North Carolina Medical Society

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98On April 25, 2012, NCMS president Robert Monteiro, MD, and senior NCMS staff met with Melanie Combs-Dyer, Deputy Director, Provider Compliance Group at the Centers for Medicare and Medicaid Services (CMS) to discuss programs aimed at reducing improper payments in the Medicare program. While there are five categories of contractors, each fulfilling different roles in improper payment mitigation for CMS, the majority of this meeting focused on the Recovery Audit Program (RAC) and Zone Program Integrity Contractors (ZPIC). Information about all of these programs can be reviewed here.
Source: ncmedsoc.org

Video: North Carolina Medicare Enrollment.wmv

Critical Information on Medigap Insurance Policies and Medicare

Medicare is a type of wellness insurance available for those over 65 or those beneath the age of 65 with certain disabilities, this kind of as Finish-Stage Renal Illness, which benefits in long term kidney failure that calls for both a kidney transplant or dialysis. If you have Medicare Element A or Element B, you are eligible to also buy Medigap insurance. Medicare Element A is Hospital Insurance coverage, and helps to cover inpatient care in hospitals as well as skilled nursing facilities, hospice, or residence wellness care. Element B is medical insurance, and helps cover doctors’ and other wellness care providers’ services, outpatient care from hospitals, and preventative services to aid preserve your wellness or to stop certain illnesses from acquiring worse. There are also Element C and Element D coverage. Element C is typically acknowledged as Medicare Advantage Plans, and they cover prescription drugs and other benefits. Element D is the Medicare Prescription Drug Coverage, which helps to cover the charges of prescription drugs and may aid lower prescription drug charges and aid shield against larger charges. These Element D plans are run by Medicare-accepted private insurance companies.
Source: autoinsurance-northcarolina.org

Volunteers continue to be essential for SHIIP’s operation

In addition to the program’s professionally-operated call center, SHIIP has a volunteer base of 124 county coordinators and 753 volunteers assisting Medicare beneficiaries in all 100 N.C. counties. They must successfully complete a computerized training course to become certified to better help people with Medicare. They are required to attend quarterly follow-up trainings, and they must provide 40 hours of counseling services annually to maintain their certification. Without these volunteers, SHIIP could not reach out to all the people using Medicare across the state.
Source: kinston.com

ACOs Multiply As Medicare Announces 27 New Ones

Accountable Care Coalition of Caldwell County, LLC Lenoir, NC 5,000 Accountable Care Coalition of Coastal Georgia Ormond, FL (Serving beneficiaries in GA and SC) 8,000 Accountable Care Coalition of Eastern North Carolina, LLC New Bern, NC 10,000 Accountable Care Coalition of Greater Athens Georgia Athens, GA 8,500 Accountable Care Coalition of Mount Kisco, LLC Mount Kisco, NY N/A Accountable Care Coalition of the Mississippi Gulf Coast, LLC Clearwater, FL (Serving beneficiaries in the Mississippi Gulf Coast area) 7,000 Accountable Care Coalition of the North Country, LLC Canton, NY 5,300 Accountable Care Coalition of Southeast Wisconsin, LLC Milwaukee, WI 10,000 Accountable Care Coalition of Texas, Inc. Houston, TX 70,000 AHS ACO, LLC Morristown, NJ (Serving beneficiaries in NJ and PA) 50,000 AppleCare Medical ACO, LLC Buena Park, CA 8,000 Arizona Connected Care, LLC Tucson, AZ 7,500 Chinese Community Accountable Care Organization New York, NY 12,000 CIPA Western New York IPA, doing business as Catholic Medical Partners Buffalo, NY 31,000 Coastal Carolina Quality Care, Inc. New Bern, NC 11,000 Crystal Run Healthcare ACO, LLC Middletown, NY (Serving beneficiaries in NY and PA) 10,000 Florida Physicians Trust, LLC Winter Park, FL 16,500 Hackensack Physician-Hospital Alliance ACO, LLC Hackensack, NJ (Serving beneficiaries in NJ and NY) 11,000 Jackson Purchase Medical Associates, PSC Paducah, KY 6,000 Jordan Community ACO Plymouth, MA 6,000 North Country ACO Littleton, NH (Serving beneficiaries in NH and VT) 6,000 Optimus Healthcare Partners, LLC Summit, NJ 29,000 Physicians of Cape Cod ACO Description of Organization Hyannis, MA 5,000 Premier ACO Physician Network Lakewood, CA 12,500 Primary Partners, LLC Clermont, FL 7,500 RGV ACO Health Providers, LLC Donna, TX 6,000 West Florida ACO, LLC Trinity, FL 10,000
Source: mhhealthsearch.com

North Carolina Medicare Part D Plans

After you have narrowed your list of plans to criteria which you find to be important, i.e. premium, deductible, gap coverage, etc. , you should visit plan websites to review the formulary. The formulary will also indicate which tier specific drugs are listed in. This will have have an impact on your out-of-pocket costs as you use your plan. Drugs may be placed in different tiers by different companies.
Source: partdplanfinder.com

Medicare releases states’ catheter infection rates; NC in middle

Central-line infections are introduced into the body when hospital staff do not properly clean and administer a catheter. Because a central-line infection is a hospital-induced infection, it is a clear result of medical malpractice. Yet even though the development of these infections can clearly indicate negligence on the part of a doctor or his staff, central-line infections are not uncommon — according to the study, one in six hospitals nationally suffers from high rates of the infection.
Source: charlottepersonalinjurylaw.com

North Carolina Medicare Leads

A common list among Medicare supplement and Medicare Advantage insurance agents you could purchase from Affordablemedicareleads would focus in on individuals who are approaching the age of 65.  By focusing on this demographic you are certain to find those that are new to Medicare and are looking for either a Medicare supplement or Medicare Advantage plan that you are offer.  The downside to focusing on individuals turning 65 is that these individuals are new to Medicare and be quite confused.   They are getting bombarded by a number of different agents, not to mention their mail box is being flooded by numerous different insurance carriers.  Affordablemedicareleads can provide another list that is commonly used by Medicare insurance agents.  That would simply be individuals that are in the age range of 67-78.  By calling or mailing this age demographic what you are going to find this that #1; their agent the initially enrolled them in their plan is long gone by now.  #2; they have been on Medicare for at least a couple of years an have most likely to have had at least one premium increase.  They should understand that by now Plan F is Plan F and if you can offer them the same plan at a lower rate, you may just be able to gain a client.  By not going over the age of 78 will help you focus in on the more healthy individuals.
Source: affordablemedicareleads.com

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Source: forum-romania.ro

Patsy Keever vows to protect Medicare at senior citizen roundtables

If passed in 2010, Republican Congressman Paul Ryan’s budget plan, which every Republican member of the U.S. House supported, would have replaced Medicare with a voucher system. Seniors would have had to shop for their own insurance and hope they could find coverage that was affordable. Though seventy percent of voters want to keep Medicare as it is today, according to a recent Kaiser Family Foundation poll, Republicans in Congress still seem determined to raise seniors’ health care costs while giving more tax breaks to millionaires and Big Oil companies.
Source: bluenc.com

The American Spectator : Obama's Latest Plan to Snooker Seniors

Posted by:  :  Category: Medicare

Except, genius, among the reasons you have a banana lodged where it must be strangling the oxygen to your brain, you are equating constitutional providing for the common defence, with unconstitutional domestic spending, unless you friggin try the liberal gambit that social security is constitutionally promoting the general welfare, in which case, how, exactly, is the general welfare promoted, exactly, by a general welfare promotion that is already actually unfunded in ponzi scheme actuality by more than $100 trillion, which means is actually unfunded in ponzi scheme actuality by more than $1 million for each and every single taxpayer already, actually, which actually unconstitutionally unsecures not only the blessings of liberty to ourselves, but unsecures the blessings of liberty to our posterity created equal that is actually endowed with actual birth, not to mention the unsecured blessings of liberty to our posterity created equal that is not actually endowed with actual birth, insanely, much less unconstitutionally forming a less perfect union, unconstitutionally unestablishing justice, and unconstitutionally uninsuring domestic tranquility, in exactly insane liberal progressive socialist tyrannical insane order, insanely.
Source: spectator.org

Video: Florida Medicare Advantage Plans – Supplement Health Insuran

Hiding Obamacare’s Results Before November

As we know, most provisions of Obamacare don’t kick in until after the 2012 election. But to prepare for massive changes to the Medicare Advantage program (a very popular and more market-oriented alternative to Medicare), 12 million seniors would have to learn by the end of this year about how their health insurance program will face slashes. Presumably most seniors would be herded back into traditional Medicare.
Source: ricochet.com

Is Obama propping up Medicare Advantage until after the election?

I have been blessed my entire life with good friends, loving parents, and a supportive wife. I have a profound love for America that runs deep. God is the cornerstone of the foundation that America is built on and it is through God that our unalienable rights of life, liberty, and the pursuit of happiness have been granted and not by a system of government. These rights are nonnegotiable and should be treated as such. I believe that it’s the individual that makes America great and I soundly reject the collective mentality of the far left. I believe we need to restore our Constitution and get back to the principles of our Founders that helped unite America under a system of “limited” government. I believe we need to find our way back to a free market system and limit government regulation and interference in a system that had once served this country well; it’s the only vehicle that can carry us out of our current economic woes. The government does not create wealth, it consumes it. This is an undeniable truth that we must come to embrace. The solutions to our problems can be found in “We the People.” The American people have always been masters of their destiny and with perseverance and determination we will once again restore the republic. We must ally ourselves and our core beliefs with that of our Founding Fathers and a vision of a free and prosperous America will once again emerge. We will see an America in its purest form and revert back to its original charter; one of individual liberties, property rights, and freedom and will become once again a shining example to the world and a beacon that leads those in darkness into the light of freedom.
Source: conservativehideout.com

Medicare Advantage Plans Florida Options

My sister Brenda send me some information in an e-mail about medicare advantage plans Florida. She told me that she is extremely impressed with this website and believes that it can be an excellent resource to anyone that has questions about this process. She said that they also have access to speak with someone lie over the telephone if you have further questions about coverage or plans. I am definitely looking forward to learning as much as I can about Medicare.
Source: everydaytherapeutics.com

Finding Out The Options You Could Have With Medicare Advantage Plans Florida

Treatment options are going to be similar in a lot of cases but the preventative care is not going to be the same at all. The biggest difference is seen when a preventative treatment, no matter how successful, has to be done with a surgery because it is not offered to everyone. It is also alarming to know that the experience level of surgeons, surgical teams, and doctors can be related to insurance as well.
Source: selling-medicare-supplements.com

Obama’s $8 Billion Cynical Ploy

But along came a Government Accounting Office (GAO) report released yesterday which recommends that HHS cancel the project. The GAO said the project “dwarfs all other Medicare demonstrations” in its impact on the budget and criticized its poor design. “The design of the demonstration precludes a credible evaluation of its effectiveness in achieving CMS’s [Centers for Medicare & Medicaid Services] stated research goal,” according to the report. As the Wall Street Journal puts it in this editorial, “there’s no control group to test which approaches work better. It’s a demonstration project without the ability to demonstrate.” Senator Orrin Hatch of Utah, the senior Republican on the Finance Committee, and Representative Dave Camp, chairman of the Ways and Means Committee, released a statement in which they said they were concerned that the government might be “using taxpayer dollars for political purposes, to mask the impact on beneficiaries of cuts in the Medicare Advantage program.”
Source: commentarymagazine.com

Winners And Losers In Medicare Advantage Extras: Avalere Report

One quarter of Medicare beneficiaries get their care through private Medicare Advantage health plans, which are mostly HMOs and PPOs. If a plan bids less in an area than a government benchmark for traditional Medicare, then it gets a rebate of 75 percent of the difference that it must pass along to seniors in extra benefits or lower cost-sharing. That can translate into lower prescription drug premiums, or it can provide benefits that traditional Medicare doesn’t cover, such as vision and hearing.
Source: kaiserhealthnews.org

Scam on Senior Citizens: The Truth about Obama’s Medicare Advantage Cuts, Government Accountability Office “Smelled a Rat” Hiding in President’s Political Ploy (video)

Tags: 2012 election, 2012 reelection, America, America’s health care, Barack Obama, bonus, bonuses, CMS, Congress, Democrat lies, Democrats, demonstration project, doctor, elderly, elderly people, election, federal government, fraud, GAO, GOP, Government Accountability Office, government health care, government lies, government program, government-run health care, government-run healthcare, health care issue, health care nightmare, health insurance, hoax, hospital, insurance, left-wing fraud, low income families, medical, medical treatment, Medicare, Medicare Advantage, Medicare fraud, medicine, minorities, Nancy Pelosi, Obama, Obama election, Obama fraud, Obama health care, Obama reelection, ObamaCare, old people, political lies, Pres. Obama, Pres. Obama lies, reelection, Republicans, retire, retiree, retirement, retirement age, scam, senior, senior citizens, seniors, socialized health care, socialized medicine, taxpayers, Team Obama, waivers
Source: frugal-cafe.com

Medicare To Add Hospital Efficiency, Patient Safety To Payment Formula

Posted by:  :  Category: Medicare

THE LITTLE MAN KILLED MEDICARE FOR EVERYBONE by SS&SSRates of serious complications that could have been avoided. This “patient safety indicator” combines a hospital’s frequency of punctured lungs, blood clots after surgery, wounds that split open after an operation, bedsores, catheter and bloodstream infections and broken hips from falling after surgery. The accuracy of the measure has come under criticism from teaching hospitals and some independent quality experts.
Source: physiciansnews.com

Video: 2011- 4/19 MEDICARE PATIENTS HAVE SHORTER HOSPITAL STAY AFTER HIP REPLACEMENT BUT

Hip Replacement Class Action Suits And How Medicare And Health Insurers Will Be Getting All The Money : Pennsylvania Injury Law Report

The most widespread medical implant failure in the United States in decades, involving thousands of all-metal artificial hips that need to be replaced prematurely, has entered the money phase. Medical and legal experts estimate the hip failures may cost taxpayers, insurers, employers and others billions of dollars in coming years, contributing to the soaring cost of health care. The financial fallout is expected to be unusually large and complex because the episode involves a class of products, not a single device or just one company. The case of Thomas Dougherty represents one particularly costly example. He spent five months this year without a left hip, largely stuck on a recliner watching his medical bills soar. In August, Mr. Dougherty underwent an operation to replace a failed artificial hip, but his pelvis fractured soon afterward. The replacement hip was abandoned and then a serious infection set in. Some of the bills: $400,776 in charges related to hospitalizations, and $28,081 in doctors’ bills….The so-called metal-on-metal hips like Mr. Dougherty’s, ones in which a device’s ball and joint are made of metal, are failing at high rates within a few years instead of lasting 15 years or more, as artificial joints normally do.The wear of metal parts against each other is generating debris that is damaging tissue and, in some cases, crippling patients.
Source: pennsylvaniainjurylawreport.com

Many Years Young: HHS announces new Affordable Care Act options for community

The Independence at Home demonstration, which is voluntary for Medicare beneficiaries, provides chronically ill Medicare beneficiaries with a complete range of in-home primary care services.  Under the demonstration, the Centers for Medicare & Medicaid Services (CMS) will partner with primary care practices led by physicians or nurse practitioners to evaluate the extent to which delivering primary care services in a home setting is effective in improving care for Medicare beneficiaries with multiple chronic conditions and reducing costs. Up to 10,000 Medicare patients with chronic conditions will be able to get most of the care they need at home.
Source: manyyearsyoung.com

Patient survey results help you choose a home health agency

Now there’s an objective and meaningful way to compare other patients’ actual experiences with home health agencies and services—the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey – and we’ve just released the first set of survey results on our Home Health Compare page.
Source: medicare.gov

Health Care Reform Isn’t Entitlement Reform

But even that calculation overstates the program’s fiscal outlook. That’s because it relies on the assumption that ObamaCare’s Medicare payment reductions and other structural reforms will produce savings that shore up Medicare’s trust fund. The problem, as Medicare Trustee Charles Blahous recently pointed out, is that these savings—roughly $500 billion over the next decade—are also expected to be used to finance the law’s vast expansion of health insurance coverage. If that money is spent on insurance coverage, then Medicare’s trust fund would hit insolvency in 2016.
Source: reason.com

Medicare Fraud in New Jersey: Diakon agrees to pay federal government $10.5 million :: Health Care Fraud Blog

Posted by:  :  Category: Medicare

“Health care providers that make billing compliance, self policing, and self reporting a priority foster trust in the health care industry” said Nick DiGiulio, special agent in charge for the United States Department of Health and Human Services’ Office of Inspector General. “These actions demonstrate that Diakon Hospice Saint John cares about returning money, incorrectly attained, to our federal health payment programs.”
Source: healthcarefraudblog.com

Video: Medicare Free B Spanish 2012 Ocean County, NJ

A.M. Best Revises Outlook to Positive for the Oxford Life Insurance Company and Its Subsidiaries

The revised outlook reflects Oxford Life’s profitable and improved consolidated operating results, increased net premiums written and continued strong capital base. The group’s business strategy of focusing on the senior market has resulted in continued growth in its final expense, Medicare supplement and single premium whole life businesses over the past two years. A.M. Best notes that a major part of the growth is attributed to several strategic acquisitions by means of reinsurance arrangements; however, the group was able to maintain upward premium trends from its lines of business, while preserving high risk-adjusted capitalization. A.M. Best also notes that all subsidiary companies of Oxford Life were generally profitable on a standalone basis barring the impact of reinsurance transactions.
Source: sheryljmoore.com

Romney Comes to New Jersey for Kyrillos Fundraiser

Kyrillos abandoned thousands of his NJ District 13 constituents when he remained silent on the efforts of Union Beach to prevent a 40-story noisy industrial wind turbine with blades each the size of a cell tower from being erected at the BSRA sewer plant there just a little over 1,000 feet from homes. Hazlet, Matawan, Holdmel, Keyport, Union Beach, and Monmouth County (all District 13) passed resolution opposing the siting of this industrial intrusion into a densely populated residential area. The issue is still tied up in the Appellate Court, although the BSRA is thumbing their nose at the court and pushing to truck it in prior to the court’s decision. When Sea Girt was faced with a similar threat, all three of their state reps went to bat for them, and the project was defeated. In District 13, only Amy Hanldin has gone to bat for the town. Kyrillos is a booster of Big Wind. He was the only Republican to cosponsor a bill that would have allowed industrial wind installations on preserved farmland in southern NJ. Luckily, Christie vetoed that bill. Kyrillos is a big government Lib posing as a conservative. He does not deserve to be our senator.
Source: patch.com

N.J. Plans To Use Managed Care System For Medicaid Enrollees With Mental Health Problems

Milwaukee Journal Sentinel: Medicaid Changes To Hit Community Centers First Community health centers, which provided care to 271,000 patients statewide and almost 78,000 in Milwaukee last year, would be among the first to see the effects of the proposed changes to BadgerCare Plus and other state health programs (in Wisconsin). The changes — approved Thursday by the legislative committee that oversees the state budget — could result in an estimated 65,000 people dropping or losing their coverage, according the Legislative Fiscal Bureau…. And the community health centers, like everyone in the health care system, keep a wary eye on the number of uninsured patients they treat (Boulton, 11/11).
Source: kaiserhealthnews.org

Payne Supported Medicare for All

“Right now, the Republicans are wrangling votes for another unbalanced and partisan scheme to end Medicare as we know it. Republicans are focused on protecting the top 2 percent of Americans at the expense of 98 percent of our families. Unfortunately, on April 15, 2011, House Republicans passed a budget that would end Medicare and replace it with a system where seniors get a voucher to go out and buy private insurance. Under the Republicans’ program, there would be benefit cuts and cost increases for seniors. Rather than supporting our elderly and disabled citizens, tax breaks would be provided to special interest groups, Big Oil and corporations that ship jobs overseas. Republicans argue that the Medicare program cannot be maintained and must be completely replaced. “I reject the Republicans’ efforts to end Medicare. I will continue to work with my colleagues on both sides of the halls of Congress to reach a balanced, bipartisan solution to reduce our deficit, create jobs, grow our economy and protect Medicare, Social Security and Medicaid beneficiaries.”
Source: njoneplan.org

Letter: Shelly Adler Criticizes Jon Runyan’s Medicare Vote

Our dedication to saving Medicare shows who we are as a nation – it serves as proof that we value and support those who have worked their entire lives to move our country and our economy forward. As a member of Congress, I will not let such an important program end for those who need it most, while corporate special interests are rewarded. Together, we will fight to protect this life-saving program that is so vital for seniors to live with the dignity that they have earned.
Source: tomsrivernjonline.com

Realtors’ group poll: Property taxes irk N.J. residents

When the voters polled were asked to consider alternative legislative plans that propose income-tax credits of 10 percent and 20 percent, respectively, in any given year, the support for Christie’s plan fell. When they were given details of the alternative plans, support for the Christie plan increased.
Source: philly.com

New Mexico Medicare Leads

Posted by:  :  Category: Medicare

KNOW WHO YOUR CZARS ARE --ENOUGH TO MAKE YOU SICK ---ONLY OBAMA COULD CREATE POSITIONS FOR THESE INCOMPENTENT COMMUNISTS AND SOCIALISTS by SS&SSA common list among Medicare supplement and Medicare Advantage insurance agents you could purchase from Affordablemedicareleads would focus in on individuals who are approaching the age of 65.  By focusing on this demographic you are certain to find those that are new to Medicare and are looking for either a Medicare supplement or Medicare Advantage plan that you are offer.  The downside to focusing on individuals turning 65 is that these individuals are new to Medicare and be quite confused.   They are getting bombarded by a number of different agents, not to mention their mail box is being flooded by numerous different insurance carriers.  Affordablemedicareleads can provide another list that is commonly used by Medicare insurance agents.  That would simply be individuals that are in the age range of 67-78.  By calling or mailing this age demographic what you are going to find this that #1; their agent the initially enrolled them in their plan is long gone by now.  #2; they have been on Medicare for at least a couple of years an have most likely to have had at least one premium increase.  They should understand that by now Plan F is Plan F and if you can offer them the same plan at a lower rate, you may just be able to gain a client.  By not going over the age of 78 will help you focus in on the more healthy individuals.
Source: affordablemedicareleads.com

Video: Dozens charged nationwide in $163M Medicare scam

Highmark (MAC Jurisdiction H) Dates Released

The Centers for Medicare & Medicaid Services (CMS) recently released the Medicare Administrative Contractor (MAC) transition dates for Jurisdictions 4, which covers Texas, Colorado, New Mexico and Oklahoma,  and 7, which covers Louisiana, Arkansas and Mississippi.  As previously reported, CMS is consolidating these two jurisdictions into a new Jurisdiction H, and has awarded the contract for administering all Medicare Part A and B operations to Highmark Medicare Services. After an unsuccessful appeal by TrailBlazer Health Enterprises and Pinnacle Business Solutions, the current MACs for these regions, implementation is moving forward.
Source: lilesparker.com

New Poll: New Mexicans Overwhelmingly Support Medicare, Medicaid

[…] […] […] The poll, which was conducted by Research and Polling, Inc., for six advocacy groups, shows that the vast majority of voters (83 percent) believe Medicaid is important to residents in New Mexico with 66 percent saying Medicaid is very important. Medicaid is the health program for the disabled, seniors in nursing homes, low-income children, and impoverished families. The majority (59 percent) of voters do not believe there should be any reductions in Medicaid spending as a way to reduce the federal debt.Source: nmvoices.org […]Source: nmvoices.org […]Source: nmvoices.org […]
Source: nmvoices.org

New Mexico: New Mexico Medicare

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Source: blogspot.com

Patients often stop taking heart drugs during Medicare coverage gaps / American Heart Association

Posted by:  :  Category: Medicare

meds: it's obscene by fallsroadPatients who did not receive financial assistance during the coverage gap were no more likely to die or be hospitalized for cardiovascular-related conditions than those who did have financial assistance — contrasting with previous research results that looked at the impact of lapses in drug coverage in other, non-Part D settings. The difference could be due to the current study’s relatively short follow-up of 119 days, the typical amount of time patients spent in the coverage gap, said Polinski, who is also an epidemiologist at Brigham and Women’s Hospital and an instructor in epidemiology at the Harvard School of Public Health.  The coverage gap’s impact on cardiovascular health outcomes in the long-term remains unclear.
Source: heart.org

Video: Medicare Drug Coverage – Part D Plans

SHIIP offers guidance on the ins, outs of Medicare

First, she said, individuals will be asked to determine whether to enroll in Medicare Part A and Part B? If individuals determine with Social Security that the answer to that question is yes, then they will have to determine how they want to get their Medicare coverage – through traditional Medicare or a Medicare Advantage plan. Next, individuals will have to determine if they will enroll in Medicare Part D for prescription drug coverage. Finally, individuals will have to determine if they have some type of supplemental coverage which will cover costs not paid by Medicare.
Source: newtonindependent.com

How you can Compare Medicare Drug Plans

Where do you live? Your personal alternatives will probably be affected by the plans that are sold in your area. The convenience of actually obtaining prescriptions filled by a distinct strategy will also be a large factor for many older or disabled men and women.What type of medicine do you should take? Different plans cover prescription medicine in distinct ways. You wish to maximize advantages that may aid you save income on the drugs you need to take.The monthly premium must also be considered. Premiums differ a whole lot.. I have observed some for much less than $15 a month, while other individuals may price much more than twice that considerably.The monthly premium can be an critical issue to think about for numerous folks who need to lived on a restricted income. More affordable plans could be very attractive. Nevertheless, be wary due to the fact some low priced plans could have the ability to keep premiums low because of restrictions on covered drugs or covered drug stores.
Source: soveryvirginia.com

Tricare Help – Do I need Part D when I turn 65?

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Source: militarytimes.com

Seniors In Medicare ‘Doughnut Hole’ More Likely To Stop Heart Drugs

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Source: wnyc.org

InsureBlog: Patient Assistance Programs

We invite you to contact Susan at Special Patients in Need if you are on Medicare, or if you are having difficulty in paying for your medications. We’ve included her website in our “Resources” section in the sidebar.
Source: blogspot.com

Premium Rebates, Coverage Labels, Reduced Medicare Drug Costs Highlight 2012 Health Law Changes

Starting in August, the Obama administration’s new rules on contraceptive coverage that have generated such controversy take effect. That means that women in a new health plan or in an existing one that has changed its benefits enough to not be considered grandfathered under the law will be able to receive contraceptives without an out-of-pocket charge. In addition, these plans will have to provide a variety of basic women’s health services, including well-woman visits; screening for gestational diabetes; HPV testing; counseling for sexually transmitted infections; counseling and screening for HIV; and screening and counseling for interpersonal and domestic violence.
Source: kaiserhealthnews.org

The basics of Illinois Medicare

Medicare consists of four major parts. These are known as Medicare Parts A, B, C, and D. Part A is also called hospital insurance since it helps to cover the costs for inpatient health care for those who need treatment in a hospice, a skilled nursing facility after a stay in a hospital, or in a hospital. Medicare Part B is referred to as medical insurance and it’s designed to help cover the costs for doctors and several medical supplies and services that aren’t taken care of hospital insurance in Part A.
Source: abchealthplans.com

COLUMN: All Medicare plans are above average now

The quality bonuses were to be paid only to above-average plans starting this year, and ramped up over time. Instead, the U.S. Department of Health and Human Services put in place a huge quality demonstration program that has resulted in quality bonus payments to 91% of plans. In comparison, just 25% of plans would have received bonuses under the statutory provisions of the ACA, according to MedPAC.
Source: thedoctorschannel.com

Medicare Supplement Insurance Still Worth The Cost

Even if you supplement Medicare with a Medicare Part D Prescription Drug plan, you may also enroll in one of the ten Medigap plans. During a six-month period that begins on the first day of the month in which you become 65 and you are enrolled in Part B, your application for a Medigap plan is guaranteed to be accepted regardless of your health problems. You may switch to a different plan during this time, and guaranteed acceptance also applies to the application for the other plan.
Source: online-business-expert.com

ObamaCare Sticks It To Seniors and Future Seniors

Under the Medicare Modernization Act of 2003, Congress deliberately created a gap in Medicare drug coverage (donut hole) in which seniors are required to pay 100% of drug costs up to a specified amount.  Now ObamaCare did toss out another bread crumb to  provide you with a $250 rebate if you fall into that hole and will require drug companies to give you a 50% discount on brand name prescriptions filled while in the hole.  Sounds good, right?  Well, in 2011 ObamaCare imposed a new tax on the sale of these brand name drugs, ranging from $2.5 billion in 2011 to $4.1 billion in 2018.   So even though  those drug companies will have to give you that 50% discount, the price of those drugs have increased due to ObamaCare and not just for drugs purchased during that donut hole period, but for the entire year.
Source: franklincountyvapatriots.com

The basics of Illinois Medicare

Posted by:  :  Category: Medicare

New Online Rx System Makes UM Student 'Top Entrepreneur' Finalist by University of Maryland Press ReleasesMedicare consists of four major parts. These are known as Medicare Parts A, B, C, and D. Part A is also called hospital insurance since it helps to cover the costs for inpatient health care for those who need treatment in a hospice, a skilled nursing facility after a stay in a hospital, or in a hospital. Medicare Part B is referred to as medical insurance and it’s designed to help cover the costs for doctors and several medical supplies and services that aren’t taken care of hospital insurance in Part A.
Source: abchealthplans.com

Video: Turning 65 Becoming Eligible for Medicare – 2011

Foundation Resources on People Dually Eligible for Medicaid and Medicare

To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents Chronic Disease and Co-Morbidity Among Dual Eligibles: Implications for Patterns of Medicaid and Medicare Service Use and Spending Medicaid Financial Eligibility: Primary Pathways for the Elderly and People with Disabilities State-Specific Data Number of Dual Eligible Beneficiaries Medicaid Income Eligibility Requirements for the Aged, Blind, and Disabled Comprehensive Medicaid Managed Care Activity for Dual Eligibles Additional state-by-state data about dual eligible beneficiaries, spending trends and service use are available in the Medicare and Medicaid topic areas at statehealthfacts.org. Managed Care and Dual-Eligible Beneficiaries Medicare Advantage 2011 Data Spotlight: Special Needs Plans: Availability and Enrollment A Profile of Medicaid Managed Care Programs in 2010: Findings from a 50-State Survey Briefings and Webcasts June 3, 2011 Caring for People Covered by Both Medicare and Medicaid: A Primer on Dual Eligible Beneficiaries October 10, 2010 Improving Care and Reducing Costs for Medicare Beneficiaries in Nursing Homes
Source: kff.org

Experiencing Rheumatoid Arthritis: Medicare Supplements

I came across an article the other day which made mention of how people who are retired have many more expenses during their retirement than while they were still working. Most of the money goes towards covering the costs of living such as a roof over your head and the associated monthly utility bills, food, transportation, and last but certainly not least; health care. There is a Dutch expression which, literally translated, says ‘old age comes with deficiencies’ and that is not beside the truth. The older we get, the more likely we encounter physical inconveniences and are more susceptible to all kinds of diseases and medical conditions. Health care, medical equipment and medications can run up the bill rather quick, especially when you don’t have sufficient or proper coverage. Being eligible for Medicare does not automatically mean all your medical expenses are covered. You probably need a Medicare supplement to close the gaps in your insurance where it concerns deductibles and co-pays and it would be a good idea to shop around, compare and find the cheapest Medicare Supplement available. This doesn’t have to be a painstaking and long, drawn out process; you can already find what you need by visiting just one site on the Internet. Even when you think you already got it covered, it could turn out to be well worth it!
Source: blogspot.com

Expected time in retirement at age 65 is more than 40 percent longer than in 1940

Proposals to raise the ages of eligibility for Medicare and Social Security generally reflect concern about the effects on the federal budget of demographic trends that will make supporting retirees more challenging in decades to come. The aging of the population—which stems both from increases in life expectancy and from past declines in fertility—accounts for about half of the growth (relative to GDP) in spending on Medicare and other major federal health care programs projected for the next 25 years and essentially all of the growth (relative to GDP) projected for Social Security outlays. If life expectancy increases and retirement ages do not rise, people pay taxes for a shorter portion of their lives and are retired—and collecting Medicare and Social Security benefits—for a longer portion.
Source: jobmarketmonitor.com

Potentially Avoidable Hospitalizations of Dually Eligible Medicare and Medicaid Beneficiaries from Nursing Facility and Home

Abstract OBJECTIVES: Beneficiaries dually eligible for Medicare and Medicaid are of increasing interest because of their clinical complexity and high costs. The objective of this study was to examine the incidence, costs, and factors associated with potentially avoidable hospitalizations (PAH) in this population. DESIGN: Retrospective study of hospitalizations. SETTING: Hospitalizations from nursing facilities (NF) including Medicare and Medicaid-covered stays, and Medicaid Home and Community-Based Services (HCBS) waiver programs. PARTICIPANTS: Dually eligible individuals who received Medicare skilled nursing facility (SNF) or Medicaid NF services or HCBS waiver services in 2005. INTERVENTIONS: None. MEASUREMENTS: Potentially avoidable hospitalizations were defined by an expert panel that identified conditions and associated Diagnostic Related Groups (DRGs) which can often be prevented or safely and effectively managed without hospitalization. RESULTS: More than one-third of the population was hospitalized at least once, totaling almost 1 million hospitalizations. The admitting DRG for 382,846 (39%) admissions were identified as PAH. PAH rates varied considerably among states, and blacks had a higher rate and costs for PAH than whites. Five conditions (pneumonia, congestive heart failure, urinary tract infections, dehydration, and chronic obstructive pulmonary disease/asthma) were responsible for 78% of the PAH. The total Medicare costs for these hospitalizations were $3 billion, but only $463 million for Medicaid. A sensitivity analysis, assuming that 20%-60% of these hospitalizations could be prevented, revealed that between 77,000 and 260,000 hospitalizations and between $625 million and $1.9 billion in expenditures could be avoided annually in this population. CONCLUSION: Potentially avoidable hospitalizations are common and costly in the dually eligible population. New initiatives are needed to reduce PAH in this population as they are costly and can adversely affect function and quality of life.
Source: journalfeeds.com

California’s Criteria for Dual

Federal law only requires that states provide coverage to individuals who fall within the mandatory categories of eligibility. Consequently, states may choose whether or not to cover individuals who are classified as Optional Categorically Needy or Medically Needy (in which the income standard is called the “medically needy” income level). The Medically Needy qualify for a federal eligibility category, even though their income or resources exceed the categorically needy levels. States electing to include the medically needy must use a single resource eligibility standard and a single income eligibility standard.
Source: pilothealthadvocates.com

Tennessee: Identifying Snakes In Tennessee

Serving approximately 35.8 million people, Aetna offers individual and family plans. Tennessee residents who get new health care contributions even while salaries are staying the identifying snakes in tennessee. That prevented many small businesses from protecting their employees with health plans. Beginning in 2010, insurers are required to have a lot to consider because the identifying snakes in tennessee can find go-karts, miniature golf, bumper boats, laser tag, water games and a new stadium so soon after the nearby Great Smoky Mountains National Park. The Park is a lot of research on different properties for sale. You will never find a shortage of places that you visit one of the identifying snakes in tennessee by more than 2.4 million consumers, as stated by the identifying snakes in tennessee for Consumer Information and Insurance Oversight.
Source: blogspot.com

Research Roundup: Practice Guidelines May Not Stop Defensive Medicine

Urban Institute/Robert Wood Johnson Foundation: The Value of Clinical Practice Guidelines As Malpractice “Safe Harbors” — Overspending on health care has frequently been attributed to doctors practicing defensive medicine — ordering extra tests, for example — so that they avoid malpractice lawsuits. The authors of this brief write that while some have said clinical guidelines “should give caregivers a liability ‘safe harbor,’ shielding them from any malpractice claim for failing to provide services not included in the guideline.” The brief “suggests that quality-promoting guidelines hold some promise for cutting wasteful defensiveness, but that practical feasibility limits their reach,” as does patients’ lack of understanding about appropriate care (Bovbjerg and Berenson, 4/25).
Source: kaiserhealthnews.org

Tricare Help – Do Medicare

Neither Medicare nor Tricare require their beneficiaries to enroll in the Medicare Pharmacy Plan, Part D of Medicare. To the contrary, Medicare Part D is not recommended for Tricare for Life beneficiaries. The Office of the Assistant Secretary of Defense for Health Affairs is on record for saying that the only Tricare beneficiaries likely to achieve any financial advantage from Medicare Part D enrollment are those whose incomes are below the federal poverty level and who qualify for financial aid to help pay their Medicare Part B premiums.
Source: militarytimes.com

Pentagon funding a priority for Mitt Romney

Posted by:  :  Category: Medicare

GOP Priorities by Leader Nancy PelosiTheeagle.com is pleased to offer readers the ability to comment on stories. We expect our readers to engage in lively, yet civil discourse. Theeagle.com cannot promise that readers will not occasionally find offensive or inaccurate comments posted in the comments area. Responsibility for the statements posted lies with the person submitting the comment, not theeagle.com. If you find a comment that is objectionable, please click “report abuse” and we will review it for possible removal. Please be reminded, however, that in accordance with our Terms of Use and federal law, we are under no obligation to remove any third party comments posted on our website. Full terms and conditions can be read here.
Source: theeagle.com

Video: 2009 Medicare TV spot for Priority Health Medicare plans – couple RV’ing

Many Years Young: HHS announces new Affordable Care Act options for community

The Independence at Home demonstration, which is voluntary for Medicare beneficiaries, provides chronically ill Medicare beneficiaries with a complete range of in-home primary care services.  Under the demonstration, the Centers for Medicare & Medicaid Services (CMS) will partner with primary care practices led by physicians or nurse practitioners to evaluate the extent to which delivering primary care services in a home setting is effective in improving care for Medicare beneficiaries with multiple chronic conditions and reducing costs. Up to 10,000 Medicare patients with chronic conditions will be able to get most of the care they need at home.
Source: manyyearsyoung.com

This Week’s TriFacta April 23, 2012

Who should Control Health Care Decisions?:  Securing and strengthening Medicare is a priority of House Republicans.  The House Republicans’ “Path to Prosperity” FY2013 budget resolution explains “in health care, as in any other economic arrangement, control of money is power.  When it comes to controlling health care costs and saving the nation from bankruptcy, the question is:  Who gets the power?  One centralized federal government, or 50 million empowered seniors holding providers accountable in a true marketplace?  Patient power will always serve the needs of the people far better than bureaucrats managing the decline of a government-run system on the verge of bankruptcy.”
Source: gop.gov

The Coming Entitlement Crisis

By 2025, there will be a paltry two workers per retiree, which is staggering, considering it used to be fourteen workers per retiree in 1950.  The retirement age will have to go up and keep going up in increments to ensure solvency.  We will have to discuss the possibility of creating private retirement accounts to decrease the burden on the system.  The introduction of choice and subsequent competition are usually effective in reducing costs.  The Heritage Foundation has also released policy prescriptions for Medicare that suggests, amongst many things, raising the eligibility age to sixty-eight.  The premium support that is outlined in Congressman Paul Ryan’s Path to Prosperity is essential.  It injects choice, personal responsibility, and fiscal discipline into a rigid system that incentivizes waste.  In short, recipients receive a voucher to buy a plan that fits their critical needs.  It is not a wasteful one size fits all approach. With this, Americans have more of a stake in how their money is spent on their insurance and reestablishes discipline and responsibility. This is not an alien concept.  During the Kennedy Administration, the average recipient paid forty-seven cents for every dollar of Medicare spending.  Medicare, of all entitlements, is the one that needs priority attention since it carries  $37 trillion dollars in unfunded liabilities, which will fiscally destroy us if it is not dealt with soon.
Source: goldwatergal.com

Daily Kos: Promises, promises: Repealing Medicare now GOP’s top priority

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

Each American Household is on the Hook for $328,404 Each for Medicare 

I wonder if anyone has done any research into the United States Corporation that is given jurisdiction over 10 sq. miles in DC & over U.S. territories? If the Corp has usurped the authority of the united states of America & the original Constitution then would that not remove any restrictions as to who is president over the Corp? If Obama is merely the CEO of the U.S. Corp, & the politicians who are employees of the U.S. Corp, would of course be protecting the interest of the Corp. The Corp is in fact paying their salaries & managing their retirement funds so representing their own selfish interest would be top priority instead of serving the American people. And if they did not want us to know that the original govt had been overthrown by the Corp; then that would explain why we are getting nowhere with this Natural Born Citizen thing. 
Source: visiontoamerica.org

Priority Health now offers free dental cleaning to Medicare patients!

Medicare age people that have Priority Health Insurance now have Delta Dental coverage for one periodic exam and one prophy (cleaning) per year paid at 100%.  They also cover one set of bitewings x-rays per year paid at 50%.
Source: wilderndental.com

Medicare Part D Prescription Drug Plans – Health Care in a Rough Economy

Posted by:  :  Category: Medicare

For someone who is not actually too involved in politics, I can’t help but be curious on the Obamacare issues which are being challenged as unconstitutional. As an employed individual, it is very important to be properly informed of the developments that have a direct effect on our lives not to mention the essential health insurance coverage. What comes to my mind as of this moment is the Medicare Part D Prescription Drug Plans.
Source: oasl.info

Video: Medicare Part D and Prescription Drugs

The ABCs Of Medicare Part D

Open-enrollment season for Medicare Part D often brings confusion for seniors all over the United States trying to sign up for prescription drug plans. Most counties in the U.S., however, have  programs to help seniors wade through the options.
Source: kaiserhealthnews.org

Tricare Help – Do I need Part D when I turn 65?

15 percent age appeal catastrophic cap child born out of wedlock claims continued care cost share death DEERS dental dependent disabled divorce doctor doctors FEHBP handbook health care reform hospital ID card 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

SHIIP offers guidance on the ins, outs of Medicare

First, she said, individuals will be asked to determine whether to enroll in Medicare Part A and Part B? If individuals determine with Social Security that the answer to that question is yes, then they will have to determine how they want to get their Medicare coverage – through traditional Medicare or a Medicare Advantage plan. Next, individuals will have to determine if they will enroll in Medicare Part D for prescription drug coverage. Finally, individuals will have to determine if they have some type of supplemental coverage which will cover costs not paid by Medicare.
Source: newtonindependent.com

TMK Reports Higher, Affirms Outlook

Along with the earnings release, the company also announced significant changes in its top brass. As per the announcement, Mark S. McAndrew will no longer serve as the Chief Executive Officer and will be replaced by Gary L. Coleman and Larry M.Hutchison, both of whom have been appointed as co-Chief Executive Officers. Mark S. McAndrew will, however, continue to act in his capacity as Chairman of the Board of Directors of Torchmark.
Source: dailymarkets.com

Florida Health Insurance the Ups and Downs

Posted by:  :  Category: Medicare

GOP Plan For Women! Occupy St Pete by Fifth World ArtMost florida health insurance plans are in–network services meaning that all the various services are attended to by qualified and supported physicians within a defined network. They are chosen based on certain criterion and their fees are paid by the network.  One of the florida health options is to opt for Health Savings Plan. These will ensure that you are eligible to save money for your future medical expenses. There are 100% deductible after florida health plans which means that the plan will pay for all the expenses after you have met the deductibles. Short term health insurance plan florida give you cover during the period when you are changing policies or are in between jobs.
Source: 1healthinsurance.org

Video: Pinellas County: Medicare Advantage Plans Florida- Zero premium

Medicare in Florida Spells P

Moreover, new immigrants are not entitled to benefits such as Medicare. Demographics in 2010 shows that around 1.6 million veterans are in Florida comprising more or less 20% of Florida’s population number. This fact justifies the turnout level in the enrolled Medicare recipients. Also, though Medicare Component B can be bought practically by anyone, the monthly costs range from $600 to $1,000 per head. A costly mistake is certainly avoided, unless the necessary Medicare details override the usual indifference. Medicare in Florida, however, must not be confused with Medicaid. Medicaid is a jointly funded health program by the state and federal government which caters families in United States with little incomes. This is the largest health funding source for those with limited amounts of income and is not to be used interchangeably with Medicare. Getting to know Florida’s Medicare system helps much. Medicare in Florida is all about health plans. These health plans are further divided into four major components under the federal government’s health coverage program, Parts A, B, C and D. All of these benefits are based on medical necessity and varies in terms of services covered. Component A is basically hospital insurance. Inpatient stays covering expenses such as semiprivate rooms, food, tests and doctors’ fees fall under this. Component B is medical insurance. This kind pays for services and products excluded from component A and are utilized under an outpatient basis. Among others, physician and nursing services, diagnostic tests, ambulance transportation (with a certain limit though) and x-rays are included under Component B. Component C, forwarded by the Balanced Budget Act of 1997, offers another option through private health insurance companies. Aside from the original Medicare standard list, Medicare advantage plans, as commonly referred to, provide coverage for new items in exchange for additional fees. These new items can come in the form of savings or net extra benefits exclusive to those who enrolled and in add-on services such as a more comprehensive dental and vision coverage. Prescription drug plans are accommodated in Component D and no standard provisions are available. Though the Medicare program explicitly approves and regulates, the choice as to what drugs are covered depends on the providers. It is imperative therefore that interested parties interact closely with providers to get necessary information and make wise investment decisions.
Source: ezinemark.com

How to care for florida medicare plans

Medicare fraud comes in several forms. In some cases, agencies have billed the Medicare program for home health services that they claim were rendered for homeless individuals. IAccording to a piece of writing printed Monday by the Associated Press, “a massive proportion of the patients are diabetics who claim they’re blind and bill Medicare for every day and night nurse to allow them insulin shots.” However, upon more investigation, the beneficiaries aren’t truly blind.With the nation’s attention centered on the present healthcare discussion, many U.S. voters are growing increasingly involved over the promise of a rise in healthcare bills over the approaching year and decades. Medicare participants, especially, stand to check a major increase within the value of their healthcare, consistent with some specialists, particularly supporters of the Republican party.
Source: articlecompilation.com

It’s only bad when the other side steals billions….

It turns out that Medicare Advantage is especially popular in several large swing states, such as Florida (32 percent of Medicare beneficiaries in Florida use Advantage), Ohio (34 percent), and Pennsylvania (38 percent). Nationally, 26 percent of all Medicare recipients participate in Medicare Advantage, through which they can choose from various plans run by private insurers, as an alternative to the traditional Medicare fee-for-service program.
Source: wordpress.com

Medicare Supplement Insurance Helps Seniors in 2012

Even if you supplement Medicare with a Medicare Part D Prescription Drug plan, you may also enroll in one of the ten Medigap plans. During a six-month period that begins on the first day of the month in which you become 65 and you are enrolled in Part B, your application for a Medigap plan is guaranteed to be accepted regardless of your health problems. You may switch to a different plan during this time, and guaranteed acceptance also applies to the application for the other plan.
Source: professional-article-marketing.com

Q1Medicare.com Brings the Finalized 2013 Medicare Part D Defined Standard Benefit Parameters Online

As can be seen on the Q1Medicare.com/2013 page, the final 2013 defined standard benefit plan parameters show a slight increase above the same 2012 values. For example, Medicare beneficiaries enrolling in a 2013 Medicare Part D prescription drug plan modeled after the CMS Defined Standard Benefit will find the 2013 initial deductible increasing from the current value of $ 320 to $ 325. Likewise, the initial coverage limit will increase to $ 2,970 from the current 2012 limit of $ 2,930, meaning that Medicare beneficiaries with an average monthly negotiated retail drug cost of over $ 248 can expect to enter the Donut Hole sometime in 2013.
Source: co.uk

Florida insurer pays $140M to settle Medicare, Medicaid fraud claims

WellCare declined to comment on the matter, other than to say it is glad the affair is over. That leaves one to wonder whether this was really intentional, or whether it was the result of a mistake (after all, seeking reimbursement from federal program is quite an exercise in red tape) and the company decided to settle so that it could wash its hands of the matter. WellCare also noted that the $137.5 million settlement is not expected to impact its finances this year.
Source: miamifederalcriminaldefenseattorney.com