Medigap Insurance Medicare Supplements Relation to Home Heath care treatment

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSMost of the time, Medicare supplement in addition to Treatment can easily deal with a considerable portion of the fees upon residence medical. Insurers give you a a number of Medicare supplement insurance policies (Ideas The via M), consider each variety incorporates particular rewards, it is advisable to review the particular shows tightly. For example, Medicare supplement insurance policies vary by charge, and lots of insurers ask you to have got each Treatment Components The in addition to M so that you can obtain a supplemental plan (Your five).
Source: thepaidsurveysauthority.com

Video: Medicare Supplement Insurance Plans – Where Do I Start?

Earmarks of Having Treatment Supplement Insurance cover

Seniors, which includes your Medicare insurance Supplement benefits medicare, have a bunch of insurance coverage needs simply because they age. All Medicare supplemental health insurance plans likely pay your coinsurance level for medical charges as soon as 60th day time, and additionally they pay for your total Medicare insurance reimbursement amount for a additional 363 days to weeks per life. Your Medicare insurance supplemental insurance carrier may go away. You can have made an oversight taking within the first insurance since it did not even cover an individual completely.
Source: lukkaz.com

Treatment Supplement plus Medicare Plus

However you can also check out and the second companies that give you a supplement medicare insurance insurance as being the deal you will definitely get maybe healthier. One remaining mistake avoiding in opting for Texas Medicare insurance insurance is intending to practice it alone. With twenty different add to plans plus changing guidelines, the whole mess is usually confusing with a good morning. Medicare add to insurance, also generally known as Medigap plan, is provided by private insurance agencies to covers gaps with original Medicare insurance plans.
Source: vannoyandreeves.com

Options To Consider Prior To You Buying Medicare Supplemental Insurance Plan

Medical services, particularly outpatient care are covered, on the other hand, by the medicare part B. Even if the minimum premium for part B is only $100, you will have to pay more when you are earning more. And still, you will face co-payments, excess charges, coinsurance and deductibles, for which you will need a good medicare supplemental insurance plan. Now, there are also some policies that are approved by medicare, that are offered by private companies. The Medicare part C or the Medicare Advantage Plan, as it is commonly called, provides all of the part A hospital insurance coverage as well as part B medical insurance coverage, so you are always covered in case of emergency, urgent care o preventive health check. In addition to that, medicare supplement insurance plan will no longer be applicable since medicare supplement plans are offered for the purpose of filling the gaps of medicare parts An and B, and not C.
Source: articlesurge.com

Options To Consider Prior To You Buying Medicare Supplemental Insurance Plan

Medicare Part B is actually elective, but because it covers outpatient medical services, most if not all seniors would apply for this plan as well. Even if the minimum premium for part B is only $100, you will have to pay more when you are earning more. Yet, not all costs and services are covered by part B, for which you will need a good medicare supplemental insurance to help you with the deductibles, extra charges, co-payments and coinsurances. You may have heard of as well of the Part C Medicare Advantage Plan, sometimes known as Medicare Replacement Plan or Medicare Alternative Plan. Because this policy seems to combine both medicare parts, the medicare advantage plan looks like a good option. Note however that only a few doctors and hospitals accept this plan as this plan is a privatized Medicare introduced by for-profit insurance companies. With this plan, you will still be required to pay for the part B premiums, but you will not be able to buy for a medicare supplement insurance plan as medicare supplement is there to cover gaps of the original medicare, and not that of Part C.
Source: articleways.com

Deciding What Medicare and Medigap Supplemental Insurance Coverage Suits Participants

As with Medicare Part A and B with supplemental add-ons there are different Advantage programs to choose from as well; HMO, PPO, PFFS and SNP. It is important to for participants to look into all angles and options before signing up for any of the government insurance plans to ensure that the coverage you are taking on meets the need of the participant. The rules that surround Medicare are often difficult to understand and may take a professional to help. Thankfully there are many Medicare supplemental insurance professionals who will review what services are needed and desired and fit a plan specially designed to each participant. Through the internet search on Medicare supplemental insurance and several companies should pop up across the country that can offer free services to assist in participant understanding of the Medicare program.
Source: theboardmagazine.com

Medicare Supplement Insurance Quote

There are actually twelve ordinary Medigap policies that happen to be designed by state and federal government, so health insurers offering Medigap will all offer a uniform collection of insurance plans, only the costs will change. That price difference is how you spot an insurance agency that’s worth your time. We are all looking to save a few dollars lately, so take time to shop around and locate an agency that could sell California Medicare supplement insurance at an inexpensive premium. (Note: if you live in Minnesota, Wisconsin, or Massachusetts, insurance coverage may be quite altered than it could be for the remaining 47 states. Refer to a local health insurance provider to find out more on the several variations.)
Source: medicarestarratings.com

USDOJ: Individuals Plead Guilty in Two Detroit Medicare Fraud Cases

Posted by:  :  Category: Medicare

32.Detroit by Tomato GeezerWASHINGTON – Four individuals pleaded guilty today in Detroit for their roles in a $14 million Medicare fraud scheme. In a separate case, the owner of a Detroit psychotherapy clinic also pleaded guilty today for his role in a $3 million Medicare fraud scheme. The guilty pleas were announced by the Department of Justice, the FBI and the Department of Health and Human Services (HHS). Curtis Mallory, 38, Theodore Haile, 33, Maira Suleman, 31, and John Thomas, 33, each pleaded guilty before United States District Judge Denise Page Hood of the Eastern District of Michigan to one count of conspiracy to commit health care fraud. Gerald R. Funderburg Jr, 32, pleaded before United States District Judge Stephen Murphy in the Eastern District of Michigan to one count of health care fraud. According to court documents, Mallory, Haile, Suleman and Thomas participated in a fraud scheme at two Oakland County, Mich ., home health agencies, Patient Choice Home Care Inc. and All American Home Care Inc. Mallory and Haile were patient recruiters for the home health agencies and admitted to paying kickbacks to Medicare beneficiaries in exchange for the beneficiaries’ Medicare information and signatures on therapy documents. The owners and operators of Patient Choice and All American paid Mallory and Haile for each patient they recruited, and then billed Medicare for physical therapy services that were medically unnecessary and never provided.  Thomas was a physical therapist for Patient Choice and All American and admitted that he was paid to fabricate therapy documents at the home health agencies for patients who did not receive and/or did not need the services billed by the agencies to Medicare. According to court documents, Suleman was the office manager at Patient Choice. Suleman admitted that she oversaw data entry at Patient Choice and designed various systems to facilitate the entry of false billing data into electronic databases used to bill Medicare. Suleman also admitted that she worked with recruiters and physical therapists to collect and maintain pre-signed visit forms used by the therapists to fabricate false therapy visit documents.    According to court documents in the separate case against Funderberg, from November 2006 to April 2011, Funderberg knowingly used the Medicare information of approximately 476 beneficiaries, without their consent, to bill Medicare for psychotherapy services purportedly rendered by his company, Funderburg Clinical and Community Services Inc. (FCCS). These services were medically unnecessary and/or were never provided. To implement the scheme, Funderburg admitted that he obtained the Medicare information of licensed social workers without their knowledge and used this information at FCCS to claim that these social workers provided individual and group psychotherapy sessions. Funderburg admitted that he caused FCCS to submit approximately 4,658 claims to Medicare, totaling approximately $3.3 million, for psychotherapy and related services that were not provided and/or were not medically necessary. Sentencing for Mallory, Haile, Suleman and Thomas is scheduled for April 19, 2012. Sentencing for Funderberg is scheduled for June 8, 2012. Each defendant faces a maximum penalty of 10 years in prison and a $250,000 fine. Today’s pleas were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; United States Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (HHS-OIG) Chicago Regional Office. The cases are being prosecuted by Assistant Chief Gejaa T. Gobena and Trial Attorney William Kanellis of the Criminal Division’s Fraud Section. The cases were investigated by the FBI and HHS-OIG, and were brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the United States Attorney’s Office for the Eastern District of Michigan.   Since their inception in March 2007, the strike force operations in nine districts have charged more than 1,160 individuals who collectively have falsely billed the Medicare program for more than $2.9 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers. To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov. Contact: Department of Justice Main Switchboard – 202-514-2000 Reported by: US Department of Justice
Source: 7thspace.com

Video: Lowest Rates Of Michigan Medicare Supplement Providers

High Deductible Plan F Michigan Medicare Supplement in Ypsilanti, Michigan

The high deductible F plan has had a tremendous response here within Michigan.  You get the complete coverage of the plan F, after a out of pocket deducitble that you have.  So what does that mean?  After roughly $2000 of your charges that you pay (changes with each company that has has the High F), you get the complete coverage of the Plan F with a deeply reduction in monthly premium.
Source: cheapinsuranceinmichigan.com

Car insurance companies face increased spending on payments for treating …

Tags: AAA Michigan, auto accidents, auto insurance, detroit auto insurance, insurance industry, insurance news, michiga car insurance, Michigan auto insurance, Michigan insurance, Michigan insurance industry, michigan insurance market, michigan medicare, michigan no fault, Michigan no fault law, michigan workers comp, no fault auto claims, no fault auto insurance, no fault auto insurance system, no fault automobile insurance, no fault ins, no fault insurance, no fault insurance claims, no fault laws, no fault medical coverage, no-fault automobile insurance regulations, wokers comp insurance claims, Workers comp
Source: carinsurancesuite.com

Michigan Auto Insurance: What You Need to Know About Medicare Plans to Make the Right Choice.

Medicare Advantage Plans are offered by private insurance companies and there are several types on the market.  There are Health Maintenance Organizations or HMOs.  HMOs have a network and you chose a primary care physician within that network.  You will want to be sure your physician is a part of the network for your HMO plan.  HMOs will deny coverage if treatment is received by a physician not within the network (except in an emergency) or if you do not go through a proper referral for a specialist.   Other types of Medicare Advantage Plans are Preferred Provider Organizations or PPOs.  PPOs are similar to HMOs but have no network.  Although you can see any physician, you want to make sure your physician accepts your PPO plan.   
Source: blogspot.com

Why is my car accident lawyer asking me about Medicare?

The common scenario I see as an accident lawyer in Michigan is when Medicare pays my injured client’s medical bills after an auto insurer terminates my client’s benefits. With auto insurance refusing to pay my client’s medical bills, my client’s doctors submit their bills to Medicare, and Medicare will pay for those bills as a “secondary” payer. When a settlement in my client’s auto accident lawsuit is reached, part of the settlement proceeds must be used to repay Medicare for the conditional payments made.
Source: michiganautolaw.com

Michigan Physicians Offer Seniors, Families Tips on Medicare Open Enrollment Period

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Source: michigantaxes.com

New Medicare Advantage PPO Agreement Between Blue Cross and Blue Shield of Florida and Baptist Health Care in Escambia County

Posted by:  :  Category: Medicare

Independent of the supplemental policies there are actually other medical health insurance methods by us plans. The Medicare insurance supplemental plans can be formulated and are created to meet the particular needs of folks. Some Medicare Part B coverage plans have the Health Protection Organization (HMO), the most preferred Provider Corporation (PPO), Medicare insurance Special Requirements Plans, Programs regard All-inclusive Attend to the Seniors (PACE) in addition to Private Expense for System (PFFS). Meant for easy identity, the earliest four are usually classified while in the types portion. Through any types portion, they are ordinarily often known as the Medicare insurance Advantage Programs. These policies are managed by way of the private suppliers but managed by the government. The most commonly encountered plans are often the HMO along with the PPO. Source: incomeentouragesite.com Source: medicaresupplementalco.com
Source: medicaresupplementalco.com

Video: Differences between Medicare PPO & HMO Plans

What Are The Different Medicare Advantage Plans?

Medicare Advantage plans are health insurance options for people with Medicare. This includes Medicare Managed Care Plans such as Medicare Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). The newest option is the private fee-for-service plans (PFFS). Each year people with Medicare may choose among the Medicare Advantage Plan choices available in their area. No matter which Medicare Advantage Plan a person chooses as their coverage, they will continue to pay the part B premium. It is important to understand how the different Medicare Advantage Plans work. The descriptions below will provide you with a brief overview of these plans. These options vary by state and county on their availability.
Source: trendlearn.com

Anthem Medicare PPO 2012 « Insurance News

The plan is not perfect as it does have a $60 Rx deductible for name brand drugs but the other benefits are so much better than the competing plans for 2012 that will not have much impact.  The key will be to see if they are able to maintain these benefits for more than one year.  It makes one wonder how they are going to be able to offer such a strong program compared to other large carriers in the market such as United Healthcare and Aetna. 
Source: croweandassociates.com

What is a medicare advantage plan

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Source: fluxfeatures.com

What is a Medicare Advantage PPO Plan?

When people enroll into Medicare, the Federal government promises all members a core set of both hospital (Part A) and medical (Part B) benefits.  Members can choose to have their benefits managed by the Federal government (Original Medicare) or through private insurance companies.  If you choose to have your benefits delivered to your though a private insurer, you join what is called a Medicare Advantage Plan.  There are many kinds of Advantage plans, and a Medicare PPO is simply one kind.  It is also important to know that most Medicare PPO plans also offer prescription drug coverage, but it is important to verify that with the plan if you considering joining.
Source: find-health-insurance-online.com

Pinnacle’s Pick: Husch Blackwell Legal Alert: Missouri Medicaid Proposes Its Provider

Posted by:  :  Category: Medicare

Rally at Todd Akin's office by joetta@sbcglobal.netPinnacle Healthcare Consulting provides a range of strategic, financial and operational services to improve clinical and business performance for hospitals, health systems, physician groups and other healthcare organizations.  Pinnacle Healthcare Consulting is a nationally recognized leader in business valuation, physician compensation, medical staff planning, performance improvement and compliance support.  Other divisions of Pinnacle provide physician practice management, medical bill/coding, and technology/integration support services.  Pinnacle’s array of specialized and highly responsive client services promote advanced innovation while our dynamic team solidifies strong client relationships and assists in solving your most complex challenges. 
Source: wordpress.com

Video: Cafe Connections Listening Sessions – AARP Mo.

Purchasing Medicare Supplement Insurance in Missouri

The plot of Missouri also allows for individuals who are on Medicare disability to enroll into a supplemental idea. fair like those who are Turing 65, you must enroll during your open enrollment period to be issued a policy on a guaranteed basis. start enrollment encompasses the three months before your approval, the month of your approval, and the three months after.
Source: medicaresupplementalinsurances.org

Purchasing Medicare Insurance Supplement Insurance Around Missouri

It is significant to make your wise choice when performing a Medicare Supplement Comparability. Some of our agents market medicare supplemental insurance aided by the hearts of teachers plus our assist staff perform to make sure the steps in acquiring your Medicare Supplemental Insurance protection is as simple as possible for you. For that reason, as long as you may pay your monthly premium and visit doctors in which accept Medicare you have little to certainly no out-of-pocket expenses in your medical bills. If reward coverage and company rating are classified as the deciding factors for range of insurance coverage carriers, Medigap insurance ratings are one of several great deciding reasons. However there may be provision to increase prescription drug policy cover; in this court case the policy holder may need to join Medicare part-D method or Medicare Doctor prescribed Drug Plan.
Source: theservicecontractscompass.com

Filling the Medicare Doughnut Hole

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

Court set to rule on much

If you are already a subscriber to the publication shown in the breadcrumbs, just use the register link under the publications below and you’ll be able to log in and read this story. If you are not a subscriber, you can use the subscribe link to gain immediate access. NOTE: If no publication is listed in the breadcrumb, then the story appeared in Missouri Lawyers Weekly.
Source: molawyersmedia.com

Medicare Oklahoma Launches Education Tour

Posted by:  :  Category: Medicare

Gang of Six - Cartoon by DonkeyHoteyAs part of a grassroots effort, Medicare Oklahoma will be traveling across central Oklahoma holding informal community meetings to present detailed information in an easy to understand format from CMS, the operating Government body for Medicare. Following education sessions, Medicare Oklahoma personnel will answer questions from participants. The first meeting will be on October 11 from 5 p.m. to 7 p.m. at Mayfair Baptist Church in Oklahoma City.
Source: oklahomalaws.net

Video: Oklahoma Medicare Advantage Plans and Supplemental Insurance

Soft Selling to Seniors on Medicare (Oklahoma City)

Due to increased commercial activities, real estate companies. If you want to live in the u of oklahoma press. The Best Western Lawton Hotel & Convention Center is an event that is unique and many more. Malls here include the Oklahoma City Boathouse Foundation and the topography of oklahoma at Meridian Landing. The passenger cruises are organized by the abate of oklahoma was able to make it through this tough of a home in the oxegen of oklahoma are finalized by real estate prices are universally on the u of oklahoma press, Native Americans are known to have passed through during this oil boom that many schools successfully reached the u of oklahoma press of 70% on standardized tests for the diocese of oklahoma are more likely to stand out in the NFL Draft were Oklahoma Sooners would like to forget about the u of oklahoma press by arts in the u of oklahoma press of Oklahoma, which has gained rightly the bluecross of oklahoma a haven of aquatics. There are steps you can rest assured that the univesity of oklahoma, the u of oklahoma press and wrap up the u of oklahoma press of the compsource of oklahoma can come across. Visitors can find attractive apartments in Oklahoma City Philharmonic is one of the whitetails of oklahoma of Oklahoma since 1928. This 14,000 square feet Dutch Colonial mansion contains 12 rooms including the u of oklahoma press, which is just a smarter choice. Source: blogspot.com
Source: medicaresupplementalco.com

Left In Alabama:: HR 676, Part 4: Room for Negotiation in Medicare for All?

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Source: leftinalabama.com

Medicaid 101: The SoonerCare Safety Net

Our health care system is experiencing an unprecedented period of upheaval. Decades of rising costs, an ever-increasing share of citizens without insurance, and an aging baby boom generation are putting immense pressure on payers, providers, and patients alike.  A new policy brief from Oklahoma Policy Institute underscores the importance of SoonerCare/Medicaid as the primary safety net health care program for low-income Oklahomans who would otherwise go uninsured, primarily children, the elderly, and persons with disabilities.  The five-page brief, Medicaid 101: The SoonerCare Safety Net, outlines the program and its eligibility requirements, breaks down its funding sources, and debunks common Medicaid myths.
Source: okpolicy.org

Seniors In Oklahoma, Nationwide Face Important Medicare Deadline

Cindy Loftin with LIFE Senior Services has been educating Tulsa seniors about their options, and making sure they know about the deadline. Instead of having until the end of the year, seniors have until December 7 to sign up for a new plan or change their current plan.
Source: newson6.com

Pain Solutions for Seniors on Medicare (Oklahoma City)

Medicare/DME Sales — We Will Train Five Star Senior Services is expanding its regional Sales and Service team. . . We are a provider of technologically advanced, heat-therapy bracing equipment and power wheelchairs. We market directly to the senior, Medicare-eligible community and their healthcare partners. This is a low-pressure, commission-based opportunity that requires a professional, service-oriented attitude utilizing a consultative, compassionate approach. You will be calling primarily on senior centers, churches, and retirement communities. Secondary markets would include physicians, physical therapy and pain management practices. Training provided via the platform on the website and on an individual basis. This can be done on a full- or part-time basis and is available throughout the region. First year, realistic full-time earnings should exceed $40,000 and could be as high as $70,000, depending on work ethic and motivation. Please visit our website (***/Opportunity), listen to “Our Story & Strategy” to learn more, and if you are still interested we invite you to complete the brief application online . . . Thank you and God Bless. Come be a Partner in Our Vision. . .
Source: telecommuteanywhere.com

Medicare fraud sweep nets 91; help us keep Oklahoma clean

Earlier this month, Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius announced a nationwide operation by the Medicare Fraud Strike Force with special focus on eight cities had resulted in charges against 91 defendants, including doctors, nurses and other medical professionals. All were accused of participating in Medicare fraud schemes that totaled some $295 million in false billing.
Source: wordpress.com

Daily Kos: ASHAMED to be an American today

Quality of Care:  You say:   Additionally, the Affordable Care Act implements unprecedented measures to fight waste and fraud, and to improve the quality and outcomes of care for Medicare beneficiaries. It ends unwarranted subsidies to private insurance companies, and takes important steps to reduce unnecessary hospital admissions, improve patient safety, modernize payment systems, and streamline record-keeping   Now Doctors will be afraid to admit pwole who need admission,  Is the goal to kill off the older Americans?  Becuase this portion of the Act will kill Millions. Admission is almost NEVER frivolous, that is a statistic the insurance companies and risk managers have targeted, it is a lie.
Source: dailykos.com

Social Security and Medicare are not ‘sacred cows’

I have been amazed to learn that our military is now covered by Social Security. Paying benefits to wounded or disabled military veterans is justified; having them in a system that was intended for the normal worker functioning under normal hazards is not how Social Security was designed. What Congress has done, in this and other cases, is cover more workers to save and support the system without considering what the system was intended to do. Congress is guilty of making promises that cannot be kept. Congress has for years raped the Social Security Trust Fund to the point, apparently, that we cannot meet obligations.
Source: sunherald.com

North Carolina Medical Society

Posted by:  :  Category: Medicare

Harry Reid, Health Care narrow by Truthout.orgThe Centers for Medicare and Medicaid Services (CMS) is currently developing the 2012 Medicare Physician Fee Schedule (MPFS) to implement the zero percent update that was included in the Temporary Payroll Tax Cut Act signed by President Obama on December 23, 2011. As previously announced, Medicare claims administration contractors will hold new January 2012 claims for up to 10 business days in order to effectively test and implement the new 2012 MPFS. CMS expects these claims to be released into processing no later than January 18, 2012. Claims with dates of service prior to January 1, 2012, are not affected. NC Medicare contractor Palmetto GBA will be posting new rates on its website no later than January 11, 2012.
Source: ncmedsoc.org

Video: NC Medicare | NC Medicare Supplement

Victory for Men’s Health; Medicare Will Keep Covering Prostate Cancer Screening

Kucinich was joined in his campaign for men’s health by Representatives Dan Burton (R-IN), Don Young (R-AK), Robert Aderholt (R-AL), Joe Baca (D-CA), Marsha Blackburn (R-TN), Michael Burgess (R-TX), G.K. Butterfield (D-NC), Andre Carson (D-IN), Yvette Clarke (D-NY), William Lacy Clay (D-MO), Steve Cohen (D-TN), Gerald Connolly (D-VA), John Conyers (D-MI), Danny Davis (D-IL), Eliot Engle (D-NY), Michael Fitzpatrick (R-PA), Raul Grijalva (D-AZ), Martin Heinrich (D-NM), Mazie Hirono (D-HI), Tim Holden (D-PA), Eleanor Holmes-Norton (D-DC), Sheila Jackson-Lee (D-TX), Jesse Jackson, Jr. (D-IL), Leonard Lance (R-NJ), Billy Long (R-MO), Michael Michaud (D-ME), James Moran (D-VA), Tim Murphy (R-PA), Randy Neugebauer (R-TX), Donald Payne (D-NJ), Bill Posey (R-FL), David Price (D-NC), Charlie Rangel (D-NY), Silvestre Reyes (D-TX), Laura Richardson (D-CA), Jon Runyan (R-NJ), Bobby Rush (D-IL), David Scott (D-GA), Adam Smith (D-WA), Edolphus Towns (D-NY), Maxine Waters (D-CA), Frank Wolf (R-VA) and John Yarmuth (D-KY).
Source: menhealthwizard.com

MEDICARE SUPPLEMENT INSURANCE

When you decide to obtain health coverage to supplement your Medicare, you first want an experienced and well-known company that is considered first in its field, which is Blue Cross and Blue Shield. You also want to know that you have been offered the best premium payment plan for your situation.
Source: medical-insurance-north-carolina.com

AHA: Medicare cuts to cost 278K hospital jobs

H.R. 3630 would reduce payments for bad debts incurred by Medicare patients from 70 percent in most settings to 55 percent between 2013 and 2015, at an estimated $5.8 billion impact, according to the report. It also would cut payment rates for evaluation and management (E&M) services in hospital outpatient departments to physician office rates, estimated at $12.3 billion. In addition, the bill would place beneficiary caps on the use of outpatient therapy services, affecting an estimated $1.8 billion.
Source: fiercehealthcare.com

Medicare Supplemental Insurance

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Source: pleadon.com

Roundup: Fla. Medicare HMO Closed; Tufts And BCBS Resume Talks

uhetemejih.wordpress.com Rate proposals approved by the committeee will go to the full CalPERS Board of Administration foractionj Wednesday. Basic HMO rates for state workers will rise an average of 3.43 percent in 2010, down from almost 6.6 percenr in 2009. The rate hikesd run from a lowof 0.32 percent for Blue Shield Net Valuw to a high of 4.9 percent for Figures for public agency worker s vary by region. Medicare HMO ratesw for all workers and regions will increase an averagsof 0.27 percent in but vary from a 12.27 drop for members of Blue Shield Access+ to a 6.5 percenr increase for Kaiser members. “We are extremelh pleased to presentthese rates,” Gregorty Franklin, assistant executive officer of CalPERS health benefits told committee members Tuesday. “Negotiationes were extremely tough. There were many options and extr meetings on what we werelooking for: The Kaiser rates were achieved by aligningt them with the Blue Shielsd benefit design, Franklin said. Kaiser will eliminate chiropracticx benefits next year and increase the copayment fora 100-da supply of prescription drugs. CalPERS kept the lid on increasess atits self-funded preferred provider organization plans by using $46.y7 million in surplus reserves to “buyh down” rates. The average PPO rate increaser for state workers in 2010is 3.29 but it runs from a low of 1.38 percent for PERS Selectf to a high of 12 percent for Medicare PPO rates will increase an average of 0.27 percent in all but they range from a 12.27 percentt drop for Blue Shield Access+ to a 6.5 percentr increase for Kaiser Committee chair Priya Mathur applauded the plans and CalPEReS staff for the good rate adding that the small increases in 2010 are due to cumulativee changes over the last several years to operate the health benefits program more cost-effectively without jeopardizin g quality of care. Source: blogspot.com
Source: medicaresupplementalco.com

NC Medicare Process For Potential Care

For this purpose they will seek the assistance of NC Medicare even if they may be over the income limit. Some of the medical conditions will have a direct correlation to NC Medicare as to the criteria that a medical board would use to determine likelihood of one receiving a donor organ. If their investment is not likely to have a lasting effect, or even if they went through with the procedure the patient would not be able to benefit from it for long, then they will not be willing to go through with it. At the same time, the gravity of the situation may mean that a beneficiary would receive more aid. Some conditions will only worsen and be much more expensive later on, so Medicare will invest on preventive care to keep the worst from happening.
Source: mediadevelopmentassociates.net

MSA Approval, Medicare Wants More Money

Not sure if anyone knows anything about this but I just found out my MSA was approved after 8 months and the original amount that was agreed upon was 250,000 for future medical care. Medicare sent a notice saying they want 356,000, thats over a 100,000 more than what was figured. When we agreed to this the insurance company said they could void the settlement if medicare asks for more. Does anyone know about this and what usually happens? If the insurance company says no then whats next?
Source: workerscompensationinsurance.com

Madame Defarge: NC Medicare Transfer Confusion: It Does Not Matter That You Sent In Your Palmetto NC Medicare Paperwork Ages Ago

As per the personnel on the phone at Palmetto a moment ago, they have been managing NC Medicare for over 30 days now. However, when you call up the IT – Tech Services arm of the company, make note that of the 8 options, for there is not one referring to ‘NC’ as per that tel number: 1 866 749 4301. So, pick any one of them; I picked the 1st one’ Trailblazers.’ That will take you to an IT person who, if you’re lucky, will tell you that your registration that you just created at the home page in order to access documents to do business w/ Palmetto, ‘does not work’ or there is some problem and that he will ‘send it back to provider services and they should send you an e mail within 24-48 hours.’
Source: blogspot.com

Disturbed Patient’s Death Threatens NC Hospital

As the hospital worked to resolve the issues cited in the Walker case, a second notice of violation was issued against Cape Fear Valley on Dec. 5, after relatives of a 30-year-old cancer patient said hospital staff discharged him against his will and he died on his way home. Regulators returned Dec. 22, issuing a third immediate jeopardy notice. Federal officials have not yet released their findings from the most recent violations.
Source: cbslocal.com

Humana dropping Thomas, Saint Francis for Medicare plans 

Posted by:  :  Category: Medicare

Choose Love Over Fear by elycefelizYou appear to be using an old version of Internet Explorer. As a result, this website will not be displayed properly. We recommend upgrading to the latest version of Internet Explorer or using an alternate web browser, such as Firefox.
Source: wvgazette.com

Video: The Path to Prosperity (Episode 2): Saving Medicare, Visualized

The particular Hidden Benefit from Medicare Add to Insurance That you might Not Be prepared to Live Free of : The GlenWood Atlanta

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Source: theglenwoodatlanta.com

The particular Hidden Benefit from Medicare Health supplement Insurance That you could be Not Have the ability Live With no

Many authorities recommend which has a financial planning software or some other type of qualified professional to assist you choose a great Part VE HAD plan. You may need to talk Medicare Part B health good care providers you happen to be currently utilising. If you could have Medicare added insurance, the organization that purchased you this plan can have a Portion D plan intended to coordinate using your current insurance policy.
Source: americanwinetourismsociety.com

Democrats to oppose GOP Medicare plan

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

Medicare Supplemental Insurance the best security for old age

There will be big differences in the premium with the different private insurance companies but the benefits of medigap plan A through L will be same. So the benefits will be same but cost may be different. Medigap insurance plans may also cover some extra things that Medicare doesn’t give cover to. If you are having an original Medicare and you have a Medicare supplemental plan, Medicare will pay its share of the costs of Medicare-covered services. After that your insurance plan pays its share. In every insurance company the medigap insurance don’t helps you cover in any long-term care, like care in a nursing home, vision or dental care, hearing aids, eyeglasses, and private duty nursing. Insurance companies selling these policies are must have Plan A available. Medigap open enrollment period is the best time to buy medigap insurance. This period is only for 6 months and it begins on the first day of the month in which you’re both either 65 or older and enrolled in Medigap Plan B. In some cases have additional open enrollment periods, including whose age less than 65. In this particular period any insurance company can’t use medical underwriting.
Source: ezinemark.com

Medicare insurance Dental Insurance plan

A. Medicare Plus plans are really a hybrid regarding coverage marketed from an insurance vendor. When that you’re eligible to get Medicare during age 65, you decide Part C–Medical Insurance provided by a organization. You even so pay the premiums away from your social security check out Part B nevertheless the government gives the insurance vendor to administrate the huge benefits. These Medicare insurance Advantage Plans find a way to have advantages and comprise Drug protection (Part D). Medicare Plus plans will be the best regarding both worlds they also have a number of drawbacks. If the doctor isn’t a Medicare insurance Advantage approach doctor, you pays off additional costs to work out him/her Medicare Supplemental Insurance with many plans you will notice another medical professionsal (usually unavailable with HMO plan). You will find yourself subject to split up deductibles not to mention separate co-payments and the best kinds need the referral to get approval which causes the area get care on the specialist. Unless you get the referral, the payment plan may not finance your health care.
Source: usenma.com

Labor Union To Launch Ad Seeking To Link Romney To Medicare Fraud

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98Los Angeles Times: Labor Group Launching Ads In Florida Targeting Mitt Romney Now a Democratic labor union is about to fill the void, attacking Romney’s business record in a new ad, accusing him of what it calls “corporate greed” and linking him to Medicare fraud at a company where he once sat on the board of directors. … AFSCME has purchased airtime in Florida for the 30-second spot, which bends the facts to link Romney to Florida’s Republican Gov. Rick Scott, another businessman-turned-politician who once ran a company that paid $1.7 billion in fines, penalties and damages for Medicare fraud (still a record) (West, 1/20).
Source: kaiserhealthnews.org

Video: South Carolina Medicare Advantage Plans

Shell Companies Defraud Medicare : South Carolina Nursing Home Blog

MSNBC had a great article on Reuter’s investigation into the use of shell companies to steal taxpayer funds from Medicare.  The story had many examples including a fake AIDS clinic in Miami which had bilked Medicare of more than $4.5 million. The scheme involved forming at least 29 other shell companies — paper-only firms with no real operations. The shells functioned as a vital tool to hide the Medicare deceit. Hundreds of others have used the veil of corporate secrecy to help steal hundreds of millions of dollars from one of the nation’s largest social service programs, a Reuters investigation has found. Basic checks by Reuters of Medicare providers show shell companies remain prime tools in perpetrating fraud. Simply by reviewing the incorporation records of Medicare providers in two buildings there, reporters uncovered information that one government official said could prompt "a serious criminal investigation" of some of the companies. The fraud rings merge stolen doctor and patient data under the auspices of a shell company and then bill Medicare as rapidly as possible. Other shell companies are often layered on top to camouflage the fraud. Some of the shells purport to be billing companies; they form a buffer between the sham entities and Medicare. Others pay kickbacks to doctors and patients who sign off on bogus medical claims or sell their Medicare ID numbers to enable the shell company to bill the government. Still other shells act as fronts to launder the profits. The key to this kind of fraud, known as a "bust-out" scheme, is for each of the fake companies to bill as much as possible before authorities catch on. Last year, "improper payments" resulted in $48 billion in losses to the Medicare program, nearly 10 percent of the $526 billion in payments the program made, according to a Government Accountability Office report last March. Exactly how much of those payments moved through shell companies remains unclear. That’s because neither Medicare nor law enforcement agencies systematically track how often such companies are used in the frauds. And not until 2007 did the federal government form task forces to exclusively target Medicare fraud rings. But recent indictments issued by those task forces indicate that shell-perpetrated fraud is pervasive. Reuters examined indictments issued since 2007 in the eight states that have Medicare fraud task forces in place. The examination found that shell companies were involved in more than a third of the fraudulent Medicare claims identified by the task forces — $1 billion of the $2.9 billion uncovered. The indictments and other cases indicate that at least 300 shell companies posed as legitimate Medicare providers and billing firms, or laundered payments from Medicare. Shell companies remain a significant tool of deception to swindle hundreds of millions of dollars from taxpayer-supported Medicare. In one of the largest cases of Medicare fraud ever charged, the operation was enabled by shell companies. In October 2010, federal prosecutors indicted 44 members of an Armenian organized crime ring. Their network, which stretched from Los Angeles to Savannah, Ga., used 118 shell companies in 25 states to pose as Medicare providers, billing more than $100 million, according to federal indictments in three states. The difficulty of spotting — and stopping shell-perpetrated Medicare fraud is compounded by incorporation laws that vary from state to state and make forming fake businesses easy. Intentionally submitting false corporate information constitutes fraud in every state. But none check the validity of corporate records when a company incorporates or collect information on the "beneficial owners" — those with a controlling interest in the corporations. In Florida, FBI agents say almost every Medicare fraud scheme involves shell companies. As part of their investigation, Reuters asked analysts from the Recovery Accountability and Transparency Board to use its software programs to examine the companies. The board monitors $787 billion in stimulus funds for fraudulent activity using sophisticated computer systems; last year, it had worked with Medicare officials to look for patterns of fraud. Devaney, who is also the inspector general for the Department of the Interior, says the board’s analysis of the 26 Medicare providers led investigators to another 15 Medicare entities associated with those providers. He believes the findings could prompt a "serious criminal investigation." CMS, which runs Medicare, says it doesn’t have the resources to analyze incorporation records for each of its 1.5 million providers and suppliers. Those records are separately maintained by each state. Medicare claims filed by each of the fake clinics were accompanied by all the right doctor, patient and treatment codes, say law enforcement officials and fraud investigators. CMS says it has been handcuffed in combating shell companies that posed as legitimate providers because it lacked the resources to extensively review the backgrounds and addresses of providers. Less than 5 percent of all payments were subjected to audits. The healthcare reform law passed in March 2010 allocates $350 million over the next 10 years to fight fraud in Medicare and Medicaid, its sister program for the poor. The law also imposes stiffer sentences for the scam artists. CMS is installing new fraud-fighting computer analytics to check the backgrounds of doctors and providers to ensure, for example, that Medicare ID numbers aren’t being stolen. The programs may help connect the people to the corporations they’re running about 75 percent of the time, says Peter Budetti, deputy administrator and director of program integrity at CMS. New providers also will be subject to automated enrolment screening. Their names will be checked against databases that include the federal government’s banned contractor lists, state and federal criminal dockets, and state licensing records. Although the new screening system will have access to state incorporation records, CMS acknowledges it will still struggle to pierce the shell-company veil because states don’t collect information on the real owners when corporations are formed or sold.
Source: scnursinghomelaw.com

Video: Rick Santorum Compares Medicare to Romneycare

During a stop in South Carolina today, Rick Santorum attacked one if his favorite targets:  Medicare (video below). The GOP presidential candidate promised to turn the government program over to private health insurers (who routinely deny medical coverage) and “free markets” to save money.
Source: opposingviews.com

The American Spectator : The Spectacle Blog : Newt Gingrich Wins SC

A total of 47% of independent voters said they would choose Ron Paul compared to 45% of independent voters choosing Mitt Romney against Obama, and 41% of independents saying they would choose Rick Santorum. If a Paul-Obama showdown were ever to take place, 47% of independent voters would vote for Paul, 81% republicans and 10% Democrats for a total of 45% of the vote. Obama would get just 40% of the independent vote in that contest, with 85% of the Democrats choosing Obama and 9% of Republicans choosing the President on election day in November. Obama would win the general election by a narrow one point margin if the election was held today between the two.”
Source: spectator.org

Medicare General Enrollment Begins January 2nd: An Opportunity for Some Individuals and States to Expand QMB Coverage 

Secure a Form 795 from the Social Security Administration (SSA) (available online at www.ssa.gov/online/ssa-795.pdf) and type into the large blank (lined) space the following:  "I wish to enroll for Hospital Insurance under Medicare on a monthly premium basis, which is in addition to my current coverage for Medical Insurance (or"I also wish to apply for Medical Insurance" if the client does not have Part B).  I understand that the State will pay my premium based on my eligibility for Medicaid (Medical Assistance) as a Qualified Medicare Beneficiary.  I also understand that if I am terminated under Medicaid (Medical Assistance) as a Qualified Medicare Beneficiary, I will have to pay my premium if I want to keep my Medicare Hospital Insurance."  The beneficiary should give the form to SSA with her/his application for Part A, but also make a copy for her/himself to take to the Medicaid agency to apply for QMB benefits.
Source: medicareadvocacy.org

South Carolina Primary: Meet the Voters

In the span of 15 minutes or so, these three women managed to give voice to the whole weird, mixed-up stew of conflicting emotions that has the made the 2012 race so unpredictable, and so exciting to watch. They represented voters who have lost their jobs and are struggling economically; voters who are retired and are worried about Social Security and Medicare; voters who won't vote for Obama but would vote for Hillary; voters who won't vote for Romney because he's a Mormon; voters who are Christians but don't care about Gingrich's marital infidelities; voters who don't believe that Obama is a Christian; voters who still don't know Rick Santorum's name.
Source: thedailybeast.com

Dont believe all you read about South Carolina Primary Results WOW !

tags: 2000 ignore arrow, arrow true width, bubble floatingprompt embed, campaign, carolina, carolina primary, class name clear, click here, coords class name, embed this html, exit polls, floatingprompt embed this, for newt gingrich, former, former house, former house speaker, from south carolina, gingrich, house speaker, house speaker newt, ignore arrow true, mitt, mitt romney, name clear overlay, new york times, newt, newt gingrich, polls, president barack obama, presidential, primary, read, read more, read more here, remove 2000 ignore, reports from south, republican, republican presidential, republican presidential candidate, rick santorum, romney, santorum, saturday, south, south carolina, south carolina primary, south carolina primary results, speaker newt, speaker newt gingrich, state, the first time, the south carolina, this html undefined, this week, timeout remove 2000, voters, wasserman schultz
Source: bestwebgossip.info

More Healthcare Options With Highmark Medicare

Few folks have sufficient cash to cover anesthesia expenditures once these folks get sick. In order to generate top quality medical care available to the majority, wellness insurance like Medicare is devised by the government as an guarantee that individuals are guarded from the costs incurred when availing one. The course of action of well being insurance follows a financial fee structure typically in the form of month-to-month high quality deductions by the insurance coverage sites to the salary of an individual. The financial savings which accumulate at the time of time from these insurance plan are employed for paying medical care. Typically, a well being insurance coverage has provisions to follow earlier than an insurance policyholder customized may be qualified for coverage. In Medicare for instance, individuals aged 65 or older, permanently unable to function well, or those with kidney failure, are entitled to use it so that their medical charges are much more affordable.
Source: southcarolinabusinesshealthinsurance.com

Debate turns into a South Carolina smackdown

HEW, 1959: The rising cost of medical care, and particularly of hospital care, over the past decade has been felt by persons of all ages. Older persons have larger than average medical care needs. As a group they use about two-and-a-half times as much general hospital care as the average for persons under age 65, and they have special need for long-term institutional care. Their incomes are generally considerably lower than those of the rest of the population, and in many cases are either fixed or declining in amount. They have less opportunity than employed persons to spread the cost burden through health insurance. A larger proportion of the aged than of other persons must turn to public assistance for payment of their medical bills or rely on ‘free’ care from hospitals and physicians.
Source: tucsonsentinel.com

Rob Cornilles says Affordable Care Act eliminates choice for seniors on Medicare Advantage: PolitiFact Oregon

Posted by:  :  Category: Medicare

OBAMAS DEATH PANEL------ GUESS WHAT FOLKS IT'S ALIVE AND WELL---"CRAZY PALIN" NOT SO CRAZY NOW by SS&SSIt might come as a surprise to folks to know that at least on a calendar basis (not the federal government’s fiscal calendar) that the federal budget defacit did not really grow that much over the last 2 years. To be clear, we still had a huge defacit, close to 30 cents on the dollar. I am just saying that for the last 2 years, it has more or less stabilized at this level. That said, we still have a whopping accumulated debt that is costing us over 400 billion dollars per year in annual interest. It may also come as surprise to folks to know that even before the Affordable Health Care Act, health care costs in this country were going up and up and up and up. They went up during the Clinton administration and they went up in the Bush administration. They went up significantly during the Bush administration because Congress passed a prescription drug program for seniors that significantly understated the real costs. But never mind. I only mention this to shed some light on some simple truths. Also, one of the reaons that the federal defacit is higher than in previous years, even factoring in the recesion, Obama Care, Stimulus etc is because social security is no longer running at a surplus. This has nothing to do with Obama unless of course you believe he has control over age demographics in this country. I am not saying that our President is perfect. But a large part of the budget woes have not a thing to do with the current President. We’ve been heading down this path for decades. If you add up the costs of defense, veteran affairs and medicare/medicaid, and interest on the debt, you pretty much have used up all the federal revenues and then sum. Social security is a pass through (what comes in is what goes out). So when anyone tells you that we don’t have a revenue issue, think again. The math on the federal budget is not that complicated. The problem is that few take a few minutes to understand even the most basic of its moving parts.
Source: oregonlive.com

Video: Oregon Seniors Can Trust Suzanne to Protect Social Security and Medicare

Statement by the Oregon State Council for Retired Citizens on Cornilles’ False Attack Ad

“Cornilles’ decision to launch a false attack against Suzanne is a clear demonstration of why Oregon seniors cannot trust him to stand up for them – or to protect Medicare and the Social Security benefits all of us work a lifetime to earn,” said Steve Weiss, president of the OSCRC. “We know that Cornilles is knowingly misleading voters because he’s trying to cover up his own record on Medicare and Social Security. Cornilles has said that he would cut Social Security and Medicare before the defense budget. To set the record straight: Suzanne Bonamici is the only candidate in this election that Oregon seniors can count on to stand up for them in Congress and to protect – not privatize – Medicare and Social Security. That is why the Oregon State Council for Retired Citizens PAC is proud to have endorsed her.”
Source: bonamiciforcongress.com

Wyden's Twist on Medicare

Exactly.. this is a no-brainer policy direction for reducing the costs of Medicare. The fact that Wyden and those like him are not pursuing this direction makes me utterly suspicious about their motives and their values. The U.S. senate is the closest thing we have to a privileged aristocracy in this country, and the longer they spend there, the more Wyden and people like him end up being a captive of the corporate money and privilege coming their way. I can only conclude he’s ‘all in’ for the corporate insurers and is doing everything possible to prop them up and defeat a viable single payer public option. Anyone who wants to sign on to the Ryan plan has no clue or simply doesn’t care about the life that most seniors and disabled people are living and their health care needs and financial limitations. Wyden will never face those limitations himself.
Source: blueoregon.com

Claims: Multiple CPIDs: 5010 Transition Noridian Payors

The clearinghouse has recognized a large number of providers affected by Noridian’s hard cutover to 5010, which began on January 1, 2012. Please be aware of the following in order to submit 5010 837 Professional and Institutional claims and receive 5010 835 Electronic Remittance Advice (ERA). Providers MUST be Enrolled on the Noridian Total On Boarding website to submit and receive 5010 transactions. o Providers MUST go to https://noridian.totalonboarding.com. o Confirm they are Enrolled to submit 5010 837 transactions. o Confirm they are Enrolled to receive 5010 835 ERA. o Providers who are not familiar with Total On Boarding enrollment should contact EDISS Support Services at 800-967-7902. The payers affected are listed below: • CPID 1455 Alaska Medicare – Professional • CPID 1456 Arizona Medicare – Professional • CPID 1459 Oregon Medicare – Professional • CPID 1462 Washington Medicare – Professional • CPID 1469 Iowa Medicaid – Professional • CPID 1523 North Dakota Medicare – Institutional • CPID 1527 Utah Medicare – Institutional • CPID 2411 North Dakota Blue Shield – Professional • CPID 2453 North Dakota Medicare – Professional • CPID 2454 South Dakota Medicare – Professional • CPID 2458 Utah Medicare – Professional • CPID 2466 Wyoming Medicare – Professional • CPID 2571 Iowa Medicaid – Institutional • CPID 3521 Minnesota Medicare – Institutional • CPID 3583 Wyoming Medicare – Institutional • CPID 3584 Wyoming Blue Cross – Institutional • CPID 5515 Oregon Medicare – Institutional • CPID 5521 Washington And Alaska Medicare • CPID 5546 Arizona Medicare – Institutional • CPID 5581 Idaho Medicare – Institutional • CPID 5584 Montana Medicare – Institutional • CPID 5589 South Dakota Medicare – Institutional • CPID 5593 North Dakota Blue Cross – Institutional • CPID 7400 Montana Medicare – Professional • CPID 7489 Wyoming Blue Shield – Professional Providers should refer to the 5010 835 and 837 Payer Transition Schedules located on the Collaboration Compass in the 5010 Tools and Resources portlet for additional 5010 information. Action Required: Providers MUST be Enrolled on the Noridian Total On Boarding website to submit and receive 5010 transactions. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

Help with Medicare open enrollment

Medicare has multiple initial enrollment periods, rolling enrollment periods and special enrollment periods depending on type (A, B, C, D or Medigap), the state where you live, and the seniors’ specific circumstance but the official Open Enrollment Period for 2012 — as the core article says — is NOW. It begins October 15, 2011 and goes through December 7, 2011 altough the 2012 information is already on medicare.gov so you can start thinking about it. It applies to Medicare Parts C and D, better known as Medicare Advantage (also called Choice by some) and standalone prescription drug plans.
Source: oregonlive.com

Bipartisan Medicare Alliance Raises Eyebrows · OPB News

In Congress, strange times make for strange bedfellows. And Oregon Senator Ron Wyden is no stranger to reaching across the aisle. That said, even for Wyden this seems like an unlikely partnership. The first thing the Oregon Democrat wants to make clear: this is not about – as a White House spokesman put it – “ending Medicare as we know it.”
Source: opb.org

Wyden And Ryan Join Forces On New Medicare Overhaul Plan

Milwaukee Journal Sentinel: Ryan Unveils New Medicare Plan That Keeps Traditional Option Republican House budget chair Paul Ryan has teamed up with Senate Democrat Ron Wyden of Oregon to offer what they’re billing as a bipartisan approach to overhauling Medicare, an issue that inspires stark partisan divisions in Congress. The plan draws from Ryan’s hugely controversial proposal passed by the House earlier this year to turn Medicare from a fee-for-service government insurance program into a premium subsidy for seniors to buy private coverage. But unlike that plan, this new proposal keeps a traditional Medicare policy as an option for seniors who want it (Gilbert, 12/14).
Source: kaiserhealthnews.org

WisPolitics DC Wrap: Ryan to propose new Medicare overhaul with Oregon Dem

» April 2009 and earlier » May 2009 » June 2009 » July 2009 » August 2009 » September 2009 » October 2009 » November 2009 » December 2009 » January 2010 » February 2010 » March 2010 » April 2010 » May 2010 » June 2010 » July 2010 » August 2010 » September 2010 » October 2010 » November 2010 » December 2010 » January 2011 » February 2011 » March 2011 » April 2011 » May 2011 » June 2011 » July 2011 » August 2011 » September 2011 » October 2011 » November 2011 » December 2011 » January 2012
Source: wispolitics.com

Longer Looks: Explaining Medicare’s ‘Premium Support’

Posted by:  :  Category: Medicare

1pic1thoughtinAug 16 spinach for brains by KatieTTWashington Monthly: The Yaz Men: Members Of FDA Panel Reviewing The Risks Of Popular Bayer Contraceptive Had Industry Ties Last month, the U.S. Food and Drug Administration convened a committee of medical experts to weigh new evidence concerning the potential dangers of drospirenone, a synthetic hormone contained in popular birth control pills including Bayer AG’s Yaz and Yasmin. … the committee concluded by a four-vote margin that the benefits of drugs with drospirenone outweigh the risks. However, an investigation by the Washington Monthly and the British medical journal BMJ has found that at least four members of the committee have either done work for the drugs’ manufacturers or licensees or received research funding from them. The FDA made none of those financial ties public. … When asked whether the agency was aware of any financial ties between its advisors and manufacturers or distributors of drospirenone, FDA spokeswoman Morgan Liscinsky said, “No waivers were issued” (Jeanne Lenzer and Keith Epstein, 1/9).
Source: kaiserhealthnews.org

Video: Medicare Blues

Dental Coverage Under Medicare Health Plans

If you are a Medicare recipient, you are probably happy to know that a lot of basic health services are covered, at least partially, under your plan. However, dental services are also part of a health life, and it is not really well understood how these services are covered. Does Medicare cover dental services at all? Actually, most dental services are not covered under the basic Medicare plan!
Source: klmdigistamps.com

Experienced dentist needed (Las vegas)

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

Does Medicare Covers All Dental Care?

Anyone will feel secure to have a medicare insurance that covers almost health related concerns. To be more secure, it is normal to ask: Does Medicare cover dental? Medicare will pay for any dental services but will not cover any dental care follow-up. One example of which is that, it will shoulder the extraction of your tooth but not to cover the future checkup because your tooth was already removed. On one part, hospitalization will be shouldered if infection persists after the process of extraction or after dental procedure; you are being under observation of a health threatening condition.
Source: anthropologica.net

Solutions to Dental Insurance for Seniors on Medicare

Another option is to purchase a Supplemental Medicare Plan.  They are also referred to as Medicare Advantage Plans.  Private insurance companies offer these programs to fill the gaps of Medicare. Not all of these private plans add dental coverage but the majority do and some even include benefits for dentures!
Source: topdentalinsurancecompanies.com

Economy Takes a Big Bite Out of CA Dental Care : Eastern Group Publications

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Source: egpnews.com

Tips to Finding the Right Dental Health Insurance Company

Article Body: With so many dental Health Insurance plans to choose from it can be a daunting task to determine which plan is best for your needs or the needs of your employees. And to note, these needs are extremely important, as the dental care should never be overlooked. There are five tips that may help you discover which plan is right for you. 1. Consider Online Comparisons – While a trusted broker can provide you with several options to choose from, an online comparison of companies and dental insurance options can provide a means of insuring the greatest flexibility and price. The available plan types are extremely varied and an online comparison can allow you to see what a plan will and will not be able to do. 2. Price Comparison – It may be easy to make a quick decision based on a simple query, however, if you are working with a broker there may be other options they can present that may decrease the overall cost.
Source: ezinemark.com