N.J.’s Community Health Centers Strengthen the Health Care Safety Net

Posted by:  :  Category: Medicare

New Jersey’s community health centers are treasured assets in their communities. That is why Gov. Christie provided a record $50 million in the current state budget to reimburse health centers for the medical care they provide to the uninsured. Since the governor took office he has increased funding to health centers by $10 million. In addition, the state Department of Health provides nearly $9 million in grants to health centers for an array of health services including immunizations, cancer screening, HIV counseling, testing and treatment and management of chronic diseases like diabetes, heart disease and stroke.
Source: trtnj.com

Video: Medicaid Strategy – New Jersey Elder Law

New Jersey physical therapy assistant be charged with Medicare fraud

All these activities may result in charges  related to participating in a Medicare fraud  scheme,  including bribery, health care fraud, falsifying  medical records, and various conspiracy charges. In order  to prove their case, the prosecution will have to show that the physical therapy assistant knew  the information  he provided was false, or that the  forms he signed contained false information and would be used to fraudulently  bill Medicare. It is not a defense for a physical therapy assistant to  claim that he was just doing what his  bosses  told him to, if he knew that he was actively participating in fraud.
Source: nj-criminallawyer.com

The Official Medicare Set Aside Blog And Information Resource: New Jersey DWC Changes Position on MSAs

The federal case in question is obviously an interesting one which I cannot wait to read in its entirety. In the pages from the pleadings that were published in support of the DWC’s change in position, it is obvious that CMS is being accused of bad faith in failing to respond to proposals for WCMSA approval. I’m not an expert in bad faith, but NJ’s law must have some pretty extensive reach to get to CMS. Questionable pleading aside, it appears that the delay may have something to do with plaintiff not answering development letters. Could it be that the requests cannot be answered? I think we’ve seen that before. Still it doesn’t mean that CMS is the real problem – the fact that the parties elected to prevail themselves of that program is the issue.
Source: medicaresetasideblog.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

Home Care in Mt. Laurel NJ

At some point or another, many of us will either need to consider home health care for ourselves or for a loved one. Choosing home health care may be an easy choice for some, since it allows the person to remain in their own home and continue a certain level of autonomy while providing the attention and health care necessary. However, there are many other details included when it comes to implementing a home health care system.
Source: hometostayhc.com

physical Therapy Software Can get ready You For Medicare Audits

Therapy clinics that have been on the fence about  transitioning from paper based documentation to an electronic curative records ideas should get on board in 2009.  A good physical therapy software solution will enable clinics to overcome, and continue to thrive in the face of such government regulations. Faultless and accurate clinical documentation is the key to meeting Medicare requirements and a good therapy software program that is integrated with billing is the best solution.
Source: blogspot.com

GRANISOL (Granisetron) Oral Solution Eligible for Medicaid Reimbursement

PediatRx, Inc. (OTCBB: PEDX) announced that the U.S. Centers for Medicare and Medicaid Services (CMS) recently notified state Medicaid agencies to include PediatRxs GRANISOL, NDC 52547-0801-30, in their list of reimbursed products. CMS funds the Medicaid and State Children Health Insurance Programs jointly with state governments. These programs provide health insurance, including prescription drug coverage, to over 40 million low-income families,* and this number is expected to grow with the implementation of health care reform legislation.
Source: premiumstockpicks.com

OPINION: Protect Patients & Even The Playing Field For All NJ Hospitals

For-profit hospitals also receive charity care assistance funding from the state treasury – at last count about $70 million a year. And these are not the only public dollars these hospitals rely on – there is Medicare, Medicaid, and state funded hospital stabilization funds available to hospitals in real financial trouble. However the current law and regulations do not require these for-profit institutions to disclose the same information as their non-profit counterparts. Yet this information is essential to ensure that these hospitals are not cutting costs at the expense of patient care. Consumers, elected officials, and state regulators need this important information to make choices and decisions based on full and accurate information about the finances of our hospitals – and how they allocate public dollars for patient care.
Source: njtoday.net

What ObamaCare Means for Those Who Already Have Health Insurance

Posted by:  :  Category: Medicare

KNOW WHO YOUR CZARS ARE --ENOUGH TO MAKE YOU SICK ---ONLY OBAMA COULD CREATE POSITIONS FOR THESE INCOMPENTENT COMMUNISTS AND SOCIALISTS by SS&SSNew Mexico has received some $35 million for planning and creating the health insurance exchange, although implementation has been slow. New Mexicans participating in the exchange will get federal benefits to purchase insurance amounting to more than $4 billion over the first seven years (2014-2020). If state leaders elect to expand the state’s Medicaid program, New Mexico stands to receive between 4.5 and 6.2 billion in federal funding over the seven-year period. The ACA, including the Medicaid expansion, will create between 30,000 and 38,000 new jobs, stimulate the economy, and level the playing field for New Mexico’s businesses by making it affordable for small businesses to offer their employees coverage. The taxes generated by the new jobs and economic activity will more than cover New Mexico’s share of the cost of the expansion. The ACA expansion will also take the burden of uncompensated care (care provided—usually in emergency rooms—to people who don’t have insurance)—an estimated annual cost of $335 million—off of the hospitals, providers, and those who already have insurance.
Source: nmvoices.org

Video: Dozens charged nationwide in $163M Medicare scam

Heather Wilson Tries to Re

Wilson Supported Cut, Cap, & Balance Plan That Would Force Deep Cuts To Social Security And Medicare While Protecting Tax Breaks For Millionaires And Big Corporations. In June 2011, Wilson released a video announcing her signing of the Cut, Cap and Balance Pledge. According to the Center on Budget and Policy Priorities, “It is inconceivable, however, that policymakers would meet the bill’s severe annual spending caps through automatic across-the board cuts year after year; if they did, key government functions would be crippled. Policymakers would have little alternative but to institute deep cuts in specific programs. […] Reaching and maintaining a balanced budget in the decade ahead while barring any tax increases would necessitate deep cuts in Social Security, Medicare, and Medicaid.” [Heather Wilson Youtube Channel, accessed 8/15/11; Center on Budget and Policy Priorities, 7/16/11]
Source: donaanademocrats.com

Medicaid expansions saves lives, Harvard study says

Rates of death also declined among elderly adults, though the relative changes represented only one third of the mortality decline among adults between the ages of 20 and 64 years. One possible explanation for these findings is that expanding coverage had positive spillover effects through increased funding to providers, particularly safety-net hospitals and clinics. Publicity about the expansion may also have encouraged uninsured higher-income and elderly persons to obtain insurance from other sources, including those over the age of 65 years who did not meet lifetime earnings requirements for Medicare.
Source: elgritonm.org

Medicare/Medicaid Lien Reduction for Attorney Fees

Main Office: 400 Gold Ave. SW Suite 500 Albuquerque, NM 87102 (505) 242-5958 http://www.newmexicoinjuryattorneyblog.com/June 7, 2010 Medicare/Medicaid Lien Reduction for Attorney Fees New Mexico has a high rate of uninsured. The state has the highest rate of uninsured motorists in the nation. The numbers related to those lacking health insurance are comparable. As a result, many personal injury cases in New Mexico involve Medicare and/or Medicaid. Many who have suffered personal injuries from the negligence of another are very surprised to hear that Medicare/Medicaid will claim liens against any personal injury settlement funds. Medicare/Medicaid will assert a lien for the amount of medical bills related to the personal injuries. Both Medicare and Medicaid are very aggressive about collecting on those liens. The penalties are quite severe for failure to properly account for and pay these liens. It should be kept in mind that Medicare/Medicaid may assert liens only for medical bills related to the personal injuries related to the settlement. This includes both past and future medical expenses. However, it includes only medical expenses and only those related to the personal injuries on that particular claim. Because the liens may only include medical expenses related to the personal injuries on that claim, Medicare and Medicaid liens are often overstated. There are a number of areas where the lien might be overstated and subject to reduction. The area addressed here are attorney fees related to the personal injury claim. Medicare/Medicaid will reduce their liens by the amount of attorney fees. For instance, if attorney fees are 1/3 of the recovery, the liens will be reduced by 1/3 as well. However, like most issues surrounding Medicare and Medicaid, it is important to negotiate these reductions prior to settlement. Both Medicare and Medicaid laws dictate that they be notified prior to any settlement. They are both quite reasonable when approached prior to settlement. The process of lien reduction negotiations is significantly more difficult when initiated subsequent to settlement. This includes the reduction for attorney fees. If Medicare and/or Medicaid are properly addressed from the beginning of the personal injury action, the reduction of the lien for attorneys fees is automatic. Failure to properly address the liens in advance of settlement can make even the legally mandated reduction of the liens for attorney fees very difficult. In addition, the settlement proceeds cannot be distributed until Medicare and/or Medicaid have been properly addressed. Distribution of the settlement proceeds prior to addressing the liens can be disastrous both for the injured client and the attorney. In the event the case has Main Office: 400 Gold Ave. SW Suite 500 Albuquerque, NM 87102 (505) 242-5958 http://www.newmexicoinjuryattorneyblog.com/settled prior to working out the Medicare/Medicaid liens, this can be a long and difficult process. All the while, the clients funds must be held in trust and cannot be released. Those who have suffered personal injuries must understand the importance of addressing Medicare/Medicaid liens. As stated, many are surprised and even angry that Medicare/Medicaid has asserted liens against their recovery. Many will go further forbidding their attorneys to pay the liens. Of course, this is simply not a possibility and any lawyer heeding those directions would get both the client and the lawyer in a serious financial bind. And in the end, Medicare/Medicaid will recover on their liens. The only question is whether or not the liens have been properly reduced or collected in full due to the failure to properly account for them in advance of settlement.
Source: jdsupra.com

Medicare Part D Plans for New Mexico Seniors

Are you still wandering around the internet looking for how you can make money on the internet? Have you spent time looking for opportunities and mentors that were going to fly you to the promise land. If you have been thru hell and back with your MLM and Network Marketing and your ready to finally GET PAID. Then join us at Empower Network where YOU GET PAID 100% COMMISSION http://www.empowernetwork.com/jennifersalhi
Source: posterous.com

Medicare Prescription Drug Coverage Is Here!

Posted by:  :  Category: Medicare

meds: it's obscene by fallsroad. Appear for enrollment events in the location. More than the subsequent couple of months, you are going to be able to get assist with your drug program selections at dozens of locations throughout your community, like schools, senior centers, clubs, faith-based organizations, and your pharmacy. Or you can talk with buddies and family or call your local workplace on aging for help. For the telephone number, pay a visit to www.eldercare.gov on the Net. The Eldercare Locator can support you find places to go to get personalized assistance.
Source: loseweightqna.com

Video: Medicare drug coverage changes

Medicare Prescription Drug Coverage Is Right here!

. Look for enrollment events in the region. More than the subsequent few months, you will be in a position to get help with your drug strategy selections at dozens of places all through your community, like schools, senior centers, clubs, faith-based organizations, and your pharmacy. Or you can talk with friends and family or call your neighborhood workplace on aging for support. For the telephone number, go to www.eldercare.gov on the Net. The Eldercare Locator can aid you find places to go to get personalized assistance.
Source: qnapoker.com

Medicare Prescription Drug Coverage

Gary Phillips is a licensed insurance agent based in western North Carolina. He specializes in the senior market and is knowledgeable in multiple insurance lines including Medicare, Medigap, Long-Term Care, Part D Prescription Drugs, Part C Medicare Advantage, Health, Life and Final Expense insurance. He also enjoys writing and helping others. www.bizpartner.homestead.com
Source: seniorliving.net

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

What Is the Medicare Donut Hole?

There are enhanced plans that provide additional benefits to help with donut hole coverage, but everything comes at an additional cost. According to a study done in 2007, premiums for plans offering gap coverage are roughly double those of defined standard plans. The 2010 Health Reform bill (Patient Protection and Affordable Care Act) attempted to address the coverage gap by creating discounts on brand name and generic drugs purchased within the gap range. By 2020, the changes in the health care reform act aim to close this coverage gap bringing down the enrollee responsibility to 25% of the costs rather than the current 50%.
Source: bradeninsurance.com

Medicare Part D Information « Insurance News from Crowe & Associates

 It depends on when you need your Medicare prescription plan coverage to begin.  Initially, you have a seven (7) month window of time to join a Medicare Part D or Medicare Advantage plan.  So if you enroll in a Medicare Part D plan within the three (3) months before the month that you become eligible for Medicare (for example, the 3 months before you turn 65), your Medicare plan coverage will start on the first day of your birthday month (or Medicare eligibility month).  If you join a Medicare plan during your birthday (or eligibility) month, your prescription drug coverage will start on the first day of the next month.  Finally, if you join a Medicare plan during the three (3) months after your birthday (or eligibility) month, your drug coverage will start the first day of the month following the month when you enroll.
Source: croweandassociates.com


“The level of customer service at Volk & Bell is second to none. Whenever I call or e-mail, response times are immediate…Never does it take hours or days to get feedback on questions I feel are important…” “Strategic Planning in the world of rising health care costs is a major issue that is made much simpler in our business because Volk & Bell does all the leg work. Every year during our partnership with Volk & Bell they have been proactive, providing us a “heads up” on expected price increases and then working to help us control cost increases without compromising the quality of health care coverage we offer to our employees.”
Source: vbbenefits.com

New Studies Highlight Unintended Consequences of Medicare Drug Benefit

What are the lessons from these two new studies? Medicare Part D has been a godsend for many seniors—allowing them access to drugs that they otherwise might not be able to afford. But the benefit has also led to overuse of medications and unsupportable price increases in name-brand drugs. The AARP is calling “for action by Congress and the drug industry to bring more competition and transparency to the marketplace.” One place to start is to allow Medicare to more aggressively negotiate with drug companies on prices for name-brand drugs. In the case of the overuse of antibiotics—the authors of the Annals study suggest greater cost-sharing by Medicare recipients when their doctors write prescriptions for antibiotics to treat colds or other conditions when their use is unwarranted.
Source: healthbeatblog.com


Posted by:  :  Category: Medicare

When I'm 64 by MuffetCurrently, New York State Insurance Law requires individual and small group health insurance policies and contracts to be community rated. A policy issued to an association group that consists of individual members of an association is considered a small group health insurance policy and must be community rated. If a group policy or contract is subject to community rating, then their premium must be the same as the premium rate charged to all other groups holding the same policy in the same region. The bill would exempt the group from being considered a small group under the Insurance Law. As such, the group health insurance policy issued does not need to be community rated during demonstration program. The former employees in the group would be able to maintain the status quo by keeping their existing package of benefits at a premium rate that is based upon the collective claims experience of that one group.
Source: joerobachkodak.com

Video: Turning 65 Becoming Eligible for Medicare – 2011

Home Health Care: Medicaid Eligibility Requirements

There are many benefits that go along with the Medicaid program. As long as you meet eligibility guidelines and requirements, you will have access to these benefits. It is executed state to state but the funding is made through reimbursements from the federal government. Currently, there are 25 categories of eligibility which can be classified into five coverage groups. These groups include children, individuals over the age of 65, individuals with disabilities and adults with dependent children. The eligibility will differ from state to state, but all states are required to cover mandatory groups. However, the state can decide whether to cover groups that are categorized as optionally eligible. Most states have forms online that you can download and print out, however no states currently allow you to submit an online application. These groups include pregnant women, children and low-income families who have dependent children. The income level of these groups must be lower than the poverty level. Some Medicare beneficiaries may also be eligible for additional coverage by Medicaid. These beneficiaries will vary from one state to another. Each state is allowed to use their own discretion to provide benefits to these groups. Always be sure to check the eligibility requirements for your state when planning an application. If you believe you have met the requirements and have been denied coverage, you have the right to appeal the decision. Any appeal information will be printed on your eligibility notice that will be received in the mail. To apply, you can obtain an application at an office run by your state government. You cannot yet apply for it online. If you fill out an application at an office, the office is responsible for processing the application. While the application process does take some time, most states are required to complete the application within 45 days. If the application is based on a disability, the state has up to 90 days. The most common reason for denial is an incomplete application, so make sure all parts of the forms are completed when filling out the application. Also be sure to have all required documentation available to include with the application. In some cases, if you are receiving Medicare, it may pay for some of the premiums, coinsurances and deductibles. You could also be eligible for Medicare related expense payment if your income is more than 100% or less than 120% of the poverty level. If you are disabled, it will pay for Medicare Part A premiums if you have lost your Medicare coverage due to employment. Your income must be below 200% of the poverty level. For state run programs to be eligible for funding there are certain services that must be provided to certain populations. The health care help must include services including hospital services, payment for physician services, nursing facilities for people over 21 years of age, surgical dental services, family planning, midwife services, x-rays, laboratory services, pediatric services, rural health clinic costs and federally-qualified health center services. An optionally eligible program will cover clinical services, prescription drugs, dental, prosthetics, optometry, nursing facilities and intermediate care for the mentally retarded. Each state will determine the duration of all its benefits. Federal guidelines must be followed and they require that the amount and duration of service is reasonable. Each state is responsible for placing a limit on benefits thereafter. In most cases, those on it are allowed to choose between health care providers. The state may also elect to run the program through an HMO. Always check with the state laws and guidelines for it to know what benefits are available. Payments are made directly to the health care providers. Providers are required to accept all its reimbursements in full. However, the state is allowed to change the copayments and deductibles for certain recipients. For emergency care and family planning services, the state cannot make these changes. Pregnant women, children under 18 and individuals in nursing homes are exempt from copayments. Currently, there is no limit or cap on the services received under it. The federal government is required to match what each state provides. The reimbursement rates must be sufficient so that providers will be attracted. This allows Medicaid benefits and services to be available to the qualifying population in the state.
Source: blogspot.com

Strengthening CMS Demos for Persons Dually Eligible for Medicare and Medicaid

Accessibility Adolescents Adults Aging Assistive Technology Bladder Dysfunction Bowel Dysfunction CDC Cerebral Palsy Children Communication Community Community Integration Depression Developmental Disabilities Diabetes Education Elderly Emergency Preparedness Environmental Toxins Exercise Health Care Health Care Professionals Health Disparities Health Promotion Hearing Impairments Intellectual Disabilities Learning Disabilities Mental Health Mental Illness Mentoring Minority Mobility Multiple Sclerosis Native Americans Nutrition Obesity Paralysis Parents and Caregivers Physical Activity Physical Disabilities Post-Traumatic Stress Disorder Program Evaluation Psychiatric Disabilities Public Policy Sexuality Smoking Cessation Social Determinants of Health Social Participation Spina Bifida Spinal Cord Injuries Substance Abuse Training Traumatic Brain Injuries Veterans Violence Visual Disabilities Women Young Adults Youth
Source: aahd.us

Medicare Eligible? Resources at Mature Health Center Online

While you do not have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. In 2011 the monthly premium for Part B is $96.40 for most with incomes under $85,000 (single) and $170,000 (married). However, the monthly Part B premium for 2011 will be $115.40 for people enrolling in Medicare for the first time in 2011. It is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of the above payments, Medicare sends you a bill for your Part B premium every 3 months.
Source: stewardshipmatters.net

CMS Proposes New Hardship Exemptions for E

The new proposed rule would extend the e-prescribing hardship exemptions to certain eligible professionals and group practices participating in the meaningful use program for the first time (Health Data Management, 8/2). Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicare and Medicaid incentive payments.
Source: ihealthbeat.org

Organizations Unite to Urge Caution in Demonstration Programs Serving Low

[1] See cover letter, summary recommendations and full document. [2] Senator Rockefeller’s letter is here; the MedPAC letter is here and the FAH letter is here. [3] Section 2602 of the Affordable Care Act (ACA), Pub. L. 111-148 (March 23, 2010) [4] Section 1115A of the Social Security Act, as added by § 3021 of the ACA.  See letter of December 13, 2010 to Health and Human Services Secretary Kathleen Sebelius concerning provisions of § 3021 affecting dually eligible beneficiaries and signed by 38 individual scholars or practitioners, state and national advocacy organizations, available at: http://www.medicareadvocacy.org/2011/07/15/recommendations-for-beneficiary-protections-in-models-approved-by-cmmi/ [5] These states are MO, CA, IL, MA, OH, WI, CO, CT, IA, NC, WA, MI, MN, OK. [6] Information about the demonstrations, including proposals from all 26 states, is available at: http://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialModelstoSupportStatesEffortsinCareCoordination.html [7] Letter of June 27, 2012 to Secretary Kathleen Sebelius, available at: http://www.medicareadvocacy.org/wp-content/uploads/2012/07/Savings-letter-to-Sebelius-062712.pdf [8] Section 1115A of the Social Security Act, added by § 3021 of the Affordable Care Act, Pub. L. 111-148 (March 23, 2010)
Source: medicareadvocacy.org

Information on Medicare Part 1: Finding Medical Help for Seniors

There are many ways that information about Medicare coverage can be obtained online, several are fraudulent or unreliable. We only use information from government websites and simplify it to help you find reliable resources for seniors. In this post, we will only be using information from the government website and putting it in an easy to understand and simplified manner for you.
Source: elderhelpers.org

National Rural Health Resource Center: Medicare Meaningful Use Incentives: A Confusing Minefield for Critical Access

Critical access hospitals (CAH) need to be aware of what is eligible for Medicare Meaningful Use incentives, and it can be confusing. Sure, we need to purchase a certified electronic health records (EHR), but the incentives for Medicare specify that CAHs can get a portion of the “reasonable costs” of acquiring certified technology. There are several catches (just read the FAQ 10163 and you will see what I mean). Here are some very important considerations when signing a contract for an EHR, whether from a vendor or a larger hospital system offering a great deal on their system. A Right To Use Agreement is the most common contract for an EHR, at least historically. This type of agreement is similar to what you get when you purchase office software, such as from Microsoft. Surprisingly, you do not technically “own” the software in this case (or any that I will talk about). You merely have a right to use the software. These agreements generally also state that you lose that right to use the software if you quit paying the annual support and maintenance fees. One of the secrets in the software industry (not just health care) is that vendors make money on the maintenance agreement, not necessarily the licensing agreement. This is why vendors will usually negotiate aggressively on the licensing fee, but not on the maintenance. Even though you don’t own the software, the right to use licensing agreement fees (not the maintenance fees – those are non-capital) are usually a capital expense and thus eligible for CAH Meaningful Use incentives from Medicare. If you choose to lease the software over a period of time, then things get a little more tricky. Thankfully, the Centers for Medicare and Medicaid Services (CMS) recently clarified what is a qualified expense in FAQ 10722. Leasing can make sense if the hospital can not afford the licensing fees up front. Many vendors offer leasing packages as an option when that final contract is delivered. However, an Operating Lease is not depreciable, and therefore not eligible for Meaningful Use incentives. Capital Leases are eligible expenses, and it is important that you understand the difference. One of the four following conditions must be met for the purchase to be a capital lease:
Source: blogspot.com

TORT TALK: More Decisions Regarding Impact of Medicare Liens on Finalization of Settlements

Below are summaries of two recent federal court decisions regarding the impact of potential Medicare liens on the finalization of a settlement of a third party action: Carty v. Clark, Civil Action No. 11-6083 (E.D.Pa. June 14, 2012 Rueter, Mag. Judge)(Order by Robreno, J.) In Carty, the Plaintiff agreed in a Release that defense counsel could hold settlement amount in escrow until Plaintiff produced Final Demand Letter from the Centers for Medicare and Medicaid Services. The Plaintiff thereafter produced a Final Demand Letter and the defense counsel refused to release settlement amount citing fears that an unpaid medical bill might be paid by Medicare in the future and would have to be added to the lien. The Court granted Plaintiff’s Motion to Enforce settlement citing the clear terms of the Release which stated that, once the Final Demand Letter was produced by the Plaintiff from Medicare, the settlement proceeds were to be released to the Plaintiff.  The Plaintiff’s request for sanctions were denied as it did not appear to the court that the defense had acted in bad faith. To view Federal Magistrate Rueter’s Report and Recommendation, click HERE. To view the Eastern District Court Order issued by Judge Eduardo C. Robreno adopting Judge Rueter’s Report and Recommendation, click HERE. I send thanks to Attorney Bill Mabius of the Pennsylvania Association of Justice for bringing this case to my attention. Sipler v. Trans AM Trucking, Inc., et al, No. 10-3550(DRD)(D.N.J. July 24, 2012 DeBevoise, S.J.) Although the Sipler case is a Federal District Court of New Jersey decision that was marked by that court as “NOT FOR PUBLICATION,” a number of Pennsylvania litigators are pointing to the case for its persuasive authority on the issue of the impact (or more appropriately, the non-impact) of Medicare issues on personal injury settlements.  In the District of New Jersey case of Sipler, the parties settled a personal injury action arising out of a motor vehicle accident.  The parties were unable to finalize the settlement due to disagreements over the terms of the Release, which dispute included issues over release terms pertaining to Medicare matters.  The Plaintiff brought the matter before the court by way of a Motion to Enforce Settlement. After thoroughly reviewing the applicable law pertaining to Medicare and the potential for Medicare liens, the court in Sipler noted that, while the Plaintiff was Medicare eligible, there was no evidence that Medicare had paid for any of the Plaintiff’s accident-related treatment. Based on the demands of the defense in this matter in terms of the requested provisions of the release, one of the issues in this case became whether the Medicare Secondary Payer statute required language in the release provisions of the plaintiff’s settlement agreement specifying (1) the plaintiff’s obligation not to seek such payments from Medicare, and (2) that a portion of the settlement amount would be set aside for future medical expenses arising out of the accident. The court in Sipler noted that, while set-aside agreements were common in workers’ compensation matters, “no federal law requires set-aside arrangements in personal injury settlements for future medical expenses.”  Op. at p. 6. The court went on to note that personal injury settlements should not be required to have such set-aside agreements because “to require personal injury settlements to specifically apportion future medical expenses would prove burdensone to the settlement process and, in turn, discourage personal injury settlements.”  Id. at p. 7. In a footnote, Judge DeBevoise also stated “Indeed, it would be particularly discouraging if litigants were required to obtain Medicare’s approval of a settlement.”  Id. at p. 7, n. 1. Accordingly, the court held that “the parties in this case need not include language in the settlement documents noting [the Plaintiff’s] obligations to Medicare or fashion a Medicare set-aside for future medical expenses.”  Id. at p. 7. To view the Sipler decision online, click this LINK. I thank several attorneys for pointing this decision out to me including Attorney Andrew Bigda of the Wilkes-Barre, PA law firm of Rosenn, Jenkins & Greenwald, Attorney Jason Ohliger of the Milford, PA law firm of Weinstein, Kannebecker & Lokuta, and Attorney Thomas Foley, Jr. of the Scranton, PA Foley Law Firm. To review, other Tort Talk posts (as well as my July of 2012 Pennsylvania Law Weekly article) on this issue of the interaction of Medicare lien issues and personal injury settlements, click this LINK.
Source: torttalk.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

Foundation Resources on People Dually Eligible for Medicaid and Medicare

About 9 million people in the United States are covered by both Medicare and Medicaid, including low-income seniors and younger people with disabilities. These dual eligible beneficiaries have complex and often costly health care needs, and have been the focus of many recent initiatives and proposals to improve the coordination of their care aimed at both raising the quality of their care while reducing its costs. These resources examine the dual eligible population, their health care needs and spending, and ongoing efforts to coordinate care across the two programs.
Source: kff.org

CMS Still Evaluating Cost of Modifying Medicare Beneficiaries’ ID Cards

Posted by:  :  Category: Medicare

GOP Priorities by Leader Nancy PelosiRep. Sam Johnson (R-Texas), chair of the House Ways and Means Social Security subcommittee, noted that the Department of Defense and health organizations already have taken steps to redesign their insurance cards and that CMS was asked to do the same for Medicare years ago. “I don’t understand what’s taking so long,” Johnson said.
Source: californiahealthline.org

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

Frankel to team up with Pelosi for Medicare forum in North Boca Monday

2010 campaigns 2010 elections 2012 campaigns Alex Sink Allen West Barack Obama Bill McCollum Bill Nelson BP Charlie Crist Dan Gelber Dave Aronberg Dean Cannon Deepwater Horizon education elections Florida House Florida Power & Light Florida Senate Florida Supreme Court FPL gambling gop2012 Jeff Atwater Jim Greer Joe Negron John Thrasher Kendrick Meek Marco Rubio Mike Haridopolos offshore drilling oil spill Pam Bondi PSC Public Service Commission Republican Party of Florida Republicans Rick Scott state agencies state budget State House State Senate stimulus U.S. Senate unemployment
Source: postonpolitics.com

Medicare Supplemental Insurance Plan Is Very Essential

Nowadays, Medicare Plans are very beneficial plans especially for those people, who are looking for superior medical amenities provided by the top insurance companies during the crisis time. Medical amenities are increasing with affordable yearly and monthly premium to the health care providers, thanks to the health care providers to the rising health care technology. Mostly, people love only to overlook the benefits of Medicare cover, even the most educated ones but it is very essential that one should keep you on the priority. Medicare Supplement Plans makes you eligible for choosing the right plan to protect yourself completely. It is very good comparison to choose the best plan for you.
Source: wordpress.com

Poll Watch: Gallup Issue Priority

59 Policy Proposals That Will Get America Back To Work 1. Maintain current tax rates on personal income 2. Maintain current tax rates on interest, dividends, and capital gains 3. Eliminate taxes for taxpayers with AGI below $200,000 on interest, dividends, and capital gains 4. Eliminate the death tax 5. Pursue a conservative overhaul of the tax system over the long term that includes lower, flatter rates on a broader base 6. Reduce corporate income tax rate to 25 percent 7. Pursue transition from “worldwide” to “territorial” system for corporate taxation 8. Repeal Obamacare 9. Repeal Dodd-Frank and replace with streamlined, modern regulatory framework 10. Amend Sarbanes-Oxley to relieve mid-size companies from onerous requirements 11. Ensure that environmental laws properly account for cost in regulatory process 12 Provide multi-year lead times before companies must come into compliance with onerous new environmental regulations 13. Initiate review and elimination of all Obama-era regulations that unduly burden the economy 14. Impose a regulatory cap of zero dollars on all federal agencies 15. Require congressional approval of all new “major” regulations 16. Reform legal liability system to prevent spurious litigation 17. Implement agreements with Colombia, Panama, and South Korea 18. Reinstate the president’s Trade Promotion Authority 19. Complete negotiations for the Trans-Pacific Partnership 20. Pursue new trade agreements with nations committed to free enterprise and open markets 21. Create the Reagan Economic Zone 22. Increase CBP resources to prevent the illegal entry of goods into our market 23. Increase USTR resources to pursue and support litigation against unfair trade practices 24. Use unilateral and multilateral punitive measures to deter unfair Chinese practices 25. Designate China a currency manipulator and impose countervailing duties 26. Discontinue U.S. government procurement from China until China commits to GPA 27. Establish fixed timetables for all resource development approvals 28. Create one-stop shop to streamline permitting process for approval of common activities 29. Implement fast-track procedures for companies with established safety records to conduct pre-approved activities in pre-approved areas 30. Amend Clean Air Act to exclude carbon dioxide from its purview 31. Expand NRC capabilities for approval of additional nuclear reactor designs 32. Streamline NRC processes to ensure that licensing decisions for reactors on or adjacent to approved sites, using approved designs, are complete within two years 33. Conduct comprehensive survey of America’s energy reserves 34. Open America’s energy reserves for development 35. Expand opportunities for U.S. resource developers to forge partnerships with neighboring countries 36 Support construction of pipelines to bring Canadian oil to the United States 37. Prevent overregulation of shale gas development and extraction 38 Concentrate alternative energy funding on basic research 39. Utilize long-term, apolitical funding mechanisms like ARPA-E for basic research 40. Appoint to the NLRB experienced individuals with respect for the rule of law 41. Amend NLRA to explicitly protect the right of business owners to allocate their capital as they see fit 42. Amend NLRA to guarantee the secret ballot in every union certification election 43. Amend NLRA to guarantee that all pre-election campaigns last at least one month 44. Support states in pursuing Right-to-Work laws 45. Prohibit the use for political purposes of funds automatically deducted from worker paychecks 46. Reverse executive orders issued by President Obama that tilt the playing field toward organized labor 47. Eliminate redundancy in federal retraining programs by consolidating programs and funding streams, centering as much activity as possible in a single agency 48. Give states authority to manage retraining programs by block granting federal funds 49. Facilitate the creation of Personal Reemployment Accounts 50. Encourage greater private sector involvement in retraining programs 51. Raise visa caps for highly skilled workers 52. Grant permanent residency to eligible graduates with advanced degrees in math, science, and engineering 53. Immediately cut non-security discretionary spending by 5 percent 54. Reform and restructure Medicaid as block grant to states 55. Align wages and benefits of government workers with market rates 56. Reduce federal workforce by 10 percent via attrition 57. Cap federal spending at 20 percent of GDP 58. Undertake fundamental restructuring of government programs and services 59. Pursue a Balanced Budget Amendment
Source: race42012.com

Teamster Nation: These rich CEOs want to steal your Medicare and Social Security

…and they have a good chance of getting away with it. Remember when the Congressional Republicans threatened to shut down the government unless something was done about the deficit? They were talked off the ledge after both parties agreed on a package of tax increases and across-the-board budget cuts — including massive reductions in defense spending. A battalion of wealthy CEOs invaded Washington recently with a plan to take away your Medicare and Social Security — so they can have more money, of course. They’ve been scurrying through the back rooms of Congress, trying to persuade YOUR elected representatives to cut Social Security benefits by nearly 10 percent over time. They also want to raise the Medicare eligibility age. Good thing insurance is so cheap for 60-year-olds. The blogger digby notes, …not to worry. These “grown-ups” will reluctantly agree to close a few loopholes (yeah, right) in exchange for lowering their rates which every Very Serious Person agrees is not only a great way to raise revenue but also a tremendous sacrifice for the millionaires. Dean Baker agrees: At a time when we have seen an unprecedented transfer of income to the top one percent, these deficit warriors are placing a top priority on snatching away a portion of Social Security checks that average $1,200 a month. Yes, the country needs this. As the peerless Michael Hiltzik writes, So as much as corporate CEOs and other privileged incumbents claim they’re concerned about the future, it’s their future they mean.  Digby performs an invaluable service by showing how much these seven wealthy CEOs earned in 2011. in one year, they took home $110 million. Now they want to take your Social Security. The seven moral dwarfs are: David M. Cote J.D. Chairman and Chief Executive Officer, Honeywell International Inc. $37,842,723 annual compensation Alexander M.(Sandy) Cutler Executive Chairman, Chief Executive Officer, President and Chairman of Executive Committee, Eaton Corporation $13,586,010 annual compensation Gregg M. Sherrill Executive Chairman and Chief Executive Officer, Tenneco Inc. $5,750,640 annual compensation Martin L. Flanagan Chief Executive Officer, President and Executive Director, Invesco Ltd. $13,420,458 annual compensation Mark T. Bertolini Chairman, Chief Executive Officer, President, Chairman of Executive Committee and Member of Investment & Finance Committee, Aetna Inc. $10,556,335 annual compensation Thomas J. Quinlan III Chief Executive Officer, President and Director, R.R. Donnelley & Sons Company $6,059,714 annual compensation James Dimon Chairman, Chief Executive Officer, President and Member of Operating Committee, JPMorgan Chase & Co. $23,105,415 annual compensation
Source: blogspot.com

Majority in poll seek president who will create jobs, combat corruption : Conservative Base

Supporters of President Barack Obama (Democrats and liberal independents), who is seeking reelection, and the Republican presidential nominee Mitt Romney (Republicans, conservatives, Libertarians and moderate independents) usually disagree on how to deal with the major problems facing the country, but they both rated job creation and reducing government corruption among their top priorities for the next president, Gallup said in its report.
Source: conservativebase.com

Today in labor and people’s history: Medicare and Medicaid established

On July 30, 1965, President Lyndon Johnson signed legislation establishing Medicare and Medicaid. It came after decades of struggle. The movement for national health insurance dates back to the struggles of the Great Depression of the 1920s and ’30s, and the New Deal. It was strongly opposed by the medical establishment, including the American Medical Association. A key turning point, according to historian Peter Corning, came in 1957 when the executive council of the AFL-CIO committed the labor federation to an “all-out battle for government health insurance.” “Government health insurance was pressed as labor’s number-one legislative priority, and organized labor became the rallying point for all those who favored the measure,” Corning wrote. Medicare and Medicaid were signed into law in 1965 as an amendment to the Social Security Act of 1935. Medicare provided hospital and medical insurance for Americans age 65 or older. In 1972, eligibility for Medicare was extended to people under 65 with certain disabilities, and people of all ages with kidney disease requiring dialysis or transplant. Medicaid, a state and federally funded program, offers health coverage to low-income people. Some 19 million people enrolled in Medicare when it went into effect in 1966. By 2010, Medicare provided health insurance to 48 million Americans – 40 million people age 65 and older and 8 million younger people with disabilities. Medicare and Medicaid serve a large population of seniors, sick, disabled, and low-income people, most of whom would be unable to afford health care otherwise. Photo: President Lyndon Johnson (right), Secretary of Health, Education and Welfare John Gardner (second from left) and Social Security Administration Commissioner Bob Ball (left) received the first Medicare Part B application from a member of the general public, Tony Palcaorolla of Baltimore, Md., (next to President Johnson), Sept. 1, 1965. SSA History Archives
Source: peoplesworld.org

Medicare and Medicaid Insurance

(1) Will Medicare and social security for seniors stay in place when you are elected? I nursed during the years health ins. AndMONEY gave priority to care. Most of my patients were POOR. As a nurse seeing these patients with the least attention – most DIED . It was heart breaking! Needless to say, when Pres. Johnson signed the Medicare Bill, I said ‘thank you Lord “.It’s heart breaking to see history repeat itself. Should Medicare and Soc. security be scrubbed I will be among the poor. Untreated seniors even though I worked for min. wage , and less for over thirty (30) yes. My husband and I worked long, hard hrs., saved what we could-put our adopted baby (son) through college and Seminary with no Gov. help. Needless to say, at the age of eighty (80) we live a frugal lifestyle hoping and praying those with financial security will will have some understanding about the “haves and have-nots”. Too, I would like to add: we have never taken anything such as Welfare or anything from our Gov., but we certainly don’t want to be dependent or worse yet be like the people I described in the first of my letter.
Source: lettertobarackobama.com

Gallup: Jobs are voters’ top priority

Job creation has certainly been and will continue to be a major topic during the remainder of the campaign. And both candidates will surely need to outline their plans for reducing the federal budget deficit. However, it is unclear whether government corruption will become a major issue in the campaign, even though Americans see reducing it as an important goal.
Source: channel7today.com

How Will Health Reform Affect Medicare? Part D, Donut Holes, Limits, and More

Posted by:  :  Category: Medicare

If you select “Keep me signed in on this computer”, every time you visit WebMD.com you won’t have to type your email address and password. This means that a cookie will stay on your computer even when you exit or close your browser which may reduce your levels of privacy and security. You should never select this option if you’re using a publicly accessible computer, or if you’re sharing a computer with others. Even if you select this option there are some features of our site that still require you to log in for privacy reasons.
Source: webmd.com

Video: Medicare Part D and Prescription Drugs

Medicare Part D Information « Insurance News from Crowe & Associates

 It depends on when you need your Medicare prescription plan coverage to begin.  Initially, you have a seven (7) month window of time to join a Medicare Part D or Medicare Advantage plan.  So if you enroll in a Medicare Part D plan within the three (3) months before the month that you become eligible for Medicare (for example, the 3 months before you turn 65), your Medicare plan coverage will start on the first day of your birthday month (or Medicare eligibility month).  If you join a Medicare plan during your birthday (or eligibility) month, your prescription drug coverage will start on the first day of the next month.  Finally, if you join a Medicare plan during the three (3) months after your birthday (or eligibility) month, your drug coverage will start the first day of the month following the month when you enroll.
Source: croweandassociates.com

Can I Use A Canadian Pharmacy With Medicare Component D?

If you devote exactly $2250 for prescription drugs subsequent year and each single medication you take is covered by way of the Medicare Part D plan you have chosen, you can save about 52% on your medication expenditures. If you invest less than that amount or take a number of medications that are not insured with your plan, your savings drop as you get farther away from $2250.
Source: ilove3c.com

Vermont Medicare Part D Plans

HMO (Health Maintenance Organization) plans are the least expensive option. The effect of lower cost is reflected as restricted access to health care. Plans have a set monthly fee, covering doctors within the plan. If you visit a doctor outside of the plan, you are then responsible for the bill. Within a given plan, you have given the right to choose a Primary Care Physician (PCP) who will look after your care. The HMO CIGNA medicare plans cover regular and preventive care costs, referrals to a network specialist or facility when necessary, treatment for injuries and illness. There is no need of paying any additional fees in HMO plans as it has no fees for doctor visits. The CIGNA Part D plan is called CIGNA Medicare Rx offers coverage for 94% of available drugs, access to over 58,000 network pharmacies, no deductibles for select plans, no copayments for common drugs and diseases like diabetes and drug pressure. The CIGNA plan D in turn offers three types of plans namely, Plan 1, Plan 2 and Plan 3. Source: arcadiamax.net
Source: medicaresupplementalco.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

What Is the Medicare Donut Hole?

There are enhanced plans that provide additional benefits to help with donut hole coverage, but everything comes at an additional cost. According to a study done in 2007, premiums for plans offering gap coverage are roughly double those of defined standard plans. The 2010 Health Reform bill (Patient Protection and Affordable Care Act) attempted to address the coverage gap by creating discounts on brand name and generic drugs purchased within the gap range. By 2020, the changes in the health care reform act aim to close this coverage gap bringing down the enrollee responsibility to 25% of the costs rather than the current 50%.
Source: bradeninsurance.com

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

At 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

Medicare Part D Proves That Competition Lowers Health Care Spending

Few patients switching plans. Another critique of competition is that a general reluctance to switch plans “reflects the large number of plan choices available combined with the costs in terms of time and energy of doing research and of actually making a switch.” This claim, taken from behavioral economics, does not negate a person’s price sensitivity. Experience with the Federal Employees Health Benefits Plan (FEHBP) shows that about 5 percent of patients switch plans each year. This reluctance to switch reflects well-documented satisfaction with plan choices. This only proves that people make decisions based on many factors, including how much they like their plans.
Source: heritage.org

Why Did I Lose My Medicare Part D? »

handbook, the new Medicare rule was first explained and Social Security sent out letters informing Medicare beneficiaries that they would have additional premium including the Part D prescription drug premium.  The new IRMAA (Income Related Medicare Adjusted Amount) rule has never really been publicized and only if your income is higher can you be affected.  IRMAA states that if your income is above $85,000 for an individual or $170,000 for a couple, then, you may pay an income related adjustment amount (additional monthly premium), in addition to your Medicare prescription drug premium.  The IRMAA Part D premium can range from $11.40 to $66.40 which is based on your reported income.
Source: tonisays.com

Medicare Part D Spending Trends: Understanding Key Drivers and the Role of Competition

This brief commissioned by the Foundation examines factors that contributed to Medicare’s lower-than-expected spending on prescription drugs under the Medicare Part D drug benefit that started in 2006. Since its launch, Medicare has spent about 30 percent less on Part D benefits than the Congressional Budget Office originally projected. Some cite the program’s design, with private plans competing for enrollment, as the driving factor in lower spending; others point to factors in the overall market for prescription drugs as more influential. Author Jack Hoadley of Georgetown University examines the evidence on both sides of this debate. In addition to a discussion of the role of plan competition, the report cites a number of other factors that contributed to lower spending, including the growth in generic alternatives for popular-but-expensive brand-name drugs and a reduction in new brand-name drugs entering the market – trends that dampened prescription drug spending outside of Medicare as well.
Source: kff.org

Medicare Part D Resource for you by Mature Health Center

Some categories of beneficiaries are not bound by the lock-in rules and may enroll or disenroll from a PDP plan in other than the AEP. An individual may at any time, during a designated Special Election Period (SEP), discontinue the election of a PDP plan offered by an PDP organization and change his or her election to original Medicare or to a different PDP plan. Examples of situations which may entitle an individual to an SEP include the termination or discontinuation of a plan, a change in residency out of the service area, the organization violating a provision of a contract or misrepresenting the plan’s provisions, or the individual meeting other exceptional conditions as CMS may provide. CMS has also designated an SEP for individuals entitled to Medicare A and B and who receive any type of assistance from Title XIX (Medicaid), including full-benefit dual eligible individuals, as well as those eligible only for the Medicare Savings Programs. This SEP lasts from the time the individual becomes dually eligible until such time as they no longer receive Medicaid benefits. Individuals who are eligible for an SEP under the guidance for Part D enrollment and disenrollment may use that SEP to also make an election into or out of an MA-PD plan. from Medicare.gov, Prescription Drug Coverage (2012), Prescription Drug Coverage: Basic Information (2012) Return to top
Source: stewardshipmatters.net

In Florida, Obama Attacks Romney On Medicare Plan

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 marsmet481Miami Herald: As Thrill Fades, President Barack Obama Fires Up Supporters On Medicare, Tax Cuts But Obama steered clear of attacks on Romney’s business record and instead tailored his message toward seniors and the middle class on the first day of a two-day campaign swing in the nation’s biggest battleground state. He stops in Fort Myers and Orlando on Friday. The president warned that Romney’s proposal to repackage Medicare as a fixed benefit is a “voucher” system “will end Medicare as we know it” as it forces seniors to purchase private health insurance. He said his health care reforms have helped seniors receive discounted prescription drugs and get access to free preventive care (Klas and Caputo, 7/19).
Source: kaiserhealthnews.org

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

Medigap plans Hobe Sound Fl

With these cautionary steps, you will successfully protect yourself against Medicare fraud. Remember, you are able to return a policy for any reason within 30 days of purchasing it and receive a full refund. In fact, you can cancel your medigap plan at any time. 
Source: floridahealthinsurancebroker.com

Obama in Florida: Romney’s Medicare Plan Leaves Seniors ‘Out of Luck’

“Florida, that is wrong. It’s wrong to ask you to pay more for Medicare so that people who are doing well right now get even more,” the president added. “That’s no way to reduce the deficit. We shouldn’t be squeezing more money out of our seniors. My plan is to squeeze more money out of the health care system that is being wasted.”
Source: wbobradio.com

Health safety Florida specific and loved ones Health Plans Medical insurance RTC

Perhaps your are among work or even you a d Such as in order to save some funds placing your loved ones over a Florida specific and also household health programs.   This kind of Medical health insurance typically can help save individuals Money in comparison to a family team insurance plan.   This is because how the insurance rate is based with your age and also wellness status.   in case you are wholesome or have a small problem or 2, a Florida individual and also loved ones health programs may be for you personally.   It a s best to obtain a quote out of an independent agent Like us all.   we all shop throughout almost all major Medical carriers to get you the best rate or The type of unique selling points you are looking for.
Source: co.cc

FL health, insurance quotes Orlando, Medicare Florida

12 month loans Advertising Aggregate Crushing Plant Art Barbera’s Autoland beats Beats by Dre Beneficiation Plant business Cheap GHD cheap ghd straightener Cheap Oakley Sunglasses Christian Louboutin Christian Louboutin Outlet Christian Louboutin Sale Christian Louboutin Shoes cuffie Monster cuffie monster beats entertainment Flotation Beneficiatiion Plant Gary Barbera ghd straightener health key duplication keys locks Locksmith Magnetic Beneficiation Plant marketing medical Michael Kors Outlet monster beats News Nike Shox no credit check loans oakley sunglasses cheap oakley sunglasses outlet payday loans red bottom shoes SEO software technology Tn Pas Cher weight loss www.frbeatsbydrebeats.com
Source: pressreleasesworld.com

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

Assisted Living in Florida: What the Affordable Care Act Does to Senior Citizens

In popular assisted living facilities in Florida heard the news about the Supreme Court deciding to “push through” the Affordable Care Act otherwise known as “Obamacare.” To all the seniors living in West Palm Beach (or anywhere in Florida for that matter), this is undoubtedly going to affect you. Fortunately, senior citizens that do not have health and/or cannot afford it are not in trouble yet. Due to the main part of the bill going into full effect in 2014, senior citizens have approximately 18 months to prepare and plan to obtain health insurance. Regardless of the demographic, those who do not have health insurance by this time will face fines. Especially for senior citizens trying to plan for retirement, carrying the cost of health insurance can be a burden on finances. Because health insurance is so expensive (especially for senior citizens), it can be difficult to afford it; unfortunately, this often results in senior citizens obtaining health insurance that does little to nothing to help them in the long-term. Senior citizens that obtain health insurance when they cannot afford it are usually stuck with paying a premium every month that will only pay a percentage on medication, doctor’s visits, and the like that is so miniscule it isn’t even worth the premium they pay monthly. Thus, this is exactly why so many senior citizens opt to obtain Medicare (and Medicaid for lower-income seniors), and for senior citizens who wish to continue using Medicare and Medicaid, there are a few interesting attributes that actually make the continued use of Medicare and Medicaid desirable. The first (and arguably biggest) benefit under the Affordable Care Act is the lowering of drug prices. In the past, when drug plans (Part D of Medicare) lapse into what is known as the “doughnut hole,” senior citizens would be forced to pay a significant amount of money just to continue obtaining their prescription drugs. With the Affordable Care Act, the amount of money seniors in Florida assisted living facilities will have to pay once they reach the “doughnut hole,” reduces significantly. In fact, the reductions that have slowly trickled down have already saved Medicare and Medicaid users billions of dollars in drug costs, and these savings will continue as the plan goes into full affect. Medicare and Medicaid is great for those that are in their mid-60’s, but what about those that are currently in their 50’s and early 60’s? For those that are too young to afford Medicare and require more health benefits than Medicaid offers, it can be difficult to find a private health insurer that will provide seniors with a level of health care they require. Fortunately, under the Affordable Care Act, private insurers cannot refuse to insure anyone simply because of their preexisting health conditions. Thus, when looking into local assisted living facilities in Broward County, finding health insurance is not only a reality, but is actually much easier thanks to the Affordable Care Act. So why is everyone up in arms about “Obamacare?” Many feel that literally “forcing” everyone to obtain healthcare is unconstitutional, no matter how great the benefits may be. Florida residents are no different, and while many believe the benefits are ideal others are still not buying it. “Although it sounds pretty good and it means I could get cheaper prices on my medication and doctors’ visits through my Medicaid,” said Irene Watson, a 67-year old retired nurse living in an assisted living facility in West Palm Beach, “But I don’t think it’s right to force our country to get a health insurance plan. Everybody should be able to decide if they want to get health insurance or not, and the government shouldn’t decide for them.” Others, such as 45-year old Emma Carson, believe the Affordable Care Act will not only help people like her mother, but will help everyone regardless of their age: “Health care is outrageous right now,” she said, “I can barely afford health care every month for my family, and the health car we have now is barely worth the premium we pay per month. This act should lower the cost of health care significantly for people my age and younger, and will even lower the price of Medicaid for my mother.” Carson continued with, “…I understand people are up in arms about having to get health care even if they don’t want it, but we have to pay taxes, we have to pay for car insurance, we have to pay for all sorts of things we don’t want to pay for already, so why get upset about this? Especially since it is going to lower the cost of health care for everyone, I don’t see the big deal about it. It’s a great thing I think.” These opposing views are more than likely not going to go away anytime soon. Is a decrease in health care worth it if American citizens must purchase health care against their will? Only time will tell. Send more information or to submit stories and comments via snail-mail to: Assisted Living Services of Florida LLC 2300 Palm Beach Lakes Blvd. #101a West Palm Beach, FL 33409 (561) 921-8384 http://www.assistedlivingofflorida.com/
Source: sbwire.com

Local Public Forums Provide Original Medicare Education

Tagged With: Brevard County, BREVARD COUNTY FLORIDA, Cape Canaveral Hospital, Cocoa Beach, Crane Community Center, Florida, Government, Health, Health First Health Plans Inc., healthcare needs, Healthcare reform in the United States, Holmes Regional Medical Center, Indian River County, Indian River County Chamber of Commerce, Margaret Haney, Medicare, Melbourne, Rockledge, Social Issues, United States National Health Care Act, Vero Beach
Source: spacecoastmedicine.com

Medicare Part D Information « Insurance News from Crowe & Associates

 It depends on when you need your Medicare prescription plan coverage to begin.  Initially, you have a seven (7) month window of time to join a Medicare Part D or Medicare Advantage plan.  So if you enroll in a Medicare Part D plan within the three (3) months before the month that you become eligible for Medicare (for example, the 3 months before you turn 65), your Medicare plan coverage will start on the first day of your birthday month (or Medicare eligibility month).  If you join a Medicare plan during your birthday (or eligibility) month, your prescription drug coverage will start on the first day of the next month.  Finally, if you join a Medicare plan during the three (3) months after your birthday (or eligibility) month, your drug coverage will start the first day of the month following the month when you enroll.
Source: croweandassociates.com

Obama kicks off Phase II in Florida

As Jon Chait noted, “The Obama campaign’s attacks on Mitt Romney’s business record and personal finances will probably continue for a long time. But I think that, when the campaign is remembered in history, they will not be seen as the central element but rather as a prelude. The main event is going to be a fight over the priorities of the Paul Ryan budget.”
Source: msnbc.com

Q1Medicare.com Simplifies the Medicare Part D Plan Selection Process for Long

To begin using the LTC drug tool, site visitors can simply select their state and get an overview of drug coverage for all qualifying Medicare Part D plans and institutional Special Needs Plans in their area. Drug usage management restrictions, such as quantity limits or step therapy requirements are shown with text and color-coding for each prescription drug and Medicare plan combination. Users will find that the LTC charts are interactive with direct links to each Medicare Part D prescription drug plans complete online formulary, as well as plan features and plan contact information. By clicking on the drug names in the chart, users can also see a specific drugs detailed coverage information for all Medicare plans in the chosen service area.
Source: wzlstrgeh.info

If You Don’t Believe Me, Maybe You’ll Believe Paul Volker

Posted by:  :  Category: Medicare

Gang of Six - Cartoon by DonkeyHoteySince the mid-1800s, Appalachian coal has been a regional curse and a blessing. It has generated great wealth reflected today in philanthropy boosting universities and hospitals. It has also been a curse, locking coalfield people in a perpetual cycle of poverty, ruining mountain environments and killing miners. This book explores Massey Energy, formerly based in Richmond, in its notorious recent history that has involved a renegade chief executive, big political money and this country’s worst deep mining disaster in 40 years. Publication date: Sept. 18
Source: baconsrebellion.com

Video: Virginia Medicare Advantage Ad Senate

VA: Medicaid expansion costs puts Virginia on the bubble

But the widely speculated figures account for only the currently uninsured. ACA includes a loophole that could allow employers to offer incentives to employees with high-risk medical conditions to jettison them from group plans. The workers then would pursue coverage through the health exchanges. The exchanges offer insurance plans that are eligible for government subsidies.
Source: watchdog.org

Legal Ease: Medicaid tests your needs

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Source: fredericksburg.com

MCDONNELL: Fix health care once by fixing it right

Bigger government is not the answer to our health care crisis. There has to be an impetus for change, and the change must be an economic driver. In Virginia, employers of all sizes purchase private health coverage for more than 4.3 million employees. Recognizing that an opportunity exists to align economic incentives while promoting quality and value, the newly created Virginia Center for Health Innovation (VCHI) is the central hub for employer engagement in health reforms and innovation. VCHI is a nonprofit, nonpartisan partnership sponsored by the Virginia Chamber of Commerce and designed to fast-track the adoption of value-driven models of wellness and health care throughout the commonwealth. This privately led entity is a place where employers, providers and other stakeholders can come together to establish priorities for research, design demonstration projects, and engage employers to leverage their purchasing power to encourage the adoption of proven delivery-system practice and payment reforms. The results of this organization will enable businesses to optimize their health care investments and increase their global competitiveness. Essentially, the private sector is coming together to reform from within.
Source: medicaltips.org

Speak Out: Should Virginia Opt Out of Medicaid Expansion?

Mr. Connolly clearly doesn’t understand that Fairfax County and his policies that Sharon Bulova continues to push isn’t representative of the Commonwealth of Virginia as a whole. In Virginia if you can’t pay for a program, it isn’t implemented….period. Novel concept for those governing in Washington, DC, but until he and his peers in Congress figure out how to pay for this program (and pass laws paying for it), I see Virginia opting out regardless of the value to citizens. Where are the $9.2 billion coming from and what federal strings are attached that might saddle states with further debt? Mr. Connolly and President Obama….speak in terms people can understand. Show us the figures as to how this program is paid for and then show us how it doesn’t increase our debt and burden future generations with yet another mandate from Washington that can’t be paid for in the long run (think of the future of Social Security and Medicare right now….do we need another program headed for failure as well?). A plan backed up by REAL data and reasonable expectations around savings and costs is needed for the healthcare system in America. If homeowners, auto and life insurance companies can survive and people don’t get up in arms when they don’t buy these why can similar systems not be put in place for healthcare? It baffles the mind….
Source: patch.com

Potter Williams Report: Unvetted CMS Director Tavenner Warns Governors, Comply with ObamaCare

The Democrats, who had the majority in both houses until 2010, have refused to hold confirmation hearings for the last 6 years when it involves bureaucrats in charge of healthcare. Now the unpopular law has made them even more obstructionist. The same party who calls out the Republicans for stonewalling legislation will not place the people’s interests above their own political concerns. In not allowing a public vetting of individuals who control a budget four times larger than the Pentagon, the Obama administration continues to raise suspicion about its unconfirmed appointments.
Source: potterwilliamsreport.com

virginia insurance, VA health insurance, insurance plans

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Source: pressreleasesworld.com

West Virginia Medicare Part B

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Source: virginiamedicarepros.com

Aug. 3, 2012: Medicare/Medicaid; Rockefeller; Kaufman commentary 

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Source: wvgazette.com

Viewpoints: Health Law No Threat To Innovation; Failure To Expand Medicaid Would ‘Doom’ Thousands; Don’t Stigmatize Mentally Ill

Richmond Times-Dispatch: Expanding Medicaid Is A No-Brainer The recent Supreme Court decision upholding the constitutionality of the Affordable Care Act (ACA) left Virginia with a choice: expand Medicaid — at a bargain-basement price — or leave more than 400,000 Virginians out in the cold without insurance options. Imagine a single mom who earns minimum wage working as a cashier. Her employer doesn’t offer health insurance, and she can’t afford to buy it on her own. Currently in Virginia, that mom makes too much money to qualify for Medicaid, the health insurance program that covers mostly seniors in nursing homes, people with disabilities, and children. But the health care law gives states a strong financial incentive to expand Medicaid to include adults — like that single mother — with incomes up to about $26,000 a year for a family of three (138 percent of the federal poverty level), many of whom don’t have insurance now because they can’t afford it (John McInerney, 7/29).
Source: kaiserhealthnews.org

Aging & Law in West Virginia: Medicare redesigns claims and benefits statement

The redesign of the MSN includes several features not currently available to Medicare beneficiaries with the current MSN: · A clear notice on how to check the form for important facts and potential fraud; · An easy-to-understand snapshot of the beneficiary’s deductible status, a list of providers they saw, and whether their claims for Medicare services were approved. · Clearer language, including consumer-friendly descriptions for medical procedures; · Definitions of all terms used in the form; · Larger fonts throughout to make it easier to read; · Information on preventive services available to Medicare beneficiaries.
Source: blogspot.com

Can Medicare become True Social Insurance?

Posted by:  :  Category: Medicare

True Social Insurance. Some Americans think that since they have paid into the system, they are entitled to receive something back. But this is not how insurance works. True insurance means that Americans pay in for protection, in this case from health care costs that exceed their means. Income adjustment would return Medicare to a true insurance program. This means that the safety net will be strengthened and ensure that all Americans, of every generation and income level, will get the financial assistance to pay for retirement health care costs if and when they need it. To encourage Americans to prepare adequately for retirement, the Heritage premium support plan pairs Medicare and other entitlement reforms with comprehensive tax reform that makes it easier to save and invest for the future.[20]
Source: medibid.com

Video: 090924 Dems say no to posting healthcare plan and cost estimate and protecting Medicare benifits

Understand Medicare benefits to Plan for Aging Parent’s Care

To help you better understand the options of care available for your parent in the community, Genworth offers an explanation of the four primary types of providers, including home care agencies and nursing homes. NPR also recently ran an informative piece entitled, “Financial Planning For The End Of Life” which offers more suggestions and tips on how to plan to pay for end-of-life care.
Source: cheaplikemeblog.com


Those who have experienced damage from the storms may be eligible for FEMA’s Individuals and Households Program.  This may cover expenses for temporary housing, home repairs, replacement of damaged personal property and other disaster-related needs, such as medical, dental or transportation costs not covered by insurance or other programs.
Source: blogspot.com

Getting the affluent to pay for payroll tax cut

It was a bad idea because of where it came from. Most of you complained when the Republicans were talking against the payroll tax cut and rescinding it. If there was a tax cut, it should be an income tax cut and not a payroll tax cut. Why? Because the payroll tax cut takes out of Social Security fund. Which means that a system that is already paying out more than taking in and a system that is projected to go bankrupt in 2036. And that was before we took billions of dollars more out of it. If this was not so pathetic, it would be sad. You cried for your payroll tax and sided with the democrats. What is going to happen when you retire and the democrats tell you that there is no money in the SSI fund to pay for your retirement? Watch and see. They will then blame it on the Republicans. The total blame lies on the democrats for this payroll tax cut, for scaring senior citizens, for pushing granny off the cliff. Val, not entirely true. Employees hired before 1984 do not pay in to the SShttp://www.ssa.gov/history/hfaq.htmlI. Maybe not a lot of them, but it is true.
Source: nbcnews.com

Medicare Benefits for Homecare

One of the most common questions asked by potential in-home care clients is ‘Will Medicare pay for my caregiver?’ Sadly, the answer is NO. This is alarming as many seniors are not properly prepared for the expense to assist with their daily needs and keep them safe/independent in the comfort of their own home. Although the coverage information is readily availalbe, few seniors or their adult children take the time to research and plan ahead. Home Care Services are typically sought immediately after a healthcare emergency. Learn now about what Medicare covers and discover other options for affording home care services. Proper preparation can not only help in determining solutions beforehand but reduces so much of the stress associated with the healthcare crisis and its aftermath. http://questions.medicare.gov/app/answers/detail/a_id/1347
Source: accreditednursing.com

Blue Hampshire: Politics ::: NH GOP Chair repeats $500 billion Medicare lie

We should probably retire that moniker.  The ACA is about how we pay for medical care. If Republicans don’t like the ACA, then we should expand Medicare to serve all. As it is, it is my considered opinion that the age exclusions are un-Constitutional.  After all, illness and injury do not discriminate by the age of their victims. Exclusive programs for elderly persons are merely a stratagem for keeping the segregationist impulse satisfied. The perennial threat to end Medicare affects different populations differently. Both Medicare and Medicaid give official recognition to the fact that health is a matter of social security. The exclusion of some people affirms the belief that society is a hierarchy in which some people are more important than others. Segregationists don’t care as much about who’s more important as that somebody is. I suspect that segregation is attractive, or perhaps even necessary, to people who need a contrast/antagonist in order to define themselves. Adherents of the Party of No are people who define themselves by what they are not (not a woman, not a pansy, not a black, not a thespian, not a liberal, not a crook). That every ‘not’ has a positive opposite makes it easy define what they are.
Source: bluehampshire.com

Tips on Successfully Marketing Accountable Care Organizations, Part 2: Less Can Be More

Currently, if an ACO isn’t part of the Medicare Shared Savings Program (MSSP), then it’s in the process of applying for MSSP inclusion. Consequently, your first primary market likely will be Medicare beneficiaries—which means that you’ll be talking to people who are 65 and over. They may be wary of any legislation that might change Medicare. Even if your program also includes a broader patient base, your communication efforts should be composed with the Medicare population in mind—these are the people who will need the most convincing. Since the Medicare population cuts across a broad swath of social demographics, make sure you keep the language in all marketing materials accessible and legible. Avoid fine print whenever possible, since very tiny type tends to raise suspicions very quickly—and for good reason.
Source: gojunto.com

What is the Medicare Advantage maximum out pocket?

Posted by:  :  Category: Medicare

The insurers who offer Medicare Advantage benefits must follow rules set by Medicare. However, each Medicare Advantage plan can charge different out-of-pocket costs and have different rules for how care is provided. For example, they can determine whether or not you need a referral to see a specialist or if you have access to a specific network of doctors and hospitals. These rules can change from year to year.
Source: ehealthinsurance.com

Video: Differences between Medicare PPO & HMO Plans

Anthem Blue Cross and Blue Shield in Missouri Offers Six Tips for the Traveling Boomer : e Yugoslavia

Make arrangements to get and transport medication. One way for members to stock up on prescription medication is to order a 90-day supply through mail order. Call the number on your insurance card for details. Travelers can transport medication in carry-on or checked baggage, although some supply should be with the passenger in the case of lost luggage. The Transportation Security Administration (TSA) recommends that the prescription label match the passenger’s boarding pass and that the passenger bring supporting documentation. 2 Large, national drugstore chains may be able to fill customers’ prescriptions when they’re away from home.
Source: eyugoslavia.com

Anthem Medicare Connecticut « Insurance News from Crowe & Associates

The PPO offers substantially better benefits than the HMO to such an extent it does not make much sense for a consumer to consider the plan.  The PPO utilizes the nation anthem BCBS nationwide network.  It has out of network benefits which are almost par withe in network benefits.  They have $0 copay for a primary doctor and $0 copay for some generic drugs as well.  Two of the better benefits are the Hospital benefit which is $250 a day for 6 days in or out of network.  Meaning that you can go to a non participating hospital and pay the same as if it was an in network hospital.  The outpatient surgery benefit is a max copay of $250 which is the best available.  Lastly, the out of pocket max on this plan is $3,400 in and out of network combined which is far better than any other advantage plan in CT.
Source: croweandassociates.com

Alliance Medicare PPO Plans Review

[…] […] […] Optional supplemental benefits for dental and gym memberships are offered through the plan.  The dental gives two options at $23.40 and $44.90/month while the gym programs are either $25 or $40 a month.  These plans are two of the most expensive plans I have seen.  At these prices, be sure to compare against a Medicare supplement to see if a Plan F might make more sense for you!  More details about these plans can be found at their website.Source: medicare-plans.net […]Source: medicare-plans.net […]Source: medicare-plans.net […]
Source: medicare-plans.net

Medicare Advantage Plans 101

You or your senior loved one receives coverage administered through a private insurance company instead of Medicare – it effectively “combines” Parts A and Part B, enhances it somewhat, and gives you a “brand new Part C” plan. As such, no Medigap Supplement policies are allowed. Basically, you end up saving on premium dollars but potentially spending more on healthcare due to the various cost-sharing provisions, such as copayments…
Source: seniorliving.net

Medigapcomparisons.com Releases a Revamped Version of Website With Latest Humana Medicare network

With escalating costs of healthcare and the downturn of economy it has become crucial for citizens to explore mediums to make most of their healthcare premiums. There is no dearth of plans from established insurance companies – some cover drug and medical coverage, then there are some which provide stand-alone prescription drug coverage. But as found in UCLA Study – 2011, commissioned by Department of Sociology, when it comes to choosing a plan as per personal needs, lack of standardized and credible information definitely hampers citizens. Medigapcomparisons.com is an effort to bridge this gap with comprehensive, unbiased and authentic information. With this version of the website, the founders have incorporated many features the site’s beta users suggested during 2010-11. “On our site one can find in-depth analysis of all leading Medicare Supplement and Medicare Advantage Plans including those from the likes of market leaders Humana Medicare Health Plans care and Florida Medicare Advantage Plans from Freedom Health” informs Mark Carter, Media representative of Medigapcomparisons.com. Current news, renewal rates and updated benefits are key points to note when making a decision about insurance plans. So, providing updated content is another aspect the site owners are working on. For example the of news story of Humana Inc, which has been at the forefront of health and well-being companies recently announced inclusion of Northwest Medical Center, Oro Valley Hospital and their urgent care centers in Tucson for their Medicare Advantage Plans – PPO, HMO and Private Fee for Service plans. This story is likely to benefit many of the 83000 Humana beneficiaries in Arizona. Such current news coverage will definitely help site visitors. The site now has a tips section as well – It has been noted in the UCLA study that due to lack of information, in many cases citizens find their insurance plan is unable to cover certain illness or procedures, only after they have nowhere to go. These missteps can be easily avoided with proper knowledge about Medicare Supplements like those offered by Humana. These supplement plans could be really beneficial to people who would like to have the benefit of say World-wide coverage and don’t want to take an alternative new plan. With predictable costs one could keep a check on their budget as well. With Advantage plans one gets added benefits to those originally provided with Medicare plans, covering majority of healthcare costs. Both Supplement and Advantage plans also help to remove network restrictions which generally come with Medicare select plans. Such tips could really help seniors who are not abreast with latest information. It has been long said information is one major way we are going to change the present American Healthcare System for the better and we are gradually moving towards it. Scalable user generated information and authentic news in the internet environment is one way to tackle this issue. About Medigapcomparisons (http://www.medigapcomparisons.com ) Medigapcomparisons is an interactive insurance information site oriented toward Medicare-eligible citizens. The site features information about all leading Medicare Insurance and Supplement providers and their most preferred plans. The founders share the vision to make it one-stop site for all to make the most informed decision. Since its creation in 2009, the site has clocked over 10, 000 visitors per month for last 14 months. To learn more and experience the arrived revolution in healthcare, please visit http://www.medigapcomparisons.com/
Source: sbwire.com

What Is The Best Medicare Plan?

A Medicare Advantage plan is an alternative way of receiving your Medicare benefits. Although you are still enrolled in Medicare and continue to pay your Part B premium, you receive your benefits from a privater insurance company which is contracted with the Centers for Medicare and Medicaid Services.
Source: seniorsupplementinsurance.com