered. In the case of Advantra Plans this year, you will need to choose another Medicare Plan. Some Advantra Freedom plans were offered as MAPD which means that the plan itself included the prescription drugs. You may also have a PFFS and a seperate Part D. If the part D is seperate you should still have RX coverage. If you do want to keep Advantra as your Part D you can still get a seperate Part D plan as long as it is a PFFS. You should call a broker and get a list of comparable options. You can ask for health plans only if you wish. Also if you just want an evidence of coverage you can call Advantra back or visit http://www.choicesformedicare.org and request one. Make sure you are specific in your request and they will know what to send.
Source: wordpress.com

The Sullivan Independent News

The Visiting Nurses Association will hold a flu shot clinic at the Sullivan Senior Center on Tues., Oct. 13 from 12 p.m.- 3 p.m. In order to be sure a vaccine is available for you, you must call or stop by the Senior Center and have your name put on the vaccine list. The VNA will be bringing 150 vaccines, but more will be available if we see more people are signing up. This will be a one-time clinic. Those planning to receive their vaccine may show up anytime from 12 p.m.-3 p.m. To avoid the congestion and long waiting periods, you may wish to wait a little later and not all show up at 12 p.m. Insurances accepted by the VNA for this clinic include: Medicare Advantage Plans, Essence, Coventry Advantra Freedom, GHP, Advantra, GHP Advantra Freedom, GHP Gold Advantage, Humana Choice PPO, Humana Gold Choice PFFS, Humanna Gold Plus HMO and Mercy Medicare Advantage. Other insurances that did not contract with the VNA and will not be accepted are: Medicare Advantage Plans, Secure Horizons, Aetna Medicare, Anthem Senior Advantage, Cigna Medicare Access, Sterling Option, Wellcare, Evercare or any other Medicare Advantage or out-of-state plans. Medicaid is not accepted. If you have another primary insurance, you may not use Medicare or Medicare Advantage. Those wishing to pay “out of pocket” for the vaccine may do so. The cost is $30. Visiting Nurses Association is a non-profit community based organization dedicated to serving the healthcare needs of your community. Please help us by giving us your correct insurance at the time of service.
Source: mysullivannews.com

Health America www.EasyToInsureME.com

This entry was posted on July 29, 2008 at 7:13 pm and is filed under a, america, blue cross pa, coventry, coventry health america, cvty, harrisburg, healh insurance pennsylvania, health, health america, health america one, health insurance, health insurance pa, healthamerica, healthamerica com, healthamerica cvty, healthamerica cvty com, insurance, lancaster, low cost health insurance pa, low cost pa health insurance, ohio, pa, pa health insurance, phila, philadelphia, pittsburgh, ppo, scranton, www healthamerica com, www healthamerica cvty. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
Source: wordpress.com

Advantra Rx NOT Renewing Their Medicare Contract

one of my customer’s sent me a copy of the letter from AdvantraRX dates October 2. Here is what it says (sorry about typos, i type fast): Dear Mr. Smith, AdvantraRx Preimer by Coventry Life and Health Insurance Company, a stand-alone prescription drug plan with a Medicare Contract, will no longer operate as of January 1, 2011 so your Medicare Prescription drug coverage through AdvantraRx Premiuer will end December 31, 2010. If you want Medicare prescription drug coverage starting January 1, you need to join a new Medicare drug plan by December 31, 2010. Take Action by December 31 to avoid losing drug coverage. If you want Medicare Rx drug coverage after December 31, you need to join another Plan or medicare advantage plan that offers drug coverage. You can join a new medicare drug plan anytime between October 1 and January 31, 2011. However your AdvantraRx Premier coverage ends December 31, so you should join a new medicare drug plan by december 31 to make sure you have drug coverage january 1. If you join a new plan AFTER december 31, your new coverage won’t start until the month after you join. What happens if you don’t join another medicare drug plan? if you don’t join another medicare drug plan by January 31, your next chance to join will be from october 15 through december 7, 2011. You may also have a pay a late-enrollment penalty to join later. The the letter gives a list of a bunch of companies and the 1-800 Medicare number and website. It doesn’t state anything anywhere about automatically enrolling them into another plan if they do nothing. In fact, it states the opposite.
Source: insurance-forums.net

Coventry Advantage with John Winters 05/27 by Americas Healthcare Advocate Show

Cary Hall talks to John Winters, Medicare Sales Director of Conventry Advantra about the Medicare Advantage Plan. If you or a loved one is making decisions about Medicare and need information on what works best. Cary Hall and John Winters will give you very good information to find the right plan.
Source: blogtalkradio.com

Medicare’s Substantial Flaws Elude Policy Makers

Posted by:  :  Category: Medicare

Bubbles? Take something like 'Not I! .....item 1..Wakulla Republicans Protest Against Taxes in the County (September 06, 2011) ... by marsmet552Recently there has been substantial attention paid to underfunding in state and local government pension plans, a longstanding problem made more urgent by recent troubles in the larger economy.  There has of yet been comparatively less attention given to a similar (though smaller) set of mounting financial risks associated with private-sector worker pensions covered by the Pension Benefit Guaranty Corporation (PBGC).  Yet here, too, public policy corrections are required to address underfunding and avoid another taxpayer-financed bailout, says Charles Blahous, […]
Source: dcinsider.com

Video: Weekly Address: Medicare Officially Safer After Health Reform

The New Frontier of Liability Medicare Set Asides: Part 3

A large problem with today’s MSP compliance hysteria is that defense attorneys and insurers are routinely including “kitchen sink” language in their releases to address Medicare. This language frequently shifts all of the responsibility of creating a Medicare set aside to the injury victim while identifying an arbitrary amount to be set aside. This practice is dangerous because those releases typically have the injury victim acknowledge a responsibility to set funds aside while picking an arbitrary, usually small, amount to be set aside. This is a bad practice and exposes the injury victim as well as plaintiff counsel since if CMS ever refused to pay for Medicare covered services related to the injury there would be no way to justify the amount of the set aside. A better practice is to actually do an MSA analysis, which may or may not include getting a formal MSA allocation done. There are certain instances where an MSA may be unnecessary based upon factors present in the case such as a private primary health insurance policy, Workers’ Compensation coverage for future medical or where there is no future Medicare covered expenses related to the injury. These should be identified and the release language specifically tailored to that exception but with an indication that Medicare’s future interests where considered with nothing needing be set aside. If the case requires the full-blown MSA analysis, it should be done and the cost of doing so passed along as a client cost. Most MSA allocation reports cost between two thousand and three thousand dollars, which is a small price to pay for the proper analysis of the client’s future Medicare covered services. The allocation gives all parties the proper amount to be set aside, arguably subject to a reduction formula.
Source: injuryboard.com

Central Florida Republican News: Members of the GOP Doctors Caucus Address Medicare Reimbursement Rates

++++++++++please click on the small envelop at the bottom of this post to email this to others. This blog is not authorized by any official Republican organization. Material presented on this blog is not necessarily considered an endorsement but is included as a political courtesy, and or to help educate our readers.
Source: blogspot.com

Lawmakers work to address Medicare cut as year

can only be viewed by members of the American Academy of Sleep Medicine. If you are already a member you can LOG IN to view this article. If you’re interested in becoming a member of the AASM you can APPLY for membership online.
Source: aasmnet.org

Analysis of Medicare’s Effects on the overall Health Care System : Labor & Employment Law Navigator : Employer Attorneys & Labor Management Lawyers : Frantz Ward Law Firm

A recent Reason magazine article by Peter Suderman on Medicare’s Whac-a-Mole approach to cost control is both an excellent analysis of why Medicare is in trouble and an explanation of one of the reasons we are having so much trouble in the rest of the health care system.  As employers trying to do the best we can for our employees, we don’t always see that our problems are linked to the way Medicare (along with other public programs) pays and doesn’t pay providers.  The fix for Medicare is going to create pain for non-Medicare consumers, whether as part of the Patient Protection and Affordable Care Act’s provisions or otherwise.  Prior to Medicare’s addition of 19 million consumers with fully subsidized care into the system, health care took up a steady 5% of GDP–now it is more than three times that, and rising. The article is well-worth reading.
Source: laboremploymentlawnavigator.com

Understanding Baby Boomer Wellness Expense Issues

advertising advice Arts and Entertainment beauty business Business and Investing Reviews computers Computers/Internet Reviews Cooking and Food education entertainment exercise family finance fitness general health Health and Fitness hobbies home Home and Garden home based business home improvement internet internet business internet marketing lifestyle marketing mlm network marketing news online business other Parenting & Families Product Reviews recreation relationships sales seo shopping society technology travel weight loss women
Source: reviewandcoupons.com

Medicare Oversight Entities Miss Opportunities to Address Patient Safety

State agencies and CMS missed opportunities to incorporate patient safety principles in their responses. For complaint surveys at accredited hospitals, CMS directed state agencies to assess the CoPs on performance improvement in only 33 of the 78 surveys and the CoP on the hospital’s governing body in only 12. State agencies performed little longer term monitoring to verify that hospitals’ corrective actions resulted in sustained improvements. After completing complaint surveys, state agencies required the hospitals to submit performance data for only one of the 19 complaints that required corrective action plans. State agencies did not always disclose the nature of complaints to hospitals, thus limiting hospitals’ ability to learn from alleged events.
Source: wolterskluwerlb.com

Medicare health insurance Supplemental Insurance plan ? A

Posted by:  :  Category: Medicare

OBAMACARE WATCH:....THE PUSH IS ON, ........THEY WILL CONTROL WHAT YOUR DOCTOR KNOWS AS WELL AS WHAT HE OR SHE TREATS by SS&SSRight now, let’s say you will be collecting friendly security, in addition to receive Treatment automatically. Examine opt beyond Part N coverage, it requires will still possess a Medicare card together with part SOME coverage. Part A has to be your hospital protection. For almost all people, Part SOME is acquired by the costa rica government because you may have been resulting in it by way of payroll deductions for ages. If a person opt beyond B and also have part SOME, what will do this mean with regards to your set coverage? The result is frequently nothing. Your manager sponsored set coverage has to be your primary coverage and will also be covered as per their bonus schedule. Part A doesn’t necessarily pay co-pays unlike what most people think. Such as, if you now have the co-pay for the emergency location visit, its your responsibility to spend it.
Source: gadgetsclub.com

Video: Medicare Advice

The Rewards Of Possessing A Medicare Supplement Insurance Program

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Special Needs and Elder Law Blog at SpecialNeedsNJ.com

Medical emergencies can happen anywhere so it is important to have comprehensive medical benefits when traveling outside the United States. While Medicare provides high qualify insurance for medical costs within the country, it usually will not pay for foreign treatments or evacuations. To fill this void, Americans should consider Medigap plans or other insurance that covers foreign care. Finally, because limitations apply and benefits may change over time, contact your insurer before you travel outside the United States to make sure you have adequate coverage. The State Department website also can be a wealth of information on dealing with emergencies when traveling abroad.
Source: specialneedsnj.com

Advice from Lorraine Hora on Medicare Plan B premium/reimbursement

premium reimbursed to you quarterly. However, should your Part B premium be greater than $99.90/mo., you will need to notify EUTF and send a copy of the statement to receive the greater quarterly reimbursement.
Source: wordpress.com

Shield Yourself With an Illinois Medicare Complement

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Gang of Six - Cartoon by DonkeyHoteyIllinois Medicare is a complex jumble of data and providers and is a superb way to supplement yourself. Should you manage to sort via the mess, you will find that Medicare nonetheless does not cowl all the providers that you need. Plans A, B and C do not even have prescriptions drug plans and even plans that take care of at-residence care nonetheless may not go so far as your situation demands. Either that, or the circumstances are difficult to satisfy, such as hospital stay needing to be over three nights long in order to be covered. To ease the difficulty concerned, many retirees are turning to Medicare Complement plans Medicare supplemental insurance illinois.
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Shield Your self With an Illinois Medicare Complement

Illinois Medicare is a complex jumble of information and services and is an excellent solution to supplement yourself. Should you handle to sort by the mess, you will find that Medicare nonetheless does not cowl all of the services that you need. Plans A, B and C do not even have prescriptions drug plans and even plans that cope with at-dwelling care nonetheless could not go so far as your condition demands. Both that, or the conditions are troublesome to satisfy, reminiscent of hospital stay needing to be over three nights long as a way to be covered. To ease the difficulty concerned, many retirees are turning to Medicare Complement plans Medicare supplemental insurance illinois.
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Illinois Review: A Bipartisan Way Forward on Medicare

Under our plan, Americans currently over the age of 55 would see no changes to the Medicare system. For future retirees, starting in 2022, our plan would introduce a "premium support" system that would empower Medicare beneficiaries to choose either a traditional Medicare plan or a Medicare-approved private plan. Unlike Medicare Advantage, these private plans would compete head-to-head with traditional, fee-for-service Medicare on a federally regulated Medicare exchange.
Source: typepad.com

Study Shows Nursing Homes Shuffle Around Patients to get Extra Medicare Reimbursements :: Illinois Injury Lawyer Blog

• Involve patients in planning their care while they’re still able to do so, and make sure wishes like “do not resuscitate” or “do not call 911″ are spelled out in legal documents. • Develop good relationships with nursing home staff and attending physicians so they understand the family’s goals of care. • Consider hospice care when seniors with advanced dementia are admitted. • Revisit and review the plan whenever there is a change in a loved one’s status. Someone may not be end-stage when they enter a nursing home but that can change. • Seek advice. The Alzheimer’s Association has a 24-hour toll-free number, with counselors to help families.
Source: illinoisinjurylawyerblog.com

Protect Yourself With an Illinois Medicare Complement

Illinois Medicare is a complex jumble of data and services and is an excellent way to complement yourself. In the event you manage to type by the mess, you can see that Medicare nonetheless does not cover all of the services that you just need. Plans A, B and C do not even have prescriptions drug plans and even plans that deal with at-home care nonetheless could not go so far as your situation demands. Both that, or the circumstances are tough to fulfill, reminiscent of hospital stay needing to be over three nights long with a purpose to be covered. To ease the issue concerned, many retirees are turning to Medicare Complement plans Medicare supplemental insurance illinois.
Source: forexfinanceanalysis.com

December Illinois Senior Medicare Fraud Tip

Kung may magnakaw ng iyong numero ng Medicare, maaaring maningil ng serbisyo ang magnanakaw gamit ang iyong akawnt ng hindi mo nalalaman! Mahuhuli lang ang panlilinlang na ito kung babasahin mo ang iyong statement. Binabasa natin ang ating mga credit card statement para masiguro na walang maling pagsingil dito. Kailangan ring basahin natin ang ating statement sa Medicare para masiguro na walang magnanakaw ng ating benepisyo! Kung mayroon kang Medicare, tatanggap ka ng statement apat na beses sa isang taon. Basahin ng maigi ang mga statement para masiguro na tama ang lahat ng nakasaad. Bantayan ang mga singil ng serbisyo o kagamitan na hindi mo tinanggap, mga serbisyo na hindi pinag-utos ng iyong duktor, o ano mang ibang pagkakamali. Kung nais mong makatanggap ng Paunawa ng Buod ng Medicare (Medicare Summary Notice) sa ibang wika maliban sa Ingles, tumawag sa 1-800- Medicare upang mahingi na ipadala sa iyo ang statement na ito sa iyong wika. Kung mayroon kang mga katanungan ukol sa iyong makikita sa Paunawa ng Buod ng Medicare, tawagan ang Illinois Senior Medicare Patrol Program sa AgeOptions para matulungan ka: (800)699-9043.
Source: filamnation.com

State of IL Reminding Residents of Medicare Open

“As the Medicare open-enrollment period winds down, Medicare enrollees who have not yet reviewed and compared available prescription drug and Medicare Advantage plans should call the Department’s toll-free SHIP hotline or the 24-hour Medicare hotline to help make sure they continue to have the most appropriate coverage,” said Andrew R. Stolfi, Acting Director of the Department.  “As always, the Department’s dedicated SHIP volunteers also provide information and assistance to Medicare beneficiaries and caregivers year round.”
Source: enewspf.com

HIT Exchange: Navigating Medicare Claims with Ease

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KNOW WHO YOUR CZARS ARE --ENOUGH TO MAKE YOU SICK ---ONLY OBAMA COULD CREATE POSITIONS FOR THESE INCOMPENTENT COMMUNISTS AND SOCIALISTS by SS&SS“I was getting buried in paperwork,” says Cindy Morris, recalling the stacks of DDE (Direct Data Entry) printouts that served as reminders to follow up on Medicare claims for Ross Healthcare’s 290 hospice and home health patients across central Oklahoma. Morris was equally frustrated by reimbursement delays and the additional work brought on by having to resubmit Request for Anticipated Payments (RAPs) and final claims.
Source: hitexchangemedia.com

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Cyrano's Journal Today

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Source: cjournal.info

From Paul Revere to Paul Ryan

REALITY: This is a false comparison based on a false reality. As mentioned above, the CBO reports that Medicare’s trust fund will become insolvent in nine years unless we act. This would necessitate harsh restrictions on seniors’ access to care – the kind of restrictions that the President himself alluded to later in his speech. The President is taking CBO numbers out of context and omitting the CBO’s clear warnings about Medicare’s impending bankruptcy.  That’s why comparing a Republican plan that saves Medicare to an unsustainable status quo means comparing a real solution with a false reality. The Medicare program as it exists today cannot exist in the future. The real choice is this: Do we act now to protect the program for current seniors while building a strengthened Medicare for future generations? Or do we restrict access to care for current and future seniors, as the President has proposed, while ignoring our crushing burden of debt until it becomes a fiscal crisis? 
Source: thepresidency.us

In Defense of Freedom: Medicare Cannot Afford the Status Quo

Richard Kirsch wrote a column for the Huffington Post this week titled, “The Last Thing Medicare Needs Is More Privatization”. His argument centers around the claim that privatization would shift costs from the government onto seniors because Medicare is better able to control its costs. Kirsch argues, “Health care costs have increased at a significantly lower rate under Medicare than in private insurance plans, chiefly because Medicare is much better able to limit how much it pays to doctors and hospitals. The private insurance plans that now cover about one out of five Medicare patients do so at a cost that is 13 percent greater than Medicare pays for the same benefits… Capping the premiums would not result in lower health care costs, but in shifting costs to people on Medicare, which would result in seniors forgoing the care they need, ending up in the hospital with more serious illnesses, and dying sooner.”
Source: defenseoffreedomblog.com

Documents Necessary when Filing BP Claims

BP, the gas and oil giant that caused the oil spill in the Gulf of Mexico is pressed to admit its fault in the incident and really should consider the obligation of compensating the individuals and business people who’re facing loss of wages, income and revenue. As one of many victims, what are the right actions to take to get compensated? The very first factor you must implement is always to identify when you are eligible for filing BP claims. Fundamentally, the company grouped their compensation in distinctive types including loss of revenue claims, injury claims in addition to property damage claims. It’s important to know the proper category where your claim belongs. You also have to prepare all of the connected documents that will support your claim. If you’re filing a claim for loss of earnings, you need to provide them your pay stubs for the last 2 months and 2009 W-2 forms for all those that are employees.
Source: ezinemark.com

Medicare Privatization Plans

Overall, US healthcare could make a quantum improvement leap compared to today’s dysfunctional system. Instead, bipartisan complicity has worse in mind by cutting benefits, placing greater burdens on seniors and others, letting corporate predators game the system, and still leave millions uninsured, on their own and out of luck.
Source: phillyimc.org

Editors: Let's Take Immigration/Marriage Fraud Seriously

Nwagbara is currently in jail awaiting trial, the judge having ruled that he was a flight risk and required detention. Arguing against the ruling, Nwagbara’s lawyer made an interesting claim, that his client would need a visa from Nigeria to re-enter that country, and thus he was likely to stay in the U.S. The assistant U.S. Attorney said that he had a valid Nigerian passport, and that there was no indication that he had renounced his Nigerian citizenship.
Source: cis.org