Medicare Takes Center Stage As President, Ryan Address AARP

Posted by:  :  Category: Medicare

Bubbles? Take something like 'Not I! ...item 1.. Wakulla Republicans Protest Against Taxes in the County (September 06, 2011) ... by marsmet552Meanwhile, one fact checker finds fault with both campaigns. The Washington Post: A Bipartisan Foul: ‘Medicare Is Going Broke’ We have bipartisan agreement! Medicare is going broke, busted, bankrupt…or is it? We have touched on this before but decided to take another stab after the new ad featuring Sen. Rubio was released by the Romney campaign. It’s actually a fairly effective ad, with the calm message that the GOP Medicare plan — so often inaccurately attacked by Democrats — is designed to “save” it for current retirees and be different for younger Americans, in what Rubio pitches as a bit of a gift from one generation to another. But his line that Medicare is going “broke” — using simple “math” — repeats a bit of political hokum that both parties persist in repeating (Kessler, 9/21).
Source: kaiserhealthnews.org

Video: Weekly Address: Medicare Officially Safer After Health Reform

“Medicare & You” goes paperless

and access all the same information found in your printed handbook. You can learn what’s new for the year, how Medicare works with your other insurance, get Medicare costs, and find out what Medicare covers. Even better, the handbook information on the web is updated regularly, so you can instantly find the most up-to-date Medicare information.
Source: medicare.gov

Medicare's hospital readmission penalties kick in

Some experts believe that the penalty is still low enough that hospitals will opt to pay it rather than change readmission policies.  But others believe the initiative holds opportunity for nursing homes because it encourages hospitals to partner with quality post-acute providers as a means of reducing readmissions.
Source: mcknights.com

AARP: Presidential Debates Must Address Social Security, Medicare

AARP is a nonprofit, nonpartisan organization, with a membership of more than 37 million, that helps people 50+ have independence, choice and control in ways that are beneficial 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 Americans 50+ and the world’s largest-circulation magazine; AARP Bulletin, the go-to news source for the 50+ audience; AARP VIVA, a bilingual lifestyle multimedia platform addressing the interests and needs of Hispanic Americans; and national television and radio programming including My Generation and Inside E Street. The 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. AARP has staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Learn more at www.aarp.org.
Source: enewspf.com

Obama, Ryan will address AARP in New Orleans as Medicare debate rages

The Romney campaign disputes that the proposal is a “voucher” plan, and accuses the president of pilfering $716 billion from the Medicare program to pay for the Affordable Healthcare Act, his signature healthcare reform law. The Obama campaign says the Medicare savings will come from holding down payments to hospitals and insurers, not reducing benefits to retirees.
Source: nola.com

Rep. Schwartz Talks Medicare in DNC Address

Ms. Schwartz is one of the principal social engineers who is driving GP’s and internists to retire and leave early because of the bureaucracy, higher malpractice risk and Hippocratic oath violations she created.She must have known that America will be 120,000 general doctors and nurse practitioners short by 2020, even before Obamacare but she must not have cared that there will be no doctors. She also is guaranteeing that the Catholic Church’s, immense investment in education and caring for the sick and the poor will be abandoned forever after the one year extension expires , due to their sincere religious beliefs not being in accord with what she and other Democrats wrote into the Obamacare law. As a doctor, I can say for whatever good she may have created there will also be many neglected deaths and social wreckage she will have to account for. That is a couple reasons, among others,why she should not be re-elected to Congress from the 13th District. In my opinion, her vision is too limited and she lacks mature balanced long-term judgement.
Source: patch.com

Video: Allyson Schwartz Talks Medicare in DNC Address

I’m Congresswoman Allyson Schwartz of Pennsylvania. Moving America forward means never going backward on America’s great promise of health care for our seniors: Medicare. As a daughter who cared for an elderly parent, I know medical care is not optional for seniors. We will not let the Republicans end the guarantee of Medicare, which could cost seniors thousands and endanger the health and retirement security of millions of Americans. Americans have worked for their Medicare. They have paid for their Medicare. Whether you’re 65, 55, 45 or 35, you’ve earned your Medicare. Americans deserve the security Medicare provides. President Obama will strengthen and protect Medicare. Democrats will make the tough choices—the right choices—to reduce the deficit and to preserve Medicare, for this generation and the next.  The Democratic women of the House know that a secure retirement moves America forward.
Source: patch.com

miltonwolf.com: Obama’s new Medicare rules will kill patients but they sure do sound great!

Here’s the government’s latest assault on patients: Medicare fines over hospitals’ readmitted patients. As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications. The penalties are part of a broader push under President Barack Obama’s health care law to improve quality while also trying to save taxpayers money. Sounds great. What could possibly go wrong? As one central planner put it: If General Motors and Toyota issue warranties for their vehicles, hospitals should have some similar obligation when a patient gets a new knee or a stent to relieve a blocked artery, Santa contends. “People go to the hospital to get their problem solved, not to have to come back,” he said. Weak analogy. Would you hold GM or Toyota responsible if someone drove their new car off the lot and then crashed it because they were driving recklessly? Oh, but patients always follow their doctors’ advice, you say? Uh huh. But setting aside the obvious structural flaw of this plan that punishes hospitals for outcomes that are beyond their control, consider the incentives it creates. The government is now incentivizing hospitals to deny care. No two patients are the same. Some are just sicker than others. Some will need more hospitalizations no matter how excellent their care is. Under this new plan, hospitals are incentivized to avoid the sickest patients because they’ll have a higher likelihood of bouncing back and triggering the fines. You better hope your mom isn’t one of them. And if your mom does get sick again after a recent hospitalization, the government has just created a powerful incentive for the hospital to deny her readmission. Good luck with that. UPDATE: Paul Hsieh also notes the perverse nature of this law that actually punishes good hospitals that keep their sickest patients alive: Will Obamacare Play Games With Your Actual Life? It’s also been my observation that dead patients are usually not readmitted to the hospital, though some still vote.
Source: blogspot.com

President's Weekly Address

Republicans in Congress have put forward a very different plan that turns Medicare into a voucher program—under one plan forcing seniors to pay an extra $6,400 out of their own pocket for care-and effectively ends Medicare as we know it. The President believes that our seniors deserve better and will work with anyone to keep improving the current system to give our seniors the security and peace of mind they have earned.
Source: ezkool.com

Watertown Physician Joins Harvard Vanguard

Posted by:  :  Category: Medicare

http://www.harvardvanguard.org Harvard Vanguard Medical Associates is a nonprofit multi-specialty medical group providing care to 495,000 adult and pediatric patients at more than 21 offices across eastern Massachusetts. As an affiliate of Harvard Medical School, Harvard Vanguard physicians are on the staff of Boston’s academic medical centers and community hospitals. Harvard Vanguard’s 4,100 employees, including more than 600 physicians and 1,000 healthcare professionals, are committed to making it easier for patients to be and stay healthy. Harvard Vanguard practices are among the highest rated in the state for clinical quality and accept insurance from most major health plans, including Aetna, Blue Cross Blue Shield of MA, Fallon Community Health Plan, Harvard Pilgrim Health Care, Neighborhood Health Plan, Tufts Health Plan, and Tufts Health Plan Medicare Preferred. Harvard Vanguard is an affiliate of Atrius Health (http://www.atriushealth.org), an alliance of six non-profit community-based medical groups in Massachusetts.
Source: patch.com

Video: Member Stories – Tufts Medicare Preferred HMO

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Source: exblog.jp

Granite Medical Group Achieves Top Clinical Quality Ratings

Granite Medical was founded in 1997 and joined Atrius Health in 2005. Their 20 physicians and 5 nurse practitioners are committed to providing patients with the highest quality of care at its convenient location in Quincy. In addition to internal medicine, many of the Granite Medical providers have expertise in a sub-specialty, including cardiology, endocrinology, gastroenterology, gerontology, hepatology, nutrition, podiatry, pulmonary medicine and rheumatology.  Granite Medical accepts insurance from most major health plans, including Aetna, Blue Cross Blue Shield of MA, Harvard Pilgrim Health Care, Neighborhood Health Plan, Tufts Health Plan and Tufts Medicare Preferred. For more information, visit www.granitemedical.com.
Source: patch.com

ICSI and Nine Health Care Partners Receive 3

Advancing Integrated Mental Health Solutions Center, as an integral part of the Department of Psychiatry & Behavioral Sciences at the University of Washington, is a leading center of research, training and innovation in integrated mental health programs. The department has nearly 200 full-time faculty engaged in a wide variety of clinical and research programs, plus training programs for health professionals in urban and rural sites in a five state region in the Pacific Northwest. A primary area of research interest is the development of programs in which mental health professionals collaborate effectively with primary care physicians and other health care providers to care for children, adults, and older adults with common mental disorders.
Source: ahier.net

Massachusetts Health Stats: The Boston Herald “Medicare Victim” Story on Enbrel: Dozens of Teachable Moments

Massachussetts Health Stats is an as-needed look at statistics about the Massachusetts healthcare delivery and insurance market and industry, including aspects of Medicare as they relate to Massachusetts seniors and the Medicare-eligible disabled. 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

Harvard Vanguard Medical Associates Achieves Top Clinical Quality Ratings

Harvard Vanguard Medical Associates is a nonprofit multi-specialty medical group providing care to 495,000 adult and pediatric patients at more than 21 offices across eastern Massachusetts. As an affiliate of Harvard Medical School, Harvard Vanguard physicians are on the staff of Boston’s academic medical centers and community hospitals. Harvard Vanguard’s 4,100 employees, including more than 630 physicians and 1,000 healthcare professionals, are committed to making it easier for patients to be and stay healthy. Harvard Vanguard practices are among the highest rated in the state for clinical quality and accept insurance from most major health plans, including Aetna, Blue Cross Blue Shield of MA, Fallon Community Health Plan, Harvard Pilgrim Health Care, Neighborhood Health Plan, Tufts Health Plan, and Tufts Health Plan Medicare Preferred. Harvard Vanguard is an affiliate of Atrius Health (http://www.atriushealth.org), an alliance of five non-profit community-based medical groups in Massachusetts.
Source: patch.com

Medicare Audit Challenges to Paying Nursing and Allied Health Program Pass

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSPursuant to Medicare regulations, the program shares in the cost that hospitals incur for approved nursing and allied health education programs.  Medicare reimburses hospitals for a share of the classroom and clinical costs of their approved education programs, based on the proportion of the hospital’s patients who are Medicare beneficiaries.  Federal regulations define approved educational programs as formally organized or planned programs of study that are operated by hospitals, enhance the quality of inpatient care and meet licensing and/or accreditation requirements.  The original intent of Medicare funding for educating health professionals was the promotion of quality inpatient care and the development of a suitably trained nursing workforce.  Over the years, the number of hospital-based programs has significantly declined as a result of changes in workforce demands and hiring practices, together with changes in accreditation requirements that seem to favor educational activities based at separately incorporated institutions independent of a sponsoring hospital.  Other hospital-based programs continued, however, and, in some cases, expanded into allied health training, including training for radiologic technologists, emergency medical technicians, surgical technologists and hospital chaplains.
Source: jdsupra.com

Video: Gastric bypass surgery:Medicare requirement in Texas ,and things you need to know….wmv

Senate Special Aging Cmte. Looks at Medicare Fraud

The nation’s largest employers expect health care costs to rise with the implementation of the Affordable Care Act. That’s according to a survey by the National Business Group on Health released Monday with a first look at the effects of the new health care law on large businesses. The survey outlined costs, health care plan changes for 2013 and adjustments businesses are making to ensure their benefit plans comply with the health care law. National Business Group on Health President and CEO Helen Darling announced the survey’s findings, 
Source: c-span.org

Using Medicare Advantage to Gain Political Advantage

It is almost certainly true that quality suffers when reimbursement rates are reduced. It is also appears to be true that competition amongst private providers in Medicare Advantage is leading to efficiencies that aren’t present in traditional Medicare, which we should probably take as a lesson. It is also often the case that when the government pays more for something, it spends more, and when it pays less for something, it spends less. But what all this really reveals is the folly of trying to control health spending through government-designed payment schemes. 
Source: reason.com

Compliance Alert: Medicare Part

As part of the Patient Protection and Affordable Care Act of 2010 (ACA), Plan Sponsors with group health plans which include prescription drug benefits now must provide the annual Part-D Creditable Coverage Notice by October 15, 2012. Before 2011, Plan Sponsors were to provide the notice no later than November 15, the first day of the Medicare Part-D open enrollment period. ACA changed the Part-D open enrollment to be the period between October 15 and December 7.
Source: andreini.com

Project HealthDesign Blog:Federal Government Finalizes Stage 2 Meaningful Use Requirements

We are encouraged by efforts in the proposed rule regarding patient and consumer engagement, especially regarding secure messaging; direct, downloadable access to patient data; patient reminders; inclusion of family health history; and provision of patient education. Nevertheless, we would like to see the required percentages higher than proposed in some cases. In addition, as our Project HealthDesign makes clear, patients now expect to engage with their personal health data in apps and on mobile devices of their choosing. We expect this trend to increase significantly. Further, patients will almost certainly expect that the flow of information be in two directions. In other words, patients will reasonably expect they will have both access to personal health data but also the ability to provide personal data to their health professionals.
Source: typepad.com

Missing Medicare Plan Deadlines Will Cost You: When to Enroll

Medicare Part A If you already receive benefits from the Social Security Administration or the Railroad Retirement Board, you are automatically entitled to Medicare Part A and Medicare Part B; no action is required on your part to enroll. If you do not meet the criteria listed above, then you must enroll in Medicare during the period beginning three months before you turn 65 and ending three months after your birthday.
Source: gohealthinsurance.com

Important Medicare Update

In addition to the previously detailed Mandatory ABNs, this transmittal added the following to the Mandatory ABN list:  1)   The item or service is furnished by a non contract supplier AND the item is included in the Durable Medical Equipment, Prosthetic, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) for a Competitive Bidding Area (CBA) (unless the beneficiary has already signed an ABN); or 2) The preventive service frequency limitations have been exceeded.
Source: eldercounselblog.com

Paying for nursing home care with Medicaid

Medicaid also has special rules for married couples when one spouse enters a nursing home and the other spouse remains at home. In these cases, the healthy spouse can keep one half of the couple’s assets up to $113,640 (this amount varies by state), the family home, all the furniture and household goods and one automobile. The healthy spouse is also entitled to keep a portion of the couple’s monthly income — between $1,838 and $2,841. Any income above that goes toward the cost of the nursing home recipient’s care.
Source: pomeradonews.com

Medicare defends power wheelchair pre

The demonstration program requires Medicare providers and beneficiaries to get authorization from a Medicare contractor before the wheelchair or electric scooter can be delivered. Officials from Centers for Medicare & Medicaid Services told members of the Senate Special Aging Committee that the program is needed because 80% of the claims submitted for wheelchairs fail to meet Medicare requirements for coverage, the Associated Press reported. CMS officials said this results in over $492 million in improper payments every year. Scooters and motorized chairs can range in price from $1,500 to $3,600, according to the AP.
Source: mcknights.com

Asbestos Trusts and Medicare Liens:Medicare Wants its Money Back

And how is “exposure after Dec. 5, 1980” defined? The burden is on you or, in our example, Mr. Jones, to establish that the exposure ended before Dec. 5, 1980. All of the exposure. This is a difficult burden to meet, especially in light of the trouble many people have remembering exactly when and where exposure occurred. Trying to recall facts from 20, 30 or 40 years ago is difficult. Sure, most folks know when certain milestones occurred in their lives, like marriage, entry into military service or where you were when President John F. Kennedy was assassinated. But try to remember exact dates or circumstances; it can often be difficult to recall the the “who, 
Source: motleyrice.com

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

Posted by:  :  Category: Medicare

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Source: reportingonhealth.org

Video: Mitt Romney Embraces Privatizing Medicare and Social Security and Raising Eligibility Ages

Daily Kos: Romney/Ryan will raise Medicare eligibility age for current seniors

If the increases in eligibility age are raised now because of the fiscal “crisis” and those under 55 are supposed to be dumped altogether, what guarantee is being offered that a further “crisis” caused by counter-productive Republican policies won’t prompt them to reduce eligibility further?  If their solution hastily offered now is to cut eligibility, why would that not be their preferred option during the next manufactured “crisis?”  The Republicans have already let it be known that they will never look at increasing revenues through upward changes in the tax rates, so any total revenue increases must come disproportionately from increases in the national economy, except they’ll have already cut taxes further reducing revenues.  Why should they get a third shot at dynamic scoring for revenue increases when the prior experiments under Reagan failed and Bush II totally cratered the economy?  
Source: dailykos.com

Should The Eligibility Age For Medicare Be Raised?

Maya MacGuineas, president of the Committee for a Responsible Federal Budget, makes the case for raising the eligibility age. Arguing to leave it unchanged is Aaron E. Carroll, the associate director of Children’s Health Services Research at Indiana …
Source: newamerica.net

More on raising the Medicare age

As a stand-alone policy, there is no doubt that raising the Medicare eligibility age this is a bad one. And doing so assumes the implementation of exchanges under the ACA. However, I am open to raising the Medicare age in a manner that equalizes it with the Social Security retirement age as part of a broader political deal that either brings about federally-guaranteed universal catastrophic coverage or an agreement to move ahead with implementation of the ACA that makes reform the responsibility of both parties. For many Conservatives, a move such as this one is a strong signal of seriousness in addressing long range health care cost problems. As I say, I don’t think they are correct, but there is a policy logic of increasing the age along with Social Security increases given that they have been linked for so long. In the end, I would potentially agree to this, so long as what is gained in return is consequential enough.
Source: samefacts.com

Medicare Proposal Pros and Cons

Proposed changes to the program include raising the eligibility age to 67, raising payroll taxes and requiring better-off beneficiaries to pay more. The most politically contentious plan, devised by Rep. Paul Ryan (R-Wis.), chairman of the House Budget Committee, would limit federal spending on Medicare and alter the way the government pays for benefits. Republicans say this plan is a fiscally responsible way of extending Medicare’s viability as millions of boomers enter the program. Democrats call it "the end of Medicare as we know it" and a way to shift more costs to beneficiaries.
Source: aarp.org

Website is currently unreachable (1)

The website that you are trying to access is in Offline Mode, which means the server is not currently responding. To browse the site from cache, click the button below. (Cookies and Javascript must be enabled.)
Source: daily-kos.com

Gerber Medicare Supplement Insurance

Posted by:  :  Category: Medicare

Gerber Medicare Supplement quotes are readily available in addition to a lot of other Medicare Supplemental Insurance corporations. We’ll shop the rates for you personally and assist you to find the most effective deal.
Source: theushealth.com

Video: Gerber Life Medicare Supplement

Gerber Medicare Supplement

What will happen if I decide to call or email you about a quote? I will reply promptly with the information you requested and your information will be shared with no one. If you decide that this is not the program for you, I will have no hard feelings and will thank you for the opportunity.
Source: newjerseyinsuranceplans.com

gerber medicare supplement

Medigap is health insurance that’s provided by personal health insurance firms to provide additional protection for folks on Medicare. Medigap might help spend wellness fees that are not included in Medicare, or complement Medicare installments thus that the individual gives less out of pocket.
Source: skybookmarks.com

Gerber Medicare Supplement Insurance

Should you be looking for a mobile mechanic New York arrive at you and repair your vehicle, you have come to the right place because Mobile Mechanic Pros is undisputed the most effective in the industry! But don’t take our word instead watch our customer testimonial videos. Prevent the hassles of dropping your off our car and being overcharged by BIG auto shops. Instead of wasting time and funds call mobile car repair Austin a business build on delivering convenience at affordable prices.
Source: scoop.it

Gerber life medicare supplement

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Source: fluxfeatures.com

What to Expect on a Gerber Medicare Supplement Plan

However, Medicare has its own gaps, resulting to a need for Medicare supplement plans. These supplement plans can be obtained by individuals who are currently members of the Medicare plan by the government. To be able to deal with several supplement plans, the Center for Medicare and the Medicare Services make sure that these plans are standardized for each Medicare holder. It is also helpful that Medicare supplement plans are available for view online, individuals can take a look and review which of these plans suit their needs the most.
Source: ezinemark.com

bookface: How Exactly To Get Of The Greatest Medicare Supplement Insurance?

Program A, based on the Federal Government, comprises of two essential insurance handles — household medical care and the hospitalization cover cover. You can therefore acquire of Plan A if you are hospitalized or under surgery for any cause in any of the collaborating hospitals under the Plan A spectrum. If you’ve a verified background of you or your loved ones requiring health care and consideration at any point of moment, being in an infirmary this plan is more desirable.
Source: co.uk

Summit MediGap: Do I need Medicare supplemental insurance?

When you turn age 65 you are eligible for Medicare Part A & Medicare Part B.  This also means you are eligible for Medicare supplemental insurance or Medigap insurance.  Medicare Part A will cover you for hospital related care, however you would still be responsible for such things as the Part A deductible.  Medicare Part B will cover you for doctor visits and tests.  However, Medicare Part A & B will only cover about 80% of your total medical costs.  Medicare supplement plans are designed to cover what Part A & B do not cover.  Medicare when combined with the right supplemental plan is actually great coverage and often times you will have better coverage than what you had with your employer or family plan.  In fact with the right medigap plan you can actually be covered for all deductibles, coinsurance and co pays.  Seniors find it easier to budget for a monthly medicare supplemental plan premium knowing that they will not need to worry about unexpected medical expenses throughout the year. There are currently 11 different Medicare supplement plans or medigap plans.  Seniors often find it very confusing trying to figure out which plan is best for them.  This is why it is so important to find a great independent agent that specializes in Medicare supplemental insurance.  A good independent agent will be able to show you all the plans available from the major insurance carriers.  They will also spend the time to analyze what your current health benefit needs are and match those needs with the medicare supplement plan that best fits you. There really is no reason to worry about your Medicare options.  Find yourself a quality agent that specializes in medicare supplemental insurance, that person will save you lots of time and also money.  It is also important to review your benefits with an expert every year or two to make sure you are getting the best coverage for the money.  Plans and rates change often so having an Medicare supplement specialist to turn to will give you great piece of mind. Bill Loughead SummitMedigap.com 1-888-40-Summit (888-407-8664) “We make Medicare seem easy”
Source: blogspot.com

Qualities of a Good Gerber Medicare Supplement Company

It very important that an insurance company offering Medicare plans, like Gerber Medicare Supplement, is licensed or accredited. It is never wrong to ask representatives about the company’s credentials. You may also check the company’s legitimacy through government bureaus that handle registration of insurance companies. This protects senior citizens and retirees from scams. The Internet may also be a useful resource in discovering a company’s reputation among its clients. There are different forums and websites that senior citizens can visit, to find positive or negative feedback about certain private insurance companies.
Source: onlyburn.info

Texas Annual Enrollment Period for Medicare

Posted by:  :  Category: Medicare

Kinky For Governor by Big Grey Mare ~ on vacation for 2 weeks During this time, everyone currently enrolled in Medicare may join or make changes to their health care plan. However, any changes you intend to make involving a Medicare Advantage plan or prescription drug coverage must take place during this time. There are exceptions to these dates. If you have existing coverage, but move out of your current plan’s service area or if your plan is terminated, you may add new coverage when you need it. In addition, if the Medicare Advantage plan you wish to join is rated five star, you may do so at any time during the year. And don’t forget, if you have a Medicare supplement plan, you may switch between plans at any time during the year, not just during Annual Enrollment.
Source: texasmedicarehealth.com

Video: Understanding Medicare and Its Insurance Options

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

Medicare Supplement Insurance Texas Agencies Offer Is Helpful To Certain Clients

The federal government allows private agencies to sell supplemental policies to customers. These policies help individuals to pay for the things that their original insurance does not cover. Companies that sell such policies must comply with very strict federal and state laws and regulations. They are standardized according to guidelines created by the United States government and all such policies must provide the same coverage, regardless of the agency from which the coverage is obtained. However, each agency is allowed to charge different rates for the coverage.
Source: myglobalseattle.org

State Strategies For Controlling Medicaid Costs

What about under treatment? When doctor’s get a bonus from surplus created by NOT providing health care then the incentive is to deny treatment even if it is necessary care. The problem with the HMOs from the 1990s is that they pocketed the money from premiums and then didn’t let people have sufficient health care. People died who didn’t have to die. The only way to have high quality health care but control costs is to have single-payer national health insurance because everyone is in the same system and costs can’t be shifted. Everyone has incentive to keep costs as low as possible but quality as high as possible. Every other nation has some form of national health insurance where for-profit companies are not allowed to play a dominant role in health care. We spend 31% of every health care dollar on administration because we use a for-profit health insurance based system. Traditional Medicare uses only 3% – 6% administrative costs – if you let for-profit health insurance companies take a medicare pie with the Medicare Advantage programs you increase your administrative costs to 12% – 20% but the quality of care goes way down. Quit blaming patients and doctors. The problem is the greedy for-profit health insurance company middlemen who are only takers and provide nothing of value to our health care system.
Source: thedianerehmshow.org

Texas Medicare Supplement

Texas is a big state and a lot of seniors are there. We have found that e-medigap is a great Medicare supplement brokerage to work with. They are located in Austin, Texas and have many years of experience dealing with Texas Medicare supplements. They are brokers and represent many different companies. If you are looking for a texas medicare supplement  you have found the place to go. If is important to get quotes from many different companies first since all companies offer the same benefits from company to company. The only thing that differs is price. Be sure to contact e-medigap for all your medicare needs!
Source: bellportbrookhavenhistoricalsociety.org

Texas doctor pleads not guilty again in fraud case

In June, the Texas Medical Board said Roy had agreed to surrender his license to practice medicine in the state. The order says the 54-year-old Roy does not admit or deny the federal allegations against him, but agreed to a settlement to avoid a possible lawsuit.
Source: ktre.com

Is Texas Medicare Insurance Different From Other States?

The controversy surrounding the proposed bill stems from the request that Washington provide Texas a predetermined amount of currency for healthcare. It would then be up to the state to cover any additional fees incurred. In a state where the track record of Medicare dealing have at best been described as shoddy, the passage of this bill could have a very negative ripple effect on those dependant on Texas Medicare insurance. With the entire nation keeping a close eye on these preceedings, patients everywhere are holding their collective breath.
Source: seniorcorps.org

Medicare and Appeal Rights for Hospice Care Patients

Much can be learned through the unfortunate case of Howard and Emily Back. Emily, now deceased, was a California hospice patient covered by Medicare. Howard appealed his wife’s lack of treatment through the court process. However, the court was quick to point out that there is an administrative appeals process through Medicare regarding its hospice care decisions.
Source: kenvanway.com

Eyes Turn To Arkansas’ Bold Effort To Cut Medicaid Costs, Add Transparency

Posted by:  :  Category: Medicare

ADAPT Medicaid Rally by SEIU InternationalFirst, the three entities analyzed historical billing data to determine the state’s highest-volume and most costly medical conditions. Then, they each individually targeted three conditions for which they would track the costs for “episodes of care” — meaning the total charges of treating patients for that specific illness, everything from office visits, to medications and specialty care. The conditions included perinatal care, upper respiratory infections, attention deficit/hyperactivity disorder, hip and knee replacements, and congestive heart failure.
Source: kaiserhealthnews.org

Video: What is medicaid?

Medicaid expansion rejected by Louisiana may be pursued in New Orleans

Under the Affordable Care Act, states will be reimbursed by the federal government for 100 percent of the costs of expanding Medicaid to cover people whose income is 133 percent of the poverty level, or $29,326 for a family of four in 2014, 2015 and 2016. Beginning in 2017, the federal reimbursement rate would gradually decline, until it reaches 90 percent in 2020, where it would remain as long as the law stays in effect.
Source: nola.com

Current and Emerging Issues in Medicaid Risk

Half of all Medicaid enrollees receive care through comprehensive risk-based managed care organizations (MCOs). Most Medicaid MCO enrollees today are low-income children and parents, but states are increasingly moving beneficiaries with more complex needs into MCOs. Managed care enrollment may grow more rapidly as states work with the Centers for Medicare & Medicare Services (CMS) to implement initiatives to better integrate Medicare and Medicaid benefits and care for dual eligibles. The Foundation’s Kaiser Commission on Medicaid and the Uninsured (KCMU) convened an expert roundtable meeting in Washington, DC on May 30, 2012 to learn more about how Medicaid MCOs are currently organized, consider issues that the enrollment of higher-need populations in MCOs raises, and to discuss the implications for MCOs of the expansion of Medicaid under the Affordable Care Act (ACA). The meeting provided insights that complement the findings from a 50-state survey of Medicaid managed care that KCMU conducted in late 2010 in partnership with Health Management Associates. Roundtable participants included state Medicaid officials and insurance regulators, consumer advocates, executives from a diversity of firms operating MCOs, and other key stakeholders. The roundtable discussion sheds light on important managed care-related practices and concerns, but does not statistically quantify their prevalence in industry or the nation.
Source: kff.org

Greenbelt Explorations Unlimited Explores Medicare Supplements

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSOn Friday, Sept. 21, Explorations Unlimited welcomes Mr. Greg Markomanolakis, who will be talking about the differences in Medicare plans and pricing, Medicare Extra Help and the Maryland Senior Prescription Drug Assistance Program that a lot of seniors aren’t aware of. He will also touch briefly on the importance of having burial plans established through an irrevocable funeral trust that is Medicaid waived.
Source: patch.com

Video: Learn About Medigap Plans

Today’s Influence Ads: AARP Medicare Supplement, Shale Gas Production

A slew of new ads are out today as Congress embarks upon its last week before the elections. AARP and UnitedHealthCare have a new ad today promoting AARP Medicare Supplement Insurance Plans as the only standardized Medicare supplement plan that AARP  endorses. American Clean Skies Foundation has a new ad pushing for the production of shale gas in the United States. The government of Panama’s new ad promotes the country as a good place for American businesses to invest. And Across the Aisle Foundation has a new ad inviting senior House and Senate staffers from both parties to an October event to discuss how the new Congress should tackle its first 100 days. Others with new ads, per Kantar Media’s Washington Eye, include: American Petroleum Institute, American Sugar Alliance, American Veterinary Medical Association, Consumer Electronics Association, Employee Freedom Act Committee, Fair Search, Lockheed Martin, McDonald’s, Neustar and Radiation Therapy Alliance. Those with continuing ad include: Altria, American Cancer Society, American Council of Life Insurers, American Hospital Association, AT&T, Beirut Families, Boeing Company, BP, Chevron, CIT Group, CME Group, Hologic, Honda, Huntington Ingalls Industries, Lockheed Martin, Mars Chocolate, Northern Dynasty Minerals, Nuclear Energy Institute, Pfizer, Pharmaceutical Research Manufacturers of America, Southern Company, United Soybean Board, Univision, WellPoint, WTOP and Zurich.
Source: nationaljournal.com

Medicare Supplement Leads are Premium Business Builders

One good way to jumpstart an insurance company’s bottom line is to specialize in selling Medicare supplements. This segment of the population is guaranteed buyers who have an urgent need to get their insurance needs met, more so since ObamaCare was upheld by the Supreme Court. The best way to jump on the Medicare bandwagon is to find a quality lead generation company and splurge on exclusive Medicare supplement leads.
Source: benepath.net

American Financial (AFG) Closes Sale Of Medicare Supplement And Critical Illness Businesses

AFG’s balance supplemental insurance operations consist solely of its run-off long-term care business, which has a book value of approximately $170 million, and which will continue to be based in Austin, Texas. AFG’s Austin-based life and annuity operations will transition to its home office in Cincinnati, Ohio before the end of the year.
Source: istockanalyst.com

Medicare Supplements, not government Medicare Program

Many people do not pay a premium for Part A, as long as they have contributed to the Social Security system for a minimum of forty quarters. Since the inception of the program, there has been a premium forMedicare Part B. The initial premium was $3.00 per month and the current premium is $110.50 or higher for people who began receiving medicare during 2010. There are many more complex guidelines that would have to be examined to determine the exact cost of Medicare but it is safe to deduce that it is not free.
Source: grinddaileyissues.com

Medicare Supplement Insurance Texas Agencies Offer Is Helpful To Certain Clients

The federal government allows private agencies to sell supplemental policies to customers. These policies help individuals to pay for the things that their original insurance does not cover. Companies that sell such policies must comply with very strict federal and state laws and regulations. They are standardized according to guidelines created by the United States government and all such policies must provide the same coverage, regardless of the agency from which the coverage is obtained. However, each agency is allowed to charge different rates for the coverage.
Source: myglobalseattle.org

Comparing Medicare Supplemental Insurance Benefits

These plans, called “Medigap” plans, each have different medical care coverage. Variable benefits of coverage to be considered are: • Coinsurance plus coverage that last 365 days after medicare benefits end (Medicare Part A) • Coinsurance/Copayment for medicare part B. • Pints of blood (transfusions, first three pints) • Hospice care copayments or coinsurance • Coinsurance for Skilled Nursing Facilities • Part A medicare deductible • Part B medicare deductible • Part B excess charges • Emergencies during foreign travel • Preventative care coinsurance, per Medicare Part B If any of these are important for you to have covered, comparing medicare supplemental plans that include benefits is the only way to ensure they are included.
Source: seniorcorps.org

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

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

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

The B Medicare Supplement Insurance Plan

You can’t make a good Medicare supplement insurance choice if you do not know the plans the first place to start before even looking at the rates and carriers is to have a good foundational understanding of how the plans differ and in that light, let’s take apart the B Medicare supplement plan. Although it’s incredibly popular as an option, it’s important to understand why not. First of all, do not confuse the B Medicare supplement plan with Part B. This is always confusing (understandably so) for many people when researching options for Medicare. When we are on the phone helping people go through the options, it quickly devolves into a “Who’s on 1st” routine until we delineate that Part B is the part of traditional Medicare that deals with physicians costs while Plan B, is one of the standardized Medicare supplement plans available to complement traditional Medicare. Once we have correctly separated, we can get into the benefits so on to Plan B. Plan B is the second plan (A being the first) up in terms of benefits meaning that only the A plan is less rich in benefits if we’re not considering the high deductible F plan or Advantage plans. Not too many carriers will offer the B plan but just in case, letss go through the benefits. First, there’s are the benefits relating to Part A. Part A is the hospital side of traditional medicare. By hospital, we generally mean facility based care. The B Medicare supplement plan address both “holes” in Part A coverage. The B plan will cover both the Part A deductible and the Part A co-insurance (covered by all Medicare supplement plans). The Part A deductible is the only difference between the B plan and A plan (A plan does not cover this deductible). The deductible is sizable (over $1000 per calendar year and growing) so the reason to get the B plan is this one time and if it’s priced fairly closely to the A plan, we advise the B plan between those two options if cost is your primary concern. The next section to look at would be Part B benefits under traditional Medicare. These are the charges associated with physician charges and labs. The B plan will not cover either the Part B deductible or the Part B co-insurance. This means that you will pay the Part B deductible (over $100 and growing) and afterwards, the 20% that Medicare does not pick up. This is less of a concern than the Part A deductible/co-insurance since we’re dealing with much smaller amounts but you’re also more likely to hit the Part B deductible since more common-place benefits such as office visits fall under this category. You’re pretty likely to hit (and meet) this deductible and the co-insurance of 20% so figure what the deductible amount is over a 12 month period to compare apples and apples against other plans. The rest of the Plan B Medicare supplement benefits are identical to the A plan for the remaining categories. Let’s look through them according to importance (in our humble opinion). The first is Excess charges which is not covered by the B (or A or C) plan. Excess is the amount that Medicare providers can charge over what Medicare allows. We feel this is an important consideration and potential risk since the Excess charge is not capped and can run as high as 15% of the total eligible charges. Hospice care is covered by the F plan but Skilled Nursing Facility is not. The latter is also a potential concern since this type of care is extremely expensive and only getting more expensive as can be seen by the current Long Term Care funding issue. As competition for skilled nursing become ever more in demand as a result of the Baby Boomers, the cost can be expected to increase as far as the eye can see. The first 3 pints of blood are covered but the Foreign travel emergency benefit is not covered. We’re not terribly concerned about his latter benefit since travel medical insurance can generally be purchased as needed and the cost to cover Foreign travel generally offsets any potential benefit. Preventative benefits are covered under the B Medicare supplement plan which is good news. Those are the core B plan benefits along the major categories outlined in Traditional Medicare coverage. The B plan is rarely offered so this is probably not going to figure into your decision but just in case it is, we want to make sure you have all the relevant information to make a good decision. Dennis Jarvis is a licensed insurance agent concentrating on medicare supplement insurance.

Florida Blue Is New Name for BCBS of Florida

Posted by:  :  Category: Medicare

ObamaCare - Where you're just a Tax Figure by Richard Loyal FrenchThey are also trying to decrease or hold steady their Medicare supplement rates while competitor AARP is increasing their supplement rates by 5%.  This new approach is a welcome change from the old BCBS of Florida who seemed to rely on their name recognition and less on robust benefits or a value based approach.  In less than a week the new benefit information for 2013 will be released.  Starting on October 15th you will be able to enroll into one of the Florida Blue plans if you want.  I will have updated information on this site so check back regularly.  If you have not already, sign up for my free mini-course in the upper right hand corner!
Source: medicare-plans.net

Video: Medicare HMO

Trends in Hospital Cost and Revenue, 1994

Examining two 5-year periods, one when HMO enrollment was increasing and one when it was decreasing, shows that HMOs had an effect on lowering hospital costs and revenues, albeit a diminishing one. This study looked at trends in hospital cost and revenue relative to different levels of HMO market structure. Prior to 2000, high HMO penetration was found to be associated with cost containment. But that relationship changed and weakened between 2000 and 2005 when HMO enrollment started to decline.
Source: rwjf.org

Choosing a Medicare Advantage Insurance Plan

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

Kaiser Permanente’s Medicare Plans Earn Top NCQA Health Insurance Rankings for 2012

About Kaiser Permanente Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.
Source: kp.org

Medicare Advantage HMO, PPO, and PFFS Plans For Medicare Beneficiaries: Catering Different Needs

Since I was still confused as to what to subscribe to, I asked my friends’ opinions and clarified some questions going around in my head. Anyhow, with the explanations I obtained from them, I reiterated it verbatim to my wife so we could then discuss and decide which plan to choose. Medicare Advantage HMO, PPO and PFFS Plans for Medicare Beneficiaries all have advantages and disadvantages. HMO stands for Health Maintenance Organization which, though referral is highly necessary, has a list of accredited health institutions and physicians. Should we end up with this plan, it is imperative for us to choose only the accredited ones. PPO, on the other hand, is Preferred Provider Organization which enlists a network of doctors that I chose. But then again, if a doctor outside the network is chosen, there’s a possible additional expense. Lastly, Private Fee-for-Service only needs consent from the doctor to accept all the terms and conditions including the fee covered for a certain service.
Source: boymechanicproject.com

AvMed Health Plans and Wax Custom Communications Receive Bronze at 2010 Mature Media Awards

Posted by:  :  Category: Medicare

PRLog (Press Release) – Aug 16, 2010 – Miami, August 10, 2010– AvMed Health Plans received a bronze medal at the 2010 National Mature Media Awards, the nation’s largest awards program that annually recognizes the best marketing, communications, educational materials and programs for adults age 50 and older. AvMed’s Medicare Enrollment Kit won a bronze medal in the Brochure/Booklet category. The Medicare Enrollment Kit is an annual piece distributed before the Medicare enrollment period, aimed at educating consumers on AvMed’s Medicare plans and benefits and guiding them in their decision making process. “We’re proud that the work we create with AvMed has been honored at the National Mature Media Awards,” said Bill Wax, president and founder of Wax Custom Communications. “These awards recognize the uniqueness of our work with each of our clients and the quality team we have here at Wax.” About Wax Custom Communications:
Source: prlog.org

Video: AvMed Medicare – Dwight Gym

AvMed Health Plans and Wax Custom Communications Partner in the Publication of ASPIRE

Aspire features information and updates about AvMed’s Medicare Advantage plan, along with practical information designed to help customers enhance their overall health and wellbeing. “The magazine was titled Aspire because we felt it was the perfect word to sum up our attitude towards health,” said Winston H. Lonsdale, Vice President and Chief Medicare Executive, AvMed Health Plans. “The word aspire means to have a great ambition, an ultimate goal, a strong desire, a willingness to strive. In this magazine, our goal is to inspire and support our customers as they optimize their health.” Created especially for Medicare members, Aspire includes profiles of healthy seniors and articles aimed at promoting longevity and healthy living. “Our goal is to encourage readers to use the many member benefits already offered to them,” said Lonsdale. Those benefits include a new affiliation with the SilverSneakers® Fitness Program, discounted Weight Watchers™ memberships and discounts on acupuncture, massage therapy and complementary medicines to improve their health. AvMed has also implemented new initiatives to provide additional services to their members, including the improvement of their Personal Service Representative (PSR) program. Wax, who partnered with AvMed to publish Aspire, has worked with AvMed for 20 years, starting with the publication of one title and evolving into a wide range of integrated marketing products. “AvMed has always been known for its personalized, caring approach to healthcare,” says Bill Wax, president and founder of Wax Custom Communications. “Aspire represents an outstanding opportunity for AvMed to convey information to help members take charge of their own health and wellness.” About 5069a042d0255 Founded in 1987 by Pulitzer Prize nominated photojournalist Bill Wax, Wax Custom Communications is a full-service custom publisher and integrated marketing firm based in Miami, Fla. A member of the Custom Publishing Council and the American Marketing Association, Wax is active in business sectors including health, finance, insurance, education, technology and telecommunications. About AvMed Health Plans AvMed is a Florida based not-for-profit HMO and one of the state’s leading HMO providers, serving more than 200,000 members in the state of Florida. Founded in 1969 as a health care system for pilots in the Miami area, AvMed (short for “aviation medicine”) now serves non-pilots as well, with offices throughout Florida. AvMed’s policies include employer group HMO, Medicare HMO, and point-of-service plans; the company also offers onsite health-related seminars. AvMed’s Disease Management Program provides assistance to members with congestive heart problems, asthma and high-risk pregnancies; its On Call phone line offers free health information around the clock.
Source: seerpress.com

AvMed Health Plans and Delta Dental Announce a Partnership to Help Provide Affordable Dental Coverage

Delta Dental Insurance Company, along with its affiliates, is part of a holding company system that operates in 15 states plus the District of Columbia and Puerto Rico. Both Delta Dental Insurance Company and its holding company hold an “A-“ (excellent) rating from AM Best, and are part of the Delta Dental Plans Association (DDPA). DDPA consists of 39 Delta Dental member companies licensed in all 50 states. The association collectively covers more than 50 million of the estimated 170 million people nationwide with dental insurance, making it by far the largest national system of dental plans.
Source: deltadentalins.com

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Source: amexreport.com

AvMed: New Plan Designs with Lower Prices.

** AvMed Health Plans received the highest numerical score among commercial Health Plans in Florida in the proprietary J.D. Power and Associates 2012 U.S. Member Health Plan Study. Study based on 32,868 total member responses, measuringix plans in the Florida Region ( Excludes Medicare and Medicaid ).
Source: wordpress.com