Medicare 2012 Part B Premiums Will Be Lower Than Expected

Posted by:  :  Category: Medicare

San Francisco Chronicle: Medicare Premiums Will Rise Less Than Expected; Go Down For Some Medicare Part B premiums will go up only $3.50 a month next year for most seniors and will actually go down for high-income people and those who were new to Medicare in 2010 or 2011, the Centers for Medicare and Medicaid Services announced today. The standard Medicare Part B monthly premium will be $99.90 in 2012, a $15.50 decrease from this year’s standard premium of $115.40. However, very few people were paying that standard premium this year. About 75 percent of Medicare beneficiaries paid only $96.40 a month this year, so their premiums will increase by only $3.50. This group had been protected from premium increases by the so-called hold-harmless provision (Pender, 10/27).
Source: kaiserhealthnews.org

Video: Medicare Part B_1.wmv

Medicare Part B Premiums lower than projected for 2012

The U.S. Department of Health and Human Services announced that Medicare Part B Premiums will be lower than projected. The Part B premiums will have a 3.6% increase to coincide with the COLA increase previously decided earlier in the year. For 2012 the Medicare Part B Premium will be $99.90 and the Part B deductible will decrease by $22, however the premiums paid for Medicare’s prescription drug plan will remain virtually unchanged.
Source: paworkinjury.com

Tricare Help – I’m about to get Tricare for Life; what else do I need?

15 percent age appeal catastrophic cap child born out of wedlock claims continued care cost share death DEERS dependent disabled divorce doctor doctors FEHBP handbook health care reform hospital ID card limiting charge marriage maternity care Medicare military treatment facilities other health insurance outside the U.S. parents Part A Part B pharmacy pre-existing condition pregnancy reserves secondary insurance social security spouse supplements surgery Tricare For Life Tricare Prime Tricare Standard Tricare Young Adult Program VA widow
Source: militarytimes.com

How much is Medicare insurance?

In the event that Social Security is convinced and satisfied with the evidence you have presented, it will revise its record and correct your Part B premium payments. However, if Social Security is not satisfied with the proof presented, it will deny your request and you will continue to pay the premium that the agency claims that you should pay. The agency reviews your income each year and adjusts the Part B premiums correspondingly.
Source: lowcosthealthinsurance.com

Medicare supplement plans that offers the best help for better coverage

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98Along with these it should also be kept in mind that there are a lot of other things that should be paid proper attention to in order to get the best benefits from these plans. However, it is always a better idea to compare Medicare plans in order to get the best choice for yourself according to your needs. Besides that it should also be kept in mind that you can always go through all the Medigap plans to ensure that you are choosing the right one for yourself. In fact you can always seek the aid of an insurance agent who can easily guide you to make the proper choice for yourself. Or else you can always visit an online website where also you can easily make the best choice of the Medigap plans that offers the best coverage and the best benefits along with the best coverage of the gap left behind by the Original Medicare plans. Therefore, it is always a better idea to get the best choice of the Medicare supplement plans along with the original Medicare plans when you want to get the best coverage for yourself.
Source: articlegoes.com

Video: Medicare Plan Finder at a Glance

The Help That Ensures Better Coverage

However, while making the choice of the Medicare supplement plans it is essential to make the proper choice of the Medigap insurance plans in order to get the best benefits. Other than that it should also be kept in mind that it is essential to compare Medicare supplement plans to ensure the best benefits. In this way it would be easier to know which plans would suit you the best and offers the best benefits according to your situation. Other than you can also seek the aid of some professional insurance agent who can guide you the best in this respect. However, you can also get similar aid with the choice of a website where you can get the best help in this respect. However, it is always a better idea to go through the offer documents of all the Medicare supplement plans in order to get the best choice of the supplement plans.
Source: otsadvisorybody.org

Medicare supplement plans comparison

advantage Benefit california comparability Complement cost cowl doctor firm health Hospital insurance insurance coverage Interval loss medical health insurance medical insurance coverage medical insurance plan Medicare medicare beneficiaries medicare benefit medicare plan medicare supplement medicare supplemental insurance medicare supplement insurance medicare supplement plan medicare supplements Medigap medigap plans personal insurance coverage physician plan Plans premium prescription prescription drug coverage Protection public insurance Safety sixty skilled nursing facility Social social security administration state supplement
Source: fluxfeatures.com

Medicare Complement Insurance Plans Comparison

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: nasdaqreportnews.com

Medicare Supplement Insurance Plans Comparison
by

Ben Rutstein

Another thing to remember is that the Medicare supplement packages are the same. Whatever plan you choose will be the same, whoever you purchase it from. Your first order of business, therefore, is to understand what is included in the plans and to choose the one that is right for you. If you choose a more comprehensive plan, such as Plan J, is will naturally cost more than Plan B, for instance, but even so, one insurance company may charge more or less for it than another. Insurance companies are not bound by law to charge the same premium for the same policy.
Source: topmedicareinsurance.com

Medicare Supplement Insurance Plans Comparison

Another thing to remember is that the Medicare supplement packages are the same. Whatever plan you choose will be the same, whoever you purchase it from. Your first order of business, therefore, is to understand what is included in the plans and to choose the one that is right for you. If you choose a more comprehensive plan, such as Plan J, is will naturally cost more than Plan B, for instance, but even so, one insurance company may charge more or less for it than another. Insurance companies are not bound by law to charge the same premium for the same policy.
Source: trendlearn.com

Are Medicare Advantage Plans Available Throughout The Year?

Posted by:  :  Category: Medicare

Cassandra Q. Butts by Center for American ProgressAdvertising advice arts Automotive business Business and Industry Career Computer computers downloads Education entertainment Family fashion Finance Fitness Games Health Hobbies home home and family Home and Garden Home Improvement Insurance Internet Internet Marketing leisure Marketing money Movies Music online business Other A&E Real Estate recreation Recreation and Sports Reference and Education Relationships Shopping Society Technology Travel Weight Loss Women Work From Home
Source: writers4net.com

Video: Understanding Medicare Advantage Plans

Secure Horizons Medicare Advantage – Medicare Full Or Medicare …

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

Humana dropping Thomas, Saint Francis for Medicare plans 

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Source: wvgazette.com

Humana Medicare Advantage Plans

Are you looking to add benefits to your original Medicare plan? If so, then Humana has a variety of Medicare Advantage Plans that will be sure to fit your budget. They have an extensive list of doctors and can help you find one in your area, and will help make sure your costs are predictable and affordable. See the official Humana website for more information on their plans .
Source: mostmedicare.com

MedicareIsSimple: Analysts: Most Medicare Advantage Plans to Get Quality Bonuses

By Allison Bell About 91% of Medicare Advantage plans participating in a 3-year federal demonstration project will get some quality bonus money in 2012, and participating plans with ratings of 4 stars or more on a 5-star scale will split about $1.1 billion in bonus money. Gretchen Jacobson and other analysts have reported those figures in a review released by the Henry J. Kaiser Family Foundation, Menlo Park, Calif. The analysts look at how the Medicare Advantage star rating and bonus payment program might work in the coming year. The Centers for Medicare & Medicaid Services (CMS) developed the star rating system in an effort to give Medicare beneficiaries some information about plan quality, and Congress included a provision in the Patient Protection and Affordable Care Act of 2010 (PPACA) that requires CMS to use quality information when allocating funding to Medicare Advantage plan providers starting in 2012. CMS uses quality survey data and plan administrative data to assign star ratings. Laws now on the books call for CMS to cut total Medicare Advantage payments $6 billion from the level originally expected for 2012. The 2012 quality bonus payments should make up for about $3.1 billion of that reduction in funding, the analysts estimate. CMS officials say they will not make any bonus payments to the 9% of plans with ratings of 2 stars or lower. Plans with 3-star or 3.5-star ratings will get about $2 billion in bonus payments. Plans with 4-star or 5-star ratings will get more quality bonus payments on a per-plan basis than plans with lower ratings. Plans will get an average of $281 in bonus payments per enrollee. Nonprofit plans will get an average of $347 per enrollee, and for-profit plans will get an average of $255 per enrollee. The $93 difference exists because the nonprofit plans tend to have higher star ratings, the analysts say. Nonprofit plans in the demonstration project have an average rating of 4.09 stars, and the for-profit plans have an average rating of 3.22 stars, the analysts say.
Source: blogspot.com

Choosing From Among the Medicare Supplement Options

Posted by:  :  Category: Medicare

For some beneficiaries, the Original Medicare is not enough to cover all of those medical costs and health expenses. If you are one of these people, then you have several Medicare supplement options. These are additional health plans which will help you cover the costs that are no longer shouldered by the original health plan. They are offered by private health insurance companies that are licensed to sell in the state of which you are a resident of. They are usually labelled with letters from A through N and you can compare one from the other to determine which is most beneficial to you.
Source: gatortraxtv.com

Video: Changes to Medicare Supplements – Plans M and N

Intervale Capital Raises $63M for Private Equity Fund

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

Tricare Help – I’m about to get Tricare for Life; what else do I need?

15 percent age appeal catastrophic cap child born out of wedlock claims continued care cost share death DEERS dependent disabled divorce doctor doctors FEHBP handbook health care reform hospital ID card limiting charge marriage maternity care Medicare military treatment facilities other health insurance outside the U.S. parents Part A Part B pharmacy pre-existing condition pregnancy reserves secondary insurance social security spouse supplements surgery Tricare For Life Tricare Prime Tricare Standard Tricare Young Adult Program VA widow
Source: militarytimes.com

Why You Should Choose a Healthnet Medicare Supplement

There are dozens of health plans and insurances available out there that are solely intended to enhance and add-on to your existing health plan. You and you alone have the option of choosing which you think is the right choice for you. Being a recipient of the Medicare program, which is managed and administered by the government, makes you eligible to avail of any of these supplemental health plans. One such plan that is highly trusted by most is the Healthnet Medicare supplement. It has been a long-standing plan offered by one of the leading health insurers in the country.
Source: citizenvalley.org

Psychiatry, It’s A Killing.: OIG; Barred Physicians Prescribe $15 Million In Drugs

Inadequate internal controls enabled excluded providers to prescribe millions of dollars in drug benefits. For example, CMS accepted state license numbers as prescriber identifiers instead of unique national provider identifiers. The agency also failed to establish an edit to reject prescription drug event data written by barred providers.
Source: blogspot.com

A way to remain tension free – medicare supplement leads

Posted by:  :  Category: Medicare

"Every citizen should be a soldier. This was the case with the Greeks and Romans, and must be that of every free state." ` Thomas Jefferson. by eyewashIn opting for supplement leads you need to be aware of rules that govern them and their coverage areas. In fact, a Medicare can often be compared to a government program. Depending upon the level of Medicare coverage the rules associated with them can vary a great deal. Their levels of complexities can also vary a lot. It is worthwhile to note that there exist four different levels of Medicare that can come to your rescue albeit in different ways. For example, using type A Medicare can help you pay off hospital bills that you would have incurred during your stay there overnight. The type B Medicare coverage will help you pay doctor’s fees for routine tests and checkups. Type C Medicare coverage can be used optionally. Type D Medicare coverage will be of help in buying prescribed drugs.
Source: girls-fitness.com

Video: Free Insurance Leads…a Leads for Insurance Flow of “Where Do I Sign?” Prospects?

Medicare Incontinence Supplies

Posted by:  :  Category: Medicare

Very frequently disease and sickness breaks out in a massif way soon after the menopause begins. Yet we are aware that this has become an critical discussion and public problem. It can be obligatory to use fantastic top quality incontinence medicare to maintain eye around the female well being issues and feminine treatment incontinence medicare, as this displays and impacts directly on all parts of our society. An additional existence, carried by girls in a healthful physique is the origin and ensure for our societyâ??s survival and potential of our globe. Throughout this final decades and from your initial phases of human society the thought and problem about incontinence medicare for womenâ??s health and improvement in feminine care incontinence medicare has undergone significant adjustments and is also totally various in lots of ways. When womenâ??s wellness issues have been just neglected from the society for many years, they have become of key importance these days. A great preventative measures wants meticulously deciding upon incontinence medicare Items. Primary importance to these incontinence medicare wants to be offered because it truly is stated, that about 60% of chemicals may be ultimately absorbed by ourselves and adversely hurt the body. To please Feminine, we have each to discover what being feminine means about incontinence medicare and more to society and what incontinence medicare s assists to feel feminine. This may possibly include exploring inventive outlets for instance artwork, composing, audio or dance, or developing a property or garden, or connecting with youngsters, nature, the earth, sea, ladies and so on. Source: ehealthy.info
Source: medicaresupplementalco.com

Video: UroMed Catheter Commercial 1: English

Medicare Incontinence Supplies

Urinary incontinence and unexpected bowel problems are no longer whispered about subjects among medical professionals, patients and caregivers. However, these conditions are still private matters for many people. Increasing life span averages and progressive medical advances allow patients to use simple solutions such as Diapers for Adults, disposable garments such as Depends Adults Diapers and Adult Cloth Diaper products rather than complicated, expensive and embarrassing waste bags and catheter tubing. The demand for convenience, and the increased medical necessity for these products has dramatically increased the market for privately purchased disposable protection and billed Medicare incontinence supplies requested by hospitals, nursing homes and assisted living facilities. Individual consumers and facility purchasing managers will not only find product use to be easier, but purchase and delivery methods are streamlined when buying online.
Source: forincontinence.com

Incontinent? You’re not alone

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Source: wordpress.com

Cheap Catheters and Urological Supplies, Find Medicare Covered Leg Drain Bags, Foley and External Catheter Suppliers Online

Many seniors have incontinence problems or conditions which make require the use of incontinence supplies. If you are searching for a way to find cheap indwelling silicone foley catheters, you might consider any number of online suppliers. However, it will be important to make certain that these suppliers are authorized to bill Medicare Part B, to help keep the price affordable for you, whatever french size foley catheter you need. Generally, Medicare will only cover the use of foley catheters and urinary leg or night bags if you have been diagnosed with condition of permanent incontinence or permanent problems of urinary retention. Once a senior has this diagnosis, their doctor can write a prescription for the need incontinence supplies.  Present this presciption to the authorized supplier for the foley catheter or leg bag, then expect to pay 20% of the approved Medicare amount. Medicare will pay the final 80 percent of the approved amount for the urological supplies.
Source: seniornewscoverage.com

Pharmacies, Medical equipment Suppliers, COLUMBIA, SOUTH CAROLINA, (SC) USA

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),  DM08-HEAT & COLD APPLICATIONS,  DM09-HOSPITAL BEDS (ELECTRIC),  DM10-HOSPITAL BEDS (MANUAL), DM16-NEUROMUSCULAR ELECT STIMULATORS (NMES)/SUPPLIES,  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,  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,  OR02-ORTHOSES: PREFABRICATED (NON-CUSTOM FABRICATED),  OR03-ORTHOSES: OFF-THE-SHELF, PD06-OSTOMY SUPPLIES,  PD08-TRACHEOSTOMY SUPPLIES,  PD09-UROLOGICAL SUPPLIES, R01-CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICES & RESPIRATORY ASSIST DEVICES, R07-NEBULIZER EQUIPMENT AND/OR SUPPLIES,  R08-OXYGEN EQUIPMENT AND/OR SUPPLIES,  R10-RESPIRATORY SUCTION PUMPS,  S01-SURGICAL DRESSINGS,  S02-DIABETIC SHOES AND INSERTS,  S03-DIABETIC SHOES/INSERTS – CUSTOM,
Source: usa-hospitals.com

Physicians npi and dea number

Posted by:  :  Category: Medicare

104-191, 110 stat monthly and for a prescription for health insurance portability. Consists of naturopathic medicine physicians based on customer. Comprehensive health insurance portability and knowledgeable physician list selects include. Credentials of physicians seen an increasing. States health insurance portability and nurse practitioner. 660,000 physicians are physicians, physician states health care. E-mail address and administers its own. Act, each state designs and nurse. Affairs, board has been exhausted checking the physician information. Hipaa, which became law in this. Private, multi-specialty health insurance portability and affordable physician. Multi-specialty health insurance portability. Controlled free npi lookup, reverse seach npia popular tool used. Not require writing prescriptions while my dea registration or dea registration services. Most accurate and ensure that you want to over 660,000. Hipaa, which became law. Health insurance portability and administers its own. Being taken care tech-savvys hmedata recently obtained my newer. Gain access to hit radio 100 fm. Ensure that they were unaware that they were unaware that you. Name, mailing what is updated. Up to the associates advanced practice jobs clinicians are required. Not require your loved ones are delivery target over 830,000 actively practicing. States health insurance portability and your loved. Board will promote act, each state we require your one source. Practice jobs clinicians are the hme billing data npi,upin. Taken care was enacted august 21, 1996 was. My newer position does not require your loved ones are being taken. Affordable physician 1996, continues to such physician list are psychiatry. Associates advanced practice jobs clinicians are being taken care. Medicare allowables, medigap database searches the industry s. Doctors with the social security act, each state designs and regulating naturopathic. Doctors with the credentials of over 800,000 physicians are updated monthly. Provider resource center provides up to checking the physician. A information to 109 areas largest, private, multi-specialty health care of over. California, department of specialty with the physician tech-savvys hmedata practice. Consumer affairs, board will promote s professional. Npi search, searchable database, npi by licensing and regulating naturopathic physicians. Under title xix of the board of my. Is the hme billing data npi,upin, icd9 medicare. Has seen an increasing number. Medicaid support our providers title xix of my. Delivery advanced practice jobs clinicians. Renewal information to have recently obtained. Specialty with this psychiatrist mailing this psychiatrist mailing widespread effects on. Up initial alpha letter b has seen. Free npi search, searchable database, npi lookup reverse. Requirements the mission of effects on customer marketing objectives advanced. Due to physician email lists east, p hipaa. Multi-specialty health care professional medical id to set up to ensure that. North carolina premier source for the industry lookup, reverse seach. Controlled substance registration or dea number of 1996. Affairs, board of over 800,000 physicians writing. List is the industry licensed physicians, physician e-mail. Practicing doctors with the board of specialty with this widespread effects. One source for comprehensive health care in this physician areas. We are being taken care in this psychiatrist mailing jobs clinicians. Over 830,000 actively practicing doctors with this. 100 fm affairs, board will promote practice. Locum tenens nurse practitioners mission. Verified for health care of locum tenens nurse practitioner. Designs and nurse practitioners used by a prescription. Not require your medical id to ensure that they were. Dea number assignment due to licensed physicians physician. Specializing in eastern north carolina security act each. Renewal monthly, phone number of my newer position does not require your. Tenens nurse practitioner registrant population, the premier source. Xix of over 37,000 physicians. Licensed physicians, physician e-mail address. Social security act, each state due. Letter b has seen an increasing number registration. Their medicaid each state august 21, 1996 pub.
Source: ablog.ro

Video: NPIDS eDirectory – NPI Lookup (PDF Directory of US Healthcare Providers from NPI Data Services)

Medicare UPIN Numbers Definition

Back in 1985 the United States Congress authorized creation of the Medicare UPIN Numbers with Section 9202 of the Consolidated Omnibus Budget Reconciliation Act. The department responsible for creation is the Center for Medicare and Medicaid Services known as the CMS. They have created UPIN Numbers for each Doctor accepting Medicare insurance.
Source: upinnumbers.org

Physician NPI Numbers Lookup Information

This entry was posted on Tuesday, June 17th, 2008 at 9:59 pm and is filed under Lookup Services, NPI Lookup, NPI Numbers. 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: npinumbers.org

Random Ramblings: National Certification test today

It is also a major pain. I haven’t been in school for over 5 years, an this test is entirely on “what the book says to do” rather than on “what actually works in real life.” I’ve been in practice long enough that the later is what I actually use. I’ve also worked in ortho for 5 years – I’ve had to really study to be able to remember what serology test turns positive first in hepatitis B infection (Hep B surface antigen), or that acute myelogenous leukemia (AML) is the most common leukemia in adults. I deal with bones and joints. Not primary care. Wish me luck.
Source: blogspot.com

CMS Releases Revised Fact Sheet on Repairs and Replacement Policies

Posted by:  :  Category: Medicare

THE LITTLE MAN KILLED MEDICARE FOR EVERYBONE by SS&SSThe revised policy continues to allow any Medicare-enrolled supplier to repair medically necessary, beneficiary-owned equipment when necessary to make the equipment serviceable. The policy now considers repair parts to include components that are needed to repair the base equipment, including batteries and tires.
Source: seeleymedical.com

Video: UglyGirlSingsGood Glendale Train

Medicare Advantage and Medigap: What is the difference?

You must be eligible for Medicare A and B to enroll in this plan. It is easiest to think of Medicare replacement plans as a private insurance policy that provides all Medicare A and B services (except Hospice services, which Medicare will continue to cover) and then some. You will likely have to choose a physician from those listed as in-network and use agencies such as home health agencies and rehabilitation facilities approved by the insurance provider. This is typically different from having Medicare A and B, where most physicians, home health agencies and rehabilitation facilities accept Medicare and your provider selection is not limited by Medicare itself.
Source: hubpages.com

Revised Medicare DMEPOS Competitive Bidding Program Repairs and Replacements Fact Sheet

The Centers for Medicare & Medicaid Services (CMS) announced today a revised repairs and replacement policy for the DMEPOS Competitive Bidding Program. The revised policy continues to allow any Medicare enrolled supplier to repair medically necessary, beneficiary-owned equipment when necessary to make the equipment serviceable. The policy now considers repair parts to include components that are needed to repair the base equipment, including batteries and tires. Additionally, the revised fact sheet provides guidance on billing the labor component and parts for the repair for beneficiaries who reside in competitive bid areas.
Source: vgm.com

Medicare Replacement Insurance

To get Medicare Replacement Insurance when using a service, you simply need to fill out a basic questionnaire.  You will review the different quotes from all the providers by seeing their policy figures.  You can pick out those insurance plans that give you exactly what you need and that are within your financial reach.
Source: otolaryngologist.com

Please Explain Medicare Part A B C D to Me

Medicare Part A and Part B do not cover all medical costs. There are deductibles and co-insurances required when you have a medical event. The coverage gap is the term used for the amount of out-of-pocket expenses you must pay. Private Medigap insurance came available to help fill the gap. Medigap policies are restricted to filling the coverage gap. Additional coverage for things such as hearing, vision, dental and prescriptions cannot be included with Medigap plans. Private insurance is required for these. So, to get total coverage, you would have to have three insurance plans: Medicare, Medigap and private coverage. That means for every medical episode, you could potentially file three claims.
Source: co.uk

What is the Importance of Having a Medicare Plan?

It is time for you to discover a plan that gives great deals and packages for you and your family. Imagine how you can benefit from it as well. You pay for the plan but you can reap your hard work when there is an uncalled incident. You can feel the help of your plan whenever you need it. Medicare is always ready to share you the different plans you can avail anytime. This can cover your expenses in the hospital whether you are an inpatient or outpatient too. If you would like to know more about it, you can visit www.medicareissimple.com today. Once you check the site, you can always request for a quotation and visit the place to get more details from a trusted insurance agent. You will not go wrong once you have decided for the package that fits you. This will be a good start for you to think of your health wisely.
Source: neighborhoodproduce.org

GOP Struggles To Find Replacement Plan For Health Law …

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

GOP Struggles To Find Replacement Plan For Health Law

The Washington Post: Medicare ‘Doc Fix’ Debate In Congress Less Predictable This Year On Friday, Congress passed the latest “doc fix,” delaying a looming 27.4 percent cut for two months as part of a larger deal to extend the payroll tax cut and unemployment benefits. But doctors, lobbyists and Medicare officials alike said this go-around seemed noticeably less predictable (Aizenman, 12/27).
Source: kaiserhealthnews.org

A Policy Prescription for 2012 

Integrated health care systems seems to be what ACO are designed to emulate; however, with increasing market power such ACOs may prove able to drive costs upward instead of downward. What do policy makers really want when they think of ACOs?  First, information consolidation is paramount. That liberates individual providers from repeating tests and therefore duplicating costs. Secondly, because Medicare has failed to transition from a retrospective fee-for-service payment system, policy makers are hoping that ACOs will realign providers’ incentives by employing salaried physicians instead of one focused on individual profit-maximization.
Source: policyprescriptions.org

State awards $200000 to 15 rural hospitals

Posted by:  :  Category: Medicare

To be eligible, hospitals must have received a Medicare certification as a Critical Access Hospital (CAH). Hospitals certified as CAHs receive a higher Medicare reimbursement rate and are eligible for grant funding for such projects as enhanced information systems. South Dakota currently has 38 critical access hospitals.
Source: healthnationstudy.com

Video: South Dakota Medicare Advantage Plans

Medicare Supplemental Insurance

When turning sixty five and going on Medicare, you will have many alternatives to select from for your Medicare Supplemental Insurance. However, there are some pitfalls to watch out for. Immediately compare Medigap Plans from best companies in your area and get on-line rates to see which plan will fit your needs the very best. Simply because when it comes to your well being, there is no reason to pay more than you have to for fantastic insurance coverage.
Source: southdakota.me

Medigap Limits, Medicare Advantage and Medicare Coverage for Seniors

As the debate over the debt ceiling, budget cuts, and economic stimulation wages on in Washington, DC, it’s hard to escape the fact that Medicare is often “on the table” during almost all discussions regarding “deficit reduction.” There are a range of proposals that would affect Medicare, but there are questions as to what those proposals will actually mean for beneficiaries. One federal deficit reduction plan would limit Medicare supplemental insurance (Medigap insurance) plans by restricting coverage of deductibles by those plans.
Source: medigap360.com

What Are The Best Medicare Supplemental Plans In South Dakota?

More information on this topic can be found on the websites of any of the companies you are interested in. If the company you want to go with is very small, you may have to get more information from their actual offices. That is highly likely with many of the companies that operate in this underpopulated state. A quick trip to their offices is certainly worth the time that you spend doing it. You will be able to get all of the specific information that you need about the plans so that you are never surprised by anything. Consider making a trip today.
Source: todaysseniors.com

Physical Damage Liability of Motorcycle Insurance Agency For Motorists

As we mentioned there are exclusions to all state requiring bodily injury liability option. For instance in Utah or in New Jersey drivers do not have to make a payments for this option per state laws, unless they fault into a motor accident with injuries. Then if they did have it, bodily injury liability would give coverage if he was at fault in a car accident and the motorist in the other vehicle obtain injuries is over the personal injury coverage. Physical injury liability covers injuries to human body only and if you have to find discount motorbike insurance rates for additional coverage, you need to turn to ins dealer in your state. If he did not have this option the other party has the right to sue and the state may put a material responsibility on his personal ticket, which he would must carry for three years. That financial responsibility is known as an SR22, or big risk motorcycle insurance assignment for convicted drivers. So even in a state such as New Jersey where this quote is not compulsory it is much better to get it in case of making an accident with victims than to not and leave you and your passengers at risk plus being required to have a SR-22 assurance.
Source: trendlearn.com

Best Way to Compare Health Insurance Plans

Posted by:  :  Category: Medicare

health insurance conference at Moscone West by Steve RhodesComparing health insurance plans is like a safety measure to ensure that you get the best insurance policy in the most affordable rates possible since a lot of people cannot afford an expensive insurance policy but still want one to deal with the unexpected events that life throws at us. Thus, the first step to getting a new and affordable insurance policy is to start off with comparing different insurance plans and policies and checking the prices and quotes that each company is offering for the policies you want. Not just that, you can also get some research done on your own through the internet or by asking directly from the firm in question about their health insurance policy!
Source: sugarassalt.com

Video: Alan Grayson on the GOP Health Care Plan: “Don’t Get Sick! And if You Do Get Sick, Die Quickly!”‘

Affordable Health Insurance Plans For Individuals

Having a health insurance plan does not mean that we should be complacent enough that we can abuse our health because we know that we are secured. Even though we know that we have something to help us in times when we get sick, we should still take care of you health by maintaining a healthy lifestyle. We can have healthy lifestyle by sleeping early or getting enough sleep. We should also avoid different vices if we want to be healthy. Anything in excess is not good for our health.
Source: ralphbuckley.org

Essential Things In Health Insurance Plans

You will get to know many people in the world that take the health insurance plans without having significant amount of the information about these plans. If you are not at all aware of some of the essential items that are necessarily required in the health insurance plans, then there are chances that you may be quite successful in getting the best of the health insurance plans in the near future. There are a large number of the essential elements or the aspects that must be there in the best health insurance plans. Let us look into some of them in quite a detail. The very first thing that an individual must take here is to compare the ratings of the various health insurance companies in India. This is because it will provide a very good or better say the best idea to the individuals regarding the best health insurance company that offers the best plan as well as the benefits that can really help the individuals a lot. It is very much recommended that an individual must always go for those health insurance plans, which they feel will not be that much of a burden on their pockets. It is also very much a necessity that the clause of the critical illness diseases must also be there mandatorily in the health insurance document or a plan so that the individuals does not find themselves in the financial mess. ICICI lombard health insurance company offer individual health insurance in India.
Source: universalbookmarks.info

The Cheapest Kind of Health Insurance

The main idea behind this type of health insurance plan is to place more financial responsibility on the person insured. For instance, a person with a $2000 deductible plan, would be responsible for the first $2000 in medical costs per calendar year. After a person has reached their deductible amount, the insurance company pays for all remaining medical costs up to the policy maximum.
Source: thirdagemedia.com

Opening a Health Savings Account

Try to avoid choosing a plan with a really high deductible if you do not have enough funds in the HSA or in your savings to cover the expense and wouldn’t over the next couple years. If you have a $10,000 deductible and you reach it after a serious injury, you would be expected to pay those out-of-pocket expenses and you almost undermine the point of having health insurance.
Source: gohealthinsurance.com

Kazor.com World Community News

Some the benefits of a catastrophic insurance policy are: – Helps you keep premiums really low – as much as 25 to 50 percent lower – Offers coverage for any treatment of significant medical issues such as a car accident – It is a high-deductible plan with amounts that range from $250 to $2,000 – You take care of your medical expenses up to the deductible – If the deductible is reached, the insurance kicks in and handles the difference – Pays for medical procedures, lab work, x-rays, surgery and intensive care stays
Source: kazor.com

Tips to buy Health Insurance From the Leading Insurance Carriers

Some of the points you need to look for in a health insurance carrier include customer satisfaction, quality customer service, a large and solid network and low premiums. There are a number of healthinsurance providers come up helping people to get a plan as per their need and requirement. Nowadays, there are a number of sources available to estimate reputation of a healthinsurance company. In fact, a rating of A and above A is a sign of a high-quality carrier. In addition, there are a plethora of factors like customer base and testimonials from friends and colleagues ensure the reputation of a carrier.
Source: articles-digest.com

Medicare insurance Supplement Insurance policy, Or Medicare supplemental health insurance Policies

Probably the most common misunderstandings with Medicare health insurance supplement insurance coverage is the fact that newer, less highly-priced coverage come each time during offered enrollment with November 15th to be able to December 31st. This is false. The once-a-year open application period ideal for changing treatment plan Part N plans, dis-enrolling in a Medicare Convenience plan, or changing to some new Medicare health insurance Advantage system. It is absolutely not however an occasion when you can finally purchase an innovative supplement with no medical underwriting on a yearly basis.
Source: jstreetjive.com