Medicare Benefits For Eyeglasses

Posted by:  :  Category: Medicare

Medicare Part A provides for inpatient medical center care, covering up 90 days per benefit period and 60 reserve days for your lifetime, as well as 100 days per benefit within a skilled breastfeeding facility for care. To qualify for the skilled breastfeeding facility care, however, you must have stayed in the hospital for three sequential days within 30 days prior to admission to the ability. Hospice care can also be furnished if you are confirmed to be terminally ill by your medical doctor. Home health care is covered in Medicare Part A for 100 nights, with the same stipulation which you have stayed in the medical center for three days, these kinds of being within two weeks prior to receiving care and being homebound. Medicare Part B deals with more of the outpatient doctor services. These include regular visits to the doctor as well as some preventative services, durable medical equipment, ambulance services for emergency travel, and x-rays and tests. It also includes outpatient physical, talk, and occupational therapy services as well as other home health services.
Source: virginiamedicarepros.com

Video: Why does Medicare pay for some things (Viagra) and not others (Eye glasses, for example)

4 Seniors: Save money on glasses

Or, if you’re a current or soon-to-be Medicare beneficiary, you may want to consider a Medicare Advantage plan. These are government approved, private health plans (usually HMOs and PPOs) sold by insurance companies that you can choose in place of “Original Medicare” – which does not cover eyeglasses (unless you’ve just had cataract surgery) or routine eye exams. Many Advantage plans offer extra benefits including vision care, in addition to health care coverage. See www.medicare.gov/find-a-plan to research this option. 
Source: kfor.com

Healthcare in Retirement: What Will It Cost?

Health care costs are a huge issue, especially for anyone close to retirement. According to a recent poll by Harris Interactive, almost 50 percent of U.S. adults are ‘extremely’ or ‘very’ worried about how they’ll pay for rising health-care costs. And the closer they are to retirement, the greater their concern. That’s justified considering that some financial experts are predicting that, even with Medicare benefits, a 65-year-old couple today could need well over $250,000 just to cover out-of-pocket health costs during the rest of their lives. While it sounds like a whopping sum, when you consider that only represents an annual cost of $12,500 for 20 years, it’s realistic—and may even be low.
Source: schwab.com

Is Medicare Part B Enrollment Necessary?

Part B covers several medical needs that Part A does not. It helps cover many outpatient services you may need including doctor visits, clinical laboratory services, as well as some preventive services including examinations. Maybe this will clarify the situation better. The Original Medicare Part A is pretty black and white about coverage, leaving you to add Part B for any other medical coverage.
Source: seniorcorps.org

Medicare Cuts Could Threaten NJ Jobs, Says New Report

Posted by:  :  Category: Medicare

New Jersey Hospital Association President and CEO Betsy Ryan says “these cuts would have a significant impact on the well-being of our hospitals, their patients, their communities and the entire Garden State economy, the healthcare community recognizes the importance of reducing the nation’s deficit, but hospitals have already been forced to absorb billions in Medicare cuts under the Affordable Care Act. These additional cuts would go far too deep into a critical component of our safety net and our economy.”
Source: nj1015.com

Video: Stephanie Cutter: Medicare Whiteboard

After Jobs Report, Obama Tries to Change the Subject

The president’s advisers have indicated that they are eager to re-engage their opponents on their Medicare plan, while the Romney camp would prefer to talk about the economy. A government report on Friday showed that employers had eased up on hiring in August, adding just 96,000 jobs, compared with 141,000 in July. The unemployment rate dropped to 8.1 percent from 8.3 percent, but that was largely because of people leaving the work force entirely.
Source: nytimes.com

The Last Chance Of Freedom: Democrats Twist Jobs Numbers and GOP Medicare Ideas

On Day 2 of the Democratic National Convention, speakers cherry-picked employment numbers to make President Barack Obama’s record on jobs look better than it is and misrepresented Republican proposals on Medicare to cast them in the worst light. A look at some of the claims from the stage, in speeches preceding former President Bill Clinton’s featured address Wednesday night, and how those assertions compare with the facts: Rep. NANCY PELOSI of California, House Democratic leader: “Democrats will preserve and strengthen Medicare. Republicans will end the Medicare guarantee.” REP. STEVE ISRAEL, D-N.Y., chairman of the Democratic Congressional Campaign Committee: “Paul Ryan wrote the budget that turns Medicare into voucher care and could charge seniors $6,400 more every year, while funding tax breaks for millionaires. Here’s their economic plan: if you’re a millionaire, you win the lottery. If you’re a senior, you lose your Medicare guarantee.” THE FACTS: Both are on shaky ground in declaring that Republicans will end the “Medicare guarantee,” and Israel’s figure for how much more seniors could pay is outdated. It’s actually based on a Congressional Budget Office analysis of the 2011 version of Rep. Paul Ryan’s Medicare proposal, different in several important ways from the Republican vice presidential candidate’s latest 2012 version. The latest Ryan plan would offer future retirees the choice of a government program modeled on Medicare or private plans subsidized by government. That’s not a proposal to end a Medicare guarantee. The nonpartisan Congressional Budget Office does, though, estimate future retirees would get less from the government under the Ryan plan than if current law continues.  Republican presidential candidate Mitt Romney has endorsed Ryan’s Medicare ideas in broad terms while saying the White House agenda will be his own, not his running mate’s, if they win.
Source: blogspot.com

House Calls Nurse Practitioner

Position Summary   HouseCalls practitioners conduct in-home health assessments on enrolled Medicare Advantage members.  A HouseCalls practitioner will complete visits on members within a geographic area of responsibility.  The nature of the HouseCalls visit can vary and could include performing an annual health assessment, a post discharge visit, or visiting more complex members more than once per year. General Responsibilities Conduct in-home assessments on health plan members. Average visit is 45-60 minutes in length.  HouseCalls Assessment includes: Past medical history Review of systems Physical examination Medication review Depression screening Responsible for checking vitals, conducting a physical exam that includes monofilament test, urine dipstick, and foot exam (as appropriate). Identify diagnoses to be used in care management and active medical management in the furtherance of treatment. Formulate a list of current and past medical conditions using clinical knowledge and judgment and the findings of your assessment. Communicate findings in your assessment that will be used to inform members PCP of potential gaps in care. Identify needs and opportunities to generate clinical referrals to Care Improvement Plus and / or the primary care physician. Educate members on topics such as disease process, medication, and compliance. Compliance with all HIPAA regulations and maintain security of protected health information (PHI).  
Source: careers.org

Will Paul Ryan’s Nomination Lead to a Democratic House of Representatives?

Common sense says that it is easier to attack a plan than to create a plan. Entitlement issues and an amorphous position have served the current administration well and will most likely swing at least a few seats in the house. Still, using Medicare to swing more than 25 seats in the House of Representatives (which is what democrats would have to do to gain control of the house) seems like a long shot to me. Most senators are safe, and both teams in this election have radical changes in mind for medicare. I suppose there is a slight chance that medicare could be the issue of the day, but I would lay odds that most folks vote for whoever they think will best improve the economy.
Source: newstalkkgvo.com

McMahon and Murphy Tangle Over Medicare, Jobs 

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Source: thehartfordguardian.com

No Leadership: POTUS Has No Plan to Create Jobs, Save Medicare, Protect Defense

…Creating New Jobs: The unemployment rate has been higher than eight percent for 42 months, and yet the centerpiece of the president’s campaign is a small business tax hike that would make things worse. Republicans have passed more than 30 jobs bills that remove barriers to job growth, cut red tape, and help keep jobs in America (and bring home some of the jobs that have gone overseas). These bills remain blocked by Senate Democrats.
Source: speaker.gov

In Poll, Obama Opens Medicare Edge Over Romney

At the heart of the conflict is the proposal backed by Mr. Romney and Mr. Ryan to change the way Medicare works in an effort to drive down health care costs and keep the program solvent as the population ages. Under their plan, retirees would get a fixed annual payment from the government that they could use to buy traditional Medicare coverage or a private health insurance policy. Supporters say the change would hold expenses down by introducing more competition into the system.
Source: mbcalyn.com

Ask The Experts: Retirement

First, please review previous Q&As to see if your question already has been answered. If you cannot find the answer, submit your question to our Retirement expert at fedexperts@federaltimes.com PLEASE NOTE! Do not submit ANY questions via the Comments form. Questions submitted via the Comments form will NOT be answered!
Source: federaltimes.com

TX Register Updates: 9/13 Hearing, Medicare Equalization

Posted by:  :  Category: Medicare

Medicare Corner, Dairy Queen, Lockhart, TX by adam*b[…] HHSC intends to submit Transmittal Number 12-035 to the Texas State Plan for Medical Assistance, which would exempt emergency ambulance transports and hospital-to-hospital transport services from Medicare Equalization to allow Medicaid to make higher cost-sharing payments. For more information, see the Texas Register.Source: garloward.com […]
Source: garloward.com

Video: Home Care Bedford TX: Does Medicare Pay for Home Care Services?

Group Medicare Sales Executive

View All Insurance Sales and Marketing Jobs Jobs by Type Account Representatives / Executives / Managers Brokers Directors / Executives District / Regional Managers Field Sales Associates / Representatives Insurance Agent Jobs Insurance Agent Jobs Property / Casualty Agency Insurance Agent Jobs Life / Annuities Agency Insurance Marketing Insurance Producer Insurance Sales Assistants Marketing Managers
Source: insurancesalesweb.com

TX and OK Home Health Agencies: Beware of Home Health Compliance Risks

Despite the fact that most Texas home health agencies are doing their best to operate within the four corners of the law, there are still a number of providers who are continuing to engage in wrongdoing. Texas home health providers recently received significant negative media coverage for fraudulent and abusive billing practices allegedly committed by agencies within their ranks. As you may have heard, just last week a physician and several home health agency “recruiters” in the Dallas-Fort Worth area were indicted in the largest Medicare fraud scheme in history, allegedly totaling nearly $375 million for home health services either not needed or never provided. Additionally, it was noted that over 75 home health agencies to whom referrals were made have also been implicated in the wrongdoing.  Such an enormous scheme only further demonstrates the fact that fraudulent activity in home health services is continuing, despite the fact that most Texas home health providers are well-meaning organizations, trying in good faith to provide medically necessary services to our nation’s most sick and disabled. Nevertheless, such accusations only increase suspicion and scrutiny of the entire home health industry in this region.
Source: pmimd.com

Medicare and Medicaid Cuts Raise Concerns for Texas Seniors

The Texas Health Care Association recently warned that cuts to Medicaid and Medicare could have a harmful impact on the healthcare facilities that deliver important services to Texas seniors. One consequence of these cuts could be the shuttering of nursing homes. This unfortunate possibility could lead to even more hospital emergency room visits by seniors because they have been separated from the consistent care which prevents them from needing ER visits. Shutting down nursing homes and thereby reducing daily care for some seniors may also put them at risk of situations requiring acute care.
Source: lawfirmnewswire.com

health insurance,insurance for preexisting,texas health insurance

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Source: pressreleasesworld.com

Houston Doctor Arrested on Medicare Fraud Charges

The doctor operated a family practice clinic in Houston. According to the indictment, the doctor worked with an accomplice who operated a home health care service. The accomplice would send technicians into patients’ homes to perform testing for inner ear problems. The doctor and the accomplice then “padded” those bills before sending them in for reimbursement.
Source: houstongalvestonlawyer.com

Medicaire Part D Exclusion Effects Tx of Anxiety

First-Line Treatment The Medicare Modernization Act (MMA) led to the provision of prescription drug coverage through Medicare Plan D starting in 2006, but it included the caveat that benzodiazepines be excluded. "As a result, only patients with supplemental drug insurance through Medicaid or private secondary insurance, for example have access to benzodiazepine coverage," write the investigators. "However, when used appropriately, benzodiazepines are an effective, low-cost treatment for anxiety. A major concern regarding the MMA’s…exclusion was potential adverse effects on patients with anxiety disorders," they add. The researchers note that few studies have assessed the exclusion’s effects on patients overall, and none have examined the effect on those specifically with anxiety disorders, "the population most likely to be adversely affected by the policy’s implementation." The investigators examined records for 8397 people older than 64 years (mean age, 75.5 years; 79% women) enrolled in the Medicare Advantage Plan, which has the benzodiazepine exclusion, and 1657 people between the ages of 60 and 64 years (68.9% women) who had a different managed healthcare plan. For this analysis, data on just the patients diagnosed with a new anxiety disorder in the first 6 months of 2005, 2006, or 2007 were assessed. "If anybody was going to be affected by the exclusion, it would be these types of patients because benzodiazepines are a first-line treatment for anxiety disorders," said Dr. Ong. Higher Costs, Reduced Treatment? Results showed that the participants enrolled in the Medicare plan who were diagnosed with the disorder in 2005 had significantly higher rates of claims for benzodiazepines than Medicare enrollees diagnosed in 2006 or 2007 (63% vs 0.9% and 1.3%, respectively). They also had significantly higher rates of claims for all psychotropic drugs (75.4% vs 45.9% and 50%, respectively), fewer claims for nonbenzodiazepines, and lower expenditures for all psychotropic medications. "There were no significant differences over time in utilization or expenditures related to psychotropic medication among the comparison group," report the researchers. In addition, no significant changes were found for either group in outpatient visits for behavioral care, or in hospital stays related to benzodiazepine withdrawal, or inappropriate use of the medications. "The decline in covered claims for psychotropic medication following the implementation of the MMA may reflect an overall reduction in treatment of anxiety, given that we did not find evidence that outpatient behavioral care use had increased" as a substitute, write the investigators. "Even if implementation of the MMA reduced inappropriate benzodiazepine use, any reductions achieved did not result in reduced hospitalizations or emergency department visits and were accompanied by slightly higher medication expenditures," they add. Overall, the researchers note that although the exclusion may have improved care for Medicare enrollees who do not have anxiety disorders, those newly diagnosed with the disorders have faced higher costs and reduced treatment. "These findings suggest that states seeking to reduce budget costs through restrictions of benzodiazepines may actually increase overall costs." A "Slippery Slope" However, Brent Forester, MD, director of the Geriatric Mood Disorders Research Program at McLean Hospital in Belmont, Massachusetts, and assistant professor of psychiatry at Harvard Medical School in Boston, has a different view on the role of these medications in an elderly population.
Source: dr-bob.org

Insurance Sales Manager – Sales/Medicare Compliance Manager

If you are a professional and reliable Insurance Sales Manager with a strong sense of integrity and the drive to succeed, join our sales management team at Universal American! As an Insurance Sales Manager with Universal American, you will direct the sales activities of your team and work in coordination with the marketing department to develop an annual business plan. You will coordinate each day’s activities for the sales agents, approve sales agent expense reports and conduct HR activities such as the evaluation of sales agent performance, maintenance of office operations and the completion of monthly Medicare compliance reports. You will also coordinate and attend events with centers of influence and community leaders to get insurance referrals.
Source: careers.org

Medicare Roundup: Setting the Record Straight

Posted by:  :  Category: Medicare

Comments are subject to approval and moderation. We remind everyone that The Heritage Foundation promotes a civil society where ideas and debate flourish. Please be respectful of each other and the subjects of any criticism. While we may not always agree on policy, we should all agree that being appropriately informed is everyone’s intention visiting this site. Profanity, lewdness, personal attacks, and other forms of incivility will not be tolerated. Please keep your thoughts brief and avoid ALL CAPS. While we respect your first amendment rights, we are obligated to our readers to maintain these standards. Thanks for joining the conversation.
Source: heritage.org

Video: Patty and Richard say, “Apply online for Medicare” (20 seconds) – Social Security

Preserving or dismantling Medicare

This recent article by Dr. Scott Johnson from Loveland, Colorado in the Recorder Online is a frightening account of how Paul Ryan would put the current generation of 62+ at risk for spiraling into poverty, loss of income so great that at the age of 62+ it could not be recovered resulting in a sure and quick to death without hope. The fact that the U.S. House passed the Ryan budget (which Romney endorsed) leading us to a fundamental dismantiling of the Medicaire, one of the primary protectors for the aged against total dispair and hardship is unbelievable. I am asking those of good conscience to vote for President Obama and Vice President Biden to save this country from the completely disastrous policies of Romney and Ryan. The fullout attack on the Middle Class and Poor by Romney and Ryan is unconscionable. Romney and Ryan appear to value only the rich and would do anything possible to allow that upper 10% to 1% to maintain their decadent and selfish interests without any thought to what this country is about, our core values which cry out to allow a safety net for those less fortunate.
Source: berthoudrecorder.com

Nothing found for Medicare

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Source: onlinempadegrees.com

NY Times: Challenged on Medicare, G.O.P. Loses Ground

Democrats fretted that Mr. Romney would win the retiree-heavy Florida and increase his support nationwide among older voters, who lean Republican anyway. David Winston, a Republican pollster, wrote a month ago of “a structural shift in the issue” that left the parties in “a dead heat” and Mr. Obama unable to mount an effective response.
Source: winstongroup.net

Medicare Prescription Drug Coverage Is Right here!

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Source: zidp.com

State Medical Association supports expansion of Medicaid eligibility under Affordable Care Act

Posted by:  :  Category: Medicare

Uninsured Direct-Care Workers by Geographical Region, 2007-2009 by PHInational.org“Nevada physicians are concerned that this does not improve the current Medicaid program, which is significantly underfunded,” the statement said. “Current payment levels have made it increasingly difficult for physicians and hospitals to maintain their availability for Medicaid patients. This has become particularly true for children with disabling conditions or chronic illnesses and for women facing high-risk births.”
Source: thisisreno.com

Video: Examining Abuses of Medicaid Eligibility Rules

Medicaid in 1000 Words – and Three Charts

Again: it’s complicated – though slightly less complicated than pre-ACA. Without the Supreme Court’s decision on the ACA, any American citizen that made up to 138% of the FPL would be eligible for a state’s Medicaid program – with many states continuing to have a higher threshold. If a state decided it did not want to expand Medicaid eligibility, it would lose all of its federal Medicaid money. As it happened, the Supreme Court ruled that a state could not be “coerced” into accepting the expansion, and ruled that pre-ACA Medicaid funding was safe, regardless of a state’s decision. As a result, six states have already declared they will not expand, and more are leaning towards doing the same (see the awesome graphic below from the Advisory Board Company, as of September, 2012).
Source: projectmillennial.org

Understanding the Medicaid Transfer Penalty

The penalty is a period of ineligibility, and it is calculated by dividing the total of the amount transferred by the estimated monthly cost of nursing home care.  In the state of New York, that amount is determined on a county-by-county basis, and ranges from $7,688 to $11,445.  If one is found to have made a transfer for less than fair value during the look-back period, then that person will be ineligible for the number of months that the assets would have paid for nursing home care.
Source: elderlawnewyork.com

Research roundup: Readmission risks, assessing Medicaid eligibility, health plan satisfaction

Medpage: Too Early To Make A Call On CKD Screening Screening for chronic kidney disease (CKD) has insufficient evidence to assess its routine use in asymptomatic patients, the U.S. Preventive Services Task Force (USPSTF) concluded after reviewing available data. Acknowledging undiagnosed early-stage CKD as a common occurrence, the task force found no evidence that routine screening for it improves outcomes. Members of the USPSTF panel also found no generally accepted tool for assessing the risk of CKD or its complications (Bankhead, 8/28). Medscape Today: Fitness In Middle Age Lowers Risk For Future Chronic Disease Staying fit during middle age is associated with a decreased risk of developing chronic diseases, such as diabetes, Alzheimer’s disease, and heart disease, during the next several years, a new study suggests. Benjamin L. Willis, MD, MPH, from the Cooper Institute at the University of Texas Southwestern Medical Center in Dallas, and colleagues, reported the findings in an article published online August 27 in the Archives of Internal Medicine (Hitt, 8/28). Reuters: Hormone Therapy Use Among Women Continues To Drop Years after a large study on hormone replacement therapy revealed health risks among older women using it to prevent chronic disease, the number of women who take hormones continues to decline, according to a new study. The researchers found that in 2009 and 2010, less than five percent of women over age 40, who had already gone through menopause, use either estrogen alone or estrogen and progestin. That compared to about 22 percent in 1999 and 2000 (Grens, 8/30).
Source: medcitynews.com

Medicaid Eligibility in Florida

Medicaid provides low income Florida families with free or low-cost medical insurance to provide a basic level of medical care to all Florida residents. Applying for Medicaid is a fairly complex process, requiring different steps based upon the manner in which you qualify. Some require the involvement of only the state government, while others involve the federal Social Security Administration. In this article, I break down the process step-by-step to make it simple for you and your family to get Medicaid coverage.
Source: about.com

Medicaid Expansion: A Closer Look At Vulnerable Populations And State Coverage Opportunities

Through the ACA, states have new opportunities to partner with managed care and local governments to deliver coordinated, uninterrupted care to this vulnerable population.   States and corrections departments can work together to design and implement administrative procedures to keep jail-involved individuals connected to seamless Medicaid coverage.  In particular, states can design new information technology solutions to suspend Medicaid eligibility at entry into the criminal justice system and reinstate eligibility at discharge. Federal matching dollars can be claimed for the administrative costs associated with suspension, as well as for eligibility determinations for individuals re-filing during or newly filing after their stays in public institutions.
Source: healthaffairs.org

How Will the Medicaid Expansion for Adults Impact Eligibility and Coverage?

Beginning in 2014, the Affordable Care Act (ACA) provides for the expansion of Medicaid eligibility to adults with incomes up to 138% FPL ($15,415 for an individual or $26,344 for a family of three in 2012), which would make millions of currently uninsured adults newly eligible for the program. The Supreme Court ruling maintains the Medicaid expansion, but limits the Secretary’s authority to enforce it. This change in enforcement authority may impact state decisions to implement the expansion. This brief provides an overview of current Medicaid eligibility for adults and data on uninsured adults to provide greater insight into the implications of the ACA Medicaid expansion on coverage for adults across states. 
Source: kff.org

Republican Leaders Urge Action to end Delay in Medicaid Reform Implementation :: Illinois House Republicans

“This scrubbing of the rolls component is a centerpiece of our bipartisan Medicaid reforms,” Sen. Righter said. “Individuals who make too much money, are not residents of Illinois, aged-out of the AllKids program, or have died must be removed from the rolls so that we can re-focus our limited resources on preserving access to health care for the needy. We cannot afford delay.”   Illinois’ Medicaid reform law contains tight timeframes for the procurement of the eligibility verification vendor to ensure that the eligibility reviews begin in a timely manner.  While the requirements for an initial procurement to be conducted within 60 days and for a contract to be signed within 30 days of a vendor being selected have been met, delays in eligibility reviews becoming operational pose the potential to hinder this crucial reform. 
Source: ilhousegop.org

How Medicaid Reaches Into The Middle Class

CQ HealthBeat: States Try Different Routes To Cut Medicaid Eligibility Earlier this year, Maine and Illinois officials had a similar goal: to scale back the number of people who were eligible for Medicaid in their states. But each took a different approach, and the outcomes couldn’t be more different. Each wanted to get around rules in the 2010 health care law that require states to maintain, until 2014, Medicaid eligibility policies that are at least as generous as those in place when the overhaul was signed in March 2010. Many states have complained that those “maintenance of effort” rules are too restrictive at a time when state budgets are in turmoil and legislators are looking for cuts. But federal officials say the requirements have prevented millions of people from losing coverage during the national economic downturn (Adams, 9/6).
Source: kaiserhealthnews.org

Supply and Demand (in that order): Medicaid Expansion and Jobs

Unlike other major safety-net programs like unemployment insurance and food stamps, the Medicaid program has not significantly expanded its eligibility or average benefit in recent years. Some states have restricted Medicaid benefits in order to control costs. A number of states have expanded eligibility, but those expansions were small enough that nationwide Medicaid enrollment and inflation-adjusted Medicaid spending actually grew slightly less between 2007 and 2010 than did the number of Americans in poverty.
Source: blogspot.com

Health Insurance Plans Exempt From ErisaHealth Insurance Medical

Posted by:  :  Category: Medicare

From our detail discussion it can be said that what a health insurance is known to all hopefully. As we are to discuss about the Medicare supplement plans or the Medigap plans that is why it is better to say that a health insurance plan is a helping aid for your unexpected medical costs. It is a contract between an individual and an insurance company in which the type and amount of health care costs that would be covered by the plan are specified and for which the individual agrees to pay premiums. These contracts are renewed either monthly or annually. But his basic thing is slightly different in our policies. From its very name you can imagine that there is some gap coverage between two things. Actually the original Medicare health plans are under government administration but these plans fails to pay all the costs spent in a treatment of the policy maker. In this position the person may face some real difficulties to have short of money. For their advantages solely some private companies have introduced this plan named Medigap plans or Medicare supplements plans which truly supplement the original plans responsively.
Source: healthinsurance-medical.com

Video: Learn About Medigap Plans

Shingles Vaccinations Not Covered For Some Medicare Beneficiaries

A. Shingles is a painful rash caused by a virus that can lead to long-term nerve damage called postherpetic neuralgia. All Medicare Part D prescription drug plans cover the shingles vaccine, which is recommended by the Centers for Disease Control and Prevention for people age 60 and older. But Medigap plans, which may cover the deductible and coinsurance amounts for services provided under Medicare Parts A and B (hospitalization and outpatient care), don’t offer any financial help on the co-payments for vaccines and other drugs covered under Part D.
Source: kaiserhealthnews.org

'''''Medigap Rates Age 65 and Older

Our Macon female can purchase Medicare supplement plan N for as little as $71 per month but she will not be able to purchase that plan from Mutual of Omaha or Gerber. You may know friends or relatives who bought these plans in the past but these carriers no longer offer plan N and have targeted current policy holders for significant ongoing rate increases, in some cases as high as 40%.
Source: georgia-medicareplans.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

The 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

Medigap Vs. Advantage plans

All of this makes Medicare Advantage plans sound much more attractive than traditional Medicare, but the reality is lots of people don’t like the access to care they get from Medicare Advantage plans. Researchers from the Commonwealth Fund, a nonprofit foundation that promotes better health care, found that 15 percent of  people with Medicare Advantage policies rated their insurance as fair or poor. That is more than double the number of dissatisfied Medicare/Medigap plan participants — just 6 percent of those with traditional Medicare coverage and Medigap plans rated their coverage as fair or poor.
Source: bankrate.com

Various Options for Arizona Medicare Plans

If you live in Arizona and are on Medicare, did you know there are different Arizona Medicare plans? You do have some degree of choices when it comes to your Medicare coverage level. Medicare has been around since 1965 and originally was for those 65 years and older but it as gone through different reforms over the years. For instance, today those under 65 and have a disability may be on SSDI or Social Security Disability Insurance and these people receive Medicare after two years of being on SSDI.
Source: divirazkazi.com

ObamaCare Leaves Adults without Dental Coverage

Posted by:  :  Category: Medicare

In Illinois, dental coverage has been cut back and now only covers emergency tooth extractions.  Some states have made efforts to expand their dental health coverage under medicaid as is the case with Massachusetts.  Massachusetts had previously cut Medicare benefits but recently expanded them at the urging of law makers.  Massachusetts is now covering front teeth only.  Law makers claimed that front teeth are important as front teeth are needed for Americans to be taken seriously if applying for jobs.
Source: teethcenter.com

Video: Health Insurance Information : About Medicare Dental Benefits

Changes to dental services under Medicare

The Medicare Teen Dental Plan will close on 31 December 2013. Eligible teens will be able to access the program until this date. Benefits will continue to be paid for services provided to eligible teenagers before the date of closure. The Child Dental Benefits Schedule will be available to eligible children and replace the Medicare Teen Dental Plan from 1 January 2014.
Source: com.au

PMG Agency Breaks Down Potential Effects of Medicare Health Reform

Fort Wayne, Indiana – Senior members of GOP presidential hopeful Mitt Romney’s campaign have adopted a public stance on Medicare that is drastically different from the position Republicans have historically taken on the program. Republicans have established a reputation for criticizing the Medicare program. During recent appearances in support of his campaign for United States President, Romney and his team have presented the Republican party as the program’s would-be savior.
Source: briefingwire.com

Ohio Health Policy Review: States across the county slashing Medicaid dental benefits

Without the ability to decrease Medicaid eligilbility in recent years, states have instead began reducing optional benefits for adults as a way to face financial shortfalls. And the benefit most likely to be cut is dental coverage (Source: "Sharp Cuts in Dental Coverage for Adults on Medicaid," New York Times, Aug. 28, 2012).
Source: healthpolicyreview.org

Sharp Cuts in Dental Coverage for Adults on Medicaid

The federal health care law generally prohibits states from tightening eligibility for Medicaid before 2014, when a vast expansion of the program to cover people with incomes up to 133 percent of the federal poverty line is supposed to take effect. But states are still allowed to cut optional benefits, like vision, dental and drug coverage. Whether to seek broader cuts is part of a contentious debate between Mr. Obama and Mitt Romney over the future of Medicaid and Medicare, the government health care program for older Americans.
Source: pnhpcalifornia.org

New dental clinic opens with free labor, weekend hours for people with no health insurance

The charity’s wheeled facility mostly treats children at low-income schools, but it is also leased by the nonprofit United Global Outreach in Bithlo, which is working with the Florida Hospital Foundation and the Dental Care Access Foundation to provide care in the rural community. The Bithlo program not only does routine care, fillings and extractions, but also helps clients get dentures, implants and other cosmetic work.
Source: medcitynews.com

Ask The Experts: Retirement

First, please review previous Q&As to see if your question already has been answered. If you cannot find the answer, submit your question to our Retirement expert at fedexperts@federaltimes.com PLEASE NOTE! Do not submit ANY questions via the Comments form. Questions submitted via the Comments form will NOT be answered!
Source: federaltimes.com

Eleanor Arnason’s Web Log: Money

I broke a tooth last night and am waiting till my dentist’s office opens to make an appointment. It’s not painful, though I think I’m look at a $1,000 crown, and that is painful. The credit card bill for Worldcon has not yet arrived. I am going to have a frugal fall. I am making about $17,000 a year less than when I was working three years ago. After taxes that would be $13,000, all discretionary, since I have the same basic expenses I had three years ago. This is the reality of retirement for many people. Something that would have been irritating when I had a job becomes much more disturbing. I have Medicare and carry supplementary medical and dental insurance. Still, the money I am going to have to spend on this tooth is not in my budget. A quick check of the Internet gets the following: The average Social Security payment is $1,230.Twenty-three percent of people 65 and older live in households that depend on Social Security for 90% or more of their income, according to a 2010 AARP report. About 26% more receive at least half of their family income from Social Security. So about 25% of retirees are living on $ 14,760-$16,400 a year; and about half are living on $30,000 or less a year. $1,000 begins to look like a lot of money. When people in Congress talk about cutting Social Security or increasing the cost of Medicare, they are talking about reducing the incomes of people who make this kind of money. It’s not a lot of money. In addition, one has to figure that most people have more and more medical expenses as they age. It’s scary to think of being old and sick and without adequate funds.
Source: blogspot.com

Announcements from Medicare Australia 

Prior to this announcement, Medicare dental items are available for people with chronic conditions and complex care needs, on referral from a GP. Eligible patients can access up to $4,250 in Medicare benefits for dental services over two consecutive calendar years.
Source: com.au

Medicare Open Enrollment Time: Prep Course

Posted by:  :  Category: Medicare

Self Portrait Day 37 by HopkinsiiMedicare Advantage: Also known as Medicare Part C Part C was designed to give Medicare beneficiaries the option of buying coverage through a private health insurance company. These plans provide coverage for all the same services as Part A and B, but are administered by private carriers. These plans often include additional benefits.
Source: gohealthinsurance.com

Video: Medicare Part D Open Enrollment Ends December 31st

I’m a Veteran…Do I Need Part B? » Toni Says

Thanks for your service to our Country and being there when America needed you!!  I am glad you didn’t listen to your buddies and decided to email me.  Some people are dangerous when they give advice and have no idea of what the consequences can be or how this will impact your Medicare.  Actually you do not need “Part B” to receive medical care from the VA, but when you go outside of the VA for any medical treatment you do need Part B.  You might be ambulanced to another hospital that is not a VA facility for a medical emergency or you may go to MD Anderson for cancer treatment as examples, then you will pay 100% of the medical charges that “Part B” covers because you do not have Part B. Part B covers all of your outpatient needs, doctor services such as office visits and even surgery, MRIs, chemotherapy and the list can go on.   Without Part B of Medicare, a person can have to pay 100% out their pocket and this could be in the $1,000s or hundreds of thousands of dollars.
Source: tonisays.com

2012 Medicare Open Enrollment Period

You can also enroll for the first time in a Part D plan during AEP if you did not enroll during your open enrollment window when you first became eligible for Medicare Part B.  If you do not have credible drug coverage, you may be subject to the Part D late enrollment penalty.  This penalty is calculated by adding 1% to your premium for each month you were not enrolled and should have been.
Source: ohioinsureplan.com

GRAY MATTERS: Things to know about the Medicare Enrollment Period

Medicare beneficiaries will be receiving mail in September from their current insurance company. Most important is the annual notice of change that will outline what the changes are for them for 2013. Beneficiaries can review the information to make sure their current plan will be a good choice, or may want to see if changing to another plan might offer better coverage and save them money for 2013.
Source: times-standard.com

To Cut Health Care Costs, America Should Enroll More People in Medicare.

During the passage of ACA/Obamacare some politicians said that the ACA was better than nothing. But the truth was that until the Supreme Court fixed it the ACA/Obamacare was worse than nothing at all. It would have meant the catastrophic loss of your precious liberty for the false promise and illusion of healthcare security under the deadly and costly for-profit healthcare system that dominates American healthcare.
Source: keystonepolitics.com

Medicare Advantage Special Needs Plans: SNP Enrollment Grows to 1.4 Million in 2012

ACA Access Affordable Care Act AHRQ CBO CER CMS Communications Compliance Drugs Dual Eligibles Employers FDA Fraud and Abuse GAO Health Care Spending Health Costs Health Coverage Health Insurance Health Plans Health Reform HIT HIX Hospitals LTC Medicaid Medicare Medicare Advantage MedPAC MedTech Nursing Homes Obamacare OIG Payment Pharma Pharmacies Physicians Prevention Program Integrity Providers Quality Research Safety States Waivers
Source: piperreport.com

Procedure To Enroll In Medicare Supplement

Accident Applicant Auto Insurance Benefits Car Insurance Quotes Compensation Cost of Accidents Covered Cover Many Companies Disability Benefits Discount Dental Plan Flood Insurance Group Insurance Health Insurance Health Policy Home Insurance Insurance Claims Insurance Companies Insurance Instruments Insurance Policies Insurance Program Insurance Protection Insurance Quotes Life Insurance Long Term Care Marketing Medicare Pays Members of Discount Mental Disability Motorcycle Insurance Natural Disasters New Customers Opportunity Pet Insurance Policies Protect Protect Themselves Provide Provide Coverage Purchase Insurance Rehabilitation Renters Insurance Requires Insurance Term Life Insurance Workers Compensation
Source: discoveryourtime.com

Low cognitive ability impairs enrollment in Medicare supplemental plans

Because traditional Medicare leaves substantial gaps in coverage, many people obtain supplemental coverage to limit their exposure to out-of-pocket costs. However, some Medicare beneficiaries may not be well equipped to navigate the complex supplemental coverage landscape successfully because of their lower cognitive ability or numeracy—that is, the ability to work with numbers. We found that people in the lower third of the cognitive ability and numeracy distributions were at least eleven percentage points less likely than those in the upper third to enroll in a supplemental Medicare insurance plan. This result means that many Medicare beneficiaries do not have the financial protections and other benefits that would be available to them if they were enrolled in a supplemental insurance plan. Our findings suggest that policy makers may want to consider alternatives tailored to these high-need groups, such as enhanced education and enrollment programs, simpler sets of plan choices, or even some type of automatic enrollment with an option to decline coverage.
Source: pnhp.org

ACO ‘Predecessor’ Saved Medicare Money, According To JAMA Study

CQ HealthBeat: Medicare Official Reminds Insurers Of Consequences Of Low Ratings In an effort to discourage participation in low-performing Medicare Advantage health plans, a top Medicare official Tuesday reminded an audience of insurers that seniors who want to enroll in such plans will have to call the company rather than joining online. Jon Blum, deputy administrator of the Centers for Medicare and Medicaid Services, told a conference sponsored by the trade group America’s Health Insurance Plans (AHIP) that Medicare beneficiaries will get warnings about health plans that have received ratings of fewer than three stars for three consecutive years. … The decision to discourage seniors from enrolling in low-rated plans was in a document released in April (Adams, 9/11).
Source: kaiserhealthnews.org

2012 Medicare Open Enrollment Period

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Source: medicarehelpco.com

California Medicare Supplement Plans Blue Shield

Posted by:  :  Category: Medicare

It's all there in black and white by Dave77459each month for 12 months on your Medicare Supplement Plan rates.To qualify, you must be age 65 or older, and Blue Shield must receive your application within six (6) months of the date you first enrolled for benefits under Medicare Part B. Savings will be effective for the first twelve 12 months of your plan dues.The Welcome to Medicare Rate Savings is available for all Medicare Supplement Plans that Blue Shield of California offers. You can also take advantage of our two-party rates and Easy$Pay
Source: mattlockard.net

Video: Is Freedom Blue PPO a Medicare Supplement?

The Blue Cross Medicare Phoenix AZ Locals Rely On

Having the blue cross medicare phoenix az residents know is the best will help make sure retirees get the healthcare resources they need. Medicare is an awesome resource that is offered to seniors in exchange for a lifetime of hard work. Anyone that has earned ten years of social security credit, is over 65, and is a citizen, qualifies for the free healthcare coverage. As people get older, it gets more difficult for the body to stay healthy. Organs and bones degrade and there is more exposures to sickness and disease. Dealing with these health problems significantly impacts the quality of life in later years. A good program will improve the quality of life and will help people live as long as possible.
Source: originalsourceenergy.com

MEPAC OBAMA: Mitt Romney’s Plan To Voucherize Medicare Will Lose Him The Election And Might Even Turn Some Red States Blue

I live in a Red State.  Us Blue Dog Democrats are outnumbered by Red Elephants.  But, we do talk on occasion.  I have the opportunity to talk to a few white republicans in my state – in the grocery store, at the liquor store, the bank – places where real life takes place – not on the tube or web.  These are repbulicans who tell me they might not  vote for Mitt Romney because of one word, “Voucher”, relative to Medicare.  That word scares the living hell out of voters – republicans and democrats, especially the ‘boomers’, and some Gen-X’ voters.  Some republicans plan to sit out the election; others say they’re unsure of what to do.  They are torn, because the Tea Party is telling them to, ‘get the black guy out of the White House, just because he’s black'; yet, they know this black guy’s “Got their Backs’ – Romney-Ryan doesn’t.  I suspect that many will stay home, helping Obama, by default; but, not outright casting a vote for him; thereby, saving their Medicare from becoming VoucherCare. Team Obama needs to keep reminding voters of the “V” word – Voucher, relative to Medicare.  It is working.  Voters are smarter than Romney thinks. Most already know he’s lying about Medicare.  They know, the Voucher Plan for Medicare is in the Ryan Budget, which Mitt Romney says he will sign, ending Medicare, as we know it.  Republicans ‘talk the talk’ about small government in public, but privately, they are scared of hell of insurance companies and private entites running Medicare. They trust the federal govt’ to run it.  So, many of them, when polled, will lie and say they’re voting for Romney; but, when they get in the booth in November, I suspect when that word “Voucherize” whispers to them, they will vote for President Obama.   So, ‘go at’ team Obama, tell the people the truth about Romney – drive it home!   You might even turn my Red State, Blue. Finally, Mitt Romney will lose because he thinks voters are stupid – banking on them being so ill-informed they will cast a vote for him.  This is the information age; whereby, even “Slow Johnny”, who has a computer and a smart phone,  knows what’s going on.  He is also running with issues a majortiy voters don’t give a damn about, and can’t even relate to.  WTF up with this debt thing – running a clock at their convention – Lame!   Debt ceilings, deficits – money borrowed from our grandchildren, etc.  Most voters I know could care less about the trillion-dollar deficit George Bush ran up.   They just want their Medicare, Lower Taxes, No War, More Jobs, Dream Act, Obamacare, LBGT, Abortions; voters like one-word issues.  When candidates give the 2 or more words to frame an issue, confusion sets in.  Forget the complicated three-word @hit; ie deficit ceiling/spending…   Hold that @hit for another day, or even another decade?  Or, just print some more money, and get rid of the damn deficit – simple, right?   But, just don’t “Vocherize” my Medicare.   This deficit thing –  ok, it’s important – but, not something to be dealt with in an election.  Further, it’s been drummed up by the Tea Party to hurt Obama.  Voters already know, the deficit will be around for years to come; therefore, they are more focused on ‘bread and butter” – ‘now’ issues; not complicated shit like a “federal deficit”.   Voters want, Medicare [no voucher], jobs, LGBT rights, reproductive choice, etc.  Mitt Romney is trying to confuse the hell out of voters, with issues that are too big for even God to solve immediately.   MEPAC   OBAMA 2012   TURING RED STATES BLUE WITH ONE WORD “VOUCHER”
Source: blogspot.com

Blue Hampshire: Politics ::: The Truth about the Independent Payment Advisory Board

and limitations. They are not keen on the agents of government being tasked with duties and obligations.   It seems they’ve been that way all along.  While the main body of the Constitution outlines duties and obligations (what our agents may and must do), the amendments enumerate what they may not do (restrict individual rights), unless it is necessary (warranted). The basic difference arises from whether the agents of government are to be focused on dealing with the natural and man-made environment, or on regulating man himself, in the event religious regulation fails to correct man’s flawed/sinful nature. It all depends on the prejudice one brings to the table.  Is man naturally good or evil? If the latter, then he has to be made good and some people are obviously designated to  accomplish that.  So, the prejudice that man is created evil serves to justify the exercise of authority, to exact obedience, and to punish the non-compliant. If one believes that man is inherently good, then there’s no justification for exercising dominion over him. Liberals don’t just question authority; they reject the claims of those who seek to exercise it without evidence of expertise. The liberal elite are people who rely on training, talent and expertise. The conservative elite prefer to rely on the force of personality. Personality is a sophisticated characterization  of  predatory dominion. “If you don’t do what I want, I will kill you” is the implicit argument of the brute.
Source: bluehampshire.com

Obama hammers Romney with new Medicare study

We allow third-party companies to serve ads and/or collect certain anonymous information when you visit our web site. These companies may use non-personally identifiable information (e.g., click stream information, browser type, time and date, subject of advertisements clicked or scrolled over) during your visits to this and other Web sites in order to provide advertisements about goods and services likely to be of greater interest to you. These companies typically use a cookie or third party web beacon to collect this information. To learn more about this behavioral advertising practice or to opt-out of this type of advertising, you can visit www.networkadvertising.org.
Source: capitolhillblue.com

GOP Ally’s Ads Hit Nolan On Medicare, Mining Jobs

The American Action Network began a $570,000 campaign against Nolan on Monday. That includes $430,000 for an ad about Medicare in the Twin Cities and $80,000 for an ad about the proposed PolyMet mine in the Duluth TV market.
Source: cbslocal.com

The Blue Button on MyMedicare.gov and What it Means to You

Insurance companies are constantly trying to improve the level of service they provide to customers even if it means a lot of work on new products and services. In 2012 Medicare is trying to improve service on their website with the “Blue Button” that should help with navigation. Your information and previous records will be much easier to access with this tool. You can logon from anywhere at any time and be able to access your medical history, health care providers and medications.
Source: medicare-medicaid.com

Ohio Health Policy Review: Ohio insurers turn attention to growing Medicaid, Medicare markets

“I think you’ll likely continue to see consolidation, particularly among the government managed care plans. I think there is far greater growth in this sector than other sectors,” said Michael Muntner, managing director in the health care investment banking group for Credit-Suisse. “In the government sector the price is really dictated by the state government itself. When you look at the Medicaid dollars only 20 percent of Medicaid dollars goes through managed care today. As the proportion goes up, I think the states will start to save money.”
Source: healthpolicyreview.org

Research finds Medicare and private insurance spending similar throughout Texas

Variations in health care spending by Medicare and Blue Cross Blue Shield of Texas (BCBSTX) are similar throughout the state despite previous research, which found significant spending differences between the private and commercial sector in McAllen, Texas. The latest research results from the University of Texas Health e Center at Houston (UTHealth), the Commonwealth Fund, and the Brookings Institution are published in the December issue of the American Journal of Managed Care.
Source: sciencecodex.com

Special Election Coverage: Rape, Medicare and GOP Convention 08/25 by veracitystew

Sounds like Queen Latifah may have the patter of little feet in her sights. “As an adult, as a I looked back on how my mom raised us,” the superstar tells our wOw Effect host, “I was so thoroughly impressed, and I figured, If I can be just half the mother she is, I’ll be doing just fine.”
Source: blogtalkradio.com

West Virginia Blue:: Paul Ryan's Medicare Plan

Copyright 2011 West Virginia Blue Site content may be used for any purpose without explicit permission unless otherwise specified. This site exists thanks to financial support from BlogPAC, dedicated volunteers and participation by members of this community. The views expressed at West Virginia Blue belong solely to their respective authors.
Source: wvablue.com

Older Americans Have Been Highly Resistant to Medicare Changes

Posted by:  :  Category: Medicare

Bubbles? Take something like 'Not I! ...item 1.. Wakulla Republicans Protest Against Taxes in the County (September 06, 2011) ... by marsmet552The income gap among Republicans and Republican leaners is about as large as the difference between GOP supporters of the Tea Party and non-supporters. Among Republicans and Republican leaners who agree with the Tea Party, 57% view deficit reduction as more important than preserving Social Security and Medicare benefits as they are. Among Republicans and leaners who do not agree with the Tea Party, just 36% say that reducing the deficit is more important than maintaining benefits.
Source: people-press.org

Video: Senior Care Concierge Medicare 2011 part1

Obama’s Health Care Record

Obama repeatedly touts provisions in the 2010 health law that aim to expand coverage and bring down costs in so-called entitlement programs. The law’s approach includes the expansion of Medicaid; the creation of the Independent Payment Advisory Board, accountable care organizations, and other payment pilots and demonstration projects to reward providers for delivering quality — rather than quantity — of care; and various cuts to Medicare providers and insurers. The administration has made clear that it is willing to go beyond the changes included in the law, particularly in the Medicare program, to ensure its solvency.
Source: kaiserhealthnews.org

What are the Effects of Repealing ObamaCare for Medicare Solvency and Its Impact on Beneficiaries?

In summary, the Medicare provisions of the ACA played an important role in putting Medicare on stronger financial footing, while offsetting some of the cost of the coverage expansions of the ACA and also providing additional benefits to people on Medicare.  These savings were achieved primarily by reducing payments to providers (such as hospitals and skilled nursing facilities) and Medicare Advantage plans.  As a result of these changes, Medicare spending per beneficiary is projected to grow more slowly than private health insurance spending per capita over the next decade; premiums and cost-sharing for many Medicare-covered services are lower than what they would be without the ACA; delivery system reforms are being developed and tested; and the Medicare HI Trust Fund has gained additional years of solvency.  Some have argued that the Medicare savings in the ACA may come at the price of reductions in access to care in the future, while others believe the ACA will leverage greater efficiencies without necessarily creating access concerns.  Repeal of the ACA would undo these changes, raise costs for beneficiaries, and increase federal spending at a time when the nation is struggling to address the deficit and debt.
Source: decisionsonevidence.com

Are Medicare's new quality incentives large enough to change hospital behavior?

The program is part of a major shift for Medicare, which historically has paid hospitals and doctors based on the nature of services they provided to patients without taking into account how good a job they did. Medicare has already launched several trial programs that are intended to reward hospitals based on performance, but those are voluntary; the value-based purchasing program is the first one that will be applied to nearly all acute care hospitals regardless of whether they want to participate. It kicks in at the same time that 2,211 hospitals will also begin losing money because of high readmission rates, another program created in the health law. 
Source: minnpost.com

Paul Ryan’s 2011 Medicare Plan: A Primer

(WASHINGTON) — Welcome to the next phase of the U.S. presidential campaign: a debate over Medicare. With Mitt Romney’s selection of Rep. Paul Ryan, R-Wis., as his vice presidential running mate, conversation will swiftly turn to the proposal that has come to define Ryan’s political career — a plan to reinvent Medicare as a way to limit the growth in taxpayer spending on health care. Ryan has pushed some version of his plan since 2008, but it exploded as a topic of national discussion in the spring of 2011 when Ryan introduced it as part of his 2012 budget outline. President Obama blasted it. Newt Gingrich called it “right-wing social engineering.” House Speaker John Boehner didn’t exactly embrace it. Romney himself has not endorsed it in full, and since its roll-out, Ryan has worked with Democratic Sen. Ron Wyden, Ore., to modify it. Here’s what you need to know about Ryan’s Medicare plan: HOW IT WORKS If implemented, the government would no longer pay doctors to treat Medicare beneficiaries. Instead, beneficiaries would buy their own private insurance plans, and the government would give people money to pay to buy health plans from an approved list. Critics have called this the “end of Medicare as we know it,” and that’s true. Until now, Medicare has operated as a “fee-for-service” system; under Ryan’s plan, it would operate more like a voucher system, although Ryan and his aides have resisted this term.  Medicare would cease to pay for health services directly, instead operating as a board that approves a menu of health plans for public sale and doles out predetermined lumps of money to people enrolled in Medicare, to help them buy those plans. Ryan’s staff has defended this plan as “progressive,” and it is: If you’re poorer or sicker, you get more money from Medicare to cover your premiums. Think of it like “Obamacare” for seniors: Beneficiaries buy plans listed on a government-approved “exchange” of sorts, with more subsidy payments going to poorer people and those more expensive to cover. Everyone over 55 would be grandfathered into the current Medicare system. So if you’re of Medicare age right now, nothing would change if Ryan’s 2011 plan became law tomorrow. IT SHRINKS THE DEFICIT During the health overhaul debate, much was made of the deficit-neutrality of President Obama’s law, which Democrats achieved, in part, by taking $500 billion out of projected Medicare spending over the next 10 years, even as Medicare spending continues to grow. Ryan’s plan gets more aggressive. Under Ryan’s 2011 budget plan, the CBO projected in 2011 that deficits would be 2 percent of GDP by 2022, compared to 2.75 percent under current law, and compared to 9 percent in 2010. PEOPLE WILL HAVE TO PAY MORE A big part of Ryan’s method for slowing the rapid growth of health-care costs is by shifting incentives. Under his plan, it’s in the best interest of Medicare beneficiaries and health insurers to pay less for health care, avoiding superfluous services and procedures. Under the current system, that incentive doesn’t exist, as the government foots some of the bills. That said, the Congressional Budget Office projected in 2011 that individuals would have to pay more under his plan, with their share of (albeit lower) costs skyrocketing to 61 percent by 2022. The CBO’s preliminary long-term analysis included this chart of findings that drove much of the discussion of Ryan’s plan in 2011: WHAT PRESIDENT OBAMA HAS SAID ABOUT THE PLAN Democrats have roundly bashed Ryan’s Medicare plan, even picking up a House seat in a spring 2011 special election largely thanks to their loud campaigning against its recent release. Democrat Kathy Hochul ran ads attacking her opponent’s support for the plan, gaining a GOP-held seat in May of last year. After its release, the president called Ryan’s plan “fairly radical” and posited that it would “change our social compact in a pretty fundamental way,” ABC’s David Kerley reported. “I guess you could call that bold. I would call it short-sighted,” Obama told 500 Facebook employees and 200 other attendees at a town-hall meeting held at Facebook headquarters in Palo Alto, Calif., in April 2011. “Nothing is easier than solving a problem on the backs of people who are poor or people who are powerless or don’t have lobbyists or don’t have clout.” WHAT RYAN HAS SAID ABOUT IT Ryan himself has argued repeatedly that major changes are the only way to save Medicare, that if the cost curve isn’t bent dramatically, Medicare will drive the United States to insolvency, endangering the entitlement altogether. Faced with an onslaught of criticism, Ryan released a pitch for his plan in May 2011:
Source: abcnewsradioonline.com

Medicare Open Enrollment: What are the Dates for Fall 2011?

Leaving the closing date to the last day of the year has caused problems in the past for some seniors who have waited until close to deadline to make changes. Bringing it forward should simply make it easier for the system to get up and running on January 1 2012 as it should. This also takes the Christmas holiday period out of the equation. Although some people do use the holidays to consider their options, others get diverted and have to make snap decisions at the last minute.
Source: suite101.com

Aging and Parkinson’s and Me: The Medicare Debate: An Expert’s View

These days, it’s tough to find links from unbiased experts when you’re searching for political topics on Google. I thought I’d hit paydirt on one particular piece about Medicare reform, until I saw that two colorful — and controversial — celebrities had given the author their endorsements: C. Everett Koop, Reagan’s Surgeon General, and John McLaughlin, the bombastic host of his own TV talk show, The McLaughlin Group. Hmmmm. Nevertheless, the author of the promising link– Robert Laszewski — is regarded as a leading authority on health care reform. His analysis of the two parties’ Medicare proposals is thought-provoking and balanced. See what you think. But first, bear with me a moment. A Personal Note and Plea: I’ve been getting some good comments and e-mails after saying I’m so fed up with politics today that I may not vote this year, and that I’m not donating any money. Believe it or not, I recognize that I’ve spent a lifetime careening back and forth on issues from one side of the road to the other, and it can take me a long time (or never) to find that ever-elusive middle of the road. One reason I’m writing this blog is that I need others to offer occasional course corrections. So, please keep the critical comments coming! If you’re tiring of my political commentary, ALERT: I’ve got a couple more I want to put up (and see if they get shot down). I promise we’ll return to the real world next week. The Medicare Expert Bob Laszewski’s blog –Health Care Policy and Marketplace Review — struck me as clear and balanced. Speaking.com shows him among the top five speakers on health care reform. Here’s their blurb: Robert Laszewski is president of Health Policy and Strategy Associates and national advisor on health policy issues for Ernst & Young. He is widely regarded as one of the most influential independent consultants on health care reform. As an executive of Liberty Mutual Insurance Group, Laszewski participated as a member of the non-partisan Alliance for Health Reform chaired by Senator Jay Rockefeller. USA Today called him “one of the boldest advocates for reform.” In his current role, he is an advisor to an impressive list of organizations concerned about the changing marketplace environment for health care.I checked several of his speeches and op-ed pieces, and he seemed to present a balanced, expert perspective. And, heck, as a lifelong liberal, I’m trying to keep this blog balanced. In my earlier political post featuring columnist Stephen Pearlstein, I didn’t worry about his having worked for Senator Durkin (D-IL). So here we go. Romney-Ryan Medicare Plan vs. Obama Medicare Plans  Laszeweski’s blog post is worth reading in full, but here’s a summary. He first asks the question: Who’s telling the truth on Medicare?  His answer: “They both are and they both aren’t.” Then he addresses these questions: Will current seniors suffer under the Romney-Ryan Medicare Plan? Aware of senior voting power, both parties see similar futures for seniors. “If you are over age 70, there is virtually no chance there will be any significant changes in Medicare benefits in your lifetime,” Laszewski says. “Even if you are over 6o, the chances that there will be any major structural changes to Medicare benefits as long as you are around are quite small.” Can Medicare as we know it be preserved for the next generation? “Absolutely not,” is Laszewski’s quick answer. But here Laszewski gives Romney/Ryan better marks than he does Obama. On Romney/Ryan he says: I will tell you that Romney and Ryan have taken the more courageous political stand — they say Medicare can’t be preserved and big fixes have to happen. Now, that doesn’t mean necessarily they have the right policy answer, only that they are willing to face the problem.As for Obama: Obama and the Democrats are being disingenuous by trying to use the Romney-Ryan plan to scare voters without facing this tough issue in a direct way themselves.The Republicans have been harping since the 2010 elections on the $700 billion cuts in Medicare that Obama and the Democrats used to help pay for the Affordable Care Act, but doesn’t Ryan have the same Medicare cuts in his budget plan? Short answer: Yes. Laszewski provides a detailed review of the claims being made by both sides on this $700 billion and concludes: Both sides are making the same cuts and have really been playing games with this one.Republicans are using the success of the Medicare Prescription Drug Plan as evidence that the market can control health care costs. Is this evidence on their side? Short answer: “Not in any kind of clear cut way.” It’s clear that Medicare drug costs are coming in way below what the Congressional Budget Office predicted when the new drug benefit was added to Medicare in 2003. However, all drug costs are coming in lower than predicted. In 2003, drug costs were exploding. Since then, the greatly increased use of generic drugs and fewer new expensive drugs in the pipeline have helped reduce drug spending. Also Medicare Part D (the drug benefit) enrollment has cost less than originally projected. Romney and Ryan say their plan will include the traditional Medicare plan as one of the options. But critics say there is a good chance Medicare will end up with the sickest seniors, while rich people are able to buy the private plans, thereby destroying the Medicare program everyone has enjoyed. Is this true? Short answer: Probably not. Ryan has sponsored several different Medicare plans. Under the more detailed Wyden-Ryan Medicare Plan (which Ryan co-sponsored with Democratic Senator Wyden of Oregon), if one of the health insurance options attracts a disproportionate number of sick people, it gets more money to offset the resulting higher costs. This provision would protect Medicare or any other plan, Laszewski says, adding, “So, it is not clear to me how, if the traditional Medicare plan got sicker people, it would make it more expensive for consumers after these inter-plan adjustments.” The Romney/Ryan plan relies on the marketplace to control costs but there is no evidence that the market does a better job than government-run plans? “That is right,” Laszewski says, “but Romney and Ryan are calling for a different kind of health market.” While there’s no proof based on past practices that the market has controlled costs, we have never tried a market like the one Romney and Ryan propose. They are proposing a very different system where health plans have to bid their price in each market. They argue that competitive bidding will result in real competition in the market and, with seniors being given limited  support in the government’s vouchers, they will have a greater incentive to shop for plans that cost less. All of which, they argue, will result in controlling costs. Most health policy experts believe that we must fundamentally change the health care delivery system from the current fee-for-service system that largely pays for quantity, to one that pays for quality and cost control. The Democratic health care reform law has lots of pilot programs to test these new ideas. It is also likely, Laszewski says, that the new Medicare cost board enacted as part of the Affordable Care Act will end up requiring providers to get their payments through these new payment programs in order to control costs. The Republicans also embrace these same ideas for new programs that pay providers a fixed amount for health care. These new payment systems, he says, also would take better advantage of electronic payment management systems and administrative simplification. All of these ideas, generally accepted by Democrats and Republicans, have yet to be proven, he cautions. What do Obama and the Democrats propose as an alternative to Romney and Ryan? Laszewski faults the Democrats for taking “the safer political path” by letting the other guys make controversial proposals and saying little about how they see Medicare operating differently in ten years. But he says he is optimistic that the Medicare cost control board called for under the Obama Affordable Care Act “could do a lot of good toward pushing the Medicare program to more sustainable payment models.” That board begins its work in 2015 under the ACA, but not until 2020 for the largest category of costs — the hospitals. And, he adds, if the ACA board is successful in remaking Medicare, it will not be the “Medicare as we have known it” that the Democrats claim they can preserve. Republicans criticize the Medicare cost board for being a “non-elected bunch of bureaucrats.” But Laszewski says that our elected members of Congress — Republicans and Democratics — have not shown the political courage to make the tough decisions to reform Medicare. He says he also is optimistic that the system of competitive bidding and consumer choice envisioned in the Romney/Ryan Medicare plan “could push the Medicare system toward more sustainability.” Both parties’ reform plans “are untried solutions and controversial among the experts,” he cautions. Obama says that Paul Ryan’s Medicare plan will increase a senior’s health costs by $6,400 a year. Is this accurate? No. That estimate is based upon a Congressional Budget Office (CBO) estimate of an earlier version of Ryan’s plan, Laszewski says. In his latest plan, Ryan increased the rate at which the federal premium support (the “vouchers”) would grow as medical costs increase. He opened up the plan by allowing Medicare to be offered as one of the coverage choices. All seniors would be assured that they could afford at least the two least costly plans on the same basis as Medicare subsidizes them today. There is no way to tell which two plans they would be or whether traditional Medicare would be one of them. But these plans would have to offer at least the traditional Medicare benefits. The CBO has not yet provided estimates on the revised Ryan plan. But Obama and the Democrats should be doing comparisons using this plan, which is a big change from the 2011 Ryan plan. Bottom Line Question: Whose Medicare Plan Will Work? “My sense is that either could work,” Laszewski says. “It all depends how they are implemented.” Put a conservative and a liberal in the same room and give them all the facts about Medicare and health care spending, what has and hasn’t worked in government and in the market, and then ask them to come to a conclusion. The liberal would like the Democratic approach that relies on the government, and the conservative would come out on the side of consumer choice and markets. My Take on This  So after all that, we end up where we started.  But I was struck by one thing in reading Laszewski’s analysis. Both sides are proposing $700 billion cuts in Medicare.  Both have the same idea that Medicare needs to be shifted away from fee-for-service to a system that puts more emphasis on quality of service rather than quantity and on cost control.  Obama’s ACA uses insurance exchange programs for those not covered by Medicare and Romney/Ryan proposes them for Medicare reform If we had a normal functioning democracy, you’d think a compromise resolution of the issue should be easy. But we don’t have a normal function democracy.
Source: blogspot.com