Three Midnight Rule For Medicare SNF Explained: How To Get CMS To Pay for a Nursing Home Stay.

Posted by:  :  Category: Medicare

In honor of Tax Day by swanksalotMedicare will pay a portion of these SNF costs (the rest of which are picked up by patients’ supplemental policies) for a up to 100 days for every benefit period.   Once these days are used up,  the patient will be financially responsible for any other skilled nursing benefits until the next benefit period begins.  How does Medicare define a benefit period?   A benefit period ends when you have not been in a hospital or in a  SNF for 60 consecutive days.  Once a new benefit period begins you will need another three midnight stay to qualify for additional SNF days (up to 100 days every benefit period).  If Medicare won’t pay for additional days, neither will the supplemental policy as these policies will usually only cover the portion of approved days that Medicare doesn’t cover. Most patients who use up 100 days of SNF benefits would never go another 60 days in a row without being admitted to the hospital.  They use up their 100 days for a reason. They cannot avoid living at home without avoiding frequent hospital level care.  Clinically, what I see is that most patients who have used up their 100 days in a benefit period will are palliative care candidates or require long term care in a nursing home.
Source: blogspot.com

Video: Medicare Insurance – Basics Explained

GLOOM AND DOOM REPORT: PAUL RYAN MEDICARE EXPLAINED IN SIMPLE TERMS

ITS ALL ABOUT …. COUPONS…!! YOU KNOW WHAT A COUPON IS DON’T YOU…GRANNY…? LIKE FOR PANCAKE MIX AT THE SUPERMARKET… ONLY NOW ITS FOR YOUR DOCTOR AND HOSPITAL BILLS… Look… This is all just a way to get to single payer…which everyone else has had for decades… Single Payer works well enough for 98% of the population…save for a few cranks…who want to complain…but can’t really afford to pay for their own medical care… Yes, its a little less profitable for Insurance companies…and medical providers…but not that much… But it gives the system sustainability …which it does not have now… And perhaps…if SOME 90 year old with TERMINAL cancer…DOESN’T GET A HEART TRANSPLANT…? IE “DEATH PANELS…! WELL…LET THEM PAY FOR ONE IN INDIA…IF THEY CAN AFFORD IT… Postscript: OK…maybe its all a liberal plot to kill Trigg…! But I doubt it…!!
Source: blogspot.com

The Law Office of Marc June: Paybacks are a Pain: Health Insurance, Workers’ Compensation, Medicaid, Medicare

   The most important priority for accident victims is necessary medical treatment.   Whether  paid by Health Insurance, Workers’ Compensation, Medicaid, Medicare, each payor is protected by “subrogation” or “lien” rights.    This can best be explained as all medical expenses must be repaid out of any recovery.  This is rationalized under the principles of “one cannot recover the same damages twice” and “this is how these programs minimize their costs.”  Every dollar paid back is one less dollar for the client.    Depending on the specific facts of each case, a lawyer may be able to negotiate reductions in these paybacks, sometimes entirely.  You have to play your hand smartly.  See www.junelawyer.com
Source: blogspot.com

The Medicare Hospice Benefit Explained

Congress established the Medicare Hospice Benefit in 1983 to ensure that all Medicare beneficiaries could access high-quality end-of-life care. Today, more than 65 percent of hospice patients are Medicare beneficiaries. The Medicare Hospice Benefit offers dying Americans the option to experience death free of pain, with emotional and spiritual support for both themselves and their families.
Source: hrrv.org

Happy Anniversary, Medicare!

Visit earnedsasay.com to see the pros and cons of some of the options to change being debated in Washington, DC, explained in simple terms by bipartisan experts. Be assured, AARP is committed to preserving and strengthening this essential program for generations to come.
Source: aarp.org

Affordable Care Act Has Saved $3.9 Billion on Prescription Drugs for Those on Medicare, CMS Announces | HelpingYouCare™

As a result of the Affordable Care Act, over 5.2 million seniors and people with disabilities have saved over $3.9 billion on prescription drugs since the law was enacted.  The Centers for Medicare & Medicaid Services (CMS) also released data today showing that in the first half of 2012, over 1 million people with Medicare saved a total of $687 million on prescription drugs in “donut hole” coverage gap for an average of $629 in savings this year.
Source: helpingyoucare.com

Medicare Supplements Explained

This year’s Halloween is coming rapidly and also people have certainly you covered with our exceptional halloween fashions! Everyone makes sure to be delighted to invest the holiday breaks. Some may need have vacation. Others will merely invest some high quality time with their families members. As well as maybe, most are going to be enrolling Halloween functions. Right now, that sounds really entertainment. Get up presently and also register the commemoration! No outfit to excite however? Look at these awesome, exceptional fashions and also make this Halloween a memory you are going to never forget– also in your grave!
Source: scoop.it

Oregon Hospitals show marked improvement in hospital quality and safety

Posted by:  :  Category: Medicare

OBAMAS DEATH PANEL------ GUESS WHAT FOLKS IT'S ALIVE AND WELL---"CRAZY PALIN" NOT SO CRAZY NOW by SS&SS“Oregon hospitals work daily to provide the best care possible for the patients they serve, particularly in reducing readmissions, improving language services, and addressing patient flow through the emergency department,” said Diane Waldo, OAHHS director of quality and clinical services. “Hospital commitment to quality processes and outcomes is evident in the results from the Robert Wood Johnson Foundation’s Aligning Forces for Quality program. Hospitals continue to demonstrate that consistent care processes indeed result in improved clinical outcomes.”
Source: hospitals4health.org

Video: Trillium Medicare Advantage – Oregon Medicare Plans

07.31.12 Your Morning Buzz

Amber Browne Anthony Petchel Assistant City Manager Bank of the Cascades Bryan Cosgrove Calendar Chelsea Cossey Chris Workman City Manager City of Beaverton City of Gresham City of Hillsboro City of Portland City of Tigard Clackamas County Claire Oliver ELGL Geoff Pursinger GFOA Helpful Information ICMA Job Posting Knope of the Week Lane County Local Government Marty Wine Metro Michael Brown Mike Golub Multnomah County Networking News Article OMFOA Oregon Cities Patrick Quinton Patti Peters PDC Phil Keisling Portland Timbers Rob Cornilles Tigard Times TriMet Umpqua Bank WA West Linn Tidings
Source: elgl.org

For the sickest patients, Medicare tests home

A home-based primary care program started by the Department Veterans Affairs health system appears to have saved signficant money. The VA says the program lowered the average annual cost of care for a patient with multiple chronic conditions from $38,168 to $29,036. Timely and well-coordinated primary care had the greatest effect on hospital spending, which fell from $18,868 to $7,026 per patient per year, a reduction of 63 percent. The VA has boosted enrollment to more than 24,000 people. 
Source: oregonlive.com

CCO Oregon: Oregon’s Federal Agreement on Health System Transformation Finalized

Kathleen Sebelius, Secretary of the Department of Health & Human Services, said, “These efforts to coordinate care, which mirror our efforts at the national level thanks to the Affordable Care Act, will mean better care for those on Medicaid, better health outcomes, and lower costs. This is another example of how we are collaborating successfully with States in their efforts to find innovative healthcare solutions that work for their communities.” Under the agreement, Coordinated Care Organizations responsible for providing care to Oregon Health Plan members will have more flexibility to pay for services that improve health and lower costs, but that are not traditionally covered by Medicaid. Examples include preventive services to reduce unnecessary hospitalizations and acute care, more primary care, and greater emphasis on local community health workers who can help Oregon Health Plan members manage chronic illnesses. 
Source: blogspot.com

Medicare Advantage 2012 Data Spotlight: Enrollment Market Update

Posted by:  :  Category: Medicare

This data spotlight examines the growth in private Medicare Advantage plan enrollment in 2012, with a record 13 million Medicare beneficiaries enrolled as of March, representing 27 percent of all Medicare beneficiaries.  Enrollment jumped by more than 1 million enrollees from the previous year and increased in every state except Alaska and New Hampshire.
Source: kff.org

Video: Jed Weissberg, MD, Talks About Medicare Advantage Health Plans and the Special Enrollment Period

Jed Weissberg, MD, Talks About Medicare Advantage Health Plans and the Special Enrollment Period

Kaiser Health Plans . For the first time, the US Centers for Medicare & Medicaid Services will allow Medicare beneficiaries to enroll in a 5-star Medicare Advantage plan one time before the next annual enrollment period. This Special Enrollment Period, which began in December, lasts through Nov. 30. In the video below, Jed Weissberg, MD, chief medical officer, Kaiser Permanente Medicare, explains what the 5-star rating system is about and how seniors can benefit from the Special Enrollment Period. Last fall, CMS announced its 2012 Medicare Star Quality Ratings for the nation’s Medicare plans. Plans are rated on a scale of one to five stars, with five being the highest, based on more than 50 care and service quality measures. Of the 440 Medicare plans rated nationally, only nine plans received a 5-star rating reflecting excellent performance. Four of those plans are Kaiser Permanente Medicare Advantage plans operating in Kaiser Permanente regions in Northern and Southern California, the Northwest, Colorado, and Hawaii. For more, go to kp.org/medicare.
Source: blogspot.com

Medicare Advantage Enrollment Climbs, Premiums Fall

For brokers who want to engage Medicare, Word & Brown will help train them on how to sell these products and will help them establish relationships with carriers.  Brokers can also add Joppel – a CMS approved quoting engine to their own website. Gregg Ratkovic of Joppel said, “Every day 10,000 people are aging into Medicare and that trend is expected to continue for the next two decades. There are close to 50 million individuals enrolled in Medicare or Medicare Advantage plans with an increasing number of employers transitioning their retired workers into Medicare Advantage plans rather than keeping them in company-managed pension programs. Similarly, the individual and family plan market is a growth opportunity as employer groups reduce benefits, unemployment remains high, and group and government markets shrink. The implementation of health insurance exchanges and a growing desire among consumers for portable healthcare as frequent job changes become more common all point to opportunity as Americans look for quality coverage with flexibility and choice. With the recent Supreme Court decision to uphold the individual mandate proposed in the Patient Protection and Affordable Care Act signed into law in 2010, many employers may consider offering their employees lump sums so they can purchase Individual plans rather than maintain group coverage as early as January 2014.” For more information, visit www.wordandbrown.com. Source: calbrokermag.com
Source: medicaresupplementalco.com

CMS Announces Medicare Advantage Demonstration Project; Also Issues New Proposed Rules to Medicare Advantage Plans

The Centers for Medicare and Medicaid Services announces a three-year demonstration project with financial incentives to improve quality. The project, which begins in 2012, will award Medicare Advantage plans earning the highest performance rating “the largest bonuses equal to 5 percent. Additionally, all Medicare Advantage plans that have a score of three stars and higher will qualify for a bonus payment in 2012.” CMS also issued proposed changes to the Medicare Advantage and the Medicare Prescription Benefit programs (Medicare Part C and D) that codify “clarifications to CMS authority to negotiate plan bids, [expand] restrictions on charging higher cost-sharing than traditional Medicare for certain services, and [limit] long-term care pharmacy waste by specifying efficient dispensing practices.” One of the pharmacy proposals includes a plan to require Part D sponsors to return unused medications for credit and reuse.
Source: kff.org

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

Choosing a Medicare Advantage Insurance Plan: ‘Medicare HMOs,’ Other Plans May Offer Bonuses, Lower Costs

For many Medicare beneficiaries, there are definite benefits to joining Medicare HMOs and other Medicare Advantage plans. Insurers may offer free drug coverage, low deductibles and co-payments for doctor visits, and even additional perks such as eyeglasses and health club memberships, all for little or no more money than the traditional Medicare Part B premium. More plans offered reduced deductibles and co-payments in 2009 than any other benefit, according to the Medicare program.
Source: suite101.com

Social Security Disability & Medicare Eligibility

Posted by:  :  Category: Medicare

If you have health insurance coverage already, you need to figure out how Medicare works with your health insurance. Many health insurance policies state that Medicare is to provide the primary coverage. Thus, your present health insurance may pay only for what Medicare does not cover. You need to check with your health insurance company when you get your Medicare card.
Source: disabilitydenials.com

Video: Continued Medicare Eligibility and Work Incentives

Daily Kos: Celebrating 47 Years of Medicare!

Seniors across the state gathered last week and this week to celebrate 47 years of Medicare.  We built our Medicare system because it is by far the best way to provide America’s seniors and people with disabilities with affordable health care they can count on. For nearly half a century, Medicare has given seniors and people with disabilities access to critical health care. It protects beneficiaries and their families against health-related expenditures that might otherwise overwhelm their finances—or worse, force them to forego medical treatment needed to survive.
Source: dailykos.com

Statement from HHS Secretary Kathleen Sebelius on the 47th anniversary of Medicare and Medicaid

For our elderly, the pledge reflects the acknowledgement that after contributing a lifetime to our nation’s well-being, our seniors deserve to be able to live out their years with the security and peace of mind that comes with having affordable health insurance under Medicare. For low income children, parents and people with disabilities, Medicaid created a federal-state partnership to provide a secure health care safety net to promote stronger families and communities across our country.
Source: iht2blog.com

Homelessness Resource Center

Conclusions: Greateruse of primary care and specialty care visits by disability-eligibleveterans is most likely related to greater health needs not captured bythe patient characteristics we employed and eligibility for VA care atno cost. Outpatient care patterns of disability-eligible veterans mayforeshadow care patterns of veterans returning from Afghanistan and Iraqwars, who are entering the system in growing numbers. This studyprovides an important baseline for future research assessingutilizations among returning veterans who use both VA and Medicaresystems. Establishing effective care coordination protocols between VAand Medicare providers can help ensure efficient use of taxpayerresources and high quality care for disabled veterans. (Authors)
Source: samhsa.gov

Time to save Medicare from extinction

We get so busy with our lives, so distracted by entertainments and so lazy from denial, that the things we take for granted are up for grabs. We forget that there are misguided people who by word or deed will take away our fundamental rights, rights that were won in decades of struggle. I am a senior, and twice a week I eat dinner with seniors. I see that eventually we all become seniors or disabled. This is the time of the year that we should thank President Lyndon Johnson and his staff and Congress, who enacted Medicare on July 30, 1965, and implemented it in 1966. If seniors, the disabled and their families stand up and fight for Medicare as we know it, we shall have it for many years more.
Source: pnhpcalifornia.org

DownWithTyranny!: Can you imagine Medicare being enacted by a zombified Congress that takes a worthless doodysack like Paul Ryan seriously?

by Ken We’ll come back to the egregious Representative Ryan. First let’s pause to ponder the lead story today from history.com’s “This Day in History,” which my friend Paul kindly passed on: Jul 30, 1965: Johnson signs Medicare into law.On this day in 1965, President Lyndon B. Johnson signs Medicare, a health insurance program for elderly Americans, into law. At the bill-signing ceremony, which took place at the Truman Library in Independence, Missouri, former President Harry S. Truman was enrolled as Medicare’s first beneficiary and received the first Medicare card. Johnson wanted to recognize Truman, who, in 1945, had become the first president to propose national health insurance, an initiative that was opposed at the time by Congress. The Medicare program, providing hospital and medical insurance for Americans age 65 or older, was signed into law as an amendment to the Social Security Act of 1935. Some 19 million people enrolled in Medicare when it went into effect in 1966. In 1972, eligibility for the program was extended to Americans under 65 with certain disabilities and people of all ages with permanent kidney disease requiring dialysis or transplant. In December 2003, President George W. Bush signed into law the Medicare Modernization Act (MMA), which added outpatient prescription drug benefits to Medicare. Medicare is funded entirely by the federal government and paid for in part through payroll taxes. Medicare is currently a source of controversy due to the enormous strain it puts on the federal budget. Throughout its history, the program also has been plagued by fraud–committed by patients, doctors and hospitals–that has cost taxpayers billions of dollars. Medicaid, a state and federally funded program that offers health coverage to certain low-income people, was also signed into law by President Johnson on July 30, 1965, as an amendment to the Social Security Act. In 1977, the Health Care Financing Administration (HCFA) was created to administer Medicare and work with state governments to administer Medicaid. HCFA, which was later renamed the Centers for Medicare & Medicaid Services (CMS), is part of the Department of Health and Human Services and is headquartered in Baltimore. As it happens, today is also the day that The New Yorker unleashes on the world an embarrassingly toadying paean to the increasingly egregious Paul Ryan by the increasingly alarming Ryan Lizza. With one or two fleeting exceptions, of which I doubt that Lizza himself grasps the significance, the piece reads as if it came straight out of Frankenryan’s PR shop. It’s pretty much PRyan’s own view of himself and the world he lives in, faithfully transcribed by RyanL as if it were true. The coincidence of the Medicare anniversary is oddly ironic, because as we all recall from the 2010 election season, Medicare is a program that all the Teabagging cretins managed to forget as they blithered their imbecilic diatribes against government. And the egregious PRyan is one of the more immediate threats in the land to the future of Medicare as well as Social Security. Early on in RyanL’s puff piece, there’s a surely unintended glimpse of his status as a made-to-order mark for a self-importantly earnestly geeky self-promoter like PRyan:Unlike most members of Congress these days, Ryan is relatively accessible to reporters. “The key to understanding me is really simple,” he said. “I am not trying to be anybody other than who I actually am.” Even his ideological foes comment on his friendliness and good nature. After his sophomore year in high school, back in 1986, he worked the grill at McDonald’s. “The manager didn’t think I had the social skills to work the counter,” he said. “And now I’m in Congress!” RyanL appears so enthralled by his access to PRyan that he appears to completely miss the chill of that declaration, “And now I’m in Congress!,” coming from a man who historically lacks the social skills to work the counter at McDonald’s. We do learn some interesting things about PRyan, like the big-fish-in-a-small-pond world of entitlement he was born into:Janesville, Wisconsin, where Ryan was born and still lives, is a riverfront city of sixty-four thousand people in the southeast corner of the state, between Madison and Chicago. Three families, the Ryans, the Fitzgeralds, and the Cullens, sometimes called the Irish Mafia, helped develop the town, especially in the postwar era. The Ryans were major road builders, and today Ryan, Inc., started in 1884 by Paul’s great-grandfather, is a national construction firm. The historic Courthouse section of Janesville is still thick with members of the Ryan clan. At last count, there were eight other Ryan households within a six-block radius of his house, a large Georgian Revival with six bedrooms and eight bathrooms that is on the National Register of Historic Places. PRyan makes an enormous effort, and it’s completely successful with Ryan L, to portray himself as an aw-shucks ordinary feller, a true man of the people. The reality, it appears, is that he has always had an inborn sense of entitlement — the unearned sense of self of a born princeling. We learn too that, at age 16, PRyan suffered a trauma from which it seems likely he’s never recovered:[T]he summer of 1986 brought a life-changing event. One night in August, he came home from work well past midnight, and he slept late the following morning. His mother was in Colorado visiting his sister, and his brother, who had a summer job with the Janesville parks department, had left early. Paul answered a frantic phone call from his father’s secretary. “Your dad’s got clients in here,” she said. “Where is he?” Paul walked into his parents’ bedroom and thought his father was sleeping. “I went to wake him up,” he told me, “and he was dead.” “It was just a big punch in the gut,” Ryan said. “I concluded I’ve got to either sink or swim in life.” His mother went back to school, in Madison, and studied interior design; his grandmother, who suffered from Alzheimer’s, moved into their home, and Ryan helped care for her. “I grew up really fast,” he said. One can feel sincerely sorry for little PRyan — though “a big punch in the gut” does seem a curious way of describing it, especially at this remove in time. It suggests that even grown-up PRyan thinks his father’s death was all about him. And despite his description of his supposed accelerated growing up, and with all possible allowance for the great stress of those years, it seems more likely that the upshot was that the little brat never did grow up. If you understand him as being emotionally frozen in time at the age of 16, at which point he was apparently a profoundly maladroit social misfit, lacking the social skills for McDonald’s counter work, then I think you’ve got the profile of the adult PRyan. It’s a shame no one put him together with the kind of mental help he clearly needed at the time, but that’s water under the bridge now.
Source: blogspot.com

Social Security Disability Benefits and Workers’ Compensation Settlements

We are often asked how Social Security Disability benefits are impacted by a workers’ compensation settlement. Many of our clients are concerned that they will lose their right to their social security disability benefits. In fact, an experienced attorney may actually be able to increase your Social Security Disability benefits if you settle your workers’ compensation case. A skilled attorney would use what we call “Spread Language” to have your workers’ compensation settlement prorated over the remainder of your life expectancy. You would still receive your settlement money all at once, but for Social Security purposes the settlement would be considered as payment over the rest of your life. This is perfectly legal, however, the attorney handling your matters must understand how to properly word the workers’ compensation settlement document.
Source: jdsupra.com

Medicare coverage gap associated with reductions in antidepressant use in study

Posted by:  :  Category: Medicare

SCOTUS Obamacare Decision Makes Individual Mandate A Fact & Universal Healthcare Coverage A Fiction by watchingfrogsboilAccording 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

Video: Avoid the Donut Hole Coverage Gap in Medicare

Affordable Care Act: Effects on Your Coverage Right Now

Coverage for Young Adults up to Age 26 Often teenagers will attend school and stay covered on their parents’ health insurance coverage through the college years. However, if not attending school, these children would have had to leave their parents health coverage by age 19 in most cases.  The ACA extends the coverage under a parent’s group health insurance plan to age 26, regardless of whether they are attending school. They can also choose their parent’s group health coverage over any coverage offered by their own employer as long as that insurance isn’t grandfathered, which simply means that the coverage was in place prior to law and has not made any changes significant enough for the plan to longer be considered grandfathered.
Source: mondaysorchids.com

The Official Revitas Blog: Product Council: addressing Medicare Part D with Validata

Last week we held a virtual Product Council meeting that gathered 19 clients representing 10 pharmaceutical manufacturers to discuss Medicare Part D Coverage Gap transactions and Validata. The council gave input on proposed design changes, Medicare Part D challenges, and Validata requirements, such as security. One of the leading pharma manufacturers demonstrated how they tailored Validata to support Coverage Gap processing, initiating a discussion among the other manufacturers about their own specific requirements for Validata. Revitas Product Analyst Erica Bartlett then presented the overview of proposed design changes for Validata, highlighting support for the invoice and data files as well as the dispute process. Finally, a Q&A session allowed us to hear additional suggestions from manufacturers that we are investigating for possible inclusion in our solution roadmaps. The next Product Council meeting will be held on August 9th, via WebEx. This next session will seek input on our upcoming generics offering, which we expect to have available on the market by the end of the year. Also look for our Public Council meeting at the Revitas Industry Summit: Life Sciences in October. At that meeting, we’ll hear from as many representatives as possible to find the best ways of adapting Validata to the specific needs of individual manufacturers. This council will also include a review of all updates made to Validata between now and then in order to provide visibility into our progress. Leave a comment or message me directly if you’d like to know more about our Product Councils!
Source: revitasinc.com

Federal Reform Saved CT Medicare Recipients $48.3 Million In Prescription Drug Spending

Last year, Medicare recipients started to receive a 50 percent discount on brand-name drugs covered by the federal health plan and a 7 percent discount on generic drugs in the coverage gap. As a result, 39,589 Medicare recipients in the state received a total of $26 million in discounts, which is an average of $658. This year, Medicare coverage for generic drugs in the coverage gap rose to 14 percent.
Source: courant.com

Affordable Care Act Has Saved $3.9 Billion on Prescription Drugs for Those on Medicare, CMS Announces | HelpingYouCare™

As a result of the Affordable Care Act, over 5.2 million seniors and people with disabilities have saved over $3.9 billion on prescription drugs since the law was enacted.  The Centers for Medicare & Medicaid Services (CMS) also released data today showing that in the first half of 2012, over 1 million people with Medicare saved a total of $687 million on prescription drugs in “donut hole” coverage gap for an average of $629 in savings this year.
Source: helpingyoucare.com

Obamacare Saves Granny $4 Billion

The Centers for Medicare And Medicaid Services (CMS) released data showing that over 5.2 million seniors and people with disabilities have already saved nearly $4 billion on prescription drugs as a direct result of the Affordable Care Act. The CMS data also showed that over 1 million people with Medicare saved an average of $629 on prescriptions in the “donut hole” coverage gap since the beginning of the year. So far in 2012, Medicare coverage for generic drugs in the coverage gap has risen to 14 percent, saving Medicare beneficiaries a total of $687 million.
Source: bobcesca.com

Cigna Acquires Medicare Advantage Plans From Humana Covering 3,500 in Texas

Posted by:  :  Category: Medicare

The federal government required Humana to sell the Medicare Advantage plans as part of approval for buying Arcadian Management Services. Cigna will offer the new customers Medicare Advantage plans through its subsidiary HealthSpring, which the Bloomfield-based health insurer acquired in January for $3.8 billion.
Source: courant.com

Video: Cigna Plans to Sell 15 Million Shares to Fund Purchase

CIGNA fills in its Medicare portfolio with Great American acquisition

Longer-term, the Great American acquisition builds out CIGNA’s specified diseases and other special coverages business (albeit nascent with $35M in revenue in 2011). These will fit well with consumer directed and account-based products and could play a great role on a private exchange or other defined contribution model. David Cordani did say in the most recent quarterly analyst call: “We do see some employers beginning to explore how they might move to the next generation of incentive alignment, which is a bit more of a defined contribution model.” Expect more acquisitions or alliances to build out a full defined contribution approach for commercial accounts (beyond retirement).
Source: reconstrategy.com

Cigna to Acquire Arcadian and Humana Medicare Advantage Plans in Three Markets as Part of Previously Announced, Government

BLOOMFIELD, Conn., June 27, 2012 – Cigna (NYSE: CI) today announced that it has come to an agreement with Humana to purchase select Medicare Advantage plans in Texas and Arkansas. The plans in the three markets – Amarillo, Longview-Marshall and Texarkana – are part of a previously announced government-stipulated divestiture for Humana to complete its acquisition of Arcadian Health.
Source: prsync.com

Going Back to Medigap from Medicare Advantage

If your former Medigap policy isn’t available, you have the right to buy a Medigap Plan A, B, C, or F that is sold in your state by any insurance company. You can buy the Medigap policy at the best premium price available, with no review of your medical records even if you have health problems. You will have from 60 calendar days before your coverage ends until 63 calendar days after your coverage ends to apply for a new Medigap policy.
Source: medicaresupplementinsurances.com

Are You Looking For No cost Medicare Supplement Quotations?

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSlove quotes In search of Medicare supplemental insurance prices is simple provided that you are familiar with your requirements and price range. There’s no variance throughout insurance coverage when comparing 1 business to a different when Supplement Medicare Insurance is definitely consistent. Really the only variance can be in the expense of the insurance programs. Supplement Insurance coverage is definitely not at no cost. You’ll want to shell out your month to month high quality to get guaranteed. You can certainly find Medicare supplemental insurance prices on-line. love quotes Regarding Initial Medicare health insurance, your physician may ask for a high price but not what’s been pre-decided by the Us authorities. In such a situation, an individual has to repay the other total with this wallet. That isn’t the truth with Supplement Insurance cover. This specific insurance policies gives insurance coverage for all the out-of-pocket costs. Supplemental Insurance cover possesses its own down sides. That is this worth acquiring? Properly, in this unforeseen financial state, it is still your debatable issue. In order to possibly be in protected area, it is really advisable to safe a person’s health care costs with this particular insurance policies. Once you have decided to order that insurance policies, you may sooner or later begin admiring a person’s provider’s customer satisfaction and how this promises are generally paid out. Maybe you have minor complaints about the increase in prices. Nevertheless this problem can be easily managed considering that the market is booming. Once you have obtained good information about all these insurance coverages, you will notice for your self these programs are generally consistent for all the firms. So, it’s easy to find Medigap Rates affordable. You have to take into account that there is no sign up phase for Supplemental programs. You should buy all these insurance coverages each time of year. We might recommend someone to purchase these programs through wide open sign up phase. Make contact with your Medicare health insurance specialist to learn a little more about that time-period. Advantages programs as well as Part D pharmaceutical drug drug insurance coverage strategy have a very preset time-span in which the plan is going to be obtained. A lot of insurance agencies could possibly ask you to undergo your health care examine as a way to switch to some alternative strategy. It is then important to weigh up your choices before hand and choose the best accessible health and fitness strategy. love quotes You never know what could take place the next second. As a result, it is really advisable to be secure instead of possibly be my apologies in the coming future. You must make without doubt a person’s Medicare health insurance Plan is accessible after you would desire this. Something different you must remember is the price tag you happen to be finding cash for a person’s insurance policies.
Source: blogspot.com

Video: Medicare Supplement plan F High Deductible Explanation

Best places to Look for Medicare Supplement Rates?

Before a person find Medicare Supplement prices, the person must ensure actually witout a doubt signed up for Medicare Piece Your and Piece M. Folks, who will be going to switch by Medicare benefit prefer to unique Medicare, must make application for Medicare supplemental health insurance before the finish in the coverage. Plans Electronic, K, I and M are usually not marketed any further, although individuals will keep these if they are witout a doubt signed up for them. One human being may be insured within a Medicare supplemental health insurance insurance policy, thus in the instance of married couple the husband and wife ought to acquire independent insurance policy. A great insured person is essential to pay back different prices intended for Medicare Piece M and Medicare supplemental health insurance insurance policy. Medigap high grade goes to the non-public corporation you might be signed up together with. Ideal time for you to seek out Medicare Supplement Rates:
Source: quilertone.info

Anthem Medicare Supplement Rates Connecticut 2012 « Insurance News from Crowe & Associates

The Anthem Blue Cross Blue Shield Supplements for 2012 are attached to the posting. The rates are competitive with most carriers but are slightly higher than the AARP lines of Supplements. The Anthem High deductible F supplement is a very strong offering that should be considered by anyone with a Medicare Supplement in Connecticut. AARP does not currently offer a high deductible F in Connecticut. Look at other posts on our blog for additional information on the High Deductible F plan.
Source: croweandassociates.com

MEDICARE SUPPLEMENT RATE INCREASES

Summer brings us sunshine, heat and Medicare Supplement Rate Increases!  There are many options out there so you really should shop when facing a substantial rate increase.  Right now we have two different carriers who have come out to the market with new rate pools at about 20% less than everyone else. 
Source: medicaremazeadvisors.com

Medigap and Medicare Supplement Rate Information

Indian River County Pasco County Osceola County Brevard County Volusia County Seminole County Lake County Sumter County Hernando County Citrus County Marion County Levy County Alachua County Putnam County Flagler County St Johns County Clay County Bradford County Duval County Nassau County Baker County Union County Gilchrist County Dixie County Lafayette County Taylor County Hamilton County Suwanee County Columbia County Madison County Jefferson County Wakulla County Leon County Franklin County Liberty County Gadsden County Gulf County Calhoun County Jackson County Bay County Washington County Holmes County Walton County Okaloosa County Santa Rosa County Escambia County
Source: medicaremedigaprates.com

Senior Benefit Services, Inc.

Effective March 01, 2012, on New Business and April 1, 2012 on Inforced Business United of Omaha 2010 Modernized Medicare Supplement (policies effective on or after June 1, 2010) in New Jersey will be having a Rate Increase on Plans A, C, F, G, and M.
Source: srbenefit.com

seo jsr: Best places to Look for Medicare Supplement Rates?

Medicare supplemental health insurance insurance policies are offered by way of non-public insurance companies and therefore are designed load the holes overlooked by way of unique Medicare insurance policies. All these insurance policies help promote the price involving Medicare-covered providers for instance co-insurance, deductibles or even co-payments. Many of the subjected place by way of unique Medicare is additionally utilized care by way of Medicare supplemental health insurance insurance policies. People who are signed up for the unique Medicare and Medicare supplemental health
Source: blogspot.com

Important Information Regarding Medicare Claims and Payments for Part A Indiana and Michigan ProvidersHall Render

Posted by:  :  Category: Medicare

gutted bag by jason.odonnellNational Government Services, Inc. (NGS) recently announced important information regarding Medicare claims and payments for Part A Indiana and Michigan providers.  With the impending transition of these providers to Wisconsin Physician Services (WPS), NGS posted the following transition timeline:
Source: hallrender.com

Video: Medicare for All, says Pastor from Noble County, Indiana

HHS Says Indiana Cannot Refuse To Deny Planned Parenthood Medicaid Funding

“We are gratified by the federal government’s decision and thrilled that PPIN continues to be able to provide preventive health care to our patients.  Through its appeal, the State was continuing its attack on women’s rights and attempting to restrict access to basic, lifesaving services such as Pap tests, breast exams, STD testing and treatment, and birth control,” said Betty Cockrum, President and CEO of Planned Parenthood of Indiana via statement.
Source: rhrealitycheck.org

Understanding Medicare Indiana

Medicare assistance programs are also available in Indiana. These programs can cover for the health care costs of the seniors. One of these programs is the Medicaid which is a state funded program that aims to help residents who have low incomes in paying for their co-payments and out of pocket drug costs. The Indiana Association of Area Agencies on Aging or IAAAA is an agency which helps Medicare Indiana beneficiaries in choosing the plans which are best for them. They can also help the elderly of Indiana in searching for agencies that can help them in paying for their out of pocket costs.
Source: group-insurance.net

Health & Female Mysteries blog: Pearls Foundation for Women

“When considering end-of-life care options, it is important to consider hospice services at home, in nursing homes or in hospice facilities,” study author Dr. Kathleen Unroe, a scientist with the Indiana University Center for Aging Research, said in a university news release. “Our findings highlight that there is a significant difference between how white patients and nonwhite patients and their families utilize hospice services.”
Source: blogspot.com

Medicare’s Birthday: Open Letter to the President and Leadership from Health Professionals, Lawyers and Advocates for Medicare for All

Henry L. Abrons, MD, Berkeley, California; Pippa Abston, MD PhD, Huntsville, Alabama; Garrett Adams, MD, Louisville, Kentucky; Patch Adams, MD, Urbana, Illinois; Kris Alman, MD, Portland, Oregon; Paul Bigman, Business Representative, IATSE Local 15, AFL-CIO, Seattle, Washington; Mindy Blaski, MD, Seattle, Washington; Paul Blaski, Seattle, Washington; Philip Caper, MD, Brooklin, Maine; Claudia Chaufan, MD, San Francisco, California; Andy Coates, MD, Albany, NY,  Mardge Cohen, MD, Boston, Massachusetts; Mary L. De Luca, MD, Albuquerque, New Mexico; Margaret Flowers, MD, Baltimore, Maryland; Elizabeth Frost, MD, Minneapolis, Minnesota; John Geyman, MD, Seattle, Washington; Leslie Hartley Gise, MD, Kula, Hawaii; Irene Gomez, Seattle, Washington; James S. Goodman, MD, Albuquerque, New Mexico; Jeoffry Gordon, MD, San Diego, California; Paul Gorman, MD, Portland, Oregon; Nancy Greep, MD, Los Angeles, California; Oliver Hall, JD, Washington, DC; Hedda L. Haning, MD, Charleston, West Virginia; Bruce Hector, MD, North Hills, California; David Himmelstein, MD, New York, New York; Paul Hochfeld, MD, Corvallis, Oregon; Michael Huntington, MD, Corvallis, Oregon; Dana Iorio, ARNP; Seattle, Washington; Joseph Q. Jarvis, MD, Salt Lake City, Utah; Jeffrey Kaplan, MD, Baltimore, Maryland; Stephen B. Kemble, MD, Honolulu, Hawaii; Jim Kratzer MD, MPH, Fresno, California; David McLanahan, MD, Seattle, Washington; George Martin, MD, Seattle, Washington; Samuel Metz, MD, Portland, Oregon; Russell Mokhiber, JD, Berkeley Springs, West Virginia; Kathleen Myers, DDS, Seattle, Washington; Eric Naumburg, MD, Columbia, Maryland; Clark Newhall, MD JD, Salt Lake City, Utah; Carol Paris, MD, Leonardtown, Maryland; George L. Pauk, MD, Phoenix, Arizona; Glenn Pearson, MD, Fort Collins, CO, Edward Pontius MD, Topsham, Maine  Julie Keller Pease, MD, Brunswick, Maine; Ellen Punyon, Retired School Principal, Seattle, Washington; George Randt, MD, Cleveland,Ohio; Helen Redmond, LCSW, New York, New York; Katie Robbins, Mailman School of Public Health, MPH, Class of 2014, New York, New York; Cecile Rose, MD, MPH, Denver, Colorado; Rick Saling, CWA (for ID only), Seattle, Washington; Gordon Schiff, MD, Boston, Massachusetts; Ann Settgast, MD, Minneapolis, Minnesota; Elias Shaya, MD, Baltimore, Maryland; Diljeet Singh, MD, Chicago, Illinois; William Skeen, MD, Oakland, California; Paul Y. Song, MD, Santa Monica, California; Nancy Hewitt Spaeth, RN, Seattle, Washington James Squire, MD, Seattle, Washington; Karen Green Stone, Small Business Owner, Bloomington, Indiana; Rob Stone, MD, Bloomington, Indiana; Bruce Trigg, MD, Albuquerque, New Mexico; William Ulwelling, MD, Albuquerque, New Mexico; Robert Vinetz, MD, Los Angeles, California; John V. Walsh, MD, Cambridge, Massachusetts; Li-hsia Wang, MD, Berkeley, California; Daniel P. Wirt, MD, Houston, Texas; Steffie Woolhandler, MD, New York, New York; Kevin Zeese, JD, Baltimore, MD.
Source: medicalsociologyguide.com

Medicare Secondary Payer and “Future Medicals” A Movement Toward a Standardized Process?

Posted by:  :  Category: Medicare

DC Voting Rights by dbkingCMS states that its interests should be considered in every settlement where the claimant, “reasonably anticipates receiving, or should have reasonably anticipated receiving Medicare covered…services after the date of “settlement…”.  To accomplish this purpose, CMS proposes options  ranging from absolute exemptions on one end of the spectrum (i.e., CMS defined a set of circumstances in which no further action would be necessary / no “set aside” required) to alternatives on the other end of the spectrum that involve a) the beneficiary paying for all future injury-related care out of his/her settlement proceeds until they are exhausted or b) submitting a proposed Medicare Set Aside arrangement (similar to the current process in workers’ compensation).With regard to the latter options, it is important to note that CMS acknowledges that perhaps thresholds could be established (i.e., a dollar amount below which no action is necessary even if one of the other exemptions do not apply).
Source: dritoday.org

Video: Billing Medicare as Secondary Insurance

DISTRICT COURT FINDS THAT SELF

The crux of Medicare’s claim for reimbursement was a declaration submitted by its Health Insurance Specialist, asserting that the decedent was a Medicare beneficiary who received $10,757.44 for medical services. The declaration also stated that these payments were the responsibility of liability insurance, including self-insurance, as a primary plan under the Medicare Secondary Payer statute. The tortfeasor in the underlying medical malpractice case was self-insured.
Source: themedicarespa.com

Medicare Beneficiaries More Satisfied Than Privately Insured

Martha, Medicare is not free by any stretch of the imagination. Most people pay a premium for Part B and a few pay for Part A. Plus there are co-payments and such. In my area Mecicare Advantage plans are not free either with additional monthly premiums and cost sharing structure. I should hope the study controlled for situations in which the beneficiary has supplemental or secondary insurance in both groups. In the case of supplemental medi-gap policies again those have their own premiums and some forms of secondary insurance do as well. None of these scenarios translates to “free” as you put it. By all means correct me if I misread your comment.
Source: californiahealthline.org

How To Avoid Problems With Medicare?

While you are guaranteed to be able to come and go with Medicare, you have no such guarantees with Medigap?  Medicare is an insurance program that is run by the federal government.  Medigap is administered by private insurance companies.  There are only a few times when your approval for Medigap is guaranteed.  When you first turn 65, you have a 6 month window, beginning on the 1st of the month in which you turn 65, to get guaranteed approval of Medigap.  This is called your Initial Enrollment Period
Source: wordpress.com

New Online Medicare Secondary Payer Recovery Portal‏

The MSPRP gives users (attorneys, insurers, beneficiaries, and TPAs) the ability to access and update certain case specific information online. Activities that currently require written communication or telephone calls to the Medicare Secondary Payer Recovery Contractor will soon be able to be done through the portal.
Source: lienresolutiongroup.com

Medicare Secondary Payer Recovery Portal is Live

This Blog/Web Site is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog site you understand that there is no attorney client relationship between you and the Blog/Web Site publisher. The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.
Source: wordpress.com

Medicare Secondary Insurance

Medicare Secondary Insurance Reimbursement for Medicare Scooter. Medicare Secondary Insurance Choices And Guidelines. Go Here For Medicare Scooter Information. Medicare Secondary Insurance Will Enable You To Get Your Electric Power Wheelchair At No Out-Of-Pocket Cost To You. Checkout Info On Medicare Secondary Ins Here
Source: wordpress.com

Are You Looking For No cost Medicare Supplement Quotations?

Posted by:  :  Category: Medicare

love quotes In search of Medicare supplemental insurance prices is simple provided that you are familiar with your requirements and price range. There’s no variance throughout insurance coverage when comparing 1 business to a different when Supplement Medicare Insurance is definitely consistent. Really the only variance can be in the expense of the insurance programs. Supplement Insurance coverage is definitely not at no cost. You’ll want to shell out your month to month high quality to get guaranteed. You can certainly find Medicare supplemental insurance prices on-line. love quotes Regarding Initial Medicare health insurance, your physician may ask for a high price but not what’s been pre-decided by the Us authorities. In such a situation, an individual has to repay the other total with this wallet. That isn’t the truth with Supplement Insurance cover. This specific insurance policies gives insurance coverage for all the out-of-pocket costs. Supplemental Insurance cover possesses its own down sides. That is this worth acquiring? Properly, in this unforeseen financial state, it is still your debatable issue. In order to possibly be in protected area, it is really advisable to safe a person’s health care costs with this particular insurance policies. Once you have decided to order that insurance policies, you may sooner or later begin admiring a person’s provider’s customer satisfaction and how this promises are generally paid out. Maybe you have minor complaints about the increase in prices. Nevertheless this problem can be easily managed considering that the market is booming. Once you have obtained good information about all these insurance coverages, you will notice for your self these programs are generally consistent for all the firms. So, it’s easy to find Medigap Rates affordable. You have to take into account that there is no sign up phase for Supplemental programs. You should buy all these insurance coverages each time of year. We might recommend someone to purchase these programs through wide open sign up phase. Make contact with your Medicare health insurance specialist to learn a little more about that time-period. Advantages programs as well as Part D pharmaceutical drug drug insurance coverage strategy have a very preset time-span in which the plan is going to be obtained. A lot of insurance agencies could possibly ask you to undergo your health care examine as a way to switch to some alternative strategy. It is then important to weigh up your choices before hand and choose the best accessible health and fitness strategy. love quotes You never know what could take place the next second. As a result, it is really advisable to be secure instead of possibly be my apologies in the coming future. You must make without doubt a person’s Medicare health insurance Plan is accessible after you would desire this. Something different you must remember is the price tag you happen to be finding cash for a person’s insurance policies.
Source: blogspot.com

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

Covering the Gaps: Medicare Supplement Insurance

Medicare insurance provides insurance and coverage for a large number of people across the country. It is actually one of the most popular types of insurance coverage. But, like all insurance plans, there are things that do not get covered. To cover everything that a person needs to stay healthy would be a huge expense to the insurance company, and for liability reasons, they only offer certain plans, none of which cover every possible scenario. Most plans cover the basics, and others go a little more in depth when it comes to coverage, but there is no plan that covers everything. That is why Medicare has what are known as supplement insurance policies, commonly known as Medigap plans.
Source: 3steps.com

Find Medicare Supplemental Insurance in Your Area With the Senior Advisor Group

The Senior Advisor Group is an independent insurance advisory group specializing in Medicare insurance and other insurance options for those on Medicare. Their role is to assists seniors in finding with the best Medicare Supplemental Insurance, including advice on Supplemental Plans, Advantage Plans, Medicare Part D insurance and other related supplemental insurance. By partnering with over 40 different insurance companies, the Senior Advisor Group works on the side of the client’s with no obligation to any one insurance company. For the individual client they will search from all of the top insurers to find the best products at the best price – as well as provide ongoing professional, personalized service to each Medicare beneficiary year after year. The Senior Advisors also provides clients on Medicare with dental, hearing, and vision coverage, as well as Rx discount cards at no cost to customers. As a national advisory group, Senior Advisor Group represents all of the top rated and the largest Medicare supplemental insurance providers available. Their objective is to provide unbiased advice on Medicare Supplemental Insurance from highly trained, Medicare insurance specialists. Each specialist is trained on the various Medicare Insurance options, and will assist each individual with a plan selection, and provide continual advice year after year on Medicare supplement plans and Medicare Part D coverage. As Medicare insurance specialist, Medicare Insurance is not just a part of their business it is their business. The Senior Advisor Group was established to deliver what insurance companies can’t – unbiased and objective advice. They will assist and complete enrollment in the best available plan for the client, not the best available plan for the provider. For those new to Medicare or just looking to compare coverage options simply submit a request and one of their specialist will call within 24 hours.
Source: sbwire.com

Comparing Medical Insurance Quotes

When it comes to your well-being it is best to plan for the future as much as practicable. Although you could be in good shape right now, you never can tell what will happen in the future. Healthcare insurance is a way to help pay for hospital expenses, from preventative care to emergency room benefits. Medicare is one of the most popular programs, run by the US government for subjects over the age of Sixty five. Though the most basic kind of Medicare covers general outpatient and inpatient services, there may be other areas this does not cover.
Source: cuplessjoe.com

United American Medicare Supplement Insurance Quotes

Fortunately, United American is one of those companies.  At present, they offer some of the lowest priced High Deductible F Plans across the state.  That is great for seniors who want a low priced Medicare insurance plan with a reasonable deductible.  (As of 2012, the HD Plan F deductible is $2,070 yearly.)
Source: ohioinsureplan.com

Health net Health Net Medicare Supplement numbers Medicare Buz

A choices federal government bodies condition this will require some concerted, coordinated campaign by means of legislators, legislation enforcers, neighborhood neighborhood remedy tips additionally non-public insurance policy firms and in addition employers In order to deal with Some persons In addition financial costs with substance abuse along with craving. some kind of Oklahoma separated Along with mental health insurance and components mistreatment agencies, with a seed starting full major gross annual price range along with 290 Million, statements It could need another 144 Mil for each year every single child aid a good enough a reaction to some problems This kind of confronts. specialists convey insurance policy providers ought accept company accounts ponying up much more point in time maintains inside inpatient remedy programs, an activity that could assist conserve them all resources Ultimately via helping the value along with favorable final final final results. Lawmakers are really contemplating adjusts which might improve oversight with the circulation with prescription medicines plus the diversion In addition to over-the-counter decongestants to be able to manufacture meth. source Corp. closed circuit
Source: co.cc

Compare Medicare Supplemental Insurance Plans and View Rates Online

Anyone that has individuals and their family that are on Medicaid, know exactly how much of a hassle it can be to try to live with just Medicaid. This is why many people look for supplemental insurance to their Medicaid, in order to pay for the expenses that they have on a day-to-day basis. There are many things that need to be taken into account when you are analyzing these companies, including what they are going to be able to provide. Senior Health Direct is able to provide excellent supplemental insurance health plans to seniors that are looking for a little something on top of the government services that are provided to them. They strive to help every senior with low cost health insurance, that can make their lives much easier than just relying on the Medicaid that they currently have.
Source: freeprnow.com