Picking A Medicare Supplement Quote

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSThere is always the requirement to make sure that medical attention is received and kept up with throughout the course of daily life. This is a demand that is much more certain to people that have reached an older age in life which has actually made their body age and be subjected to more serious health dangers as an outcome of the process. Anyone that is seeking this kind of guidance ought to be capable of choosing a Medicare supplement quote to assist lead their medical requirements.
Source: vvy.in

Video: Medicare Supplement plan F High Deductible Explanation

Lovely County Citizen: Local News: The mysteries of Medicare decoded (10/11/12)

In many states and counties — including Carroll County — the Medicare advantage program has no or very low premiums. You may enroll in a Medicare advantage plan when you turn 65 or each year from Oct. 15 to Dec. 7. During this period, you must answer only one health question to enroll. Medicare advantage plans are also open to those of all ages who are on Medicare for disability.
Source: lovelycitizen.com

Summit MediGap: Medicare Premiums

File Individual tax return                       File joint tax return               You pay $85,000 or less                                       $170,000 or less                   $99.90 $85,000 to $107,000                              $170,000 to $214,000            $139.90 $107,000 to $160,000                            $214,000 to $320,000            $199.80 $160,000 to $214,000                            $320,000 to $428,000            $259.70
Source: blogspot.com

DeMint: Obama, AARP partners in ripping off seniors

“For instance, Jim Messina – then your deputy Chief of Staff, now your re-election campaign manager – asked AARP for ‘immediate robo calls into Nebraska urging Nelson to vote for cloture’ on the bill,” he said. “In December 2009, the White House Office of Public Engagement asked AARP to put out talking points rebutting a Republican amendment related to Medicare.”
Source: humanevents.com

Medicare Supplement or Medicare Advantage

That is correct, Jeff!!  If your group prescription drug plan is not as good as Medicare’s standard prescription drug plan, which means has a $321deductible or more for 2012.  Or if your company and/or your insurance company states that the plan is not creditable, then you should enroll in a Part D plan to keep from having a 1% per month penalty which goes back to the month your Part A started, when you do enroll in a prescription drug plan. Read page 90 of the
Source: tonisays.com

Supplemental Medicare Plans

What are supplemental Medicare plans? These are medical insurance coverage that is designed to close the gap in terms of insufficiencies in original Medicare. This aims to fill in the gaps to medical coverage in order to provide efficient medical insurance for Americans across the country. What constitutes the original Medicare plans? These are Medicare Part A (which covers hospital inpatient needs) and Part B (medical services/outpatient needs/doctor’s fees). Under these medical plans, all private insurers are required to offer or provide the same standardized aids. They cannot offer anything less than what the law provides for. What should you look out for when looking for supplement Medicare plans? Remember that all Medicare supplement plans are standardized by the federal government. It is important to know this so that you will know the minimum benefits a private insurer should offer you. With this knowledge, you will be able to compare these companies from each other on the basis of monthly premium payments, reputation and company standing. If the prices are basically the same, then the wise thing to do is to stick with a company with a track record that is proven and tested when it comes to providing medical health care. Look for companies that have a high financial strength rating or are experts in giving senior health insurance. Bear in mind that these plans can be used in any hospital or by any doctor. It does not matter which company has provided you with the coverage. In cases of Medicare supplement plans there is no need for you to fear that your coverage will be denied, unlike other healthcare providers that are mostly network-based. This makes the plan flexible and ready for use anywhere across the country. This is very beneficial for someone who often travels, or that the job requires a lot of trips nationwide. This makes Medicare a very popular choice among Americans today. When it comes to Medicare supplement health plans there is a system that allows you to make proper claims known as the “crossover” system. This means that your claims will be paid on time. You need not wait for a long time to get your reimbursements on your medical expenses. This is due to the fact that these plans are federally-standardized and to go against the standards set by the state would be unlawful. This makes it more convenient for the insured considering that there is only a minimal participation required from him or her. All you have to do is to present your Medicare card and your needs will be entertained right away. In short, supplement Medicare plans is a great way to reduce your premiums and medical expenses. It is no doubt a viable option for those who are under this medical program. The most that you will pay for your medical fees will be at best, 20% of the total expenses. This is a great way to avoid some unplanned expenses and still be covered by a reliable medical insurance. Start looking online and see which one will suit your needs best. If you are looking for the best medicare plans and medicare supplement plan, visit our site for more tips and information. Contact us for free medicare advice. If you are looking for the best http://www.medicarerep.com/ medicare plans and http://www.medicarerep.com/ medicare supplement plan, visit our site for more tips and information. Contact us for free medicare advice.
Source: abcarticledirectory.com

AOA spurs CMS to correct OD Medicare contractor enrollment glitch

Posted by:  :  Category: Medicare

Although a fix has taken longer than the CMS first anticipated, the AOA has received direct assurances from the CMS that any optometrist who experienced difficulties with the system or with a contractor can now proceed with enrollment, though it is possible that it may still take a few days for the notice to reach contractor customer service representatives.
Source: newsfromaoa.org

Video: SHIIP Medicare Enrollment Basics.flv

Idaho insurance department helps with Medicare open enrollment this fall

Medicare members who received letters telling them their plans are being terminated have up to two months after the plan’s end date to enroll in a new one. But a choice must be made by Dec. 31, or the insurance coverage will revert to Original Medicare without prescription drug benefits.
Source: idahostatesman.com

Annual Enrollment for Medicare Advantage (Part C) & Part D: October 15 – December 7 

Even beneficiaries who were satisfied with their 2012 plans need to review their plan options for 2013.  Part D and MA plans may have made changes to their coverage, provider networks and other plan features.[3] Plan information for 2013 will be available on the Medicare Plan Finder at www.medicare.gov.[4]  For the computer-savvy, the Medicare Plan Finder is an excellent plan comparison tool, allowing users to enter all their drugs and drug dosages, compare up to three plans at a time, save their drug information for later use, and actually enroll in a plan on-line.  This is the best – if not only – way to truly compare the many plans available to choose from.  People who cannot use the Plan Finder themselves may contact 1-800-Medicare, or their State Health Insurance Assistance Program (SHIP), for assistance with evaluating, selecting, and enrolling in a Part D plan.
Source: medicareadvocacy.org

Time for a Medicare switcheroo?

. While only about 3 million out of 50 million Medicare enrollees encounter the much-vaunted doughnut hole, if you are one of them it can be expensive. The doughnut hole is the gap in Part D coverage when all costs are paid by enrollees out of their own pockets. As a result of the Affordable Care Act, in 2013, the government is fiddling with the doughnut hole to lessen its impact. Recipients enter the doughnut hole at $2,970 — $40 later than in 2012 — and catastrophic coverage kicks in $50 later at $4,750. As they traverse the doughnut hole, next year recipients will pay 47 percent of premium drug costs, down from 50 percent this year, and 79 percent of generic drug costs, down from 86 percent this year. If you are likely to fall into the hole, it is especially important to make sure you’re signed up for the most economical plan for you. As you can see — even with the reductions — these are whopping costs.
Source: bankrate.com

Medicare Enrollment Starting; Help Sessions Scheduled

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Source: coudynews.com

Medicare Enrollment Starts Oct. 15

More information and assistance SHIBA: To meet with a counselor, contact the toll-free SHIBA Helpline at 1-800-722-4134. You will be asked to enter your ZIP code to be connected to a program in your area. Visit www.oregonshiba.org to view a calendar of available one-on-one counseling appointments or information events available in your county or to find a copy of the 2013 Oregon Guide to Medigap, Medicare Advantage, and Prescription Drug Plans. The guide for 2013 will be available online in mid-October.
Source: therconline.com

Medicare: Help enrolling or switching plans

Visit Medicare.gov. Its Plan Finder allows you to compare a wide range of costs across multiple drug and Medicare Advantage plans available in your county. It also has ratings on each plan’s performance and quality. Most important, it allows you to enter prescription drug names to gauge whether they’re covered and at what cost under a variety of plans.
Source: oregonlive.com

Medicare open enrollment begins Monday for thousands of area seniors

Medicare open enrollment begins Monday for thousands of area seniors Akron Beacon Journal By Cheryl Powell Ruth and Lou Cober of Dalton listen to Francine Chuchanis, ombudsman supervisor of the Greater Akron/Canton Area Agency on Aging, talks to seniors about selecting a Medicare managed-care or prescription drug plan. Do your Medicare homework, seniors told
Source: harringtonmanagementgroup.com

As Open Season Begins, More Medicare Advantage Plans Get Top Ratings

Detroit Free Press: Medicare Changes: What You Need To Know This Year Beginning this year, [Michigan] beneficiaries of chronically poor-performing plans will be notified by mail that there might be better options elsewhere and those beneficiaries may switch to the highest-performing plans throughout 2013. Medicare for the first time will cover screenings for depression, obesity, sexually transmitted diseases and alcohol misuse. It also will cover behavioral therapy for cardiovascular disease. Under health care reform, Medicare discounts continue to deepen on drugs in the donut hole (Erb, 10/14). The Columbus Dispatch: Medicare Will Prod Users To From Low-Rated Advantage Plans The federal government said yesterday that it will become more aggressive about moving people off poorly performing Medicare plans and onto higher-scoring ones. The Centers for Medicare and Medicaid Services said they will mail letters to people enrolled in 26 poorly rated plans nationwide — plans that have received 2.5 or fewer stars on a 5-star scale for the past three years. The letters will encourage those people to enroll in plans that score better on the government measures of patient health outcomes and satisfaction (Sutherly, 10/13). 
Source: kaiserhealthnews.org

Put it on your fall checklist: Medicare Open Enrollment

If your parents want to go online and sort through the details, they can get an early start, and you can help them navigate the process if needed. We’ve already made sure that the Medicare Plan Finder is fully updated with all new 2013 cost and benefit information for health and drug plans and is ready right now. All your parents need to do is start by entering the drugs and checking on the doctors and pharmacies they want to use. A few more steps will get them a personalized list of their plan choices and help them compare.
Source: medicare.gov

David Sayen: Take Advantage of Medicare Open Enrollment

Even if you were previously turned down for extra help due to income or resource levels, you should reapply. If you qualify, you will get help paying for Medicare prescription drug coverage premiums, co-payments and deductibles. To qualify, you must make less than $16,755 a year (or $22,695 for married couples). Even if your annual income is higher, you still may be able to get some extra help.
Source: noozhawk.com

Regence and Healthways Partner to Offer SilverSneakers? Fitness …

Posted by:  :  Category: Medicare

Healthways (HWAY) is the largest independent global provider of well-being improvement solutions. Dedicated to creating a healthier world one person at a time, the Company uses the science of behavior change to produce and measure positive change in well-being for our customers, which include employers, integrated health systems, hospitals, physicians, health plans, communities and government entities. We provide highly specific and personalized support for each individual and their team of experts to optimize each participant?s health and productivity and to reduce health-related costs. Results are achieved by addressing longitudinal health risks and care needs of everyone in a given population. The Company has scaled its proprietary technology infrastructure and delivery capabilities developed over 30 years and now serves approximately 40 million people on four continents. Learn more at www.healthways.com or www.silversneakers.com.
Source: posterous.com

Video: Silver Sneakers class at the Carl H. Lindner YMCA

Lovely County Citizen: Local News: The mysteries of Medicare decoded (10/11/12)

In many states and counties — including Carroll County — the Medicare advantage program has no or very low premiums. You may enroll in a Medicare advantage plan when you turn 65 or each year from Oct. 15 to Dec. 7. During this period, you must answer only one health question to enroll. Medicare advantage plans are also open to those of all ages who are on Medicare for disability.
Source: lovelycitizen.com


Unlock the door to greater independence and a healthier life with SilverSneakers. Health plans around the country offer our award-winning program to people who are eligible for Medicare or to group retirees. SilverSneakers provides a fitness center membership to any participating location across the country. This great benefit includes:
Source: blackoklahoman.com

Florida Blue Partners with Healthways to Offer SilverSneakers® Fitness Program Through 2015

Healthways (NASDAQ: HWAY) is the largest independent global provider of well-being improvement solutions. Dedicated to creating a healthier world one person at a time, the Company uses the science of behavior change to produce and measure positive change in well-being for our customers, which include employers, integrated health systems, hospitals, physicians, health plans, communities and government entities. We provide highly specific and personalized support for each individual and their team of experts to optimize each participant’s health and productivity and to reduce health-related costs. Results are achieved by addressing longitudinal health risks and care needs of everyone in a given population. The Company has scaled its proprietary technology infrastructure and delivery capabilities developed over 30 years and now serves approximately 40 million people on four continents. Learn more at www.healthways.com or www.silversneakers.com.
Source: insidesouthflorida.com

Lakeland Highlights: Silver Sneakers Enrollment in Lakeland Monday, October 1 to Friday, October 5

Benefits include: access to conditioning classes, exercise equipment, pool, sauna and other available amenities (specific per location); customized Silver Sneakers classes designed exclusively for older adults who want to improve their strength, flexibility, balance and endurance; health education seminars and other events that promote the benefits of a healthy lifestyle; a specially trained Program Advisor at the fitness center to introduce you to Silver Sneakers and help you get started; and, a member-only access to online support that can help you lose weight, quit smoking or reduce your stress. 
Source: blogspot.com

SilverSneakers Offers Free Gym Memberships

People who wish to improve their health through focused exercises specially designed to meet the needs of older adults may wish to participate in the SilverSneakers Fitness Program. Those who qualify may enjoy a free membership to a participating fitness center, but other members of the gym may also take SilverSneakers classes at that facility. With a variety of group exercise classes offered on land and in the water that are taught by certified instructors, participants can enjoy exercising in a positive social atmosphere that can meet the needs of seniors of varying levels of fitness.
Source: suite101.com

The Weight Loss And Diet Portal

Coventry believes strongly in helping people get well and stay well for a better quality of life, said Nancy Cocozza, Senior Vice President, Medicare, at Coventry Health Care. The SilverSneakers model focuses heavily on reaching out to older adults to encourage them to become more active, healthy and fit. We have seen a high level of engagement and excitement from beneficiaries in Florida through this program, and we are pleased to offer SilverSneakers to thousands more nationwide.
Source: dgw.tv

Humana Medicare Supplement Plans Great Company With silver Sneakers

Humana Medicare Advantage plans are the most popular plans in the Medicare marketplace. They are offered in almost every county in the entire country and have a vast network of doctors and hospitals. These plans are priced very well and often include prescription drug plans, but the copayments for doctors and hospitals can be very high. In addition these plans often have networks, which not all doctors and hospitals participate in. Therefore, it is very important to check with you physicians and local hospital to make sure they accept these plans before purchasing.
Source: wordpress.com

Silver Sneakers Fitness Program for Seniors

The Silver Sneakers program, started in the 1990’s, continues to provide benefits of physical activity and improved health. This has helped them receive a number of awards. The innovative program involves many health plans and fitness centers who cooperate to bring about a transformation of preventive health care. Perhaps the best news of all, it has no cost above the usual insurance premiums.
Source: suite101.com

Annual Wellness Visits; RVU Reductions; Physician Scribes

Posted by:  :  Category: Medicare

THE LITTLE MAN KILLED MEDICARE FOR EVERYBONE by SS&SSThe rules were recently updated in the Medicare teaching guidelines. They state: “Any contribution and participation of a student to the performance of a billable service must be performed in the physical presence of a teaching physician or resident in a service that meets teaching physician billing requirements (other than the review of systems [ROS] and/or past, family, and/or social history [PFSH], which are taken as part of an E&M service and are not separately billable). You, the student, may document services in the medical record; however, the teaching physician may only refer to your documentation of an E&M service that is related to the ROS and/or PFSH. The teaching physician may not refer to your documentation of physical examination findings or medical decision making in his or her personal note. If you document E&M services, the teaching physician must verify and re-document the history of present illness and perform and re-document the physical examination and medical decision making activities of the service.”
Source: physicianspractice.com

Video: Medicare Supplement vs. Medicare Advantage Plans – A Doctor’s Perspective

Daily Kos: Insurers hoping for billions in Medicare profits back Paul Ryan budget supporters

Health insurers love the idea of the Romney/Ryan plan to turn Medicare into a voucher system. They love it so much that they are rewarding all of the Republicans who voted for it, according to new analysis by Public Campaign Action Fund (PCAF) and Health Care for America Now (HCAN). A Romney-Ryan victory coupled with a Republican takeover of the Senate would boost health insurance company stock prices by 10 to 20 percent, according to Citigroup analyst Carl McDonald. Based on share prices on Aug. 18, the day McDonald published his report, a GOP sweep in Washington would quickly jack up the total market value of the 10 largest health insurers by $12 billion to $25 billion. […]
Source: dailykos.com

Knee Replacement Surgeries Soar Among Medicare Patients

About 600,000 knee replacement surgeries are done each year nationwide on adults of all ages, costing a total of $9 billion, the authors said. A journal editorial says measures are needed to control costs of these operations, noting that demand has been projected to rise to as many as almost 4 million knee operations annually by 2030.
Source: aarp.org

The Trouble with Medicare Advantage

Fillman goes on to explain: “The new accounting rules issued by the Governmental Accounting Standards Board (GASB) place a tremendous strain on public retiree health benefits and add to the lure of these private Medicare plans.  The GASB rules require public employers to estimate future costs of their retiree health benefits – 35 years into the future – and publish them on their annual financial statements.  To reduce this paper liability, more public employers are proposing a switch from their own solid retiree health plans, which include traditional Medicare, to these private Medicare plans.  This is a major factor in public employers’ decisions to switch to Medicare Advantage private fee-for-service plans.
Source: healthbeatblog.com

Study of Medicare data shows knee replacements on the rise

The researchers found that the average time spent in the hospital after a knee replacement dropped from almost eight days to 3.5 days. But the need for re-admission to the hospital increased slightly, and there was no change in the rate of serious complications such as infection or heart problems linked to a first-time procedure.
Source: medcitynews.com

Analysis of Medicare and Commercial Insurer

This issue brief from the Health Care Incentives Improvement Institute (HCI3) analyzes insurance claims for total knee replacements (TKR) using the PROMETHEUS Payment® engine and reveals significant opportunities for cost reduction and quality improvement with a bundled payment program. Analyzing two and a half years of payment data for TKR, the authors identified estimated savings of 20 percent for Medicare patients and 10 percent for the commercially insured population, or $84 million and $90 million, respectively. The authors conclude that these savings could come from a bundled, episode-of-care payment system such as PROMETHEUS, which allows for identifying and reducing potentially avoidable complications (PAC) from the surgery. PAC costs are defined as those that arise from avoidable complications during various phases of a surgical episode. The majority of increased costs for procedures above the average were associated with PACs, which represent failures in the quality of care being delivered. In an introduction to the brief, James C. Robinson, PhD, MPH, director of the Berkeley Center for Health Technology in the School of Public Health at the University of California at Berkeley, notes that the findings advance the debate over improving quality and reducing costs. The waste and inappropriate use of procedures common in the U.S. health care system can be measured, he says, and what can be measured should be managed. The Robert Wood Johnson Foundation was one of the original funders for the development of the PROMETHEUS Payment® methodology and continues to work with the project as a payment reform technical assistance provider to Aligning Forces for Quality, its signature effort to improve the quality of care in the United States.
Source: rwjf.org

Medicare knee replacement surgeries soar (Video)

This entry was posted on September 30, 2012 at 7:09 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
Source: wordpress.com

Report: CMS Not Issuing New Medicare ID Cards to Identity Theft Victims

At a House hearing in August that looked at the use of Social Security numbers on Medicare cards, Medicare Chief Information Officer Tony Trenkle said the agency would need six more months to estimate the cost of removing the numbers from the cards. CMS could not provide a timetable for the new cards without having an accurate cost estimate, Trenkle added (California Healthline, 8/2).
Source: californiahealthline.org

Proposed Medicare Fee Schedule Includes Pay Increase For Primary Care, Family Docs

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2.. Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481Medscape:  CMS Proposes Primary Care Raises Funded With Specialist Cuts Medicare would reduce reimbursement for many types of specialists to fund sizable raises for primary care physicians in 2013, according to a proposed fee schedule that the Centers for Medicare and Medicaid Services (CMS) released today.  These reductions and raises are apart from the huge pay cut — now put at 27% — set for January 1, 2013, that is triggered by Medicare’s sustainable growth rate formula, and likely to be postponed by Congress (Lowes, 7/6).
Source: kaiserhealthnews.org

Video: Medicare Physician Feedback Program: Payment Standardization and RIsk Adjustment

Medicare Advantage Plan payment shenanigans, an end run around Obamacare cuts

OACT has estimated that the MA Quality Bonus Payment Demonstration will cost $8.35 billion over 10 years, most of which will be paid to 3-star and 3.5-star plans. About $5.34 billion of OACT’s cost estimate is attributed to quality bonus payments more generous than those prescribed in PPACA, specifically to (1) higher bonuses for 4-star and 5-star plans, (2) new bonuses for 3-star and 3.5-star plans, (3) applying bonuses to plans’ entire blended benchmarks, and (4) allowing plans’ benchmarks to exceed their pre-PPACA levels. Most of the remaining projected demonstration spending stems from higher MA enrollment because the bonuses enable MA plans to offer beneficiaries more benefits or lower premiums. Taken together, the expanded bonuses and higher MA enrollment mainly benefit average performing plans—those receiving 3-star and 3.5-star ratings. In addition, OACT estimated that the demonstration will offset more than one-third of the reduction in MA payments projected to occur under PPACA during the demonstration years. The largest annual offset will occur in 2012—71 percent—followed by 32 percent in 2013 and 16 percent in 2014.
Source: quinnscommentary.com

APS Medical Billing update: New Medicare fee schedule does not mention in

The lack of a specific recommendation for the treatment of such laboratories in the proposed payment regulations, however, does not eliminate the concerns of regulators or health plan administrators about such labs.  States continue to consider practices such as direct billing or disclosure of such arrangements in physician practice billing. Several commercial plans are requiring CAP or JCAHO accreditation of the labs for them to be eligible for payment.  There are specific coding issues for urological pathology that are being considered which would reduce the profitability of such services.  And finally, the entire technical payment for 88305 is under review for reduction.  Any or all of these efforts could have a significant impact on the profitability of providing such services in a physician’s office setting.
Source: pathologyblawg.com

The Benefits of the Physicians Medicare Fee Schedule

Medicare aids individuals who have reached retirement age or are otherwise partially or totally disabled to meet medical needs without having to pay huge sums of money. This is because Medicare is a government organized medical and health benefit plan. One very important thing to remember with Medicare is that it may not cover the entire amount expended. For this purpose a Medicare fee schedule can be used. With this an individual need not wait for the hospital and/or doctor’s quote. More importantly the fee schedule requires a price ceiling on hospital fees, procedures, prescriptions as well as professional fees. This article For example Mr. A is hospitalized because of a car accident. As it so happens his Medicare plan does not cover the entire inpatient and outpatient procedures as well as the medical procedures and prescription medication. Without a fee schedule Mr. A is left in the dark as to the amount he has to pay for professional fees. This will definitely cause a great deal of anxiety. Because of the fee schedule Mr. A can determine or at least estimate the ceiling amount he has to pay. Therefore a fee schedule not only helps ease tension and anxiety but allows Mr. A more time to prepare to meet the expenses. Fee Adjustments It is very important to take note of the fact that fee schedule may adjust depending on several factors like: 1. Cost of hospital accommodation (usually teaching hospitals charge less) 2. Cost of Living in a particular locality 3. Residency or citizenship in the locality where the procedure is to occur Public Hospital Most public hospitals do not charge steep fees therefore Medicare may cover the entire procedure. However just to be sure, Medicare fee schedule also applies to public hospitals. However, take note that public hospitals rarely accommodate requests or specifications as to the attending physicians Rules 1. As of January 1, 2010 the consultation codes for the following is no longer reimbursable under Medicare Part B

GPs Doing Overtime for Health Records to Avail Benefit of Medicare Rebates

Posted by:  :  Category: Medicare

SCOTUS Obamacare Decision Makes Individual Mandate A Fact & Universal Healthcare Coverage A Fiction by watchingfrogsboilThe change in the policy has been brought about after doctors raised the issue for several months. As a result of which now these doctors will be allowed to include the extra time spent on health summaries to their consultation time and further can ask for the Medicare rebate, which will be allowed for the total time.
Source: topnews.ae

Video: MEDICARE REBATE: Review Your Health Insurance Before June 30.m4v

Medicare Part D $250 Rebate: The Donut Hole Coverage Gap

There has been a rise in scams related to this rebate scheme. Some scammers are contacting seniors and claiming to be able to speed up their access to their check. Some are charging fees and some are taking personal/banking details and Medicare and Social Security numbers in identity theft scams. Seniors should be aware that no third party is needed/can help to access or speed up the check payment as it is handled automatically.
Source: suite101.com

Daily Kos: Insurers hoping for billions in Medicare profits back Paul Ryan budget supporters

Health insurers love the idea of the Romney/Ryan plan to turn Medicare into a voucher system. They love it so much that they are rewarding all of the Republicans who voted for it, according to new analysis by Public Campaign Action Fund (PCAF) and Health Care for America Now (HCAN). A Romney-Ryan victory coupled with a Republican takeover of the Senate would boost health insurance company stock prices by 10 to 20 percent, according to Citigroup analyst Carl McDonald. Based on share prices on Aug. 18, the day McDonald published his report, a GOP sweep in Washington would quickly jack up the total market value of the 10 largest health insurers by $12 billion to $25 billion. […]
Source: dailykos.com

Limiting the Medicare rebate for genital surgery is a good move

While western women are increasingly turning to the knife and having the size, shape and appearance of their labia enhanced, feminists and activists continue the campaign to end the practice of female genital mutilation affecting millions of women living in parts of Africa, Asia, and the Middle East. Female genital mutilation is a procedure that intentionally excises genital tissue leading to problems such as frequent bladder infections, childbirth complications and the risk of later surgery. The World Health Organization estimates that there are 100 to 140 million women who have had their lives damaged by FGM.
Source: wordpress.com

Doughnut Hole Rebate Checks Fuel Medicare Fraud & Insurance Scams

Missouri Attorney General Chris Koster (also the name of the website) comments on the types of Medicare scams taking place across the nation. The article can be found in the Attorney General’s News Release titled, “Attorney General Koster Warns Seniors About Medicare Rebate Fraud Schemes” (June, 2010). According to the author (name not given), “[Koster] said a common scam related to the $250 donut hole checks was for individuals to convince seniors that the rebate check needed to be transferred to a third party or used to cover specific prescription drug payments.”
Source: suite101.com

Medicare Beneficiary Drug Rebate

Provides a $250 rebate to Medicare beneficiaries who reach the Part D coverage gap in 2010. Further subsidies and discounts that ultimately close the coverage gap begin in 2011. Implementation: January 1, 2010. Implementation update: In May 2010, CMS issued a consumer brochure with information about the Medicare Part D coverage gap. In June 2010, the first rebate checks were sent to Medicare beneficiaries who reached the Medicare Part D coverage gap, more commonly known as the “doughnut hole.” As of March 22, 2011, 3.8 million beneficiaries had received a $250 check to close the coverage gap, according to an HHS report.
Source: kaatirondackbenefitinsurance.com

The $ 250 rebate checks for people with Medicare who enter the donut hole

The Department of Health and Social Services will begin sending $ 250 rebate checks for consumers donut hole. This represents a victory for people with Medicare. Their voices have been critical in the effort of five long years to eliminate the donut hole in Medicare drug coverage.
Source: dechsy.com

New Medicare, Health Law Ads Emerge In Congressional Races Across The U.S.

Posted by:  :  Category: Medicare

HERES YOUR TOP TEN by SS&SSNational Journal: Chamber Expands Ads Into New York, Utah And Georgia The U.S. Chamber of Commerce will launch a new round of advertisements in nine House districts beginning tomorrow, including on behalf of six New York Republicans and two conservative Democrats seeking re-election this year. The Chamber’s new advertising will focus on President Obama’s health care law. Advertisements are running against Reps. Tim Bishop, Bill Owens and Louise Slaughter and ex-Rep. Dan Maffei, four New York Democrats who voted for the law; Rep. Kathy Hochul, who entered Congress after the law passed; and Democratic candidate Sean Patrick Maloney, who is running against Republican Rep. Nan Hayworth. But lest someone accuse the Chamber of only backing Republicans, the group is launching its first advertising on behalf of a few conservative Democrats. Both Reps. Jim Matheson (D-Utah) andJohn Barrow (D-Ga.) — both of whom voted against the health care law — will get advertising on their side… Now, a Democratic source sends along the totals of the buys so far, which add up to about $1.9 million. (Wilson, 10/4).
Source: kaiserhealthnews.org

Video: Linda McMahon Wants to End Social Security, Phase Out Medicare

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

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

Connecticut Federal Judge Denies Hospitals’ Challenge Of Medicare Reimbursement

NEW HAVEN, Conn. – A federal judge in Connecticut on Sept. 29 denied judicial review of a final Medicare reimbursement decision by Kathleen Sebelius, secretary for Health and Human Services (HHS), in which the federal department said the plaintiff hospitals are not entitled to include in their calculation of their Medicare Disproportionate Share Hospital (DSH) adjustment patient days for patients covered by Connecticut’s State Administered General Assistance (SAGA) program (Waterbury Hospital Center, et al., v. Kathleen Sebelius, Secretary of Health and Human Services, No. 3:09cv1701, D. Conn.; 2012 U.S. Dist. LEXIS 141523). Full story on lexis.com
Source: lexisnexis.com

Protesters slam Linda McMahon’s call to “sunset” Social Security, Medicare

Referring to the report issued this year on April 23 which found sufficient funds through 2033 and projects enough revenue beyond that date for 75% of benefits, Kennelly said, “That hardly seems like a program teetering on the brink of bankruptcy, as Mrs. McMahon claims. It also belies her claim that when she called for programs such as Social Security to be ‘sunset,’ she was merely referring to a review, not a termination of the program. Connecticut’s workers, who have Social Security taxes taken out of every single payroll check, have a right to expect their Senators to share their commitment to Social Security, our nation’s most popular and effective program.”
Source: peoplesworld.org

High Readmission Rates Force Hospitals To Forfeit Medicare Funds

At St. Raphael’s, which is merging with Yale-New Haven, Jim Judson, director of quality improvement, said in an earlier interview that an interdisciplinary team is working to improve the transition to post-hospital care and is providing patients with easy-to-understand information about the symptoms and care of pneumonia and heart conditions. Judson and other administrators have noted that inner-city hospitals often treat patients with co-morbid conditions that can land them back in the hospital after discharge. Readmissions are counted no matter why the patient returns within 30 days. That means if a patient discharged after treatment for pneumonia returns to the hospital within 30 days with a broken hip, the new admission is counted against the hospital.
Source: courant.com


The one-to-one information sessions are conducted by Susan Tracy, an attorney and trained volunteer with Connecticut’s Program for Health Insurance Assistance, Outreach, Information and Referral, Counseling and Eligibility Screening (also known as CHOICES), who helps seniors explore their options in health insurance, supplemental coverage and later life care arrangements. The purpose of the “CHOICES” program is to enable older persons to understand and exercise their rights, receive benefits to which they are entitled and make informed choices about quality of life issues.
Source: patch.com

PriMed selected by Medicare for new approach to health care

PriMed LLC, formed in 1996, is a physician-owned multi-specialty group of more than 115 health care providers with 39 locations in Connecticut. PriMed serves patients in Fairfield and New Haven counties and continues to expand. Physician specialties include internal and family medicine, cardiovascular medicine, ear, nose & throat, endocrinology and metabolism, gastroenterology, geriatrics, general surgery, infectious disease, pediatrics, podiatric medicine and surgery, pulmonary and sleep medicine, rheumatology and arthritis, urology, physical therapy, and nutritional counseling.
Source: fairfield-sun.com

Two Medicare Accountable Care Organizations Approved in Connecticut

At last Connecticut has two medical groups that have been approved to participate in Medicare’s Accountable Care Organization (ACO) program.  The two groups are:  MPS ACO Physicians in Middletown and PriMed of Shelton.  The ACO program is part of many efforts being undertaken to change how health care is both delivered and paid for; moving from a system that rewards volume to a system that rewards quality care and better outcomes. 
Source: universalhealthct.org

Anthem Medicare Advantage Plans: Offering Affordable Freedom of Choice

Posted by:  :  Category: Medicare

BCBS Medicare PPO Advantage Plan gives you more of the benefits that you need and expect, including built-in prescription drug coverage. All three plans under the BCBS Medicare PPO umbrella offer all of the benefits of original Medicare along with several services that are not generally covered, as well as the convenience of one of the largest provider networks in the state.
Source: abchealthplans.com

Video: www.DebbieDoesMedicare.com Medicare Advantage Plans

Blue Cross Blue Shield of Michigan Offers New Medicare Plans

HMO’s (health maintenance Organizations) let you select a primary care physician from the BCBS provider network and this PCP manages your overall care. He or she will refer you to a specialist or to a selected hospital for care should you need additional services beyond his scope of practice. Referring yourself to an outside provider will cause a forfeit of benefits and out-of-pocket costs. The four BCBSM HMO products, formerly known as Options 1, 2, and 3, will now be known as BCN Advantage Elements, Classic , and Prestige. The Blues Care Network will also continue to offer the BCN Advantage Basic Plan.
Source: emaxhealth.com

Trendspotter: Do Doctors Treat Medicare Patients Differently?

Coauthors Luisa Franzini, Osama L. Mikhail, and Jonathan Skinner consider the possible explanations for the contrast between McAllen’s high Medicare costs, relative to El Paso, and the spending on commercially insured patients. After discounting the impact of price, income and health in the two communities, they also dismiss the possibility that Blue Cross Blue Shield has greater market power in McAllen than in El Paso. (The company is the largest health insurer in Texas.) What they’re left with is the suggestion that the Texas Blues has become adept at managing utilization of care in ways that Medicare has not attempted. Consequently, they theorize, McAllen doctors may take advantage of Medicare to order or perform services that the Blues might question. For example, the private insurer requires preauthorization of procedures and might not approve something that the diagnosis doesn’t justify under evidence-based guidelines.
Source: physicianspractice.com

2013 Changes In Part D Plans

Our experience with My Part D USA was very helpful, courteous and answered our questions effectively. It helped so much to narrow down our choices to get the right coverage. We appreciate the personal message in our packet from Karyn Blake, the founder and writer of the blog. Everyone we dealt with and the impression all contact with your company left us with is that you CARE about helping your clients get the right coverage for their needs.  The info on your website is also very useful. – Michael & Jane Harris, Ohio
Source: mypartdusa.com

BCBS North Carolina Blue Medicare Advantage Open Enrolment

Seniors 65 and older have the choice to either participate in the original Medicare program or opting for Medicare Advantage through a private insurance company. Medicare Advantage is a guaranteed acceptance plan that is standardized. The plan is standardized which means that any senior that is eligible for Medicare but opts for Medicare Advantage will have at least the minimum coverage that Medicare Part A and Medicare Part B from the original Medicare program provides. Any other benefits above and beyond the minimum are not mandatory. BCBS Medicare Advantage plans go above and beyond the basic mandatory coverage. Source: abchealthplans.com
Source: medicaresupplementalco.com

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

Posted by:  :  Category: Medicare

When I'm 64 by MuffetIf 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

Video: Continued Medicare Eligibility and Work Incentives

Understanding Medicare – The Robeson Journal

A standardized Medigap policy typically is guaranteed renewable, which means that, as long as you continue paying premiums, an insurer cannot use your health status as a rationale for cancelling the policy. If you were diagnosed or treated for a pre-existing medical condition within six months prior to a Medigap policy taking effect, an insurer can make you wait up to six months before providing coverage for the condition. In certain instances, if you had health insurance coverage during the six-month period before the Medigap policy takes effect, the waiting period may be eliminated or shortened.
Source: therobesonjournal.com

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

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Source: reportingonhealth.org

Medicare Part D Notice Required Before October 15

This is a reminder that the deadline to distribute the Annual Notice of Creditable Coverage required under Medicare Part D is less than a week away. This notice informs participants whether the prescription drug coverage offered under your health plan constitutes creditable or noncreditable coverage. As the Medicare Part D annual enrollment period now runs from October 15 to December 7, you must distribute the notices before October 15. Employers who sponsor a health plan offering prescription drug benefits must provide an annual notice to all Medicare-eligible participants that explains whether the prescription drug benefits offered under the plan are at least as good as the benefits offered under the Medicare Part D plan. The only employers exempt from this requirement are those that establish their own Part D plan or contract with a Part D plan. The Centers for Medicare and Medicaid Services (CMS) has posted forms and instructions for providing this notice. The forms were last updated in 2011. They are available, both in English and Spanish, through the following links:
Source: jdsupra.com

Critical Decisions Await Patient, Family Members When Medicare Deadline Looms

But buying an individual plan can be daunting for older adults in their late 50s or early 60s who are more likely to have some health problems. They are at the mercy of the private insurance market. “We do frequently get calls from folks,” says Baker, “who cannot find insurance policies in the state in which they live either because they have pre-existing conditions or the policy is so expensive they really can’t afford it.” The younger spouses of Medicare beneficiaries who have been denied coverage – and have been uninsured for six months – can apply for coverage through their state’s so-called high risk pool. Baker notes that there should be better options for older adults starting in 2014, when a key provision of the federal health law will prohibit insurance companies from denying adults coverage because of a pre-existing condition. Another confounding question is what to do when someone turns 65 and decides to keep working. Should they keep their insurance or sign up for Medicare coverage?
Source: kaiserhealthnews.org

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

Daily Kos: What I Keep Not Hearing About Medicare

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Source: dailykos.com

Important Open Enrollment Announcement For Medicare

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Work with the Pros 2012 – Week 5 Medicare

Posted by:  :  Category: Medicare

Joe the Plumber - To Flush The System ... More scams aim to ensnare Brevard seniors - Their ingenuity is boundless, Archer said. (Jul 2, 2012) ... by marsmet524Posted in F as in Football, Food and Exercise, You at Home, You at Play Tags: 49er Dwight Clark, Dwight Clark, Dwight Clark the catch, Football, health insurance providers, low cost individual health insurance, medicare, Medicare Explained, Medicare Seminars, Medicare Supplements, San Francisco 49ers, What is Medicare, who is eligible for Medicare
Source: eindividualhealth.com

Video: How to report Medicare Fraud

Medicare Enrollment Starting; Help Sessions Scheduled

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Source: coudynews.com

The Official Medicare Set Aside Blog And Information Resource: Work Comp Related Meningitis?

Epidural Steroid Injections (ESIs) are the second most abused pain treatment in workers’ compensation, following excessive opioid prescribing, of course. Pain clinics throughout the nation routinely recommend ESIs, despite a failure to demonstrate a long term efficacy, particularly when they perform such procedures in their own offices. Depending upon the state fee schedule, ESIs can range in price from $750 to $3,000+ depending on the number of levels administered, whether performed bilaterally, and whether fluoroscopy is used or not. ESIs are generally administered in a series of three injections usually given in two-week intervals and are expected to provide relief for a few months and up to a year or more for some. Medicare and other private insurers will rarely approve the procedure again if only a few days or weeks of relief is obtained. Yet in workers’ compensation, we find claims with 10 to 12 injections a year all the time. In fact in Maryland, a recent release of finding of an investigation of several doctors at one pain clinic noted that one patient record indicated that she had received over 140 injections in a fairly short period of time. It is an extremely expensive procedure with questionable results and now a potentially deadly proposition.
Source: feedly.com

Biden offers senior Floridians misguided information on Medicare

Under President Obama, that coverage for the screening procedures was expanded as a result of new directives forcing insurers to cover only those preventive services recommended by the United States Preventive Services Task Force. These mandates are another symptom of the centralized control that Obamacare exerts over the practice of medicine. But under Mr. Obama, the colonoscopies have faced offsetting new restrictions that mostly make it harder for seniors to access many of the tests.
Source: aei-ideas.org

Federal Government Charges 91 Individuals for Medicare Fraud

The Medicare Fraud Strike Force, which uses federal, state and local investigators and prosecutors to combat Medicare fraud through the use of Medicare data analysis techniques, charged the parties for their alleged participation in Medicare fraud schemes involving approximately $429.2 million in false billing. According to HHS, dozens of charged individuals were arrested or surrendered in the last 24 hours as indictments were unsealed across the country.  Those indictments charge more than $230 million in home healthcare fraud; more than $100 million in mental healthcare fraud and more than $49 million in ambulance transportation fraud; and millions more in other frauds.
Source: healthcare-informatics.com

The New Medicare.gov: Making Medicare Information Clearer & Simpler

The new Medicare.gov is just one of our efforts over the past year to make it easier for you to understand your Medicare. Whether it’s putting our information in simple, straightforward language so you can understand it the first time you read it or improving the design of the “Medicare Summary Notice ” so you can better understand your Medicare claims,  we’re committed to making Medicare information clearer and simpler.
Source: medicare.gov

Utah Office of Health Disparities: Webinar :Open Enrollment Information for Medicare Beneficiaries with a Disability or Chronic Illness

This call is designed to provide you with an overview of the differences between types of Medicare plans and what it means to you, how to compare plans and important issues to consider in choosing a plan, and where you can get more information and assistance.
Source: blogspot.com

Program offered seniors info on ‘Medicare 101′

A large number of North Carolina “Baby Boomers” are now turning age 65. Those consumers can receive information on Medicare eligibility from the Social Security Administration. After becoming eligible, consumers can receive Medicare information in several ways. They can make an appointment with a SHIIP counselor at Rufty-Holmes. Consumers can also access the SHIIP website at: www.ncshiip.com or they may speak with a trained SHIIP counselor at 1-800-443-9354.
Source: salisburypost.com

Breast Cancer Awareness Month

Thanks to early detection and advanced treatments, millions of women today are beating breast cancer.  Mammograms help detect breast cancer early on, even in people who have no symptoms or signs of disease.  Medicare Part B provides for an annual screening mammogram for all female beneficiaries aged 4o and older and coverage of clinical breast exams every 12 to 24 months depending on risk level.  It also provides for a single baseline mammogram for all female beneficiaries between the ages of 35-39.  As long as your doctor accepts Medicare assignments, you will pay nothing for the screening.
Source: medicareecompare.com

APPRISE Medicare Counseling Information Sessions

 (1) Medicare 2013 will explain the options that will be available next year for persons who have (or are considering) a Medicare Advantage plan, and those who are currently enrolled in, and those considering enrollment in a Medicare managed care plan (typically, HMOs). Usually, these plans include Part D prescription drug coverage as part of the package.
Source: wordpress.com