FAQ: Decoding The $716 Billion In Medicare Reductions

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSRyan’s plan also calls for an overhaul of the program, offering beneficiaries a set amount of money that they would use toward buying a private plan or traditional Medicare. Democrats have argued that such a fundamental change could undermine the traditional Medicare program, because private plans might tailor their coverage to attract healthier beneficiaries, leaving sicker beneficiaries in traditional Medicare. Critics of Ryan’s plan also predict it will force seniors to eventually pay more for their health care because the federal payments will be capped at the rate of gross domestic product plus half a percentage point, an amount that may not keep up with the increase in medical costs. Under Ryan’s plan, insurers would have to provide benefits that are at least equal the value of those offered in traditional Medicare. 
Source: kaiserhealthnews.org

Video: What Does Medicare Cost?

Medicare Part D Premiums Holding Steady

Thanks to the marvels of medical science, our parents are living longer than ever before. Adults over age 80 are the fastest growing segment of the population; most will spend years dependent on others for the most basic needs. That burden falls to their baby boomer children. In The New Old Age, Paula Span and other contributors explore this unprecedented intergenerational challenge. You can reach the editors at newoldage@nytimes.com.
Source: nytimes.com

How is Medicare Financed?

Note: For simplicity, I have focused on the annual flow of taxes and benefits. The same insight applies if you want to think of Social Security and Medicare as programs in which workers pay payroll taxes to earn future benefits. That’s approximately true for workers as a whole in Social Security (but with notable differences across individuals and age cohorts and uncertainty about what the future will bring). But it’s not true at all for Medicare.
Source: wallstreetpit.com

Here’s Who Really Benefits When Republicans Change Medicare

The first major emergency endangering the continuance of Medicare occurred in 2008, when President Bush and the Republicans in Congress tried to block Democrats from halting a 10.6% cut, which Bush’s plan forced in the rate-schedule that traditional Medicare paid doctors for their services to their patients under Medicare. This pay-cut to doctors was expected to cause so many physicians to abandon traditional Medicare patients, that the traditional Medicare program would likely collapse. This pay-cut to doctors was scheduled to start on July 15th; but, just days earlier, on 9 July 2008, Bloomberg News bannered “Senate Votes Reversal of Cuts in Medicare Doctor Fees,” and reported that, “The Senate voted final passage of legislation that would halt a 10.6 percent cut in Medicare reimbursements to doctors.”
Source: businessinsider.com

Cutting Through The Fog: Cost Containment: What Medicare Seniors Should Worry About

For years, the bureaucrats in Washington have been trying to control rising Medicare (and Medicaid) costs by underpaying doctors, diagnosticians, and hospitals for their services using some false assumption that those healthcare professionals will find a cheaper means to provide services.  But the healthcare system can’t cheapen their services because, to do so, would open itself up to more and more costly malpractice suits.  So, more often than not, this Medicare cost containment tactic is like squeezing a balloon.  All that happens is that non-Medicare patients are billed at higher rates to compensate for the losses incurred in taking care of Medicare patients.  But, at some point, those medical professionals will find that the other private insurers won’t pay more either.  When that happens, they are likely to drop their Medicare patients to avoid going broke.  For example, in 2010, the prestigious Mayo Clinic announced it was no longer taking Medicare patients at one of their hospitals because they had lost a total of $840 million in the previous year.  Right now there are no comprehensive statistics as to how many doctors and hospitals are refusing to provide healthcare to Medicare seniors; but it is happening and gaining speed. However, what is really ridiculous is that the Democrats and Obama have decided to double-down on this cost containment tactic that is causing so many health care professionals to refuse Medicare patients.  When they crafted ObamaCare they created something called the Independent Payment Advisory Board or IPAB.  IPAB is basically a 15-member board of bureaucrats that will determine what Medicare will pay out for certain medical procedures and devices. By law, they must find ways to cut costs if those costs exceed actuarial estimates for any given year.  In effect, IPAB has the authority to independently tell the health care industry which procedures will be covered by Medicare and for how much.  Congress cannot block or overrule them unless they pass legislation that would meet or exceed the IPAB’s recommendations for any given year. The problem with all these cost containment gimmicks, like IPAB, is that they don’t address “why” costs are going up as fast as they are.  You can’t mandate a bunch of free annual check ups and free diagnostics and expect Medicare costs to be lowered.  Sure, early diagnosis might avoid some future expenses but, many experts have concluded that widespread recommended diagnostic routines are not cost effective and are not necessarily preventative.  With mammograms, for example, the U.S. Preventive Services Task Force (USPSTF) set new recommendations in 2009 that effectively removed the testing regimen of having bi-annual mammograms for women over 40.  Their new recommendation is for bi-annual mammograms for women over 50. In my opinion, the USPSTF is better able to make cost-lowering recommendations rather than IPAB.  IPAB will only result in more seniors being dropped by doctors, hospitals, and diagnosticians.  The result will be to force Medicare patients into “cattle-car” clinics with extremely long wait time and less qualified doctors.  In fact, seniors will probably wind up seeing physician assistants rather doctors. This is what every senior should fear as a result of ObamaCare. One last thing.  Healthcare costs are being driven by doctors practicing defensive medicine as a safeguard against being sued for malpractice.  Unless there is tort reform, costs will continue to rise at rates faster than inflation.  But, ObamaCare never included tort reform because the Democrats are in bed with the trial lawyers for campaign donations. For Further Reading: Mayo Clinic Bridles at Medicare Payments: http://www.cbsnews.com/8301-505123_162-43841043/mayo-clinic-bridles-at-medicare-payments/ Wikipedia On IPAB:  http://en.wikipedia.org/wiki/Independent_Payment_Advisory_Board U.S. Preventive Services Task Force Website: http://www.ahrq.gov/clinic/uspstfix.htm
Source: blogspot.com

What’s Driving up the Cost of Medicare?

Recognizing the demographic facts doesn’t obviate Medicare’s need to spend federal health care dollars effectively and efficiently to slow the growth of health care costs while improving the quality of care for each and every beneficiary. But arguments that efficiency will come from morphing Medicare into a private insurance market—the conservative “solution” to rising health care costs—make no sense. There is simply no evidence that a private marketplace can match Medicare’s ability to slow spending growth. With Medicare’s per capita cost growth already lower than GDP and projected to diverge increasingly from private health care spending, vouchers for private insurance would actually increase per capita costs.
Source: americanprogress.org

Too Much Focus on Medicare

There are important differences between Republicans’ and Democrats’ Medicare plans, especially on key technical issues like the speed of shifting the program away from fee-for-service payments. But as fact-checkers have descended on the campaigns — finding misstatements in Ryan’s charges and Sebelius’s counter-claims — they’ve also uncovered that the candidates’ Medicare proposals aren’t as wildly different as they appear on first blush. Neither plan involves rolling back benefits or coverage for current beneficiaries. And Romney’s proposed changes to the program, while largely unspecified, have dropped the dramatic overhauls once floated by his running mate Ryan.
Source: californiahealthline.org

403 FORBIDDEN : LOGGED TO HONEYPOT

Your connection details: Record #: 3296 Time: Wed, 05 Sep 2012 18:00:14 -0500 Running: 0.4.10a1 Host: gator1793.hostgator.com IP: 50.97.96.123 Post: Query: Stripped Query: Referer: User Agent: spider Reconstructed URL: http:// www.coyoteblog.com /coyote_blog/2012/09/the-medicare-problem-a-reminder.html     Generated by ZB Block 0.4.10a1
Source: coyoteblog.com

Medicare and Medicaid Costs (Utility Post)

Posted by:  :  Category: Medicare

Sign at Occupy St Pete: "Hands Off Social Security, Medicaid Medicare"  "www.SayNoCuts.org" by Fifth World ArtThe go-to source on Medicare Advantage is the official Medpac report (pdf), which currently finds MA plans costing on average 7 percent more than conventional Medicare. This is less than the premium a few years ago; apparently (pdf) because several changes in Medicare policy more or less incidentally put the squeeze on MA plans. So far those plans are still expanding, but time will tell.
Source: nytimes.com

Video: Medicare and Medicaid: What’s it all mean?

State Roundup: Ohio Sets Plan For People On Both Medicaid And Medicare; Minn. Asks Feds For Money

California Healthline: Why Basic Health Plan Failed And Why COOPs May Succeed No one knows exactly what the Basic Health Program would have looked like in California — and now we’ll likely never know. The state Legislature recently shelved the idea by relegating SB 703, by Senate Health Committee Chair Ed Hernandez (D-West Covina), to the “holding committee” in the Assembly Committee on Appropriations. That effectively killed the bill. Meanwhile, another Assembly measure (AB 1846), by Assembly Member Richard Gordon (D-Menlo Park), would establish a legal framework to set up Consumer Operated and Oriented Plans (COOPs). That proposal, like BHP, is an option under the federal health reform law with a lot of questions surrounding it. Unlike BHP, the COOPs bill is a floor vote away from the governor’s desk and appears to have widespread support (Gorn, 8/27).
Source: kaiserhealthnews.org

Massachusetts is First State to Receive CMS Approval for Medicaid

Massachusetts’ pilot program will cover about 111,000 disabled adults who are dually enrolled in Medicaid and Medicare. The state has selected a capitated financial model to fund enrollees’ services, in which integrated care organizations will receive a prospective payment to deliver care to these patients. The demonstration program will enable the state to offer expanded services for enrollees, such as additional dental care, vision, and behavioral health services. Care teams will be made up of a primary care provider, a care coordinator, and a long-term services coordinator.
Source: mentalhealthcarereform.org

Fraud detection in Medicaid / Medicare

One industry example mentioned in the reports: In one brash scheme, immigrants set up a network of fraudulent medical-supply stores in the Southwest, hoping to cheat Medicaid and Medicare. The gang hired recruiters to bring them innocent patients eligible for Medicaid or Medicare. They then paid off local doctors to prescribe motorized wheelchairs worth $7,500 but instead gave them motor scooters worth just $1,500, pocketing the difference. Investigators shut down the scheme after noticing billings for wheelchairs in Arizona, Texas, and other states scaling into the hundreds of millions of dollars.
Source: analyticbridge.com

Brad DeLong: By How Much Do Ryan

Gov. Romney and Rep. Ryan claim that no one over 55 will be affected by their health care plan. This claim is false. Their plan would harm all seniors. The Romney-Ryan plan would hurt current seniors in two important ways: * Increased drug costs and higher Medicare premiums. By repealing the Affordable Care Act, the Romney-Ryan plan would raise health care costs in retirement by $11,000 for the average person who is 65 years old today. * Increased long-term care costs, including increased costs for nursing home care, because of cuts to Medicaid. A substantial share of Medicaid spending pays for health care costs for Medicare beneficiaries. The Romney-Ryan Medicaid cuts mean a loss of over $2,500 annually for seniors currently on Medicare who also rely on Medicaid. Unlike the Medicare voucher system that would begin in 2023 the cuts to Medicaid would begin almost immediately. For seniors who will become eligible for Medicare after 2022, the financial harm would be even worse. * Increasingly unaffordable costs for all seniors who qualify for Medicare after 2022. For seniors turning 65 in 2023, Medicare costs during retirement would increase by $59,500 in 2012 dollars under the Romney-Ryan plan. Because under the Romney-Ryan plan the amount of seniors’ vouchers will not keep pace with rising health care costs, these numbers are even worse for future generations. In today’s dollars seniors who qualify for Medicare in 2030 would see an increase of $124,600 in Medicare costs over their retirement. Seniors who qualify for Medicare in 2040 will see an increase of $216,600. And by 2050 newly eligible seniors will pay $331,200 more in Medicare costs over their retirement. * Additional costs from private plans cherry-picking healthier patients. Three-fourths of all Medicare beneficiaries are currently in traditional Medicare. The Romney-Ryan plan would include traditional Medicare as an option in the proposed program, but the costs for seniors who choose to remain in the traditional Medicare program would likely increase even more sharply than for seniors who chose a private plan. Most analysts expect the traditional Medicare plan to attract Medicare beneficiaries with the greatest health needs. In that case, Medicare would no longer enjoy a balanced risk pool and seniors choosing traditional Medicare could wind up paying an extra $29,000 on average over their retirement lifetime above and beyond the costs described above.
Source: typepad.com

Cutting Medicare and Medicaid hurts economy, lacks compassion

The most astounding part of Romney’s attack is that he accuses the president of cutting Medicare by more than $700 billion despite the fact that the exact same Medicare savings are included in the Romney-Ryan budget, which Mitt Romney has eagerly embraced, said he would sign, and whose architect is now his running mate. The real scandal is that while Obamacare reinvests these savings back into Medicare to make it stronger, offer seniors new benefits, and close the prescription drug donut hole, the Romney-Ryan budget steals that same $700 billion and uses it pay for new tax breaks for the wealthiest Americans and huge corporations.
Source: protectingmedicare.org

Longitudinal Patterns of Medicaid and Medicare Coverage Among Disability Cash Benefit Awardees

This article explores the role of the Social Security Disability Insurance (DI) and Supplemental Security Income (SSI) cash benefit programs in providing access to public health insurance coverage among working-aged people with disabilities, using a sample of administrative records spanning 84 months. We find that complex longitudinal interactions between DI and SSI eligibility determine access to and timing of Medicare and Medicaid coverage. SSI plays an important role in providing a pathway to Medicaid coverage for many low-income individuals during the 29-month combined DI and Medicare waiting periods, when Medicare coverage is not available. After Medicare eligibility kicks in, public health insurance coverage is virtually complete among awardees with some DI involvement. Medicaid coverage continues at or above 90 percent after 2 years for SSI-only awardees. Many people who exit SSI retain their Medicaid coverage, but the gap in coverage between stayers and those who leave SSI increases over time.
Source: nyu.edu

Massachusetts Health Stats: The 2012 Medicare Data Book Section 3: Where Medicaid and Medicare Meet

NOTE: I’m going all Medicare all the time until further notice. There’s nothing happening in Massachusetts anyways. The legislature passed its health-care price controls, screwed a few percent of the population, and headed off to their second or third homes in the Berkshires or on the Cape for the rest of the Northern Hemisphere summer. And then they are off to the Democratic convention. Look to the postings list to the left to see what’s new. The Obama Parade of Medicare Lies is never ending. (What would you expect of a guy who lied about his dying mother’s insurance situation to get elected?) Otherwise, whenever, Massachussetts Health Stats is an as-needed look at statistics about the Massachusetts healthcare delivery and insurance market and industry. On both Medicare and Massachusetts health care, this blog overcomes the attempts from those on both the left and right of the political spectrum to use statistics to impose needless changes on one of the best healthcare systems in the world.
Source: typepad.com

Can I Be Eligible for Medicare or Medicaid Benefits?

One of the most popular requirements to receive Medicare benefits is that you have to be at least 65 years of age since this Social Security program solely caters to senior citizens. Additionally, an applicant must have worked for at least 10 years while paying taxes into Medicare, and they must also be a citizen of the United States of America. In rare cases, Medicare coverage is awarded to patients who are suffering from end stage Renal disease.
Source: seniorcorps.org

Preventive & screening services

Posted by:  :  Category: Medicare

Newsweek Magazine (February 16, 2009) ... Lenders Add Bigger Fannie, Freddie Fee – Thanks to Payroll Tax Cut (January 15, 2012) ...item 2.. Dupuy: GOP trying to sell pyrmaid scheme to voters (September 3, 2012) ... by marsmet526The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Video: Medicare covers yoga for heart disease

“All Things Medicare” workshops detail 2013 Medicare changes

“All Things Medicare” will provide a comprehensive overview of the features offered by Medicare in 2013. The presentation will look at changes to Part A (hospitalization), Part B (outpatient), Medicare supplements, Medicare Advantage plans and Part D (prescription drug) coverage. This workshop is intended for individuals who will be new to Medicare in 2013 as well as current beneficiaries who will experience changes to coverage.
Source: thesubtimes.com

Medicare Covers Alcohol Misuse Screening and Counseling Under Affordable Care Act

Medicare recipients can receive free alcohol misuse screening and counseling, as well as certain programs to help people quit smoking, under the Affordable Care Act (ACA). These are some of the ways in which the new healthcare law affects people with substance use disorders who are covered by public insurance programs, according to The Health Foundation of Greater Cincinnati.
Source: drugfree.org

Fox Covers Up Romney’s Support For Ryan’s Medicare Plan

Fox is claiming that there was “nothing about the private sector” during speeches given by Michelle Obama or any other speaker on the first night of the Democratic National Convention. In fact, Michelle Obama and more than a dozen other Democratic speakers discussed the importance of the private sector or President Obama’s record of creating private sector jobs.
Source: mediamatters.org

What Does Medicare Cover?

SevenPonds reserves the right to restrict comments that do not contribute constructively to the conversation, contain profanity, personal attacks or seek to promote a personal or unrelated business. SevenPonds is now accepting blog contributions for possible publication. Contact Us or send an email to wecare@sevenponds.com. If you are an end-of-life expert by trade and would like to be interviewed for Professional Advice, or if you have a story to share in Opening our Hearts, please contact Dana Sitar at dana@sevenponds.com. Required fields are marked
Source: sevenponds.com

Massachusetts Health Stats: What Obama’s “Medicare as we know it” Does Not Cover for Seniors

NOTE: I’m going all Medicare all the time until further notice. There’s nothing happening in Massachusetts anyways. The legislature passed its health-care price controls, screwed a few percent of the population, and headed off to their second or third homes in the Berkshires or on the Cape for the rest of the Northern Hemisphere summer. And then they are off to the Democratic convention. Look to the postings list to the left to see what’s new. The Obama Parade of Medicare Lies is never ending. (What would you expect of a guy who lied about his dying mother’s insurance situation to get elected?) Otherwise, whenever, Massachussetts Health Stats is an as-needed look at statistics about the Massachusetts healthcare delivery and insurance market and industry. On both Medicare and Massachusetts health care, this blog overcomes the attempts from those on both the left and right of the political spectrum to use statistics to impose needless changes on one of the best healthcare systems in the world.
Source: typepad.com

MedicareSupplementPlans.com Offer Comparison Shopping Resource for Medicare Supplement Plans

Medicare covers some medical expenses, but it doesn’t cover everything. Medicare leaves gaps in patient coverage, and without a supplementary insurance plan, these gaps must be paid out-of-pocket. For that reason, Medicare supplement insurance plans are becoming a popular way to fill in the gaps left by Medicare coverage. Today, many top insurance providers offer some type of Medicare supplement plans. However, some of these plans are better than others. Some supplement plans might only fill in a few gaps left by Medicare coverage, while other plans comprehensively cover seniors in any circumstance. Some supplement plans are priced affordably, while others are expensive. MedicareSupplementPlans.com has been gaining a lot of attention lately by helping seniors quickly and easily compare any type of Medicare supplement plans. At MedicareSupplementPlans.com, visitors will find information about the best Medicare supplement plans in the country. The website states that these plans – also known as ‘Medigap’ insurance plans – cost far less than what many people expect. A spokesperson for MedicareSupplementPlans.com explained what the site hopes to accomplish: “Our goal is to connect visitors with the best possible Medicare supplement plans for their needs. There are so many different ‘Medigap’ plans available in this country, and finding the right one can be difficult for those who don’t have experience in the industry. That’s why we offer free insurance quotes that can be filled out in just minutes or allow people to be guided by our team of experienced representatives. We want to make it as simple as possible for consumers to select the most appropriate policy at the best possible price.” Using the website, visitors can also discover the specific benefits included in Medigap insurance plans. The website describes the specific types of Medigap plans offered by insurance companies across the states, and plans are identified by the letters A, B, C, D, F, G, K, L, M, and N. Each of these plans is the same for every insurance company. For example, Plan F Medigap from one insurance company will be identical to Plan F Medigap offered by another insurance company. The website features a detailed list that shows what each plan covers in a simple to navigate chart. The information on MedicareSupplementPlans.com is catered to those in California. The website features unique pages for every county in California, and visitors can easily compare California Medicare plans from anywhere in the state. Whether seeking to fill in the gaps left by insufficient Medicare coverage, or simply wanting to learn more about the types of insurance plans available, MedicareSupplementPlans.com allows users to compare the different types of Medicare supplement plans available today. By filling out the free insurance quote form included on the front page, visitors can receive a free quote within hours. About MedicareSupplementPlans.com MedicareSupplementPlans.com educates visitors about Medicare supplement plans, which are designed to fill in the gaps left by Medicare coverage. The website allows users to instantly receive a free insurance quote for insurance in their area. For more information, please visit: http://www.medicaresupplementplans.com
Source: sbwire.com

Presidential Election Could Have Major Impact On Medicaid

The New York Times: 2 Campaigns Differ Sharply on Medicaid, Seeking Vast Growth or Vast Cuts The way Mitt Romney and Representative Paul D. Ryan frame it, the debate over social programs that has become a dominant theme of the presidential race is all about the future of Medicare, the government health insurance program for retirees. But the outcome of the election will probably have a more immediate and profound effect on Medicaid, the joint state-federal program that provides health care to poor and disabled people. Few other issues present a starker difference between the Republican and Democratic tickets. President Obama, through the health care law that was a centerpiece of his domestic agenda, seeks a vast expansion of Medicaid, which currently covers more than 60 million Americans — compared with 50 million in Medicare — and costs the states and the federal government more than $400 billion a year (Goodnough, 8/31).
Source: kaiserhealthnews.org

Daily Kos: Transcript of Pat Quinn remarks as prepared for delivery, Democratic National Convention

Let me repeat that for our Republican friends: more people working, not less. Then there’s Medicare. Mitt Romney and Paul Ryan want to take away the promise that makes Medicare, Medicare. They want to give seniors a voucher that caps what Medicare will cover and then tell seniors they’re on their own for what’s left. That would cost seniors thousands of dollars a year. And if they don’t have the money, it could cost them their lives. But that didn’t stop Romney and Ryan from telling the American people that their plan won’t hurt seniors. The fact is, it will. President Obama’s plan will protect Medicare and protect our seniors.
Source: dailykos.com

Meeting Your Health Care Needs With Medicare Supplemental Insurance

The question remains though of how do you find out which Medicare supplemental policy will meet your needs while being cost effective on covering the extra expenses. Finding the information you need to help you make a decision about the policy and coverage best suited for you is very important. If you end up making the wrong decision about the coverage you choose you might find that you are not covered when you really need it. Thankfully there are companies available online that help you compare rates, view policy information and insurance companies without providing personal information.
Source: professional-article-marketing.com

Therapy Health Care: 5 Things To Consider When Integrating Your Home Health Care With Medicare

Medicare can be perplexing, all the more so when you combine complex health issues and the need for medical aids such as oxygen or hospital beds. While the insurance maze can be difficult to traverse, an estimated 47.5 million people received this program in 2010, which is more than a sixth of the nation’s population. Here is a brief overview and some answers to some commonly asked questions regarding Medicare and home health care. 1. Who qualifies? Medicare is a national health insurance program provided by the U.S. government for those who are: – 65 and older – Under 65 with certain disabilities – Diagnosed with End Stage Renal Disease (ESRD), a form of permanent kidney failure requiring dialysis or a kidney transplant 2. What types of services does Medicare cover? Medicare has four different coverage sections: Part A, B, C, and D. “Original Medicare” consists of Part A & B, while Part C is known as “Medicare Advantage Plan”. These four parts are summarized briefly: – Medicare Part A: Hospital Insurance * Part A covers care while in hospital as well as health care in skilled nursing facilities, home health care, and hospice. – Medicare Part B: Medical Insurance * Part B covers doctor’s visits as well as visits to other health care providers. Additionally, Part B covers hospital outpatient care, durable medical equipment (like intravenous infusion devices), and home health care services. Part B also covers specific types of preventative services, such as getting certain vaccinations. – Medicare Part C: Medicare Advantage * Part C combines health plan options you purchase from other private insurance companies approved by Medicare. Part C also integrates Medicare Prescription drug coverage (Part D) and can be tailored to include extra benefits at an extra cost. – Medicare Part D: Medicare Prescription Drug Coverage * Part D covers the prescription of Medicare-approved prescription drugs and can lower the cost of other medications. Similar to Part C, Medicare-approved private insurance companies also run Part D. 3. Why do I need to choose between Medicare plans? The choice of “Original Medicare” (Parts A & B) entails payment of monthly premiums for part B and may necessitate additional coverage to pay deductibles and coinsurance to see physicians, hospitals, and other providers who accept Medicare. If you require Prescription drug coverage, you must pay a monthly premium to join the Medicare Prescription Drug Plan (Part D). The “Medicare Advantage Plan” (Part C, which covers Part A & B), also requires the payment of monthly premiums in addition to the Part B premium & a copayment for in-plan doctors, hospitals. If prescription medications are not covered by your supplemental coverage, you have the option of joining the Medicare Prescription Drug Plan (Part D). As with prescription medications, you can purchase supplemental coverage to cover services not covered by Medicare. The “Original Medicare” plan allows for the option of buying Medicare Supplement Insurance (Medigap), while the “Medicare Advantage Plan” does not. It is prudent to always check if you can take advantage of other additional coverage through your employer or union, military, or Veteran’s benefits. 4. Is home health care covered by Medicare? The Medicare website states, “Medicare only covers home health care on a limited basis as ordered by your doctor”. As reviewed earlier, Parts A & B are the Medicare options which cover the home health care services specified by Medicare. Coverage of home health care by Medicare in New Mexico stipulates you must meet the following criteria: – You are currently receiving regular services from a physician. This physician must also maintain a care plan unique to you, which is reviewed regularly. – Your physician must certify a “need” for specific medical services such as requirements for intravenous medication therapy, physical therapy, occupational therapy, respiratory therapy, or speech-language pathology services. – The home health care agency providing you services must be Medicare-certified (for more details see below). – Your physician must certify your health status as homebound, which is indicated by the following: * Your health condition limits you from leaving the house. * You are unable travel from home without help (i.e. transportation assistance such as aids or individuals). * Leaving your home takes considerable effort and may be detrimental to your health condition. 5. My home health company does not take Medicare, why is this? The Medicare-approval process is lengthy and costly, so while it may appear that many companies may not take Medicare, they may actually be in the process of becoming Medicare certified. Furthermore, the Medicare criteria for individual qualifying to receive home health care are very strict; the reality is that many people who may apply for coverage by Medicare for their approved home health company services will not actually receive coverage. Currently, Medicare pays only about half of all health care costs to seniors. Medicare very often denies payment due to not meeting criteria, so it is essential to be aware if you meet these criteria prior to restricting yourself exclusively to Medicare-approved home health care companies.
Source: blogspot.com

Kansas firm to pay $6.1 million Medicare settlement

Posted by:  :  Category: Medicare

Bush Crimes: IMPEACH BUSH before Bush pardons himself: 73 Days left. by eyewashdesign: A. GoldenWICHITA, Kan. (AP) The U.S. Justice Department says a Kansas hospice care provider and its Texas-based parent company have agreed to pay $6.1 million to settle allegations they submitted false claims to the Medicare program.
Source: 1350kman.com

Video: Kansas Medicare Supplements

Shepherd Elder Law Group, LLC: Medicare CLAIM Training in Kansas City

Helpful information for seniors, individuals with disabilities and their families. Guidance for paying for long term care, avoiding probate, estate planning, establishing and administering special needs trusts, powers of attorney, medicaid applications, MoHealthnet eligibility, guardianship.
Source: blogspot.com

Roundup: Texas Probes Xerox In Medicaid Overbilling; Miss. Abortion Clinic Fights To Stay Open

Kaiser Health News: California Pilot Offers Caveats For Moving ‘Dual Eligibles’ To Managed Care As federal officials evaluate state proposals to move millions of the nation’s poorest and sickest individuals into managed care plans, they might consider a recent report from the California HealthCare Foundation. The report analyzed California’s year-long transition of 240,000 low-income seniors and people with disabilities from fee-for-service plans into managed care as part of a federally approved demonstration project. Beneficiaries had to pick a managed care plan, or the state assigned one to them (Carey, 9/4). Politico Pro: Miss Abortion Clinic Fights To Survive Mississippi’s lone abortion clinic won a six-month reprieve from a new state law threatening its existence this spring. But now, it’s buried in paperwork as it fights to stay open. The law, which went into effect in July, requires all physicians on the clinic’s staff to be certified OB-GYNs with hospital admitting privileges. The Jackson Women’s Health Organization went to court and a federal judge granted a partial preliminary injunction, giving the clinic six months to try to comply without a penalty from the state (Smith, 8/31).
Source: kaiserhealthnews.org

Weasel Zippers | Archives

She said the purpose is to suppress the vote, especially among Democratic-leaning constituencies such as elderly voters. And she scorned the Republicans’ contention that the laws are designed to combat voter fraud.
Source: weaselzippers.us

Daily Kos: Biden on Romney

According to a new national poll released Tuesday, just before the start of the Democratic convention, the GOP presidential nominee appears to have received a one-point convention bounce, normal for the modern political era. Flash back to the USA Today front page story on September 8, 2008 The Republican National Convention has given John McCain and his party a significant boost, a USA TODAY/Gallup Poll taken over the weekend shows, as running mate Sarah Palin helps close an “enthusiasm gap” that has dogged the GOP all year. McCain leads Democrat Barack Obama by 50%-46% among registered voters, the Republican’s biggest advantage since Januaryand a turnaround from the USA TODAY poll taken just before the convention opened in St. Paul. Then, he lagged by 7 percentage points. So McCain got an 11 point turnaround, and Romney got 1, and CNN claims that a 1 point boost (really statistical noise) is normal for the modern era?  Kerry got a boost first, and then Bush got a bigger boost in 2004.
Source: dailykos.com

Community Forum: What’s Happening with Medicare and Medicaid

Following the election of Obama in 2008 and the yearlong effort to reform health care in our country, the Manhattan Alliance for Peace and Justice held the first community forum about the new law in 2010. The forum featured Judith Baker, Regional Director, Region 7 Office, U.S. Department of Health and Human Services; Suzanne Cleveland, Senior Policy Analyst of the Kansas Health Institute; and Dr. Tom Kluzak, pathologist from Wichita. Then in 2011 the forum took up the topic of access to health and dental care at the local level which panelists from Konza Prairie Dental, Flint Hills Community Clinic, Pawnee Mental Health and Mercy Regional Health Center.
Source: kansasfreepress.com

KS: Medicaid cops put more pressure on Kansas deadline

In April, the Kansas Health Institute News Service in Topeka reported that leaders in at least 20 Kansas counties were petitioning the state to slow the implementation of KanCare for developmentally disabled Medicaid patients and people in mental hospitals. The respective care often requires extensive institutional treatment for which managed care cost-cutters have little experience, the skeptics argue.
Source: watchdog.org

Some Obama programs embellished by Democrats

THE FACTS: These are references to a $3 million account that Mitt Romney held for several years in a bank in Switzerland and investment funds set up in the Cayman Islands in the Caribbean. A trustee handling Romney’s blind trust said that the Swiss account was active from 2003 until it was closed in 2010. The trustee said the account had been opened for “diversification.” Romney still has active investment funds based in the Caymans, Bermuda, Luxembourg, Ireland and other foreign sites.
Source: kansas.com

Brad DeLong: By How Much Do Ryan

Posted by:  :  Category: Medicare

Gov. Romney and Rep. Ryan claim that no one over 55 will be affected by their health care plan. This claim is false. Their plan would harm all seniors. The Romney-Ryan plan would hurt current seniors in two important ways: * Increased drug costs and higher Medicare premiums. By repealing the Affordable Care Act, the Romney-Ryan plan would raise health care costs in retirement by $11,000 for the average person who is 65 years old today. * Increased long-term care costs, including increased costs for nursing home care, because of cuts to Medicaid. A substantial share of Medicaid spending pays for health care costs for Medicare beneficiaries. The Romney-Ryan Medicaid cuts mean a loss of over $2,500 annually for seniors currently on Medicare who also rely on Medicaid. Unlike the Medicare voucher system that would begin in 2023 the cuts to Medicaid would begin almost immediately. For seniors who will become eligible for Medicare after 2022, the financial harm would be even worse. * Increasingly unaffordable costs for all seniors who qualify for Medicare after 2022. For seniors turning 65 in 2023, Medicare costs during retirement would increase by $59,500 in 2012 dollars under the Romney-Ryan plan. Because under the Romney-Ryan plan the amount of seniors’ vouchers will not keep pace with rising health care costs, these numbers are even worse for future generations. In today’s dollars seniors who qualify for Medicare in 2030 would see an increase of $124,600 in Medicare costs over their retirement. Seniors who qualify for Medicare in 2040 will see an increase of $216,600. And by 2050 newly eligible seniors will pay $331,200 more in Medicare costs over their retirement. * Additional costs from private plans cherry-picking healthier patients. Three-fourths of all Medicare beneficiaries are currently in traditional Medicare. The Romney-Ryan plan would include traditional Medicare as an option in the proposed program, but the costs for seniors who choose to remain in the traditional Medicare program would likely increase even more sharply than for seniors who chose a private plan. Most analysts expect the traditional Medicare plan to attract Medicare beneficiaries with the greatest health needs. In that case, Medicare would no longer enjoy a balanced risk pool and seniors choosing traditional Medicare could wind up paying an extra $29,000 on average over their retirement lifetime above and beyond the costs described above.
Source: typepad.com

Video: EHR: Medicare, Medicaid EHR Incentive Program Webinar for Eligible Professionals

Marshall Elder and Estate Planning Blog: Protecting the Rights of Nursing Home Residents

(8) The facility must comply with the requirements specified in subpart I of part 489 of this chapter relating to maintaining written policies and procedures regarding advance directives. These requirements include provisions to inform and provide written information to all adult residents concerning the right to accept or refuse medical or surgical treatment and, at the individual’s option, formulate an advance directive. This includes a written description of the facility’s policies to implement advance directives and applicable State law. Facilities are permitted to contract with other entities to furnish this information but are still legally responsible for ensuring that the requirements of this section are met. If an adult individual is incapacitated at the time of admission and is unable to receive information (due to the incapacitating condition or a mental disorder) or articulate whether or not he or she has executed an advance directive, the facility may give advance directive information to the individual’s family or surrogate in the same manner that it issues other materials about policies and procedures to the family of the incapacitated individual or to a surrogate or other concerned persons in accordance with State law. The facility is not relieved of its obligation to provide this information to the individual once he or she is no longer incapacitated or unable to receive such information. Follow-up procedures must be in place to provide the information to the individual directly at the appropriate time.
Source: blogspot.com

Last 2012 Medicare EHR reporting period begins Oct. 3

“For eligible professionals, this means that they must begin their consecutive 90-day reporting period by Oct. 3 in order to attest to meeting meaningful use and be eligible to receive an incentive payment for CY 2012,” U.S. Centers for Medicare & Medicaid Services (CMS) officials noted in an email message to health care practitioners last month.
Source: newsfromaoa.org

Our Debt and Deficit Mess — The Real Story

Still, the US budget was in balance under President Clinton.  That is because while the huge cohort of baby boomers were in their prime earning years, their payments into medicare and social security paid the costs of those programs and more.   That is why the Congressional Budget Office, under George Bush, said it was okay to fight two large wars and cut taxes.  But the CBO warned that in 2011, when the baby boomers started to retire, the rising costs of entitlements for social security and medicare would start to surge, while the boomer pay-ins would start to decline.  That is why the Bush tax cuts came with an automatic expiration date of 201o; even a dozen years ago, when we thought the Iraq war would pay for itself and before the Great Recession was in sight, it was clear that if the Bush tax cuts were extended past 2010 the federal deficit would start to explode.
Source: newpopulationbomb.com

Issue Worth Exploring: Raising the Medicare Eligibility Age May Harm Minorities

Candidate Position, Quotation, Person Career, Social Issues, Federal assistance in the United States, Healthcare reform in the United States, Presidency of Lyndon B. Johnson, Medicare, Paul Ryan, United States National Health Care Act, The Path to Prosperity, Economy of the United States, Social Security, Politics of the United States, Government, Medicaid, J. Duncan Moore Jr., Congressional Budget Office, WIS, Mitt Romney, Republican Party, purchase insurance, media coverage, congressman, co-founder, The Medicare NewsGroup, Association of Health Care Journalists, substitute insurance, health insurance, chair, Washington, Maya Rockeymoore, National Committee, presidential race
Source: reportingonhealth.org

Latest House Republican Budget Threatens Medicare and Shreds the Safety Net

What’s more, private plans could “cherry pick” healthier seniors, driving up premiums for those who remain in traditional Medicare. And private plans would be able to undercut traditional Medicare in other ways, such as by offering free gym memberships or other perks. As a result more and more seniors would gradually shift to private plans over time. This gradual privatization of Medicare does not make sense because traditional Medicare costs less than comparable private coverage. But with fewer beneficiaries Medicare would have less leverage to contain the growth in health care costs.
Source: americanprogress.org

Roundup: Texas Probes Xerox In Medicaid Overbilling; Miss. Abortion Clinic Fights To Stay Open

Kaiser Health News: California Pilot Offers Caveats For Moving ‘Dual Eligibles’ To Managed Care As federal officials evaluate state proposals to move millions of the nation’s poorest and sickest individuals into managed care plans, they might consider a recent report from the California HealthCare Foundation. The report analyzed California’s year-long transition of 240,000 low-income seniors and people with disabilities from fee-for-service plans into managed care as part of a federally approved demonstration project. Beneficiaries had to pick a managed care plan, or the state assigned one to them (Carey, 9/4). Politico Pro: Miss Abortion Clinic Fights To Survive Mississippi’s lone abortion clinic won a six-month reprieve from a new state law threatening its existence this spring. But now, it’s buried in paperwork as it fights to stay open. The law, which went into effect in July, requires all physicians on the clinic’s staff to be certified OB-GYNs with hospital admitting privileges. The Jackson Women’s Health Organization went to court and a federal judge granted a partial preliminary injunction, giving the clinic six months to try to comply without a penalty from the state (Smith, 8/31).
Source: kaiserhealthnews.org

Massachusetts is First State to Receive CMS Approval for Medicaid

Massachusetts’ pilot program will cover about 111,000 disabled adults who are dually enrolled in Medicaid and Medicare. The state has selected a capitated financial model to fund enrollees’ services, in which integrated care organizations will receive a prospective payment to deliver care to these patients. The demonstration program will enable the state to offer expanded services for enrollees, such as additional dental care, vision, and behavioral health services. Care teams will be made up of a primary care provider, a care coordinator, and a long-term services coordinator.
Source: mentalhealthcarereform.org

The Truth About Gov. Romney’s Medicare and Medicaid ‘Reforms’

The House Republican premium support plan would adjust the voucher for health status—redistributing payments from plans with healthier enrollees to plans with less healthy enrollees. This “risk adjustment” mechanism would certainly help, but current risk-adjustment methods are still far from perfect. Current methods tend to overpay plans with healthier enrollees and underpay plans with less healthy enrollees. As a result, premiums for traditional Medicare would likely rise and enrollment would likely decline over time. This outcome is even more likely because the House Republican premium support plan would not require private plans to provide a standard set of benefits—allowing them to design benefits that attract healthier beneficiaries.
Source: americanprogressaction.org

CMS: News Models for Dual Eligible Tested

Part of a CMS demonstration announced last year, the project will contract with “integrated care organizations” that will oversee and be accountable for the delivery of Medicare, Medicaid and other services for dual enrollees beginning in April 2013. Eligible beneficiaries will be able to opt out of the demonstration or choose an alternative demonstration plan. CMS estimates that up to 110,000 Medicare and Medicaid beneficiaries could participate.
Source: hcafnews.com

Daily Kos: Prepare to shed tears: Aetna murders woman by excessive rate hikes

Lupin, Angie in WA State, Joe Bob, PrahaPartizan, Chi, grollen, slinkerwink, Geenius at Wrok, Danno11, Shockwave, hyperstation, celdd, devtob, musicsleuth, exNYinTX, expatjourno, missLotus, cyberKosFan, BlackSheep1, whenwego, KibbutzAmiad, CoolOnion, boadicea, pedrito, JuliaAnn, Voter123, jalbert, Nate Roberts, antirove, dksbook, aitchdee, revsue, Texknight, Getreal1246, NYC Sophia, pat bunny, cosette, texasmom, Chirons apprentice, annetteboardman, barbwires, zerelda, Kitsap River, lonespark, vacantlook, sb, maybeeso in michigan, NoMoreLies, revbludge, Militarytracy, ccasas, basquebob, dewtx, ChemBob, Brooke In Seattle, EJP in Maine, farmerchuck, bleeding blue, SaraBeth, GreyHawk, skyounkin, most peculiar mama, blue jersey mom, Hastur, onanyes, Ozzie, spunhard, Bob B, Ginny in CO, FindingMyVoice, distraught, Cory Bantic, bookwoman, kathny, CJnyc, reddbierd, Born in NOLA, Showman, Shirl In Idaho, Kingsmeg, cybersaur, BlueInARedState, Themistoclea, seefleur, kestrel9000, triv33, twigg, gooderservice, uniqity, happy camper, middleagedhousewife, MBNYC, Turbonerd, bumbi, CA Nana, means are the ends, Statusquomustgo, Tom Anderson, Temmoku, Tamar, One Pissed Off Liberal, Noor B, pfiore8, Cronesense, tgypsy, ColoTim, gloriana, Stwriley, karmsy, edsbrooklyn, Mary Mike, wildweasels, terabytes, newpioneer, HCKAD, jayden, jnhobbs, gchaucer2, RudiB, pioneer111, uciguy30, GeorgeXVIII, Assaf, vet, aishmael, rogerdaddy, TruthFreedomKindness, wayoutinthestix, ScottyUrb, treesrock, lineatus, Akonitum, rssrai, tofumagoo, Cassandra Waites, petulans, luckylizard, priceman, palantir, enufisenuf, shortgirl, statsone, Fiddlegirl, MrsTarquinBiscuitbarrel, prettygirlxoxoxo, CanyonWren, Norm in Chicago, CamillesDad1, MKSinSA, dalfireplug, sfarkash, 57andFemale, jfromga, America Jones, Just Bob, commonmass, Broke And Unemployed, Laurilei, piers, eb23, Crabby Abbey, Simple, womankind, Kristina40, Funkygal, Betty Pinson, Otteray Scribe, Oh Mary Oh, Actbriniel, JanG, slice, praying manatheist, redlum jak, mama jo, ozsea1, Plox, spooks51, Catherine R, slowbutsure, vahana, Mistral Wind, asterkitty, OhioNatureMom, Nicci August, marleycat, thomask, SueM1121, MRA NY, createpeace, rexymeteorite, bluedust, Wood Dragon, diffrntdrummr, VeloVixen, kareylou, caryltoo, ArtemisBSG, bearette, Only Needs a Beat, jacey, GenXangster, ridemybike, anodnhajo, Williston Barrett, Mindful Nature, molecularlevel, IndieGuy, Xkeeper, Joieau, draa, FloridaSNMOM, congenitalefty, Horace Boothroyd III, swedepi, Mr Robert, radv005, OllieGarkey, sexgenderbody, Glen The Plumber, George3, Kayjay, Robynhood too, Phoebe Loosinhouse, Blue Bell Bookworm, TheMeansAreTheEnd, Late Again, remembrance, glorificus, weck, gypsytoo, MarEng, howabout, Homer177, LaraJones, BitterEnvy, JKTownsend, Michael Chadwick
Source: dailykos.com

Marxist update: Health care reform austerity

Much of the debate has focused on Medicare for the elderly. Ryan and Romney point out that under so-called Obamacare the government makes the decisions about what kind of health care people can get and how much doctors, hospitals, and other health care providers can charge. Ryan calls the Independent Payment Advisory Board, set up by Obama to control Medicare costs, “a new rationing board” that will “start price-controlling Medicare to deny access to current seniors.”
Source: blogspot.com

GOP’s Official Platform Includes Changes to Medicare, Medicaid

Specifically, the platform states that the GOP would change Medicare into a partially privatized system, giving seniors the option between the existing Medicare program and subsidies to buy private insurance. In addition, the party would convert Medicaid into a block-grant program (Baker, “Healthwatch,” The Hill, 8/28). The platform calls for changing Medicare eligibility to be “more realistic in terms of today’s longer life span,” but does not specify what age would be appropriate.
Source: californiahealthline.org

MedicareSupplementPlans.com Offer Comparison Shopping Resource for Medicare Supplement Plans

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSMedicare covers some medical expenses, but it doesn’t cover everything. Medicare leaves gaps in patient coverage, and without a supplementary insurance plan, these gaps must be paid out-of-pocket. For that reason, Medicare supplement insurance plans are becoming a popular way to fill in the gaps left by Medicare coverage. Today, many top insurance providers offer some type of Medicare supplement plans. However, some of these plans are better than others. Some supplement plans might only fill in a few gaps left by Medicare coverage, while other plans comprehensively cover seniors in any circumstance. Some supplement plans are priced affordably, while others are expensive. MedicareSupplementPlans.com has been gaining a lot of attention lately by helping seniors quickly and easily compare any type of Medicare supplement plans. At MedicareSupplementPlans.com, visitors will find information about the best Medicare supplement plans in the country. The website states that these plans – also known as ‘Medigap’ insurance plans – cost far less than what many people expect. A spokesperson for MedicareSupplementPlans.com explained what the site hopes to accomplish: “Our goal is to connect visitors with the best possible Medicare supplement plans for their needs. There are so many different ‘Medigap’ plans available in this country, and finding the right one can be difficult for those who don’t have experience in the industry. That’s why we offer free insurance quotes that can be filled out in just minutes or allow people to be guided by our team of experienced representatives. We want to make it as simple as possible for consumers to select the most appropriate policy at the best possible price.” Using the website, visitors can also discover the specific benefits included in Medigap insurance plans. The website describes the specific types of Medigap plans offered by insurance companies across the states, and plans are identified by the letters A, B, C, D, F, G, K, L, M, and N. Each of these plans is the same for every insurance company. For example, Plan F Medigap from one insurance company will be identical to Plan F Medigap offered by another insurance company. The website features a detailed list that shows what each plan covers in a simple to navigate chart. The information on MedicareSupplementPlans.com is catered to those in California. The website features unique pages for every county in California, and visitors can easily compare California Medicare plans from anywhere in the state. Whether seeking to fill in the gaps left by insufficient Medicare coverage, or simply wanting to learn more about the types of insurance plans available, MedicareSupplementPlans.com allows users to compare the different types of Medicare supplement plans available today. By filling out the free insurance quote form included on the front page, visitors can receive a free quote within hours. About MedicareSupplementPlans.com MedicareSupplementPlans.com educates visitors about Medicare supplement plans, which are designed to fill in the gaps left by Medicare coverage. The website allows users to instantly receive a free insurance quote for insurance in their area. For more information, please visit: http://www.medicaresupplementplans.com
Source: sbwire.com

Video: Medicare Supplemental Insurance – What’s the Best Plan for Me?

Get a Good Medicare Supplement Quote

Medicare supplements are basically health insurance plans, which aim at filling in the gaps of the Medicare coverage. It is a private health insurance policy which increases the original Medicare plan effectively. Often it is seen that it offers as a great helping hand by paying off many health expenses, which is not included within the Medicare plan. If you are under a Medicare policy, it is still recommended to purchase a supplement program, as both of them have their share of Medicare-approved amount for specific health care expenses.   Usually, the basic benefits offered by the Medicare supplement tend to be same. These policies also follow the Federal and state laws to protect you. By the standardization of the Medicare policies and quotes by the Federal, it has become convenient to opt for the best supplement quote smoothly.  By getting a good Medicare supplement quote, you can grab the best medical care facilities at affordable price rates.
Source: qufranciscanpress.com

Medigap North Palm Beach Fl

If you don’t do the necessary amount of shopping around, you may end up paying too much for Medicare Supplement Insurance. The different plans are standardized, which means they cannot be changed from one insurance company to another. If you have a supplemental plan in mind, find an insurance company that offers it at the best rate. You can cut the leg-work out of the process by calling an independent Florida Health insurance broker. We shop the various insurance companies for our clients, so they don’t have to. Our multiple company analysis lets clients quickly see which company offers the lowest quote for a particular plan.
Source: floridahealthinsurancebroker.com

Low cognitive ability impairs enrollment in Medicare supplemental plans

The largest health insurance is United Health Care, which offers all types of health insurance system. If you are planning to have a unified health care plans, there are several choices are available to purchase, you can use the best suited insurance. Some of their plans include copay, short term medical, student offer coverage, health savings accounts and they also dental insurance for those who have coverage through their employer dont get. individuals and families, a United Healthcare Insurance looking for, with many of the same advantages as the Employers should provide select copay. You must pay a fixed fee for preventive care and doctor visits, but after the payment, 100% testing of the costs are covered. Health care reform is a new feature in the practice came after Obama won the political battle. This is a very new service available to all Americans, but few have the knowledge of health care reform, this article focuses entirely on fact, inform the American people about health reform and the benefits they are going to get through approval of this plan. In this article I have all the advantages you will shape health care reform will be listed below. United Health Care is a popular choice and based on the company, registering one of five Medicare beneficiaries in their health plans. They also offer coverage through Secure Horizons, Evercare Choice and America. United Healthcare Medicare plans in a number of options that HMO plans, supplement insurance plans, special needs plans, and Medicare Part D offers prescription drug plans include. These plans offer different types of coverage and the best time for you to meet your individual health condition. United Healthcare also plans to Medicare Supplement Insurance. This insurance can help in the costs incurred by Medicare Part A and Part B. The special needs programs are only for people with certain medical conditions and life situations and are not open for general registration. United Healthcare is also widely accepted is a great advantage for students who attend a school may be far from home. However, your school will provide to United Healthcare for the benefit of their particular student insurance increase. Hope this article was necessary in providing important information about United Health Care, if you want more about United Healthcare Report They know how healthvote.com Source: southerninitiative.com Source: medicarehelpco.com
Source: medicarehelpco.com

Best Medicare Supplement Insurance Plans

Every Medicare supplemental plan must follow federal and state laws designed to protect you. Medicare supplement plan insurance companies can only sell you a “modernized” Medicare supplemental plan identified by letters A through N. Each modernized Medicare supplemental plan must offer the same basic benefits, no matter which insurance company sells it.
Source: wordpress.com

All Insurance Information

An adviser can enlighten you about the policies of the Medicare Supplement plans provided by the various companies and also can advice you about the plan that fits best according to your need. You should understand the best Medicare Supplement plan for you because the need differs from one to another, from a healthy individual to a sick person. You can come across a number of Medicare supplement Insurance companies those offer attractive Medicare supplement insurance plans, and then you can choose the most suitable Medicare supplement plan for you. You may enquire for clarity before the shopping what the coverage is and what is not under a specific Medicare Supplement plan. Some plans do not hold any premium pay service; however those do not cover much facility. Again, the plans that have a premium to pay cover more.
Source: insurancesinfo.info

Jonathan Paton pledges to protect Medicare in Telephone Town Hall

Posted by:  :  Category: Medicare

Racism by elycefelizAbortion AIRC Arizona Independent Redistricting Commission AZ09 AZGOP AZSEN Barack Obama Ben Quayle Cathi Herrod CD-1 CD-3 CD-5 CD-6 CD-8 CD-9 Center for Arizona Policy David Schweikert Debt Ceiling Gabrielle Giffords Greg Stanton Jan Brewer JD Hayworth Jeff Flake Jennifer Wright Jesse Kelly John McCain Kirk Adams Matt Salmon Mayor of Phoenix Mitt Romney National Debt Obamacare Paul Babeu Paul Gosar Phoenix Phoenix City Council Phoenix Elections Richard Carmona Russell Pearce Tea Party Trent Franks Tucson US Senate Wes Gullett Wil Cardon
Source: sonoranalliance.com

Video: Medicare Advantage Plans Arizona- 1.800.643.7544

Daily Kos: Celebrating 47 Years of Medicare!

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

Rim Country Gazette: 97% of AZ seniors on Medicare

AARP is a nonprofit, nonpartisan organization with a membership that helps people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates. We produce AARP The Magazine, the definitive voice for 50+ Americans and the world’s largest-circulation magazine with nearly 35 million readers; AARP Bulletin, the go-to news source for AARP’s millions of members and Americans 50+; AARP VIVA, the only bilingual U.S. publication dedicated exclusively to the 50+ Hispanic community; and our website, AARP.org. AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. We have staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands.
Source: blogspot.com

403 FORBIDDEN : LOGGED TO HONEYPOT

Your connection details: Record #: 3201 Time: Wed, 05 Sep 2012 12:00:27 -0500 Running: 0.4.10a1 Host: gator1793.hostgator.com IP: 50.97.96.123 Post: Query: Stripped Query: Referer: User Agent: spider Reconstructed URL: http:// www.coyoteblog.com /coyote_blog/2012/09/the-medicare-problem-a-reminder.html     Generated by ZB Block 0.4.10a1
Source: coyoteblog.com

Medicare Advantage Plans Arizona

Medicare Advantage Plans in Arizona are sold through private insurance companies approved by Medicare. While they typically offer similar benefits, there are significant differences between plans, making it well worth your time to compare a few of the providers. Basically, all Medicare Advantage Plans in Arizona must provide Original Medicare benefits (Part A and Part B). Some include extra coverage like dental or vision care and most include Part D (prescription drug coverage). There are a few different types of Medicare Advantage plans available, including HMO plans, PPO plans, Private Fee-for-Service plans and Special Needs plans. Whichever type you choose, Medicare pays a fixed amount for your care to the company providing your Medicare Advantage plan.
Source: medicareadvantageplansarizona.com

How Workers Compensation is Affected by Medicare Set Asides

Posted by:  :  Category: Medicare

The PARTY Is OVER ...item 3.. Mike Lofgren, Angry GOP Insider, Says The Party is Over: Book Review (August 2012) ... by marsmet471The Mandell Law Firm, in Northridge, is an aggressive personal injury and wrongful death law firm serving clients throughout the San Fernando Valley, the Greater Los Angeles area, and Southern California. If you or a family member is involved in a workers compensation settlement that might include a Medicare Set Aside, Mara Burnett can help. Experienced and reputable, Mara and the other attorneys at Mandell Law provide hands-on care and a sincere commitment to victims of accidents. Contact Mara Burnett for a free consultation at 818.866.6600.
Source: mandellaw.com

Video: Roskam Bill Saves Medicare Tens of Billions

How Medicare Works: How do I file an appeal?

The easiest way to file an appeal is to get a MSN with the service or item that you are appealing, circle the item or service that you wish to appeal, write an explanation why you disagree, sign the back of the MSN, include your phone number and Medicare number, and mail it back to Medicare contractor using the address provided.
Source: howmedicareworks.com

ALJ Decisions Drive Payment for Previously Denied Inpatient Claims

In addition, CMS says the decision requires payment for all services that would be separately payable under the outpatient prospective payment system had the hospital originally billed the services as outpatient. That would mean separate payment for associated surgical procedures, clinic or Emergency Department Evaluation and Management (E/M)-visit levels and potentially the Extended Assessment and Management Composite APC, which is triggered by the presence of observation hours plus a high-level E/M code. Many inpatient claims denied for incorrect site of service were admissions following a scheduled outpatient procedure. Many times, these cases were costly outpatient cardiac procedures with implantation of a pacemaker or cardio-defibrillator. These surgical procedures would not be billed or paid under a Part B only claim.
Source: bkd.com

Complex Rehab Network by J and R Medical

has lived much of his life with medical challenges that have affected his mobility. Five years ago, after Wilson developed a decubitus ulcer his mobility became severely restricted. “My body was just not the same as far as mobility,” said Wilson, 35. “I was a walking person who became a wheelchair person.”  After nearly five years with a manual wheelchair, Wilson said his body was worn down, his shoulder too weak to maneuver the chair. He had to move in with his mother. But Wilson said the downward spiral spun upward in February when Medicare approved him for a power wheelchair, a medical device that lifted his spirits and changed his life. “My shoulders have just about given out and the power chair has brought me back into society,” Wilson said. “Especially after the ulcer, I was basically bedridden and couldn’t get around my own house.  If I wanted to go out someone would have to push me because my shoulders quit.  With the power chair, the shoulders are not an issue.  I can go until the battery quits.” Once Wilson developed the ulcer, he stopped working. His doctor said he could have died from an infection.  Now, however, Wilson said the power wheelchair has returned some of the independence that he had missed, including grooming, preparing food, and getting to the bathroom. “And being able to leave my house, go up and down the street on the sidewalk, walk the dog, and go outside and spit in the yard,” Wilson said. “Just simple things that I would need help with, now I don’t.” Wilson is like thousands of Medicare patients across the country: they depend on power wheelchairs to allow them to live safely and independently at their homes.  For many people living with disabilities, the power wheelchair is what prevents them from being confined to a nursing home or other care facility.  Studies show that power wheelchairs actually reduce government health spending because Medicare patients have fewer falls and hospital emergency room visits with power wheelchairs. The mobility devices also delay placement in costly care facilities. Yet, over the last nine years, the Centers for Medicare & Medicaid Services (CMS) has repeatedly implemented a series of policy and regulation changes making it more difficult for Medicare beneficiaries to receive power wheelchairs prescribed by their physicians.  At the same time, home medical equipment providers have faced devastating cuts in reimbursements for power wheelchairs, excessive audits, and other policies that jeopardize their ability to continue providing the medical devices. “Senior citizens and people living with physical disabilities clearly benefit from power wheelchairs, but CMS and Congress repeatedly adopt policies that restrict use of the Medicare power mobility benefit,” said
Source: blogspot.com

BACK v. SEBELIUS, No. 11–55175., July 05, 2012

Because the Secretary has already created the administrative appeals process that Back seeks, “no present controversy exists as to which [we] can grant effective relief.” Vegas Diamond Props., LLC, 669 F.3d at 936; see also Spencer–Lugo v. INS, 548 F.2d 870, 870–71 (9th Cir.1977) (per curiam) (holding that a case was moot where the INS offered the petitioners exactly what they asked for); 13B Charles Alan Wright, Arthur R. Miller & Edward H. Cooper, Federal Practice and Procedure § 3533.2 (3d ed. 2008) (“Even when one party wishes to persist to judgment, an offer to accord all of the relief demanded may moot the case․ Action by the defendant that simply accords all the relief demanded by the plaintiff may have the same effect as settlement or an offer of settlement. So long as nothing further would be ordered by the court, there is no point in proceeding to decide the merits.”). The appeal is therefore moot.
Source: findlaw.com

Where you live matters when veterans await SSDI benefits

Continuing with last week’s theme of disabled veterans’ issues, we found a recent investigative report issued by the Center for Investigative Reporting rather interesting. Veterans in less populated states wait less than half the time for the U.S. Department of Veterans Affairs to process disability claims than do those veterans in more populated states. The wait times are fully documented in the Center’s report, which is a first-of-its-kind analysis of VA waiting periods for disability claims. Massachusetts came in at 265 days for an average wait time, with almost 11,000 veterans awaiting a response to their disability claim.
Source: dialalawyersocialsecurityblog.com

Medicare Appeals Process Explained

There are five levels to an appeal.  First, redetermination by a Medicare carrier, intermediary, or Medicare Administrative Contractor.  Second is review by a Qualified Independent Contractor.  Third is hearing by an Administrative Law Judge in the Office of Medicare Hearings and Appeals.  Fourth is review by Medicare Appeals Council, and Fifth is Judicial Review by Federal District Court.  Most cases are settled long before they get to step number five.
Source: medicare-medicaid.com

Brad DeLong: The Policy Substance Underlying Today’s Politics

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SSHey seniors! The Republican platform calls for turning Medicare into a voucher program and for eliminating important benefits for you–they want to reopen the Medicare drug “donut hole”. They would want to raise your Medicare premium by an average of $577/yr a decade from now. Why? Because they seem hell-bent on restoring $716 billion in wasteful Medicare payments to insurance companies and over-treating specialists. We don’t know the full details. They won’t tell us. Republicans’ rhetoric and plans keep shifting as the American people responds with dismay to what Republicans propose. It won’t be good. We do know that two-thirds of Medicaid dollars are used to care for the elderly and the disabled, and that the Republicans have pledged to cut Medicaid dramatically.
Source: typepad.com

Video: Start Selling Medicare Advantage – Great Opportunity

Can You Make Money Selling Medicare Advantage?

You should talk to someone who was on an MA plan and had to use it. I signed up a lady yesterday that had an MA plan in another state. Her health took a turn for the worse a few months back resulting in her spending 2 weeks in the hospital, 2 in rehab. Her $27 plan ended up costing her over $3,000 in OOP expenses. Even before her setback, her 1 – 2 monthly doc visits added to the cost of her plan. The Rx coverage that was married to the MA did not include her most expensive meds on their formulary. Since she has moved out of the service area she is GI and I put her on plan N @ $132 month plus another $38 for PDP that covers all her meds. In addition to more protection against OOP she no longer has to deal with networks and can use any doc anywhere.
Source: insurance-forums.net

Ryan Says GOP Will Protect Medicare

Politico Pro: Ryan’s Medicare ‘Raid’ Charge Open To Debate Paul Ryan accused President Barack Obama of “raiding” Medicare to pay for his own health care reform law — a claim that has already put Democrats on defense on the fight over entitlement reform. Ryan’s claim: Obama took $716 billion from Medicare to pay for his law, thus cutting the entitlement program. The problem: that’s not entirely true, as many fact-checking outlets have noted. While the Obama health care law does take money from Medicare providers, it does not shift the costs to beneficiaries. It pays Medicare Advantage private health plans less, trims annual increases that hospitals, home health and nursing homes receive under Medicare, and imposes new fees on drug and device makers (Kenen, 8/29).
Source: kaiserhealthnews.org

How the Presidential Candidates Use the Web and Social Media: Obama Leads but Neither Candidate Engages in Much Dialogue with Voters

On the eve of the conventions, Barack Obama holds a distinct advantage over Mitt Romney in the way his campaign is using digital technology to communicate directly with voters. The Obama campaign is posting almost four times as much content and is active on nearly twice as many platforms, according to the study. [Note: contains copyrighted material].
Source: usembassy.gov

ALTERNATIVE TREATMENTS FOR ROSACEA

Posted by:  :  Category: Medicare

Rosacea is a skin indisposition which causes skin to go red and also produces some pimples or bumps on the skin. Normally occurs on your exterior scrape. This disease has no permanent regenerate to right but there are sundry medicines available in the vend saying that they mend this disease completely. But thoroughly medicines are available but they cannot fully treat it. extremely of them just succour to cure some of the symptoms of rosacea. So, agency order to manage rid of rosacea you incumbency be credulous preference treatment which is additional effective and pledge permanently remove this illness from you.
Source: blogspot.com

Video: Pittsburgh Celebrates Medicare’s Anniversary

New Medicare Administrative Carrier for Jurisdiction 12 Highmark Medicare Services Acquired by Diversified Service Options Inc

Diversified Service Options (DSO) acquired Highmark Medicare Services (Highmark) on January 1, 2012. DSO is a holding company and a wholly-owned subsidiary of Blue Cross and Blue Shield of Florida, Inc. (BCBS Florida). Highmark had the contract with the Centers for Medicare & Medicaid Services (CMS) to be the Medicare Administrative Contractor (MAC), formerly known as a “Carrier” or “Fiscal Intermediary,” for Jurisdiction 12, which includes Delaware, New Jersey, Pennsylvania, Maryland and Washington, D.C. For Part B services, Jurisdiction 12 also includes the counties of Arlington and Fairfax in Virginia and the city of Alexandria in Virginia.
Source: thehealthlawfirm.com

Highmark Medicare Services Changes Name to Novitas Solutions, Inc.

Please read the following bulletin from Highmark Medicare Services. The affected payers are: CPID 2456 Delaware Medicare CPID 5912 Delaware Medicare CPID 3677 J12 Mutual of Omaha DC,DE,MD,NY,PA CPID 7402 Maryland Medicare CPID 5554 Maryland Medicare CPID 2464 Maryland Medicare (MONTG,PRINCE GEORGE) CPID 1465 New Jersey Medicare CPID 5503 New Jersey Medicare CPID 5598 Pennsylvania Medicare CPID 2457 Pennsylvania Medicare CPID 2461 Virginia Medicare (ALEX,ARLGTN,FAIRFAX) CPID 1522 Washington DC Medicare CPID 2459 Washington DC Medicare Reported by Highmark Medicare Services: As announced March 1, 2012, Highmark Medicare Services is changing its name to Novitas Solutions. Effective March 10, 2012, Highmark Medicare will begin migrating the current Highmark Medicare website to our new Novitas Solutions website. We are targeting completing our name change to all active webpage content by March 30, 2012. The new Novitas Solutions website URL will be https://www.novitas-solutions.com. Additional details, including Frequently Asked Questions, are available at https://www.novitas-solutions.com/partb/info-alerts.html. Re-enrollment is Not required. The clearinghouse will continue processing as normal. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

What happened to Highmark Medicare Services?

Physicians and medical billing companies should not face many disruptions as a result of this transition. According to Novitas Solutions, the current Highmark Medicare website will be fully transitioned to the new Novitas site by March 30, 2012. During the transition, visitors to the old website (https://www.highmarkmedicareservices.com) will be automatically re-directed to the new Novitas Solutions website (https://www.novitas-solutions.com), where a new header and page logo can be seen. Bookmarks that users may already have for the Highmark website will purportedly still work with the new page. The Electronic Payer ID has not appeared to change, so claims submission and processing should remain unaffected by the transition. For more information, see the Informational Alert here: https://www.novitas-solutions.com/partb/info-alerts.html.
Source: healthcarebiller.com

Highmark Medicare LCD’s Proposed : Med Law Blog

Highmark Medicare Services has published the initial draft set of LCDs as part of its plans to fulfill CMS requirements to consolidate ICEs by July 1, 2008. Highmark’s instructions for submitting comments for the proposed Local Coverage Determinations (LCDs) and the proposed LCDs are included in the attached link. The following LCDs are included:
Source: medlawblog.com

Linda Joy Adams: Highmark Medicare Services Inc Becomes Novitas Solutions Inc

An informal news letter of all kinds of news and comments on the news. Specific intent is to ‘track’ mergers and acquisitions at the highest levels in our world and the impact these have on individual rights. This blog was started to aid me keep track for my personal benefit. It evolved into a shared content with anyone interested.
Source: blogspot.com

More Healthcare Choices With Highmark Medicare

Few folks have adequate money to include anesthesia bills once these folks get sick. In order to make quality medical care readily available to the majority, well being insurance prefer Medicare is invented by the the us government as an assurance that individuals are protected from the prices incurred when availing one. The procedure of wellbeing insurance follows a financial fee structure generally in the kind of month-to-month premium deductions by the insurance coverage sites to the salary of an personalized. The financial savings that gather at the time of time from these insurance plan are used for spending health care. Typically, a wellness protection has provisions to adhere to earlier than an policyholder personalized might be eligible for cover. In Medicare for instance, people aged 65 or older, permanently inept, or individuals with kidney failure, are entitled to use it so which their medical charges are a lot more affordable.
Source: ivegotcoveragereview.com