The Medicare Part D “Doughnut Hole” & You: How Diplomat Can Help

Posted by:  :  Category: Medicare

Denied coverage because of a pap smear by Paul SchreiberAt Diplomat, we know that no one wants to feel as though they need to choose between  health and money. Our dedicated funding assistance team works with Medicare Part D patients in order to fill out applications for any available and applicable 501c3 organizations; sometimes we can even complete the whole application for the patient. Stephanie Turnbull, one of our knowledgeable staff, says that “these grants are generally offered based on drug and/or disease and may have income limitations.  In the event that there is not a foundation able to assist the patient with their out of pocket costs, our staff would then pursue any available assistance programs offered by the manufacturer or other resources.”
Source: wordpress.com

Video: Medicare Drug Coverage

Drug Coverage Issues, Dual Eligibles Program Draw Democrats’ Interest

According to these stories from Politico and Politico Pro, some House Democrats are calling on the Department Of Health and Human Services to use the Medicare prescription drug program as a model for the health law’s essential health benefits drug coverage requirement. Also, Sen. Jay Rockefeller, D-W.Va., is joining the chorus of voices concerned about a Centers for Medicare & Medicaid Services demonstration program for dual eligibles — they say it’s a classic example of the right idea but the wrong execution.
Source: kaiserhealthnews.org

Getting Your Flu Shots with Medicare

The Medigap Plan’s Coverage of Flu Shots One other way to avoid paying extra for a flu shot or other Medicare-covered services is to purchase a Medigap policy that covers Medicare Part B excess charges. Medicare Supplement Plan F and Plan G both cover these excess charges, along with a number of other Medicare out-of-pocket costs. So even if your Medicare provider does not accept Medicare’s assigned rates, and he is one of the providers who charge extra, your Medicare supplement picks up that excess charge for you. Then you don’t have to pay anything out of pocket.
Source: mondaysorchids.com

Medicare Coverage of Adult Daycare

alzheimer alzheimer’s Alzheimer’s Myths Alzheimer’s Trigger biosynthetic polyphenols Brain Cell Death Brain Scan caregiver caregivers care giving caregiving Creutzfeld-Jacob Disease (CJD) Deep Brain Stimulation dementia depression Dr. John Detre Dr. William Hu eli lilly father’s day gifts Frontotemporal Degeneration frontotemporal dementia FTD George Bloom Gordon Sun guidelines Gwenn Smith John Voss Living Alone with Alzheimer’s mci memantine microglia mild cognitive impairment molecule that blocks Alz moving to a community National Alzheimer’s Plan olfactory identification tests omega-3 Pasinetti Patricia Boyle Ph.D. PhD progressive supranuclear palsy PSP sadowsky Switch Off
Source: agelessdesign.com

How do I Quit Medicare Advantage?

The 5-star rating system is used by Medicare to monitor plans and ensure that they meet certain quality standards.  The ratings also make it easier for someone on Medicare to compare plans based on quality and customer service. “Low performer” icons are placed next to the names of plans that have received less than three stars for the past three years.  The star rating system considers 53 quality measures, such as success in providing preventive services, managing chronic illness, and keeping consumer complaints to a minimum.
Source: ehealthinsurance.com

MEDICARE PART D COVERAGE CRITERIA ZYTIGA (abiraterone)

Brain Tumor Early Symptoms Society for Clinical Trials Lung Cancer Herpes Azt Diabetes Diet Sickle Cell Anemia Clinical Trial Definitions Normal Cd4 T Cell Count HIV Types of T Cells Chlamydia Breast Cancer HPV Skin Cancer AIDS Statistics Medical Dictionary Bone Cancer Famous People with AIDS Pregnancy Week by Week Coronary Artery Disease Phases Clinical Trials Aplastic Anemia AIDS in Africa Clinical Trials for Pay Nevirapine Tay sachs Disease History of AIDS Hepatitis B Vaccine Clinical Trial Process
Source: starhi.com

Medicare coverage gap associated with reductions in antidepressant use in study

According to study results, being in the gap was associated with comparable reductions in the use of antidepressants, heart failure medications and antidiabetics. Relative to a comparison group that had full coverage in the gap because of Medicare coverage or low-income subsidies, the no-coverage group reduced their monthly antidepressant prescriptions by 12.1 percent and reduced their use of heart failure drugs by 12.9 percent and oral antidiabetics by 13.4 percent. Beneficiaries with generic drug coverage in the gap reduced their monthly antidepressant prescriptions by 6.9 percent, a reduction attributable to reduced use of brand-name antidepressants, researchers note.
Source: sciencecodex.com

Strategies For Purchasing Medicare Supplement Insurance coverage

Trustworthy organizations are typically very easy to get in touch with. Folks and couples can simply talk with a variety of representatives and agents that may have all the suitable alternatives and prices to provide. Take some time to appear around and study about what each and every of those providers has to offer you. This really is going to create the process go lots quicker and will show men and women where the very best medicare supplement is situated. Ensure to discover essentially the most very affordable option out there so that it truly is less difficult to have coverage all of the time. Take note of your quantity of folks which can be going to become on the policy. This can be essential and each enterprise will have different rates for couples that desire to be on exactly the same plan with each other. Discounts can even be applied, based on the business that the couple decides to sign up with. It could take slightly bit of additional time to obtain plugged into these offers so ensure that to look around at the moment.
Source: fantoffice.com

How do I Quit Medicare Advantage?

Posted by:  :  Category: Medicare

OBAMAS DEATH PANEL------ GUESS WHAT FOLKS IT'S ALIVE AND WELL---"CRAZY PALIN" NOT SO CRAZY NOW by SS&SSThe 5-star rating system is used by Medicare to monitor plans and ensure that they meet certain quality standards.  The ratings also make it easier for someone on Medicare to compare plans based on quality and customer service. “Low performer” icons are placed next to the names of plans that have received less than three stars for the past three years.  The star rating system considers 53 quality measures, such as success in providing preventive services, managing chronic illness, and keeping consumer complaints to a minimum.
Source: ehealthinsurance.com

Video: Guide to Medicare Part A and Part B

NEW TO MEDICARE!! WHAT ARE MY OPTIONS »

Step #1:  Decide if you want “Original Medicare” or a Medicare Advantage plan.  Talk to your doctor and see which plan he/she recommends.  Many doctors are accepting “Original Medicare” and not Medicare Advantage plans.  If you have a doctor that is in the Medicare Advantage plan’s provider directory, make sure you call to verify that he/she is still accepting that particular Medicare Advantage plan.  Sometimes providers are in the directory, but stopped accepting the plan long before it went to print.  The main difference between “Original Medicare” and Medicare Advantage plans is “Original Medicare” works only with Medicare and generally, you or your supplemental coverage pay the deductibles or coinsurances.
Source: medicaretruths.com

Medicare free preventive services in 2012

The Affordable Care Act – the new health care law – helped over 16 million people with original Medicare get at least one preventive service at no cost to them during the first six months of 2012, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today. This includes 1.35 million who have taken advantage of the Annual Wellness Visit provided by the Affordable Care Act. In 2011, 32.5 million people in Medicare received one or more preventive benefits free of charge.
Source: tvearsnewsandviews.com

More than 16M people w/Medicare get free preventive services in 2012

The Affordable Care Act – the new health care law – helped over 16 million people with original Medicare get at least one preventive service at no cost to them during the first six months of 2012, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.  This includes 1.35 million who have taken advantage of the Annual Wellness Visit provided by the Affordable Care Act.  In 2011, 32.5 million people in Medicare received one or more preventive benefits free of charge.
Source: wordpress.com

Accountable care delivery and payment structures: Medicare Advantage with physicians at risk

Critical success factors: The key to Medicare Advantage success is the ability and willingness of physicians to serve as gatekeepers responsible for directing and coordinating patient care across the continuum. Primary care physicians and specialists alike will be successful in this role only if they thoroughly understand and support the care model, and have the tools and information necessary for informed decision-making. Additional success factors for Medicare Advantage include successful management of chronic conditions; coordination of care, particularly during high-risk transitions; and the ability to implement effective contracts, particularly with specialists, hospitals, and outpatient care facilities. 
Source: adsinstitute.org

Medigap Advisors Hosts Live Questions and Answers after Healthcare Reform Ruling

[…] Long says, “Millions of newly insured people will be wanting to take advantage of their low-cost benefits, so Medicare actuaries are predicting doctor shortages.” He is concerned that healthcare reform encourages doctors to form Accountable Care Organizations or ACOs. Long warns beneficiaries: “You will not necessarily see the same doctor at each visit, and you will probably not be allowed to get care from doctors outside of the ACO. Because of the way that ACOs are compensated, there are incentives for them to provide less service. It is your responsibility to take an active role in your care, to ask questions and demand the treatment you feel you deserve.”Source: medigapadvisors.com […]
Source: medigapadvisors.com

Don’ts of the Medicare Advantage Special Enrollment Period

Switching from one Medicare Advantage Plan to another is not allowed as it would cause a lot of chaos for everyone involved. For those that think they simply chose the wrong Medicare Advantage Plan you are out of luck for this year. Only switching from Medicare Advantage to Original Medicare coverage is allowed, not the opposite course of action. This is plainly to say that you can get out of your decision if you think that Medicare Advantage was the wrong choice altogether. You can add a Medicare Part D Prescription Drug Plan if you switched from Medicare Advantage to Original Medicare. However, you cannot simply add a prescription drug plan because you failed to do so in the first place. It may be something that you need desperately but it will also be harder to save tax free if you don’t do it the first time. Medicare Medical Savings Account Plans are not available to switch, drop or join during this time period.
Source: medicare-benefits.com

What You Need to Know About Medicare, Supplements, Part D & Medicare Advantage

 is an HMO or PPO Medicare policy which provides the Medicare recipient with copays for services, no claims filing and may add services that are not covered by Medicare or Supplement policies such as eye exams, hearing aids, prescriptions or dental care.  Medicare Advantage HMO products require that you receive your medical services by a participating provider, with the exception of emergent treatment. A PPO Med Advantage plan has all the advantages of  the HMO provider network
Source: foglegroup.com

Do you understand how Medicare works in North Carolina?

So what I always advise my clients is that they understand the Medicare language and how the different parts of Medicare work together to give them the ultimate in health insurance protection. So you should understand that part a of original Medicare covers hospital services like inpatient hospitalization home healthcare hospice and skilled nursing facility charges part B of original Medicare covers this is the charges while you are on a hospital any type of outpatient care by can outpatient the surgery office visits to your Dr. in your local hometown in part D of original Medicare is outpatient prescription drug coverage for medications that you feel like your local pharmacy or through a mail order service provider.
Source: jorgesuarez.info

Solutions For Medicare Problems

If you elect to delay your Medicare B enrollment past your 65th birthday because you have group health insurance through your employer, that is not a problem.  Just be aware that when you do retire or lose your group coverage for any reason, you do not have the full 7 month Initial Enrollment in which to secure a guaranteed issue Medigap plan.  You qualify for a Special Enrollment Period for only 63 days.  If you have a pre-existing health condition that would prevent you from medically qualifying for Medigap, you will need to submit your application within 63 days of the Medicare B effective date on your Medicare card.
Source: wordpress.com

Medicare Premiums Qualify Are Deductible Above the Line (in some cases)

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2..Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481However, for S corporation shareholders and partnerships, a notice issued previously by the IRS requires that these premiums actually be reimbursed by the corporation (or paid directly by the employer which is not normally applicable with Medicare premiums).  This requires a check be issued by the employer to the employee paying the Medicare premiums.  These payments would then be included in the income of the employee (deducted by the employer) and then deducted on page 1 of form 1040.  If these guidelines are not followed completely, then the deduction is not allowed.
Source: farmcpatoday.com

Video: Medicare Physician Feedback Program: Payment Standardization and RIsk Adjustment

Medicare payments soar for penis pumps

Winner repackaged the manual pumps in clear plastic bags with an information sheet claiming they helped “bladder control, urinary flow and prostate comfort,” according to court papers. He pleaded guilty in November to two counts of health care fraud, the introduction of an adulterated and misbranded medical device into interstate commerce, and money laundering. Winner also agreed to reimburse Medicare more than $2.2 million and pay a fine of $12,500.
Source: standard.net

Medical Devices Today: Radiation Oncologists Question Double

Under its draft 2013 Medicare physician fee schedule (PFS) issued July 6, CMS would cut reimbursement rates for radiation oncology therapy services performed outside hospitals by 14% overall. Payments specifically to freestanding radiation therapy centers would decrease 19%. Of the one million cancer patients receiving radiation therapy in the U.S. each year, approximately one-third get their treatments in freestanding radiation oncology centers rather than hospitals, according to the American Society for Radiology Oncology (ASTRO).
Source: medicaldevicestoday.com

Proposed Medicare Fee Schedule Includes Pay Increase For Primary Care, Family Docs

Medscape:  CMS Proposes Primary Care Raises Funded With Specialist Cuts Medicare would reduce reimbursement for many types of specialists to fund sizable raises for primary care physicians in 2013, according to a proposed fee schedule that the Centers for Medicare and Medicaid Services (CMS) released today.  These reductions and raises are apart from the huge pay cut — now put at 27% — set for January 1, 2013, that is triggered by Medicare’s sustainable growth rate formula, and likely to be postponed by Congress (Lowes, 7/6).
Source: kaiserhealthnews.org

Doctors Testify on Medicare’s Physician Payment System

Author & journalist Max Holland discusses his book, “Leak: Why Mark Felt Became Deep Throat.” Mark Felt was the FBI assistant director who in 1972 leaked Watergate investigation information to several reporters, including Bob Woodward and Carl Bernstein. Holland argues that contrary to popular notions, Felt selfishly used journalists to discredit FBI director L. Patrick Gray in the hope that he would be appointed to the top spot; and that Nixon’s resignation was an unintended consequence. The Kansas City Public Library hosted this event.
Source: c-span.org

Cuts to Medicare physician payments, if change isn’t made  

AP ArkansasDemocrat-Gazette dailycaller DefenseNews FederalTimes FrederickNewsPost HuntsvilleTimes ImperialValleyPress KHON-TV KVRR-TV Marketwatch McClatchy MILITARYTIMES NationalGeographicOnline Politico PoliticsDaily ReligionNewsService Rutland Herald SanDiegoUnion-Tribune TexasTribune TheAtlantic TheTennessean TimesArgus TV2 UPI video WAMU WaterlooCourier WhoRunsGov WLIU
Source: medilldc.net

Medicare says it will enhance beneficiary role in quality care review … say what?

CMS is proposing to increase HOPD payment rates by 2.1 percent. The increase is based on the projected hospital market basket—an inflation rate for goods and services used by hospitals—of 3.0 percent less statutory reductions totaling 0.9 percent, including an adjustment for economy-wide productivity. CMS is also proposing to increase ASC payment rates by 1.3 percent – the projected rate of inflation of 2.2 percent minus an adjustment required by law for improvements in productivity of 0.9 percent. Medicare uses the consumer price index for urban consumers (CPI-U) as the inflation rate for ASCs. CMS is asking for public comment on potential data that Medicare could collect to develop an inflation index that would explicitly measure ASC cost growth.
Source: quinnscommentary.com

Why Many Find the Medicare Set

Like most governmental programs, most everyone involved in Medicare set-aside arrangements as they pertain to Workers’ Comp probably end up confused and anxious. The process, which allocates a portion of a worker’s settlement from Workers’ Comp to go toward future medical expenses can be very complex even for those who are regularly involved in it. Should there be a failure to give Medicare notice of a settlement, steep penalties could result. Further, Medicare is not allowed to make payments which are legally the responsibility of another party. Worst of all, the injured employee could find themselves ineligible for Medicare if all issues were not dealt with properly when the settlement occurred. It is recommended that a set-aside agreement be engaged in which takes a percentage of the settlement from Workers’ Comp for impending medical expenses; once this amount is gone—and accounted for—Medicare will kick in for the injured employee.
Source: joshilaw.com

MEDICARE REBATE: Review Your Health Insurance Before June 30.m4v

Posted by:  :  Category: Medicare

SCOTUS Obamacare Decision Makes Individual Mandate A Fact & Universal Healthcare Coverage A Fiction by watchingfrogsboilWith the Federal Government bringing in legislation to means-test the Medicare rebate as of July 1, 2012, now is the time to review your health insurance needs for the coming financial year. In this Skype interview, Tim Andrew from SplitIt.com.au outlines in simple terms what the legislation means and tiers of income the government will be means-testing; he also touches on why paying your health insurance up-front might potentially save you thousands of dollars. SplitIt.com.au is an open and transparent comparison service. We compare everything available to us (some 10000 health insurance policies in Australia) and where we receive any commissions we split them with you 50/50, always, no exceptions!
Source: globalhealthcareprofessional.com

Video: Medicare rebate – Nick Xenophon

Limiting the Medicare rebate for genital surgery is a good move

While western women are increasingly turning to the knife and having the size, shape and appearance of their labia enhanced, feminists and activists continue the campaign to end the practice of female genital mutilation affecting millions of women living in parts of Africa, Asia, and the Middle East. Female genital mutilation is a procedure that intentionally excises genital tissue leading to problems such as frequent bladder infections, childbirth complications and the risk of later surgery. The World Health Organization estimates that there are 100 to 140 million women who have had their lives damaged by FGM.
Source: wordpress.com

Claiming a Medicare rebate: :: Centred MGP

Every woman is entitled to have a midwife, unfortunately if you see your GP you don’t get to see a midwife until you go for your hospital visit at 19/20 weeks. This means you have missed out on vital information and building a valued relationship. This is regretable because it is beneficial for women to see a midwife from the moment she is pregnant or at least between 8 – 10 weeks. A midwife gives the woman unbiased information allowing the woman to choose different options of care, rather than the straight route to an obstetrician because she has private cover. Now with midwives having a Medicare provider number, this means that a pregnant woman can see a private midwife to discuss options of care and claim for a refund just like going to the doctors. Midwives work in collaboration with doctors and midwives are all to happy to refer the woman when it is required and the woman wishes to do so.
Source: centredmgp.com

Medicare Rebate for Counselling in Brisbane

Is male ‘menopause’ real? Is it fair to compare this to what happens for women when their hormones drop off very rapidly at menopause? Gradual decline in testosterone / androgen is normal in males aged over 30 years. On average, by the time we get to 45 we’ve lost about 15% of our male hormones, and by 60 we’ve lost over 30%. At 70 we are at about 50% of where we were when younger. So, in this respect male hormone loss with aging is … …
Source: visionpsychology.com

The circumcision debate is back

“The evidence for the benefits of infant male circumcision is impressive and growing,” he said.  “Benefits outweigh negatives by a large margin.  However, the Medicare benefit for elective male circumcision has gradually been eroded and may soon be terminated.  Middle and upper-income families can easily afford infant male circumcision but low-income families cannot.  The cost can be $800.”
Source: com.au

Plibersek Verifies Medicare Rebate for e

Ms Plibersek has verified this but it was further added that once the patients get registered to the services, "patients will be able to go online to view their record and add a range of basic health information, including emergency contact details, the location of their advanced care directives, any allergies they have or medication they’re on".
Source: topnews.us

Your Affordable Care Act Rebate Can Save Lives

Obamacare will destroy the health insurance industry if no exceptions are made. If the 80/20 rule was the only impact on the health insurance companies, some of them would still manage to survive, but Obamacare removes both the ability of health care insurance companies to use risk to determine how much to charge and how much to pay out. This is the nail in the coffin for health insurance companies because they are no longer needed. There will be no private health insurance company except those who are facades for the government within a decade. The government will be the only health care insurance provider and will not be under the same strictures of being efficient that it places on private insurers. We will be in a worse situation in the long run in terms of the ratio of how much we pay goes into overhead. The really bad thing is that none of this deal with making health care actually sustainably affordable because the real driver for escalating health care costs is the year after year demand side subsidization of the health care industry by the government. Touching Medicare/Medicaid and related programs in a meaningful way is taboo, so either we fork out more for health care or we build up towards another massive economic crisis by having the government pay for it with debt.
Source: eclectablog.com

Child immunisation schedule no Medicare

Hi When we arrive our kids will be 5 months and 2 and a half. We are on a 163 visa, so don’t qualify for Medicare (other than urgent things covered under the reciprocal agreement). I’m assuming I might have to pay for these privately (we will have health insurance) or is this type of thing covered by another scheme? Anyone got any experience with this? Thanks Ross
Source: perthpoms.com

Not All Dreams Are Free: 7dp5dt

I am getting mentally prepared for a negative result. This new calmness has enabled me to think that I will be able to accept a failed cycle ok. It’ll be shitty that I’ve just been put through all of this hormonal hell over the past 28 days for nothing, but it will be ok. Nobody has been hurt. It is not the end. There are still 2 frozen embryos that might one day become our child, and that makes me feel more relaxed. I needed to find this peace within me before I get the results. Partly because I think our family/ close friends who know about us attempting IVF are all probably holding their collective breath, waiting for me to fall apart if this all goes to shit. I am making a promise to myself that I won’t do that. I’ll accept it, find out what possibly could be done better, and eventually regroup enough courage to give it another go. But firstly, Chop and I will be pouring ourselves a few glasses of red wine on Friday night and decompressing, if the news is not good. However, if we do get a positive result, I’ll be watching Chop drinking those glasses of red, while I happily sip on a water!
Source: blogspot.com

The Econ Student: Is the medicare rebate middle class welfare?

I should start by saying this piece is more of debate about ideology rather than economics. The medicare offset known commonly as the medicare rebate can be seen as a subsidy of 30% to the holders of private health insurance. These people are mostly middle class or in a high income bracket. However, many people, especially those with health issues choice to purchase a private health insurance policy despite not having a high income. Alternatively, the policy could be seen as a way of giving health consumers choice. In that if people decide to insure themselves privately they can at least claim a deduction on their tax for the cost of the policy allowing them to pay with their gross income rather than net. How a tax offset differs from a deduction is that a deduction reduces a persons reportable income on their tax return and results in a reduction of tax of whatever the top marginal tax rate the consumer was paying. So assuming the person who bought the policy was earning 200k the deduction would be 45% plus a reduction in of the medicare levy making a total tax deduction of 46.5% of the policy cost. This would mean that the wealthy would get a bigger deduction for purchasing health insurance than people not paying the top marginal tax rate. An offset instead is a blanket 30% of the policy cost regardless of who buys it. It’s for this reason and to reduce the cost of the policy the Howard Government would have chosen to have an offset rather than a deduction. This with the fact its commonly known as a rebate has seen this policy portrayed as  middle class welfare. This with the private vs public school debate really comes down to the question should people be able to opt out of government provided services? Clearly in health people still continue to benefit partially by the public system and will still continue to receive benefits from it, but should people who choose to partially seek healthcare through the private market be made to pay the full cost of the public system that they now are far less likely to use. Many people have the view yes, if people choose to use private services than they should still contribute 100% to the public system and receive no assistant/deduction for their private expenditure. Another argument that is often used is the claim that people should pay their fair share. Too often a person’s fair share is their share and about four other peoples share and then are to be told they can’t access the service they paid for becomes of a means test. It’s apparent that the expansion of middle class welfare in the late Howard years was a response to the fact the middle class felt they were paying taxes into a system that wasn’t interested in helping them or their family. As a libertarian I believe in a perfect world much more of the health system would be left to the private market with competitive pressures rather than a system that helps line the pockets of the medical profession. (I believe we do need a public helathcare system, probably similar to what Queensland had pre Medicare) However, we do not have that system, we probably will never have that system as the average person does not under that government funding of many medical services in the long run raises the price of those services. So as a next best solution those people who do not want take a chance with government waiting lists is to allow them to choose to access services through the private market. By allowing a 30% rebate of private health insurance means the individual gets a small deduction of their tax as an incentive, while they still continue to pay the medicare levy and a significant proportion of their taxes still goes towards funding the system.
Source: econstudent.org

What Does the Supreme Court Ruling on the Health

Increasing the medical expense income tax deduction threshold to 10% of adjusted gross income, up from the current 7.5% (January 1, 2013) Increasing the Medicare Part A tax rate by 0.9% on wages over $200,000 for individuals ($250,000 for married couples), and assessing a new 3.8% tax on some or all of the net investment income for these higher-income individuals (January 1, 2013) All Americans must carry health insurance or face a penalty (in the form of a tax) of up to 2.5% of household income on individuals, with exceptions for economic hardship, religious beliefs, and other situations (January 1, 2014) Adults with pre-existing conditions cannot be denied coverage or have their insurance cancelled due to pre-existing conditions (January 1, 2014) A requirement that states establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans and includes an Exchange for small businesses; also requires employers that contribute toward the cost of employee health insurance to provide free choice vouchers to qualified employees for the purchase of qualified health plans through Exchanges (January 1, 2014) Tax credits will be available to qualifying families to offset the cost of health insurance premiums (January 1, 2014) Employers with more than 50 employees must offer health insurance for their employees or be fined per employee (January 1, 2014) Imposing taxes or fees on health insurance providers and drug companies, while doctors and hospitals will receive less compensation from government sources (January 1, 2014)
Source: markmartiak.com

Doughnut Hole Rebate Checks Fuel Medicare Fraud & Insurance Scams

Missouri Attorney General Chris Koster (also the name of the website) comments on the types of Medicare scams taking place across the nation. The article can be found in the Attorney General’s News Release titled, "Attorney General Koster Warns Seniors About Medicare Rebate Fraud Schemes" (June, 2010). According to the author (name not given), "[Koster] said a common scam related to the $250 donut hole checks was for individuals to convince seniors that the rebate check needed to be transferred to a third party or used to cover specific prescription drug payments."
Source: suite101.com

President's Email, Tuesday 4 October 2011

The AMA will continue to campaign against the Government’s decision and I encourage you to enlist the support of your patients for our efforts by raising their awareness about these changes, which are a backward step for the delivery of high quality mental health services through general practice. 
Source: com.au

How do I Quit Medicare Advantage?

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2..Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481The 5-star rating system is used by Medicare to monitor plans and ensure that they meet certain quality standards.  The ratings also make it easier for someone on Medicare to compare plans based on quality and customer service. “Low performer” icons are placed next to the names of plans that have received less than three stars for the past three years.  The star rating system considers 53 quality measures, such as success in providing preventive services, managing chronic illness, and keeping consumer complaints to a minimum.
Source: ehealthinsurance.com

Video: Medicare healthcare medical billing insurance Fraud

Getting Your Flu Shots with Medicare

The Medigap Plan’s Coverage of Flu Shots One other way to avoid paying extra for a flu shot or other Medicare-covered services is to purchase a Medigap policy that covers Medicare Part B excess charges. Medicare Supplement Plan F and Plan G both cover these excess charges, along with a number of other Medicare out-of-pocket costs. So even if your Medicare provider does not accept Medicare’s assigned rates, and he is one of the providers who charge extra, your Medicare supplement picks up that excess charge for you. Then you don’t have to pay anything out of pocket.
Source: mondaysorchids.com

Medicare Premiums Qualify Are Deductible Above the Line (in some cases)

However, for S corporation shareholders and partnerships, a notice issued previously by the IRS requires that these premiums actually be reimbursed by the corporation (or paid directly by the employer which is not normally applicable with Medicare premiums).  This requires a check be issued by the employer to the employee paying the Medicare premiums.  These payments would then be included in the income of the employee (deducted by the employer) and then deducted on page 1 of form 1040.  If these guidelines are not followed completely, then the deduction is not allowed.
Source: farmcpatoday.com

Basics You Should Know About Medicare Health Insurance

Health insurance is a maze. It is often hard to maneuver and completely understand the ins and outs. With Medicare and available supplemental plans there are many online comparisons available to help individuals select a plan that will work with their situation. Many times people want information on paper and then seek out assistance from an advisor who is able to help them compare the plans and rates with real life examples and situations. These advisors have one sole purpose and that is to match the right Medicare supplement policy at the right price with Medicare eligible participants. To them the company that the individual purchase the policy from is not as big of an issue and they can help you see through the glitz of private insurance companies and keep the focus on coverage and rates.
Source: blog-revenue-tips.com

Reform may hit hospitals harder

Tags: healthcare employment, healthcare executive recruitment, healthcare executive search, healthcare executive search firm, healthcare jobs, healthcare recruiter, healthcare recruiting, healthcare recruiting challenges, healthcare recruitment, healthcare search firm, healthcare staffing, hospital executive search firm, hospital staffing, interim healthcare leadership, interim leadership, interim management, interim nurse management, interim nursing leadership, interim services, recruiters for hospital executives, rural healthcare recruitment Posted in Healthcare Industry News, News & Events
Source: mhhealthsearch.com

Solutions For Medicare Problems

If you elect to delay your Medicare B enrollment past your 65th birthday because you have group health insurance through your employer, that is not a problem.  Just be aware that when you do retire or lose your group coverage for any reason, you do not have the full 7 month Initial Enrollment in which to secure a guaranteed issue Medigap plan.  You qualify for a Special Enrollment Period for only 63 days.  If you have a pre-existing health condition that would prevent you from medically qualifying for Medigap, you will need to submit your application within 63 days of the Medicare B effective date on your Medicare card.
Source: wordpress.com

The Economics of Obamacare (Part 3): Understanding the Lessons of Medicare

Like any organization, Medicare tries to curtail its costs. And this is where it gets tricky: bureaucrats can only set limits on the prices they are willing to pay or limit the services they are willing to cover. While this does, in fact, help curtail costs to Medicare as a program, it doesn’t do much to curtail costs in the entire health care system. All of the underlying health care products and services must be produced by somebody — nurses, doctors, medical technology manufacturers, biologists, technicians, researchers, and so forth. Therefore, these things have their own costs for labor, materials, and research, to name just a few factors. So, doctors and hospitals treating Medicare patients are frequently left with partially unpaid bills. Consequently, doctors and hospitals raise their prices for everyone else (non-Medicare patients). Naturally, these more expensive price tags ultimately flow through to higher premiums on the private insurance policies covering these patients. In effect, the rest of the country picks up an increasing share of the tab for the Medicare crowd each year. So, persons A, B, and C pay for Medicare through taxes that pay claims for persons X and Y — and then these same persons A, B, and C simultaneously pay into a private insurance pool that pays claims for persons A, B, and C, as well as the disallowed portions of persons X and Y’s claims in Medicare. Got it?
Source: cfainstitute.org

CHAMPVA Supplemental Insurance

Posted by:  :  Category: Medicare

In general the CHAMPVA program covers most health care services and supplies that are medically and psychologically necessary. Upon confirmation of eligibility, you will receive program material that specifically addresses covered.
Source: podipoda.com

Video: Acomplia Canada

Significance of Champva Insurance

Champva is a useful program in which the Department of Veterans Affairs (VA) shares the cost of some health care services, thus supplying you with eligible beneficiaries. This particular program offers you robust pharmacy benefits and supplies health care services that are needed medically or psychologically. The Champva Insurance is provided to the spouse of and children of an individual rated permanently disabled due to service connected disability or service connected condition at the time death. This also extends to people who died on active duty or due to a service connected disability. However, the dependents are not eligible for DoD TRICARE benefits. After the confirmation you will receive a handbook, wherein the program material will address the services covered. It is a simple task to acquire this insurance plan. It is important to take some time off your schedule and conduct a comprehensive search on the web before applying.
Source: 123homesolution.com

CHAMPVA Supplemental Insurance

In general the CHAMPVA program covers most health care services and supplies that are medically and psychologically necessary. Upon confirmation of eligibility, you will receive program material that specifically addresses covered. » CHAMPVA Supplemental Insurance
Source: arrivenews.com

Champva Supplemental Insurance from Department of Veterans Affairs

The program offers 100% medical payments if your accident is not incurred, such as doctor’s visit, up to $635 for a day as a hospitalization bill and others. But the plan is not paying bill for your dental care, drug addition, baby care and hospital nursery charge for newborn. You may also call at 1-800-733-8387 (ASI) to learn about your eligibility and insurance facilities. The charge and eligibility is dependable on insurance company.
Source: idealsuggestion.com

Significance of Champva Insurance

Champva is a useful program in which the Department of Veterans Affairs (VA) shares the cost of some health care services, thus supplying you with eligible beneficiaries. This particular program offers you robust pharmacy benefits and supplies health care services that are needed medically or psychologically. The Champva Insurance is provided to the spouse of and children of an individual rated permanently disabled due to service connected disability or service connected condition at the time death. This also extends to people who died on active duty or due to a service connected disability. However, the dependents are not eligible for DoD TRICARE benefits. After the confirmation you will receive a handbook, wherein the program material will address the services covered. It is a simple task to acquire this insurance plan. It is important to take some time off your schedule and conduct a comprehensive search on the web before applying.
Source: insurancequotecheaper.com

Frequently Asked Questions about The Affordable Care Act: Medicare Part 2 » Elder Options of Texas

Posted by:  :  Category: Medicare

Drug questions by Ano Lobb. @healthyrxAn out-of-towner drove his car into a ditch in a desolated area. Luckily, a local farmer came to help with his big strong horse named Buddy. He hitched Buddy up to the car and yelled, “Pull, Nellie, pull!” Buddy didn’t move. Then the farmer hollered, “Pull, Buster, pull!” Buddy didn’t respond. Once more the farmer commanded, “Pull, Coco, pull!” Nothing. Then the farmer nonchalantly said, “Pull, Buddy, pull!” And the horse easily dragged the car out of the ditch. The motorist was most appreciative and very curious. He asked the farmer why he called his horse by the wrong name three times. The farmer said, “Oh, Buddy is blind and if he thought he was the only one pulling, he wouldn’t even try!”
Source: elderoptionsoftexas.com

Video: Allen West – Nicole Sandler Medicare question

Congress questions Medicare audit coordination

"Healthcare providers are responsible for interacting with, and responding to, each of these contractors," they wrote in the letter. "In order for this contractor oversight to at once be effective at detecting improper payments and not unnecessarily burdensome to providers, it must be undertaken subject to a coherent strategic plan, consistent standards and active coordination," they said.
Source: fiercehealthcare.com

Medigap Advisors Hosts Live Questions and Answers after Healthcare Reform Ruling

Long says, “Millions of newly insured people will be wanting to take advantage of their low-cost benefits, so Medicare actuaries are predicting doctor shortages.” He is concerned that healthcare reform encourages doctors to form Accountable Care Organizations or ACOs. Long warns beneficiaries: “You will not necessarily see the same doctor at each visit, and you will probably not be allowed to get care from doctors outside of the ACO. Because of the way that ACOs are compensated, there are incentives for them to provide less service. It is your responsibility to take an active role in your care, to ask questions and demand the treatment you feel you deserve.”
Source: medigapadvisors.com

Medicare vs. Universal Health Care: An Honest Question for the Right

1) I would recommend exploring ways to establish catastrophic care for extremely serious and expensive medical conditions. I would allow people to opt out of this with some very onerous requirements. This would be paid for via payroll taxes unless the fool opted out. 2) I would recommend people buy their own insurance that meets their needs for routine, non catastrophic care. I would choose a high deductible and low premiums and few frills. Others can get low deductibles, high premiums and all the frills they would like. I would allow any company to sell any policy that people will buy as long as the company is honest and has proper reserves. 3). I would encourage experimentation with guaranteed insurability and portability, so that people would not be harmed on their routine care premiums if their health status changed. 4). I would subsidize the poor and elderly and possibly the sickly so that they could purchase the underlying coverage policy and pay their deductibles. Catastrophe coverage would be free or cheap as they do not work much or at all.
Source: ordinary-gentlemen.com

Medicare Commission Raises Questions about Care Coordination

It is the hope of the administrators in both Baltimore, Maryland (home of CMS) and Springfield, Illinois (home of Illinois Department of Health and Family Services – HFS) that the implementation of integrated care will improve care and reduce costs for the dual-eligible (Medicare and Medicaid enrollees) population . Keep in mind, that approximately 340,000 Illinois residents (3 percent of the state’s population) are dual-eligible beneficiaries and as a percentage of population, it is identical to the national percentage. On average, these dual-eligible beneficiaries have greater health and long term services and supports (LTSS) needs than beneficiaries who have only Medicare or Medicaid coverage, due to greater prevalence of chronic conditions (e.g. CHF, COPD, Diabetes, Heart Disease, etc.) in this population.
Source: chicagonow.com

5 Questions you should Ask Before Purchasing a Medigap (Medicare) Policy

The first step in purchasing a Medigap Policy is to review a government published guide, such as Choosing a Medigap Policy, and decide which of the 11 standardized plans fits your lifestyle and needs. If you want a policy that covers all the “gaps” that Original Medicare does not cover choose Plan F. However, if you are more concerned about a lower monthly premium, then consider a High Deductible Plan F or plans like K or L, which only provide partial payment for your doctor visits.
Source: inzinearticles.com

Vice Pres. Biden Speaks on Senior Issues and Medicare

White House Press Secretary Jay Carney briefs reporters at the White House where he took questions about the upcoming Supreme Court decision on the constitutionality of the Affordable Health Care Act and the upcoming House vote to hold Attorney General Eric Holder in contempt of Congress.
Source: c-span.org

La Jolla Community Center Events: Medicare Questions Answered!

Join Jim Minor while he answers all of your questions regarding Medicare. If you are confused about the upcoming Medicare Annual Enrollment Period or have any other questions, comments, or concerns, join us!
Source: ljcommunitycenter.org

Practical Insights: Dealing with Medicare Part B and COBRA Coverage

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SSGenerally, the Socal Security Act provides that individuals may enroll in Medicare Part B (which covers doctors visits and other outpatient services) when they reach age 65. If they fail to do so during a seven-month initial enrollment period surrounding their 65th birthday, they can enroll during an annual “general enrollment” period that occurs each January 1- March 31, with coverage becoming effective the following July1, though they will incur a penalty in the form of permanently higher Part B premiums (10% increase for each year of available coverage that is foregone). However, actively employed individuals who have employer-provided health coverage can postpone signing up for Medicare Part B until after age 65. When they lose the employer-provided coverage or terminate employment, whichever happens first, they are then provided an eight-month “special enrollment period” (“SEP”) during which they can sign up for Medicare effective immediately and without penalty.
Source: fordharrison.com

Video: Health Insurance Information : What Is Medicare Part B?

Medicare Coverage of Adult Daycare

alzheimer alzheimer’s Alzheimer’s Myths Alzheimer’s Trigger biosynthetic polyphenols Brain Cell Death Brain Scan caregiver caregivers care giving caregiving Creutzfeld-Jacob Disease (CJD) Deep Brain Stimulation dementia depression Dr. John Detre Dr. William Hu father’s day gifts Frontotemporal Degeneration frontotemporal dementia FTD George Bloom Gordon Sun guidelines Gwenn Smith John Voss Living Alone with Alzheimer’s mci memantine microglia mild cognitive impairment molecule that blocks Alz moving to a community National Alzheimer’s Plan olfactory identification tests omega-3 Pasinetti Patricia Boyle Ph.D. PhD progressive supranuclear palsy PSP Rachel Whitmer sadowsky Switch Off
Source: agelessdesign.com

How to Avoid Medicare Land Mines ~ USA Loans

But the clock for the Part B deadline starts when you leave your job, not when benefits end. Mary Kesel, who founded Benefit Advocates, a Winston-Salem, N.C., firm that guides individuals and businesses through the Medicare maze, says this is a common mistake with costly consequences. She advised a banking executive who lost his job and thought he could wait until his Cobra ran out to enroll in Medicare.
Source: blogspot.com

Changes to Medicare Upheld by the Supreme Court Ruling on the Affordable Care Act

New dates for Medicare’s Annual Enrollment Period (AEP) – During AEP, Medicare beneficiaries have the option to review and change their Medicare Part D and/or Medicare Advantage health coverage prior to the coming plan year when new plan benefits go into effect. Prior to the passage of the ACA, Medicare’s AEP began on November 15 and ended on December 31. But, the ACA changed those dates for the 2012 plan year. The 2012 AEP began on October 15 and ended on December 7, 2011. These dates are currently in place for all AEP’s going forward.
Source: ehealthinsurance.com

Teachers Are Not the Problem: Medicare meets Obamacare.

This blog’s target audience is retired teachers in WNY, which means that Medicare is probably at the top of your list of questions about the Affordable Care Act (ACA). Before addressing the specifics of the ACA with regard to Medicare, however, we need to do a little background work on some of the details of Medicare’s inner workings. Medicare comes in two “flavors”: traditional (sometimes called “fee-for-service” Medicare) and Medicare Advantage plans. Seventy-five percent of Medicare participants are in traditional Medicare while the remaining 25% are in Medicare advantage plans. That 3/1 ratio of traditional Medicare participants to Medicare advantage participants is important, and will have a tremendous bearing on how you personally view the Medicare changes in the ACA. Traditional Medicare is run by the government. It consists of Part A (hospital costs), Part B (doctor costs) and Part D (prescription drug costs). There is no cost to the participant for Part A, although there is a deductible for each hospital admission. Participants pay a monthly premium of $96.40 (or close to this amount) for Part B coverage. There is a yearly deductible for Part B costs. In addition Medicare only pays 80% of the covered Part A and B expenses. Traditional Medicare participants may, if they choose, purchase supplemental (Medigap) insurance to cover all or part of these costs not covered by Medicare. Traditional Medicare participants may also purchase Part D drug insurance through private insurance companies approved by Medicare. Traditional Medicare is a “fee-for-service” plan. Whenever you receive a covered medical service, Medicare provides a set fee for that service to the provider. Medicare providers have agreed to accept whatever fee Medicare provides as payment in full. (Actually, Medicare only pays 80% of this fee to the provider. The other 20% is billed to the patient or their Medigap insurance, if they have purchased it.) If you receive no covered services during a year, Medicare spends no money on your behalf. There is no upper limit on your yearly cost to Medicare if you do receive covered services. Medicare Advantage plans (also known as Medicare Part C) began in the 1970’s with the idea that the private sector could do Medicare more cheaply than the government. Over the years, Congress has made several changes to Medicare Advantage so that its focus now is attracting more private participation. Medicare Advantage plans are run by private insurance companies such as Univera, Independent Health, etc. Medicare pays these companies a flat fee to provide hospital and doctor services to their members. Some Medicare Advantage plans also include Part D drug coverage, while others require that their members purchase it as a separate entity. While participants in traditional Medicare are free to use any doctor or hospital and do not require a referral to see a specialist, Medicare Advantage plans usually require members to use only hospitals or doctors in their network. Going “out-of-network” usually results in the member paying either a larger share of the cost or, in some cases, the full cost of the service. If you are unsure which “flavor” of coverage you have, if you pay a “co-pay” when seeing your doctor, you are probably a Medicare Advantage member. Medicare Advantage members also pay their Part B premium to Medicare, usually through direct deduction from the Social Security payment each month. The amount that Medicare pays to the Medicare Advantage insurer for each member is a flat rate based on the average yearly cost to Medicare of traditional Medicare participants in your county. And there’s the rub. Medicare currently pays Medicare Advantage insurers about 15% more for each member than the average cost to Medicare for a traditional Medicare participant. Many Medicare Advantage providers use this extra money to provide services not covered by traditional medicare such as dental, eyeglasses and gym memberships. Everyone agrees that Medicare has financial problems. The Part B premium, for example, covers only about 25% of the cost of doctor services to Medicare participants. We Medicare participants often boast that we’re “paying our way” through our premiums. Sadly, that’s simply not the case. The ACA attempts to help stem the rise in Medicare costs by scaling back the increase in payments to Medicare advantage providers by about $322 billion over the next 10 years. Note that this is NOT a decrease of $322 billion from the current payment level. Instead, it is a decrease in the expected rise in these payments. If you are one of the 3-out-of-4 traditional Medicare participants, you will probably view this as a good thing. There will be no change in your Medicare services and the overall cost of Medicare will be $322 billion closer to being under control. If you are the 1-out-of-4 person who participates in a Medicare Advantage plan, you will likely see some decrease in the “extra” services such as gym memberships. To be fair, however, with everyone paying the same dollars into Medicare, it’s hard to make a case that it’s fair that Medicare spend an extra 15% on 25% of participants allowing them to receive benefits that the other 75% do not receive. And, in addition, we help bring Medicare costs under control. And, this $322 billion in savings is used to help pay the costs of the ACA. Believe it or not, there’s even more to say about Medicare in the next post. [NOTE: Click here for an excellent side-by-side comparison of traditional vs Medicare Advantage provided at the Medicare website. Click here to download a much more complete explanation of Medicare Advantage plans from the Kaiser Family Foundation.]
Source: blogspot.com

Ask The Experts: Retirement

Q. I was approved for OPM disability retirement and Social Security. I understand that I can elect Medicare Part B coverage and pay an additional premium. I already am covered under the Federal Employees Health Benefits plan and pay that premium. I also have been advised that I will pay a penalty for every year that I do not sign up for Medicare Part B while eligible. Is that so in every case? Should I pay both premiums? I am 52 years old.
Source: federaltimes.com

A Quick Introduction to Part

Now that we have a good understanding of Part A benefits and it’s general coverage for facility (loosely translated as hospital, surgicenter, skilled nursing, and hospice care) based care, let’s look at Part B, logically our next letter in the alphabet. Generally, Part A is facility care while Part B can be thought of as physician, out-patient, and preventative benefits. You can think of Part B as everything Medicare covers outside of inpatient care (Part A) and out-patient medication (Part B). It’s quite different from both so let’s take a closer look at Part B. First, we need to speak about Part eligibility and cost because this a major difference. Most people are going to pay for Part B coverage. Part A is generally paid for through taxes during employment over the course of a person’s life. Part B is different and will likely feel the blunt of cost controls going forward. First, you must sign up for Part B. It is not automatically extended to eligible members the way Part A generally is. You must also pay a premium for Part B coverage. As Medicare started to show signs of financial strain, Part B became means tested which means that you will pay more for Part B premium if you have great income on average. You can expect to see this increased premium go higher over time as Medicare tries to shore up it financial house. The premium is paid monthly and can even be taken from your Social Security check automatically. The key take away is that you probably (most people do) need to actually enroll and that you will pay for this coverage separately from any charge to have medicare supplemental insurance. Now, let’s look deeper into what Part B covers. First, you will have an annual deductible that you need meet. This deductible is $162 for 2011 but you can expect that it will go up over time. The deductible is calendar year (Jan 1st through Dec 31st) and resets each January. Once the deductible is met, you will then pay 20% of the charges for allowable expense for the remainder of the year. If you have additional coverage such as Medicare supplement insurance or Advantage plan, you may get this deductible and 20% co-insurance covered depending on the plan you choose. Part B generally covers physician charges and outpatient expenses that are allowed and not covered under Part A on an inpatient facility basis. This can be the doctors office, labs, outpatient surgeries, and allowed preventative services. Medication is not covered under Part B and we’ll cover that in Part D. There are two ways to find out if a particular benefit is covered under Part B. First there, the Medicare benefit handbook (different from the Medicare and You handbook) which is handy since it’s alphabetized by actual benefit name such ad Diabetes screening. This is generally how people search for a given medical issue they are dealing with so we advise this first. There’s also the medicare.gov benefit database where you can get even more specific information by entering in keywords such as “routine physical”, etc. Both resources have made searching for eligible benefits much easier in the last few years. One quick but important note on Part B. If you choose to wait to elect Part B after you are eligible (assuming you do not have another eligible window such as leaving group etc, you may a higher rate for this benefit if you eventually opt for it. There may also be a delay from when elect Part B to when the benefits actually kick in. It’s best to discuss your situation with a licensed agent as Medicare is only getting more complex in terms of the rules.
Source: abcarticledirectory.com

Basics You Should Know About Medicare Health Insurance

Health insurance is a maze. It is often hard to maneuver and completely understand the ins and outs. With Medicare and available supplemental plans there are many online comparisons available to help individuals select a plan that will work with their situation. Many times people want information on paper and then seek out assistance from an advisor who is able to help them compare the plans and rates with real life examples and situations. These advisors have one sole purpose and that is to match the right Medicare supplement policy at the right price with Medicare eligible participants. To them the company that the individual purchase the policy from is not as big of an issue and they can help you see through the glitz of private insurance companies and keep the focus on coverage and rates.
Source: blog-revenue-tips.com

Medicare Part B: Can I Decline the Medicare Part B Coverage?

If you do not meet the requirements for “Special Enrollment” you can only get back into Medicare Part B during the “General Enrollment” period. general Enrollment is January straight through March of each year, and your Part B coverage will not start until July. If you get back into Medicare Part B during the general Enrollment period, collective security will most likely fee you a “Premium Surcharge Penalty” on your Medicare Part B premiums. This penalty is an additional 10% of the base excellent estimate for each year that you were not covered by Medicare Part B.
Source: blogspot.com

What You Need to Know About Medicare, Supplements, Part D & Medicare Advantage

 is an HMO or PPO Medicare policy which provides the Medicare recipient with copays for services, no claims filing and may add services that are not covered by Medicare or Supplement policies such as eye exams, hearing aids, prescriptions or dental care.  Medicare Advantage HMO products require that you receive your medical services by a participating provider, with the exception of emergent treatment. A PPO Med Advantage plan has all the advantages of  the HMO provider network
Source: foglegroup.com

What is some cheap medical insurance? Question

Posted by:  :  Category: Medicare

TTT #5... 259365 by paloeticAnother option might be short-term health insurance. A short-term plan may not cover preventive care or prescription drugs but it’s easier to qualify and it will provide you with some form of coverage in case of serious accident or illness. Short-terms plans usually only last for six months at a time, but that might get you to age 19, when it becomes a lot easier to purchase health insurance on your own. Work with a licensed agent (online or off) to look into it.
Source: southernontheinside.com

Video: High-Deductible Plans ‘Quiet Revolution in Health Insurance’

Small Business Medical Insurance

You can expect to, not surprisingly, get decisions in copay and deductible amounts. Individuals afford a Cadillac health plan, then you definately still might be capable of afford a Dodge! The addition of an economical accident plan or supplemental sickness policy may enable you to opt for a very economical high deductible plan! And lastly, several small enterprises hope their staff members to contribute a portion in the premiums. The quality of the proportion that workers may play a role in a plan can vary by insurance company assuring. Supplemental sickness and accident insurance policies can be purchased by your staff with a voluntary basis, to ensure that they would be part of the premiums, yet still have the attributes of group insurance.
Source: gotbreakup.com

Affordable Health Insurance Plans

Right now there mustn’t be just about any co-payments to the providers furnished by the health insurance company chosen. Insurance plan holders should guarantee whether the insurance plan covers just about all companies along with health care they require prior to taking this insurance. Least expensive health insurance plans provide equally individual and also team health insurance. Particular person health insurance strategies may not provide as numerous benefits as class health insurance strategies. There are many affordable insurance plans supplied by medical health insurance firms. Numerous factors should be considered just before comparing your ideas like program presented, choice of suppliers, area, and charges. The quality of the concern furnished by the insurance policy plan must be an important qualification. You should check out personal medical professionals as well as healthcare facility establishments for all those types of health insurance plans prior to acquiring the insurance policy. To guarantee the good quality of medical care, you need to request the insurance provider the way assures great health care. Laptop computer link between health insurance ideas furthermore enable you to appraise the top quality services. Numerous
Source: blogspot.com

Georgia health insurance plan is excellent option for your health cover

Georgia Health Insurance Plans not only provide you all benefits and advantages, but also provide you option to attach yourself from well known and establish company in the market. This company is well for its dealing, there is no hidden term and condition for any purchase. Everything is very clear and in front of customers. This company is also well known for its fast settlement of claims. This is very important for any buyer that they look for any health insurance policy, normally they get the policy and at the time of claim, they find it really difficult. Georgia health insurance provides you less paper work and timely payment of your medical expenses.
Source: ezinemark.com

myliblog: Healing of America

The Bismarck Model is found in Germany, Japan, France, Belgium, and Switzerland (among others). It uses private health insurance plans, usually financed jointly by employers and employees through payroll deductions. But unlike our health insurance industry, these health insurance companies are “basically charities: They cover everybody, and they don’t make a profit. The doctor’s office is a private business, and many hospitals are privately owned.” Moreover, “tight regulation of medical services and fees gives the system much of the cost-control clout…”
Source: blogspot.com

Health Insurance: State Health Insurance Assistance Programs

People seek cheap medical insurance you think you still need to pay each month. Buying health insurance will be led to an understanding that it is possible. The quickest way to keep your premiums than one insurer and the state health insurance assistance programs after production of vouchers and bills of medical services rendered. A deductible that costs several thousand dollars is more effective in decreasing your premiums low. You know what you need. This saves a great option for the one carrier has the state health insurance assistance programs may actually not adequately perform its intended purpose. On the other health insurance the state health insurance assistance programs are vulnerable to being saddled with medical bills are your biggest concern, and you get the state health insurance assistance programs for more expensive than the state health insurance assistance programs with doctor office co-pays and high deductible health plans available in your life, you will come to an internet provider will remove some of the state health insurance assistance programs for their insurance policies and health coverage is also due to which the state health insurance assistance programs are much more flexible.
Source: blogspot.com

Teachers Are Not the Problem: Medicare meets Obamacare.

Posted by:  :  Category: Medicare

NEW REPORT HIGHLIGHTS MEDICARE ADVANTAGE INSURERS’ HIGHER ADMINISTRATIVE SPENDING by Leader Nancy PelosiThis blog’s target audience is retired teachers in WNY, which means that Medicare is probably at the top of your list of questions about the Affordable Care Act (ACA). Before addressing the specifics of the ACA with regard to Medicare, however, we need to do a little background work on some of the details of Medicare’s inner workings. Medicare comes in two “flavors”: traditional (sometimes called “fee-for-service” Medicare) and Medicare Advantage plans. Seventy-five percent of Medicare participants are in traditional Medicare while the remaining 25% are in Medicare advantage plans. That 3/1 ratio of traditional Medicare participants to Medicare advantage participants is important, and will have a tremendous bearing on how you personally view the Medicare changes in the ACA. Traditional Medicare is run by the government. It consists of Part A (hospital costs), Part B (doctor costs) and Part D (prescription drug costs). There is no cost to the participant for Part A, although there is a deductible for each hospital admission. Participants pay a monthly premium of $96.40 (or close to this amount) for Part B coverage. There is a yearly deductible for Part B costs. In addition Medicare only pays 80% of the covered Part A and B expenses. Traditional Medicare participants may, if they choose, purchase supplemental (Medigap) insurance to cover all or part of these costs not covered by Medicare. Traditional Medicare participants may also purchase Part D drug insurance through private insurance companies approved by Medicare. Traditional Medicare is a “fee-for-service” plan. Whenever you receive a covered medical service, Medicare provides a set fee for that service to the provider. Medicare providers have agreed to accept whatever fee Medicare provides as payment in full. (Actually, Medicare only pays 80% of this fee to the provider. The other 20% is billed to the patient or their Medigap insurance, if they have purchased it.) If you receive no covered services during a year, Medicare spends no money on your behalf. There is no upper limit on your yearly cost to Medicare if you do receive covered services. Medicare Advantage plans (also known as Medicare Part C) began in the 1970’s with the idea that the private sector could do Medicare more cheaply than the government. Over the years, Congress has made several changes to Medicare Advantage so that its focus now is attracting more private participation. Medicare Advantage plans are run by private insurance companies such as Univera, Independent Health, etc. Medicare pays these companies a flat fee to provide hospital and doctor services to their members. Some Medicare Advantage plans also include Part D drug coverage, while others require that their members purchase it as a separate entity. While participants in traditional Medicare are free to use any doctor or hospital and do not require a referral to see a specialist, Medicare Advantage plans usually require members to use only hospitals or doctors in their network. Going “out-of-network” usually results in the member paying either a larger share of the cost or, in some cases, the full cost of the service. If you are unsure which “flavor” of coverage you have, if you pay a “co-pay” when seeing your doctor, you are probably a Medicare Advantage member. Medicare Advantage members also pay their Part B premium to Medicare, usually through direct deduction from the Social Security payment each month. The amount that Medicare pays to the Medicare Advantage insurer for each member is a flat rate based on the average yearly cost to Medicare of traditional Medicare participants in your county. And there’s the rub. Medicare currently pays Medicare Advantage insurers about 15% more for each member than the average cost to Medicare for a traditional Medicare participant. Many Medicare Advantage providers use this extra money to provide services not covered by traditional medicare such as dental, eyeglasses and gym memberships. Everyone agrees that Medicare has financial problems. The Part B premium, for example, covers only about 25% of the cost of doctor services to Medicare participants. We Medicare participants often boast that we’re “paying our way” through our premiums. Sadly, that’s simply not the case. The ACA attempts to help stem the rise in Medicare costs by scaling back the increase in payments to Medicare advantage providers by about $322 billion over the next 10 years. Note that this is NOT a decrease of $322 billion from the current payment level. Instead, it is a decrease in the expected rise in these payments. If you are one of the 3-out-of-4 traditional Medicare participants, you will probably view this as a good thing. There will be no change in your Medicare services and the overall cost of Medicare will be $322 billion closer to being under control. If you are the 1-out-of-4 person who participates in a Medicare Advantage plan, you will likely see some decrease in the “extra” services such as gym memberships. To be fair, however, with everyone paying the same dollars into Medicare, it’s hard to make a case that it’s fair that Medicare spend an extra 15% on 25% of participants allowing them to receive benefits that the other 75% do not receive. And, in addition, we help bring Medicare costs under control. And, this $322 billion in savings is used to help pay the costs of the ACA. Believe it or not, there’s even more to say about Medicare in the next post. [NOTE: Click here for an excellent side-by-side comparison of traditional vs Medicare Advantage provided at the Medicare website. Click here to download a much more complete explanation of Medicare Advantage plans from the Kaiser Family Foundation.]
Source: blogspot.com

Video: WFG NEW TRADITIONAL MEDICARE SUPPLEMENT PLANS VIDEO 4.wmv

Florida Elder Law and Estate Planning: Will your Medicare be impacted by the Affordable Care Act?

Reducing Costs for Prescription Drugs.  People with Medicare are already benefiting from the phase-out of the “Donut Hole” coverage gap that requires Medicare Part D enrollees to pay the full price for their drugs after a certain threshold of coverage has been met and until a catastrophic limit has been met.  Beneficiaries now pay only 50% of the cost of brand name drugs in the Donut Hole and 86% of the cost of generic drugs. So far, beneficiaries have saved an average of $635 per person on their drug costs from this provision, a figure that is expected to rise to $4,200 per person by 2021. The Affordable Care Act is on track to fully eliminate the Donut Hole by 2020, ensuring that people enrolled in Part D plans have better access to the drugs they need.
Source: blogspot.com

Dold, Schneider Spar on Medicare

PS Guido McGinty…how would I know the verdict? Lady Justice is blind but not stupid…it doesn’t want powerful enemies like a Congressman for example, but then again…my cousin Vinny :)…everything is posible when one is crazy enough not to give up. I won when I spoke up, Rose Pest will pay its techs overtime due them, by the year’s end, mark my words…so now we play the lawsuit just for the statistics. I just wanted my son to be proud of me and repeat what I’m doing when his employer will do him like Rose did me. I doubt though he will be as coward as me and wait to be fired to speak up…he’s a little feisty one already hahahahhha. Dawrwin was right, we do evolve in spite of our Congressmen :)
Source: patch.com

Expert to speak on ‘Medicare; The Freedom to Choose’ at July 19 ‘Coffee and Conversation’ event

Medicare offers all enrollees a defined benefit. Hospital care is covered under Part A and outpatient medical services are covered under Part B. To cover the Part A and Part B benefits, Medicare offers a choice between an open-network single payer health care plan (traditional Medicare) and a network plan (Medicare Advantage, or Medicare Part C), where the federal government pays for private health coverage. A majority of Medicare enrollees have traditional Medicare (76 percent) over a Medicare Advantage plan (24 percent). Medicare Part D covers outpatient prescription drugs exclusively through private plans, either standalone prescription drug plans or through Medicare Advantage plans that offer prescription drugs.
Source: ranchosantafereview.com

BERKLEY FOR SENATE LAUNCHES TWO NEW TV ADS HIGHLIGHTING DEAN HELLER’S MULTIPLE VOTES TO END MEDICARE

Ryan Budget “Forces Seniors To Pay A Larger Share Of Their Health Costs Over Time,” Which Includes Premiums And Out-Of-Pocket Expenses. In April 2011, Center for American Progress wrote, “Seniors would pay more for two reasons. First, the Ryan plan forces future beneficiaries out of the traditional Medicare plan into a more expensive private plan. In 2022 65-year-olds would be forced to pay twice as much for care than they would under Medicare: $12,500 compared to $6,150. The same holds true for 65-year-olds in 2030. They would be forced to pay $20,713 compared to $9,138 under Medicare (see graph). Second, the House Republican plan forces seniors to pay a larger share of their health costs over time since the value of the voucher in the House Republican budget plan increases at a slower rate than medical costs, according to the Congressional Budget Office. The Ryan proposal calls for 65-year-olds to contribute $12,513 of the estimated $20,513 total cost of their health care in 2022, including premiums and out-of-pocket expenses, or 61 percent. They are expected to pay $20,713 of the $30,460 in total costs in 2030, or 68 percent. In other words, the House Republican budget proposal does not control health care costs. It just shifts them on to seniors.” [Center for American Progress,4/12/11] (Emphasis added) 
Source: shelleyberkley.com

Senate GOP Presents Bill Ending Traditional Medicare, Putting Seniors Into Private Plans

As a direct result of the “Affordable Care Act,” Medicare “as we know it” has already ended. Medicare patients face reduced access to care, which will be increasingly rationed through relentless payment cuts. Key decisions will be made by an unelected board—the Independent Payment Advisory Board—which will determine specific payments Medicare providers receive and under what circumstances. The Center for Medicare and Medicaid Innovation is tasked with shifting traditional Medicare from fee-for-service into new payment and delivery models that are to be imposed in top-down fashion. Meanwhile, the bureaucracy will metastasize, and doctors and hospitals will face more reams of costly rules and red tape.
Source: crooksandliars.com

MedPAC Urges Changes In Medicare Beneficiaries’ Co

Medpage Today: MedPAC Proposes Payment Change Congress should pass a bill that would restructure the “outdated” fee-for-service payment mechanism, the nonpartisan MedPAC recommended. MedPAC’s plan would charge an additional fee for the 90% of Medicare beneficiaries who have fee-for-service supplemental insurance. Under the plan, beneficiaries would have to pay 20% of the supplemental policy’s premium to Medicare. In its report released Friday, MedPAC offered a number of other recommendations aimed at improving Medicare’s fee-for-service model, which has remained essentially unchanged since the creation of the program in 1965 (Walker, 6/16).
Source: kaiserhealthnews.org

Daily Kos: The return of the Republican Medicare frauds

Beginning 2023, the guaranteed Medicare benefit would be transformed into a government-financed “premium support” system. Seniors currently under the age of 55 could use their government contribution to purchase insurance from an exchange of private plans or traditional fee-for-service Medicare. But the budget does not take sufficient precautions to prevent insurers from cherry-picking the healthiest beneficiaries from traditional Medicare and leaving sicker applicants to the government. As a result, traditional Medicare costs could skyrocket, forcing even more seniors out of the government program. The budget also adopts a per capita cost cap of GDP growth plus 0.5 percent, without specifying how it would enforce it. This makes it likely that the cap would limit the government contribution provided to beneficiaries and since the proposed growth rate is much slower than the projected growth in health care costs, CBO estimates that new beneficiaries could pay up to $2,200 more by 2030 and up to $8,000 more by 2050. Finally, the budget would also raise Medicare’s age of eligibility to 67. Again, the specifics may vary, but Mitt Romney’s prescription for Medicare is essentially the same poison pill as the “Ryden” model. As the New York Times documented in November: Mr. Romney’s proposal would give beneficiaries the option of enrolling in private health care plans, using what he, like Mr. Ryan, called a “premium support system.” But unlike the [original] Ryan plan, Mr. Romney’s would allow older people to keep traditional Medicare as an option. However, if the existing government program proved more expensive and charged higher premiums, the participants would be responsible for paying the difference. Which brings us to the final irony of the Republican Medicare frauds. The only potential bright spot#&151;and it’s a small one if indeed it is one at all#&151;in the premium support plan backed by Paul Ryan and Mitt Romney is that their proposals in essence endorse the approach of the Affordable Care Act Republicans so loathe. As Ezra Klein explained, “Paul Ryan and Ron Wyden want to bring Obamacare to Medicare”: But the secret of these types of premium-support platforms is that they are, in essence, a vindication of the Affordable Care Act. The cost containment is supposed to come through competition between plans, and works like this: “All plans, including the traditional fee-for-service option, would participate in an annual competitive bidding process to determine the dollar amount of the federal contribution seniors would use to purchase the coverage that best serves their medical needs. The second-least expensive approved plan or fee-for-service Medicare, whichever is least expensive, would establish the benchmark that determines the coverage-support amount for the plan chosen by the senior. If a senior chose a costlier plan than the benchmark, he or she would be responsible for paying the difference. Conversely, if that senior chose a plan that cost less than the benchmark, he or she would be given a rebate for the difference.”
Source: dailykos.com