Medicare Plan Finder for Health, Prescription Drug and Medigap plans

Posted by:  :  Category: Medicare

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations by Christiana CareThe page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Video: Medicare Supplement Plans (How to Find)

Medicare Open Enrollment: What’s your back

Nobody likes to think of back-up plans when it comes to our health, but health can be as unpredictable as the weather. It’s hard to know what you’ll feel like next week, much less what health care you’ll need next year. But that’s exactly what you need to think about when you’re shopping for health coverage during Medicare Open Enrollment – which ends on December 7.
Source: medicare.gov

In Swing States, Obama Leads on Handling of Medicare

Mr. Romney and Mr. Ryan have called for curbing the growing costs of Medicare by making major changes to the program. Their plan would change Medicare for people who are now under 55 so that when they are eligible for coverage they would no longer receive a government-guaranteed, fee-for-service health plan but rather a fixed amount of money each year that they would use to purchase private health insurance or buy into a version of the existing Medicare program. But they have not provided enough details of their plan to assess how much it might increase out-of-pocket costs for future beneficiaries. Mr. Obama has pledged to preserve Medicare in its current form, but has spoken less about its rising costs.
Source: nytimes.com

Early Evidence Suggests Medicare Advantage Pay For Performance May Be Getting Results

The ACA phases out higher payments previously given to all MA plans. Instead, Medicare in 2012 began paying bonuses only to plans with strong performance on clinical quality, service measures and patient experience of care measures. Medicare bases the 2012 bonus payments on 2011 plan performance, as rated by a five-star system. This system incorporates Health Effectiveness Data Information Set (HEDIS®) and other quality measures, Consumer Assessment of Health Plans (CAHPS®) patient experience results (See Note 1 below.), and results of the Health Outcomes Survey (HOS) that tracks patient-reported outcomes over time. It also includes metrics such as complaints Medicare received about the plan, customer service for drug benefit plans, and beneficiary access and performance problems identified in audits by Medicare.
Source: healthaffairs.org

Kaiser Permanente Leads the Nation with Six 5

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

2013 Medicare Annual Enrollment Period: eHealth Identifies Nine Costly Mistakes to Avoid for Medicare Advantage Customers / eHealth

eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, America’s first and largest private health insurance exchange where individuals, families and small businesses can compare health insurance products from leading insurers side by side and purchase and enroll in coverage online. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 180 of the nation’s leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia. Through the company’s eHealthTechnology solution (www.eHealthTechnology.com), eHealth is also a leading provider of health insurance exchange technology. eHealthTechnology’s exchange platform provides a suite of hosted e-commerce solutions that enable health plan providers, resellers and government entities to market and distribute products online. eHealth, Inc. also provides powerful online and pharmacy-based tools to help seniors navigate Medicare health insurance options, choose the right plan and enroll in select plans online through its wholly-owned subsidiary, PlanPrescriber.com (www.planprescriber.com) and through its Medicare website www.eHealthMedicare.com. 
Source: ehealthinsurance.com

Baicker: The insurance value of Medicare

Beneficiaries without any supplemental coverage thus do not have enough insurance and face too much risk. This risk is one reason that 90% of beneficiaries obtain some other type of insurance (e.g., retiree health benefits, Medigap, Medicare Advantage, or Medicaid). But beneficiaries with generous supplemental coverage probably have too much insurance. “Too much insurance” may seem like a nonsensical concept, but there is ample evidence that when copayments are lower, patients consume more care, much of which is of questionable benefit to health. The systemwide effects are considerable: the increasing prevalence of health insurance in the United States is estimated to be responsible for about half the increase in per capita health care spending between 1950 and 1990. Having little or no cost sharing may lead enrollees to consume low-value care and drive up the cost of Medicare for everyone.
Source: pnhp.org

Medicare open enrollment: How can I find a better plan?

What about doctor availability? On the Medicare site you can directly compare up to three plans, and when I selected your current plan and these other two plans, I saw that your current plan says it has 1001-1500 “physicians and providers,” compared to 4001-5000 for the other two plans. For each plan you can click on “View provider and physician network website,” which takes you away from Medicare.gov and onto the plan’s own website, where you can search its provider directory to judge for yourself whether it has enough doctors to meet your needs.
Source: consumerreports.org

Medicare Roundup 10/19: Setting the Record Straight

In recent weeks, liberal politicians, editorialists, and policy analysts have vigorously attacked reform of Medicare based on a defined contribution financing. In fact, this approach to reforming Medicare has a long bipartisan tradition going back to the 1980s and Representatives Richard Gephardt (D–MO) and David Stockman (R–MI). In fact, much of this criticism is distorted, misleading, or just plain wrong.
Source: fixhealthcarepolicy.com

Daily Kos: Medicare’s ‘death spiral’ under Romney/Ryan voucher plan confirmed in new study

Another study finds that the voucher system Mitt Romney and Paul Ryan envision for Medicare will cause the program’s demise. TPM’s Sahil Kapur reports on the study from Health Services Research, which used the model of the existing optional Medicare Advantage, the current subsidized Medicare alternative. The study’s conclusion: healthy seniors tend to gravitate to private plans and sicker seniors gravitate to traditional Medicare. That’s because private insurers craft their plans to attract lower-cost patients and leave sicker, more expensive ones for traditional Medicare—a process known as favorable selection. […] “I think what that means for premium support is that fee-for-service Medicare would gradually be a dumping ground for the sickest people and the premiums would go higher and higher if they want to stay in their plan,” said Austin Frakt, a health economist at Boston University. “And that’s a huge concern for some people.” That’s, in microcosm, a huge part of the problem the private insurance system has seen, except seniors have the option of Medicare that has to accept them, and sicker people who aren’t eligible for Medicaid are pretty much out of luck when it comes to finding affordable insurance. But in the case of Medicare, adding in private competition that markets to and selects the healthiest individuals means that traditional Medicare eventually becomes too expensive to sustain. That would lead to what Frakt calls the “classic adverse selection death spiral,” and the end of Medicare.
Source: dailykos.com

Health Care Reform Brings Major Medicare Changes

In addition, Centers for Medicare and Medicaid Services has begun this month reimbursing hospitals for Medicare services based on how well they follow “best practices” or clinical guidelines and how their patients respond to satisfaction surveys. This is known as “value-based purchasing” or “paying for performance.” Some hospitals will be paid less while higher-performing hospitals will be paid more. Beginning this month, Medicare is reducing payments to hospitals that had higher-than-expected readmission rates over the last three years for patients who returned within 30 days of being discharged after pneumonia, heart attack or heart failure. More conditions will likely be added in the future.
Source: northcarolinahealthnews.org

Choosing Between Original Medicare and Medicare Advantage

Posted by:  :  Category: Medicare

Cassandra Q. Butts by Center for American ProgressOriginal Medicare, Medicare Advantage and the maze of alphabet options can be hard for anyone to understand. It is difficult to get a clear comparison of what benefits each has to offer with the costs associated. Let’s focus on choosing between Original Medicare and Medicare Advantage based on six areas: premiums for drug coverage, prescription costs, extra benefits, overall plan costs, co-pays and access to doctors and hospitals.
Source: bradeninsurance.com

Video: Understanding Medicare Advantage Plans

Early Evidence Suggests Medicare Advantage Pay For Performance May Be Getting Results

The ACA phases out higher payments previously given to all MA plans. Instead, Medicare in 2012 began paying bonuses only to plans with strong performance on clinical quality, service measures and patient experience of care measures. Medicare bases the 2012 bonus payments on 2011 plan performance, as rated by a five-star system. This system incorporates Health Effectiveness Data Information Set (HEDIS®) and other quality measures, Consumer Assessment of Health Plans (CAHPS®) patient experience results (See Note 1 below.), and results of the Health Outcomes Survey (HOS) that tracks patient-reported outcomes over time. It also includes metrics such as complaints Medicare received about the plan, customer service for drug benefit plans, and beneficiary access and performance problems identified in audits by Medicare.
Source: healthaffairs.org

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

Who wins With Medicare Advantage?

Over the past several years, the largest insurers — Unitedhealth, WellPoint, Aetna, Cigna and Humana — have reported record profits, even during the quarters when enrollment in their employer-based and individually purchased health plans declined because of the recession. They’ve been able to do this in two ways: by taking in significantly more in premiums from their commercial customers than they have paid out in medical claims, and by persuading increasing numbers of retirees to enroll in their Medicare Advantage plans. If you enroll in one of their plans, the government sends a check to the insurance company you choose for your coverage. The amount varies depending on where you live. You might have to pay an additional premium out of your own pocket for better drug coverage, a broader network of providers, reduced copayments and discounts on gym memberships.
Source: wendellpotter.com

Senior Care in Park Cities, TX: Open Enrollment for Medicare –Now through Dec 7, 2012

Would a small increase in premiums result in a large reduction in health care costs you pay? Check, for example, what coverage is available for prescription drugs you take? Medicare representatives can create a report containing the costs and benefits of various insurance products if you supply them with a list of your drug prescriptions. Ask questions about participating doctors and clinics. Some Medicare Advantage plans limit which physicians a patient can visit.
Source: hhdallas.com

2013 Medicare Advantage Plans — Best Rated Florida Plans from AARP UnitedHealth, Blue Cross Blue Shield, Humana and Coventry

Now that open enrollment for 2013 has begun, seniors are looking for the best rated 2013  Medicare Advantage plans from large insurers like Blue Cross Blue Shield, AARP, Humana, Cigna and many others. Rates for the plans are now available.  While the rates are now available on the Medic are.gov website, rate updates are still pending for the Florida State insurance website, so Florida seniors that are searching for low cost Medicare Advantage plans will need to be careful that the rates that they see quoted are for 2013.
Source: medicaremedigaprates.com

2013 Medicare Annual Enrollment Period: eHealth Identifies Nine Costly Mistakes to Avoid for Medicare Advantage Customers / eHealth

eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, America’s first and largest private health insurance exchange where individuals, families and small businesses can compare health insurance products from leading insurers side by side and purchase and enroll in coverage online. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 180 of the nation’s leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia. Through the company’s eHealthTechnology solution (www.eHealthTechnology.com), eHealth is also a leading provider of health insurance exchange technology. eHealthTechnology’s exchange platform provides a suite of hosted e-commerce solutions that enable health plan providers, resellers and government entities to market and distribute products online. eHealth, Inc. also provides powerful online and pharmacy-based tools to help seniors navigate Medicare health insurance options, choose the right plan and enroll in select plans online through its wholly-owned subsidiary, PlanPrescriber.com (www.planprescriber.com) and through its Medicare website www.eHealthMedicare.com. 
Source: ehealthinsurance.com

Fact Check on Medicare Advantage

  Medicare Advantage plans also protect beneficiaries from catastrophic health care costs.  In 2012, all Medicare Advantage plans offer an out-of-pocket maximum limit for beneficiary costs, and about 78 percent of Medicare Advantage enrollees are in plans that have annual out-of-pocket maximums of $5,000 or less.  These out-of-pocket maximums – which are not offered by the Medicare FFS program – help protect Medicare beneficiaries from catastrophic health care expenses that otherwise might pose a serious threat to their financial security.  Medicare Advantage plans also help reduce out-of-pocket costs for enrollees by reducing premiums for Part B and Part D, and by limiting cost-sharing for Medicare-covered services, including primary care physician visits and inpatient hospital stays.
Source: ahipcoverage.com

HHS Touts Growth In Medicare Advantage Plans, Drop In Premiums

More than 13 million Medicare beneficiaries – just over a quarter of all Medicare enrollees – are in Medicare Advantage plans, an alternative to traditional Medicare offered by insurance companies. The health law will reduce payments to Medicare Advantage plans by $156 billion from 2013 through 2022, according to the Congressional Budget Office. President Barack Obama and many Democrats have backed payment cuts to the plans, citing data that the government has in the past paid about 14 percent more per beneficiary in Medicare Advantage than per beneficiary enrolled in the traditional program. Proponents of the private plans point to their better coordination of care and extra benefits and services they provide, including vision, hearing and dental benefits.
Source: kaiserhealthnews.org

How much does Medicare Advantage cost?

Plans with $0 Monthly Premiums: Among the 43,306 plans available in 2013, 13,741 plans (32 percent) will be offered at a cost of $0 above what a Medicare beneficiary already pays for Medicare Part B. By comparison, 14,297 plans (33 percent) were available with a $0 monthly premium in 2012 and 13,821 plans (35%) were available in 2011.
Source: ehealthinsurance.com

Medicare open enrollment: Will Obamacare end Medicare Advantage?

Should you be worried that Medicare Advantage plans will economize by reducing your benefits? “The plans are required to provide all Medicare benefits, so there’s no way they can cut them,” Gold explains. That includes the free preventive services added to Medicare by the Affordable Care Act. And Advantage plans that include a drug benefit are closing the doughnut hole just the same as stand-alone Part D drug plans. The only area where plans can even consider cutting back are for optional services such as dental and vision benefits, but the plan finder on Medicare.gov still features plenty of plans that have these bonus features.
Source: consumerreports.org

Medicare “Donut Hole” Gets a Little Smaller in 2013

Posted by:  :  Category: Medicare

Stella Johnson On The Impact Of Health Insurance Reform by Leader Nancy PelosiThe difference between Medicare Part D plans is that one plan may charge significantly more for specific drugs than another plan. This could also be true if you have a Medicare Advantage plan that includes drug coverage. That’s because they negotiate prices with manufacturers and middlemen.
Source: allsup.com

Video: Medicare Part D – The Donut Hole

Medicare Open Enrollment: Be a smart shopper

in the Medicare program. Average premiums for prescription drug coverage and Medicare health plans will stay around the same in 2013. People who are in Medicare’s prescription drug coverage gap (“donut hole”) will continue to save money in 2013 with big discounts on brand-name prescription drugs. Since the health care law was enacted in 2010, more than 5.5 million people with Medicare have saved nearly $4.5 billion on prescription drugs in the donut hole. 
Source: medicare.gov

What Is The Medicare “Doughnut Hole”?

During each month you have a prescription filled your drug plan sends you and Explanation of Benefits notice, which you’ll often see or hear shortened to EOB. This monthly EOB form tells you how much you’ve spent during the month on covered drugs and if you’ve reached your coverage gap, signalling you’re now responsible for the entire cost of drugs for the remainder of the year. It’s human nature, no matter how well informed we were when we read the plans fine print, it’s always a shock when prescription payments abruptly end. Out of pocket costs, especially on a fixed income, are always a bitter pill to swallow.
Source: medigapandyou.com

Study: Medicare ‘Doughnut Hole’ Not Linked To More Heart Attacks, Related Deaths

Reuters: Medication ‘Donut Hole’ Not Tied To Heart Deaths U.S. seniors forced to pay full price for their medications while in Medicare’s so-called donut hole didn’t suffer more heart attacks or deaths as a result, in a new study. During several months spent in the Medicare coverage gap, when the government-run insurance program’s Part D component stops covering medications, seniors were no more likely than peers with drug coverage to be hospitalized for, or die from, a heart-related problem (Seaman, 8/17).
Source: kaiserhealthnews.org

GAO Report Confirms Health Reform Law New Medicare Drug Discounts Saving Seniors Money

WASHINGTON, DC October 26, 2012 – A report released today by Reps. Henry Waxman, Sander Levin, and John Dingell, and Sen. Max Baucus, confirms the successful implementation of the new Medicare Part D drug discount included in the Affordable Care Act (ACA). The report shows that the landmark health reform law the congressional leaders helped pass is effectively saving seniors’ money. Prior to passage of the ACA, seniors were often forced to pay the full cost of their prescription drugs when they were caught in the Medicare Part D coverage gap, informally known as the donut hole. Thanks to the ACA, these seniors now receive a 50% discount on all brand-name drugs when they hit the coverage gap. These discounts gradually increase until 2020 when the donut hole is completely closed. GAO was asked to report on the Centers for Medicare & Medicaid Services’ (CMS) implementation of this new drug discount program and its impact on the Part D benefit. The GAO report found that the discount is working as intended. GAO’s findings reveal that CMS implemented the program in a timely fashion, establishing systems for oversight to ensure that seniors were provided with required discounts. GAO reported that “most [Part D plan] sponsors and PBMs told GAO that the Discount Program did not affect Part D plan formularies, plan benefit designs, or utilization management practices.” GAO also conducted a detailed cost comparison of popular drugs, finding that price increases of drugs likely to be discounted in the donut hole were no higher than price increases for other drugs – an indication that the new discount program did not cause manufacturers to increase drug prices. “President Obama’s health care reform law improved Medicare by immediately providing seniors with 50% discounts in the Part D drug donut hole, saving five million seniors more than $4 billion to date,” said Rep. Waxman, Ranking Member of the Energy and Commerce Committee. “Today’s GAO report confirms that the program is working exactly as intended and is helping to cut seniors’ drug costs. That’s why I’ll continue to fight Republican efforts to overturn the law.” “Today’s report is another example of how Obamacare meets its promise of improved access, affordability, and quality health care for millions of Americans on Medicare by closing the ‘donut hole’,” said Rep. Levin, Ranking Member of the Ways and Means Committee. “Republican efforts to repeal the health reform law and end traditional Medicare would turn back the clock for millions of seniors and Americans with disabilities who already benefit from the law’s vital improvements.” “This report shows how health reform is working to save seniors $4.8 billion and helping them afford their prescription drugs, closing the donut hole,” said Senate Finance Committee Chairman Max Baucus. “We need to help seniors save every dollar they can and that’s exactly what the Affordable Care Act does – reducing seniors’ out-of-pocket costs while providing more benefits.” “This is hard and fast evidence that Obamacare is doing what it was implemented to do: to make heath care more accessible and affordable,” said Rep. Dingell, Chairman Emeritus of the House Energy and Commerce Committee. “More and more seniors are able to access their medications now that they no longer have to pay steep prices on brand-name drugs. I commend CMS for their swift and successful implementation. This has improved the quality of life for millions of Americans across the country.” The full GAO report, Medicare Part D Coverage Gap: Discount Program Effects and Brand-Name Drug Price Trends, is available online here.
Source: yubanet.com

Daily Kos: I Hate Explaining the Medicare “Donut Hole” (Updated with explanation of donut hole)

I had a chance to talk to Tom Scully, the head of HMS at the time and the creator of Plan D and the donut hole about why he did it. There were two reasons. First, he had a budget of $400 billion over ten years for the program so he had to design something that hit his budget target and he did a great job on that. Medicare Part D is the only government health program where the ten year cost was actually under the budget estimate. I think it came in at $380 billion. The second reason was to make seniors really think about generics and switching from higher priced brand name drugs to lower cost generic substitutes. And that part worked as well. You need to remember that before Part D all prescriptions were out of pocket expenses for seniors on Medicare, so even with the donut hole Part D was a big benefit.
Source: dailykos.com

Some Rare Good News: Retiree Health Savings Needs Slip

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) added outpatient prescription drugs (Part D) as an optional benefit. When the program was originally enacted, it included a controversial feature: a coverage gap, more commonly known as the “donut hole.” PPACA included provisions to reduce (but not eliminate) this coverage gap.
Source: wordpress.com

What Is the Medicare Donut Hole?

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

Study: Medicare Part D “donut hole” does not linked to increase in heart attacks

After a small deductible, Part D drug plans typically cover 75 percent of drug costs up to a certain dollar figure, which was $2,400 in 2007. After a beneficiary reaches that level, there is no coverage until the person has spent potentially thousands of dollars out of pocket, then coverage kicks back in.
Source: medcitynews.com

PoliGraph: DFL falsely links state lawmakers to Medicare

The flier states that Wiener “will be just another Republican vote against closing the Medicare prescription drug donut hole.” The DFL is referring to a kink in the Medicare Part D program, which covers drug benefits for seniors. Once Medicare beneficiaries reach a certain coverage threshold, they have to pay for their prescriptions until they reach the catastrophic coverage threshold.
Source: publicradio.org

Planned Parenthood wins fight over funding

Posted by:  :  Category: Medicare

gutted bag by jason.odonnell“The people’s elected representatives in the legislature decided they did not want an indirect subsidy of abortion services such as payroll and overhead to be paid with taxpayer’s dollars and so crafted this law,” said Indiana Attorney General Greg Zoeller. “Although the injunction concerning Medicaid funding was not lifted, we note that the 7th Circuit found the state has the legal authority to decide how federal block-grant dollars – which are tax dollars – will be distributed.
Source: journalgazette.net

Video: Medicare Supplemental Medigap in Indiana by 1-800-MEDIGAP®

The Indiana Law Blog: Law

The suit alleges that the practice of putting patients in observation status not only denies them coverage for post-hospital rehab care, so they must either pay the nursing home’s full bill — more than $30,000 in the case of two plaintiffs — or forgo treatment. It also classifies them as outpatients while they’re in the hospital. Therefore, their Medicare coverage comes not under Part A (hospital insurance) but Part B (which normally covers doctors’ services and outpatient care). For some patients, this can also mean paying more out of pocket — especially if they need prescription drugs that, in this situation, would be covered under Part B and not under Part A or even the Medicare Part D drug benefit. * * *
Source: indianalawblog.com

Medicare Supplement Insurance

In the print edition of "School Board Candidates Speak Out" two responses were erroneously swapped. The answers of Matt Prusiecki and Rob Richards to the question "Why should people vote for you?" were swapped. You can find them correctly placed on our web site: http://atcentergrove.com/blog/school_board_candidates/
Source: atcentergrove.com

WellPoint reorganization will help integrate Amerigroup, expand in Medicaid market

The Indianapolis insurer agreed to buy Amerigroup in July for $4.9 billion, a move that will boost its presence in the Medicaid market. Bloomberg reported that interim CEO John Cannon sent a memo to employees Thursday that said the reorganization would create business units for Medicare, Medicaid, commercial and individual insurance, and specialty insurance including dental, vision and disability.
Source: medcitynews.com

Medicare, Abortion Grab Attention In Some House, Senate Races

Politico: Wisconsin Senate: Can Tommy Thompson Recapture Magic? The last time Tommy Thompson appeared on a ballot Mike Holmgren was the head coach of the Packers, “ER” was the top-rated show on television and Twitter was still a decade away from mainstream popularity. The year was 1998, and Thompson sailed to a fourth term as governor, disposing of his Democratic opponent by a 21-percentage-point margin. … Yet, there’s evidence that Thompson’s more recent work in Washington has tarnished his sterling image back home. Thompson served as a senior partner at the Beltway lobbying powerhouse Akin Gump, making millions as a consultant on health care issues after serving as Health and Human Services secretary under President George W. Bush (Cantanese, 10/23).
Source: kaiserhealthnews.org

Indiana Farm Bureau Offers New Medicare Supplement Plans Benefit

4G Beef cattle CBOT china commodity corn crude oil drought DuPont election energy ethanol Extension farm bill farm bureau farm policy FFA FIELD CROPS REPORT financial futures grain harvest Hibberd HSUS Indiana Soybean Alliance market report markets Mintert NPPC Pioneer Pork Pork Board President Barack Obama purdue purdue extension renewable fuel Seed Consultants soybean harvest soybeans USDA Verizon weather weeds wheat
Source: hoosieragtoday.com

Romney Narrows Gap With Obama On Medicare Issue

Most troublesome for Obama is that, among likely voters, GOP candidate Mitt Romney has pulled nearly even with him on which candidate would do a better job with Medicare — an issue that resonates in battleground states with large elderly populations, such as Florida and Pennsylvania. Obama’s advantage on that question has shrunk despite the fact that six in 10 likely voters continue to oppose Romney’s idea of changing Medicare to a premium support system, in which the government would guarantee each senior a fixed amount of money to help him or her purchase coverage. Overall, about 46 percent of voters said they prefer Obama on Medicare compared with 41 percent for Romney, a gap that is not statistically significant. In September, Obama held a 16-point lead on the Medicare question.
Source: aarp.org

Medicare Supplemental Insurance Indiana

To get part D and the supplement, you need an insurance agent. Both of these newer policies are part of the privatization instituted for Medicare, and private insurance companies disburse the monies from Medicare. Your insurance agent can give you more details about the policies. Talk to him, and let him figure out how much you would pay for plans B, C, and D. Or, you can contact Group Insurance, where a licensed agent can give you the information you need to get the best health insurance policy you can afford.
Source: group-insurance.net

Arizona, Indiana Blocked From Defunding Planned Parenthood

Indiana has the unfortunate distinction of being the first state that passed a law to exclude Planned Parenthood from the pool of its Medicaid-eligible providers, a tactic that anti-choice lawmakers often use to target the women’s health organization for performing abortions, despite the fact that abortion services represent just three percent of the care Planned Parenthood provides. Even though an estimated 9,300 low-income women in Indiana rely on Planned Parenthood for their health care — including cancer screenings, STD testing, and birth control — Gov. Mitch Daniels (R-IN) signed a law in May 2011 to cut off the Medicaid funding that finances the organization’s general health screenings.
Source: brandtstandard.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

Posted by:  :  Category: Medicare

COMPARING THE ECONOMY OF YESTERYEAR WITH TODAY'S ECONOMY... by roberthuffstutterThe page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Video: Comparing the candidates on Medicare

2013 Medicare Annual Enrollment Period: eHealth Identifies Nine Costly Mistakes to Avoid for Medicare Advantage Customers / eHealth

eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, America’s first and largest private health insurance exchange where individuals, families and small businesses can compare health insurance products from leading insurers side by side and purchase and enroll in coverage online. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 180 of the nation’s leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia. Through the company’s eHealthTechnology solution (www.eHealthTechnology.com), eHealth is also a leading provider of health insurance exchange technology. eHealthTechnology’s exchange platform provides a suite of hosted e-commerce solutions that enable health plan providers, resellers and government entities to market and distribute products online. eHealth, Inc. also provides powerful online and pharmacy-based tools to help seniors navigate Medicare health insurance options, choose the right plan and enroll in select plans online through its wholly-owned subsidiary, PlanPrescriber.com (www.planprescriber.com) and through its Medicare website www.eHealthMedicare.com. 
Source: ehealthinsurance.com

Medicare Open Enrollment: What’s your back

Nobody likes to think of back-up plans when it comes to our health, but health can be as unpredictable as the weather. It’s hard to know what you’ll feel like next week, much less what health care you’ll need next year. But that’s exactly what you need to think about when you’re shopping for health coverage during Medicare Open Enrollment – which ends on December 7.
Source: medicare.gov

Comparing Medicare prescription drug plans

Also, be aware that if you’re a low-income beneficiary and your annual income is under $16,755 or $22,695 for married couples living together, and your assets are below $13,070 or $26,120 for married couples, you may be eligible for the federal Low Income Subsidy known as “Extra Help” that pays Part D premiums, deductibles and copayments. For more information or to apply, call Social Security at 800-772-1213 or visit socialsecurity.gov/prescriptionhelp.
Source: pomeradonews.com

Why You Should Compare Medicare Part D Plans During Open Enrollment

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Source: creditvisionary.com

GRAY MATTERS: Now is the time to compare Medicare plans

Beneficiaries can call Medicare at 1-800-633-4227 anytime of day or night, including weekends, and ask for assistance to compare plans and to make a change if needed. The information is also available online at www.Medicare.gov and enrollment changes can be made online. The best time to call Medicare is in the evening or during a weekend to shorten wait times.
Source: times-standard.com

Medicare Supplemental Insurance Comparison Website Boasts 1000 Views in First 10 Days Online

A brand-new Medicare supplemental insurance comparison website has just announced that it has broken the 1000 views barrier in its first 10 days online. The new interface is in response to the huge demand for Medicare supplemental insurance comparison websites. For anyone who has searched online to compare the rates of different Medicare supplemental insurance providers, they know it can be an exhaustive process. Certainly the invention of the Internet and the implementation of convenient comparison software’s has made the process easier, but only until now have shoppers been able to retain sensitive information when seeking out the best insurance policies for their specific needs. In the past, shoppers had to part with the sensitive information such as their phone number, e-mail, home address, and in some situations, their credit card number. Fortunately recent advancements in technology has made the need for invasive information a thing of the past. Today shoppers can go online and compare Medicare supplemental insurance providers simply by entering their zip code. The software then goes to work by combing through thousands of competing insurance providers and lining up the results in a convenient side-by-side chart. Shoppers can then click on the insurance provider that interests them the most to learn more. “When we set out to build this website our primary goal was to make searching for Medicare supplemental insurance as simple as possible” said Jack Almeida, president of finance. ”These days, insurance salespeople are extremely aggressive, so we wanted a platform that allowed shoppers to look through a variety of different companies without ever having to contact them directly. With our website shoppers can see all the best supplemental insurance companies in their zip code, do a side-by-side comparison of their prices and policies, and when they are ready, contact them on their own accord.” There is another advantage of software that offers side-by-side comparisons, says the website. Medicare supplemental insurance companies know that they are being compared with other companies in their area. Because of this they will offer the lowest possible price to beat out there competition and attract new clients. In the end this creates an extremely competitive environment between insurance companies and strongly benefits the shopper. It’s with this dynamic that shoppers can contact their chosen company directly, and even if they are more expensive than the other companies on the website, negotiate pricing based on the side-by-side comparison. Jack Almeida continues: “with our convenient platform shoppers can use the information we give them to pit one insurance company against the other and get the lowest price on the plan of their choosing.” To learn more about this new Medicare supplemental insurance website please visit http://medicaresupplementalinsurancecomparison.net/ About medicaresupplementalinsurancecomparison.net Medicaresupplementalinsurancecomparison.net was created in September of 2012 to help shoppers get the best rates for Medicare supplemental insurance. The website utilizes the absolute latest in price quote technology, and has already received rave reviews from the industry.
Source: sbwire.com

Insurance Quote Free: How to Compare Medicare Health Insurance Plans

Who Benefits? Most US seniors of retirement age and some disabled people get Medicare health benefits. And even though the federal system has some issues, and does not cover all health related services, it is still important to make sure that these vulnerable and higher risk people are able to access health insurance. Most of the time, beneficiaries are entitled to Part A and B. Part A is also called hospital insurance, and it usually comes with no cost to the beneficiary. Part B, medical insurance, does require most covered people to pay a premium. Right now that premium is less than $100, and it often comes right out of a member’s social security check, so some people do not even realize they pay that amount every month. Part A and Part B are also called traditional Medicare. MedSups or MediGap Since Medicare health insurance comes with deductibles and copays, a covered member may still run up out of pocket expenses for medical services. Private insurers have developed supplemental health insurance plans called supplements or Medigap plans. These plans, which come in different levels and price tags, are purchased from an insurance company, and they cover the “gaps” that traditional Medicare will not pay for. Some examples of these gaps would be a hospital deductible or a doctor’s office copay. Understand that medigap poliices are from private insurers, paid for with a premium, and are not subsidized by tax money. Medicare Advantage Plans (MA) These plans are not the same as supplements though many people confuse them. Instead of supplementing original Medicare, an MA plan will be used instead. By law, they must provide coverage that is at least as good as original Medicare, and of course, to be competitive, they should provide much better services and coverages. Some MA plans also come with value added services like transportation to the doctor and gym memberships, and this makes them very attractive. In addition, some MA plans do not require any additional premium, and some even refund part of the Part B premium. In order to gain members, these plans must convince beneficiaries that they will benefit from them more than they would from the original plan. The advantage over med sups, is that they usually have lower (or 0) premiums in addition to the Part B premium.. Of course, most of the health coverage from MA plans is from the federal money that would have paid for traditional Medicare. Part D – Prescription Coverage The latest CMS (Center for Medicare and Medicaid) plan is called Part D, it this covers prescription drugs. Sometimes these plans are purchased by themselves, and sometimes they come bundled with an MA plan. Like MA plans, they are federally subsidized, and the premiums are usually very low for the coverage they provide to a high risk group. Part D plans may come with deductibles and copays, and probably will not cover 100% of prescription costs. But they certainly do help many seniors and disabled people afford their prescriptions. Which Plan is Best? I cannot name one best plan because covered people have unique needs, preferences, and budgets. In addition, available plans and prices will vary by zip code. A senior on a tight budget may benefit from an MA plan that includes Part D and does not require an additional premium. But other seniors, with more income, may prefer to keep a doctor who does not participate in any MA plan, and so a supplement would be better for them. How To Chose
Source: blogspot.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

Medicare News: Health Spending On Seniors Grew Faster In U.S. Than Canada

The Hill: Kaiser: Savings Hard To Find In Programs For Dual-Eligibles Everyone agrees that people who receive both Medicare and Medicaid generate significant expenses for the federal government — but controlling those costs might be harder than it seems. A new paper from the Kaiser Family Foundation says efforts to better coordinate care for “dual eligible” seniors have produced only modest savings. Dual-eligibles make up a relatively small share of all Medicare and Medicaid recipients, but they make up an outsized portion of spending within both programs. Dual-eligibles are among the oldest, sickest and poorest patients in the country — which makes their care some of the costliest. There is broad support in Washington for reducing spending through better care coordination between the two programs, but the Kaiser Family Foundation review says big savings will be hard to find (Baker, 10/30). (Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.)
Source: kaiserhealthnews.org

Medicare's 2013 Proposed Fee Schedule: The Physician Impact

Posted by:  :  Category: Medicare

4. Multiple procedure payment reductions are proposed on the technical component of second and subsequent cardiovascular and ophthalmology diagnostic services furnished by the same doctor, to the same patient, on the same day. The professional component from any doctor in a practice performing second and subsequent CT, MRI, or ultrasound scans on the same patient on the same day will be reduced by 25 percent. Since patients receiving multiple scans are often the most ill, this modification could significantly impact patient care as well as the reimbursement of those groups that care for them. Although it’s likely this rule was intended to prevent excessive and unnecessary testing, without additional qualification it is likely to create hardship for patients legitimately requiring multiple same-day diagnostic tests.
Source: physicianspractice.com

Video: Medicare Physician Fee Schedule; the Never Ending Debate

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

Medscape:  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

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

Imaging Cuts in Proposed 2013 Medicare Fee Schedule Rule Potentially Dangerous, Unfounded and Unnecessary

Further cuts to imaging do little, if anything to safely bend the Medicare cost curve. Imaging use in Medicare is down since 2008. Medicare spending on scans is at the same level it was in 2003. Imaging is also the slowest growing of all physician services among privately insured Americans according to the Health Care Cost Institute. A multitude of studies show that medical imaging exams are directly linked to greater life expectancy, declines in mortality rates, and are generally safer and less expensive than the invasive procedures that they replace. Scans also reduce the number of invasive surgeries, unnecessary hospital admissions and length of hospital stays.
Source: newswise.com

THE PROPOSED 2013 MEDICARE PHYSICIAN FEE SCHEDULE PRESENTS SOME MAJOR CONCERNS : Med Law Blog

Since utilization has increased dramatically over projections almost from the very beginning, the SGR has regularly mandated a Medicare Physician Fee Schedule decrease. Since 2002, Congress has just as regularly postponed the statutory mandated fee decrease. The result has been similar to what happens when you fail to make the minimum balance payments on your credit card; the problem just keeps getting proportionately worse. In the beginning, some of the mandatory decreases were as little as 1.5%, but postponing these decreases for the last 10 years has resulted in a proposed 27% fee schedule decrease to balance the Medicare budget for 2013. 
Source: medlawblog.com

NRHA continues to fight for MDH, LVH

The MDH designation helps rural hospitals that struggle to maintain financial stability under Medicare’s fee schedule because of their small size and the large share of Medicare beneficiaries who make up their patient base. Because of their vital nature in serving the rural Medicare beneficiary population, Congress enacted various payment modifications to help these facilities stay open and guarantee hospital access to rural Medicare beneficiaries. This designation reimburses hospitals based on their historical costs of providing care rather than on a prospective schedule based on costs incurred by other facilities.
Source: ruralhealthweb.org

New Dermagraft Coding to Streamline Reimbursement Process for Medicare Providers

“Advanced BioHealing has been working closely with CMS officials to ensure consistent coding for Dermagraft. These efforts resulted in the creation of new codes, which will ensure that payment is made appropriately for Dermagraft each time a covered service is provided, thereby reducing administrative burden for both Medicare providers and contractors,” said Kevin Rakin, Chairman and Chief Executive Officer for ABH. “Like diabetes, diabetic foot ulcers are a growing epidemic, so streamlining access to advanced therapies like Dermagraft will help reduce the need for lower extremity amputation and additional significant costs to both the Medicare system and beneficiaries.”
Source: wcei.net

Medicare Physician Fee Schedule

Improving Payment for Primary Care.  The proposed rule includes a number of initiatives designed to increase payments for primary care. Payments for primary care would increase for a variety of reasons, including a proposed new payment for managing a beneficiary’s care when the beneficiary is discharged from certain health care facilities, such as a hospital, skilled nursing facility, inpatient rehabilitation facility, and other similar types of facilities. This would be achieved by creating a new procedure code for providing “post-discharge transitional care management services”, which would apply to all services related to transitional care management within 30 days following the date of discharge from an eligible facility.
Source: beneschhealthlaw.com

Early Evidence Suggests Medicare Advantage Pay For Performance May Be Getting Results

Posted by:  :  Category: Medicare

Cassandra Q. Butts by Center for American ProgressThe ACA phases out higher payments previously given to all MA plans. Instead, Medicare in 2012 began paying bonuses only to plans with strong performance on clinical quality, service measures and patient experience of care measures. Medicare bases the 2012 bonus payments on 2011 plan performance, as rated by a five-star system. This system incorporates Health Effectiveness Data Information Set (HEDIS®) and other quality measures, Consumer Assessment of Health Plans (CAHPS®) patient experience results (See Note 1 below.), and results of the Health Outcomes Survey (HOS) that tracks patient-reported outcomes over time. It also includes metrics such as complaints Medicare received about the plan, customer service for drug benefit plans, and beneficiary access and performance problems identified in audits by Medicare.
Source: healthaffairs.org

Video: Best Medicare Advantage Plan | Medicare Advantage

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

2013 Medicare Annual Enrollment Period: eHealth Identifies Nine Costly Mistakes to Avoid for Medicare Advantage Customers / eHealth

eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, America’s first and largest private health insurance exchange where individuals, families and small businesses can compare health insurance products from leading insurers side by side and purchase and enroll in coverage online. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 180 of the nation’s leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia. Through the company’s eHealthTechnology solution (www.eHealthTechnology.com), eHealth is also a leading provider of health insurance exchange technology. eHealthTechnology’s exchange platform provides a suite of hosted e-commerce solutions that enable health plan providers, resellers and government entities to market and distribute products online. eHealth, Inc. also provides powerful online and pharmacy-based tools to help seniors navigate Medicare health insurance options, choose the right plan and enroll in select plans online through its wholly-owned subsidiary, PlanPrescriber.com (www.planprescriber.com) and through its Medicare website www.eHealthMedicare.com. 
Source: ehealthinsurance.com

2013 Medicare Advantage Plans — Best Rated Florida Plans from AARP UnitedHealth, Blue Cross Blue Shield, Humana and Coventry

Now that open enrollment for 2013 has begun, seniors are looking for the best rated 2013  Medicare Advantage plans from large insurers like Blue Cross Blue Shield, AARP, Humana, Cigna and many others. Rates for the plans are now available.  While the rates are now available on the Medic are.gov website, rate updates are still pending for the Florida State insurance website, so Florida seniors that are searching for low cost Medicare Advantage plans will need to be careful that the rates that they see quoted are for 2013.
Source: medicaremedigaprates.com

How much does Medicare Advantage cost?

Plans with $0 Monthly Premiums: Among the 43,306 plans available in 2013, 13,741 plans (32 percent) will be offered at a cost of $0 above what a Medicare beneficiary already pays for Medicare Part B. By comparison, 14,297 plans (33 percent) were available with a $0 monthly premium in 2012 and 13,821 plans (35%) were available in 2011.
Source: ehealthinsurance.com

Daily Kos: Medicare’s ‘death spiral’ under Romney/Ryan voucher plan confirmed in new study

Another study finds that the voucher system Mitt Romney and Paul Ryan envision for Medicare will cause the program’s demise. TPM’s Sahil Kapur reports on the study from Health Services Research, which used the model of the existing optional Medicare Advantage, the current subsidized Medicare alternative. The study’s conclusion: healthy seniors tend to gravitate to private plans and sicker seniors gravitate to traditional Medicare. That’s because private insurers craft their plans to attract lower-cost patients and leave sicker, more expensive ones for traditional Medicare—a process known as favorable selection. […] “I think what that means for premium support is that fee-for-service Medicare would gradually be a dumping ground for the sickest people and the premiums would go higher and higher if they want to stay in their plan,” said Austin Frakt, a health economist at Boston University. “And that’s a huge concern for some people.” That’s, in microcosm, a huge part of the problem the private insurance system has seen, except seniors have the option of Medicare that has to accept them, and sicker people who aren’t eligible for Medicaid are pretty much out of luck when it comes to finding affordable insurance. But in the case of Medicare, adding in private competition that markets to and selects the healthiest individuals means that traditional Medicare eventually becomes too expensive to sustain. That would lead to what Frakt calls the “classic adverse selection death spiral,” and the end of Medicare.
Source: dailykos.com

Issa plans subpoena of Advantage pilot documents

The House Oversight and Government Reform Committee will subpoena documents from HHS relating to the department’s $8 billion Medicare Advantage pilot program after the department failed to produce documents requested nearly five months ago to the committee’s satisfaction. The move to a compulsory order followed repeated requests for HHS to voluntarily produce documents detailing its internal deliberations on a pilot program launched in 2010 that provides bonus payments to most Medicare Advantage plans, according to a letter dated Friday (PDF) from Rep. Darrell Issa (R-Calif.), the panel’s chairman. The program, an amended and much more expensive version of a pilot authorized by the Patient Protection and Affordable Care Act, drew scrutiny from the oversight panel after the nonpartisan Government Accountability Office found this year that the pilot lacked a legal basis and recommended HHS shut it down. Issa wrote HHS Secretary Kathleen Sebelius on Oct. 19 that the subpoena was needed after 1,300 pages of documents the department sent the day before “were of no assistance to the committee’s investigation.”
Source: modernhealthcare.com

Fact Check on Medicare Advantage

  Medicare Advantage plans also protect beneficiaries from catastrophic health care costs.  In 2012, all Medicare Advantage plans offer an out-of-pocket maximum limit for beneficiary costs, and about 78 percent of Medicare Advantage enrollees are in plans that have annual out-of-pocket maximums of $5,000 or less.  These out-of-pocket maximums – which are not offered by the Medicare FFS program – help protect Medicare beneficiaries from catastrophic health care expenses that otherwise might pose a serious threat to their financial security.  Medicare Advantage plans also help reduce out-of-pocket costs for enrollees by reducing premiums for Part B and Part D, and by limiting cost-sharing for Medicare-covered services, including primary care physician visits and inpatient hospital stays.
Source: ahipcoverage.com

Medicare open enrollment: How can I find a better plan?

Posted by:  :  Category: Medicare

Martin Place 1 by Greens MPsWhat about doctor availability? On the Medicare site you can directly compare up to three plans, and when I selected your current plan and these other two plans, I saw that your current plan says it has 1001-1500 “physicians and providers,” compared to 4001-5000 for the other two plans. For each plan you can click on “View provider and physician network website,” which takes you away from Medicare.gov and onto the plan’s own website, where you can search its provider directory to judge for yourself whether it has enough doctors to meet your needs.
Source: consumerreports.org

Video: Dental Insurance Commercial for Folks on Medicare

Dental Patients Experience Total Convenience Through Medicare Dental Surgery

People would get the best dental surgery deal through medicare dental surgery. The said kind of surgery is actually just like any other surgeries people with dental problems go through only that, patients are freed from financial stress for the medicare dental insurance would take care of the bill. With this, the patient could relax and concentrate on the surgery itself, totally not minding how the surgery would be paid up. The plan is simply created to assist people during times of need and giving them the convenience they deserve. These medicare dental plans are being offered to all kinds of people, regardless of age.
Source: lydc.org

How to Save on Dental Care

I use dental discount plans (I’m on my second one).  Wanted to share some hard earned experiences: 1) I didn’t realize that the dentists get NONE of your plan membership fee.  My first yearly plan included free cleanings/xrays/checkups, and it was a horrible experience as the dental offices figure out other ways to pressure you for money (flouride treatments, bogus offices visit charges, overtreatment of moderate cavaties as needing a root canal/cap). 2) My second plan has a lower yearly fee and about 70 percent off dental fees.  Still get pressured for items not covered, like 300 dollar nightime mouth guards (that last 6 months).  Also, when I did need a specialist, his office didn’t honor the advertised rates, only gave 20 percent off. The 20 percent off was supposed to apply only to services not itemized in the dental plan. 3) Even with the aggravation, I think a dental plan is worth it because I’ve never found a dental office that will negotiate on the prices.  The office staff doesn’t want to be bothered.  They only want to deal with either insurance companies, or dental plans as all the fees are loaded in their administrative systems.  4)  One other tip, print out a copy of your plans itemized fees as I found two dental offices that changed the prices. 
Source: depositaccounts.com

State Roundup: Ore. Lawmakers Petition For Separate Dental Care

Health Policy Solutions (a Colo. news service): Public Housing Project A National Model For Supporting Health In 2009, when developers from the Denver Housing Authority worked with neighborhood partners, residents and consultants to dream up a new master plan for the Lincoln Park/La Alma neighborhood, they became one of the first 20 or so entities in the U.S. to conduct what’s known as a Health Impact Assessment (HIA). Long popular in Europe but new to the U.S., HIAs aim to identify how a project or redevelopment will impact health. Then in 2010, as reconstruction began, DHA developers ignited another health revolution. They decided to hold themselves accountable for improving health with every decision they made. They wanted to measure their success or failure and became on of the first in the country to use what’s called the Healthy Development Measurement Tool (HDMT) (Kerwin McCrimmon, 10/17).
Source: kaiserhealthnews.org

Medicare Supplemental Insurance Comparison Website Announces Brand

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSA new Medicare supplemental insurance company has hit the online world and has already been getting a lot of attention from insurance shoppers. In just its first two weeks after release the company boasted 10,000 unique views, and today, they have announced the release of their brand-new insurance comparison software. According to Ron Montgomery, director of IT, the software scrapes up to 35% more Medicare supplemental insurance companies and does it 20% faster than before. “We are extremely pleased with this software upgrade,” stated Mr. Montgomery in a recent interview. “It allows our visitors to quickly jump onto our website, enter their zip code, and within seconds be given a comprehensive list of all the most reputable Medicare supplemental insurance companies in their area. Before, they had to provide invasive information such as their home address or credit card number. But today, with the creation of new technology, all that is not necessary. All a shopper needs to do is enter their zip code. This has made our website extremely popular since its initial release.” Indeed, the demand for comparison websites of all genres has been growing since the advent of the Internet. In the past, those searching for supplemental insurance had to contact the insurance companies directly and dodge pushy salespeople and annoying follow-up phone calls. But with insurance comparison websites, the shopper can perform initial research on the insurance companies of their choosing and contact each one knowing how their price compares to their competition. “This puts the power in the hands of the shopper, and allows them to negotiate the absolute best prices possible for their chosen policies,” said Mr. Montgomery. The new Medicare supplemental insurance comparison website has been seeing an exponential increase in views since its first release in September. Now, with the new software upgrade, the website owners are expecting their daily visits to double or even triple. In addition to the fast comparison software available on the website, the company also provides articles and a learning center to educate their visitors about Medicare and Medicare supplemental insurance. To learn more, or to get a comprehensive list of all the best Medicare supplemental insurance companies in a specific area, please visit: http://medicaresupplementalinsurancecomparison.net/ About medicaresupplementalinsurancecomparison.net Created in September of 2012, Medicaresupplementalinsurancecomparison.net was specifically built to assist medicare supplemental insurance shoppers find the absolute best rates on the Internet. Recently they updated their search software to provide better and faster results to their esteemed clientelle.
Source: sbwire.com

Video: Medicare Supplement Insurance Plans – Where Do I Start?

2013 Medicare Annual Enrollment Period: eHealth Identifies 8 Costly Mistakes for Medicare Supplement Insurance Customers / eHealth

eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, the nation’s leading online source of health insurance for individuals, families and small businesses. Through the company’s website, www.eHealthInsurance.com, consumers can get quotes from leading health insurance carriers, compare plans side by side, and apply for and purchase health insurance. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 180 of the nation’s leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia, making it the ideal model of a successful, high-functioning health insurance exchange. Through the company’s eHealthTechnology solution (www.eHealthTechnology.com), eHealth is also a leading provider of health insurance exchange technology. eHealthTechnology’s exchange platform provides a suite of hosted e-commerce solutions that enable health plan providers, resellers and government entities to market and distribute products online. eHealth, Inc. also provides powerful online and pharmacy-based tools to help seniors navigate Medicare health insurance options, choose the right plan and enroll in select plans online through its wholly-owned subsidiary, PlanPrescriber.com (www.planprescriber.com) and through its Medicare website www.eHealthMedicare.com.   
Source: ehealthinsurance.com

Medicare Home Health: Medicare Supplement Insurance

For all others, the standard Medicare Part B monthly premium will be $115.40 in 2011, which is a 4.4% increase over the 2010 premium. The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $115.40 per month. For additional details, see our FAQ titled: “2011 Part B Premium Amounts for Persons with Higher Income Levels”.
Source: blogspot.com

California Medicare Supplement Insurance » Anaki Zokuldayiz

California Medicare can be confusing. California is one of the only states that has a birthday rule regarding Medicare. You are allowed to change your California Medicare supplement on your birthday each year.
Source: anakizokuldayiz.com

What Can You Do If Your Medicare Supplement Gets Too Expensive?

Medicare B has no cap on the co-insurance amount.  If your medical bills for the year are $100,000 you have to pay $20,000.  Medicare supplement insurance will pay that for you.  If you cancel your Medicare supplement insurance, you will have to use your retirement savings, Social Security or pension income to pay your medical bills.
Source: wordpress.com

Comprehensive Guide to Medicare Supplemental Insurance

CMMS or Centers for Medicare and Medicaid Services have provided Medicare Supplemental Insurance in 10 different plans. Private insurance companies offer these plans and will help you to determine which plan would be best for you. The plans are labeled with letters from the alphabet and start with the letter A and end with the letter N. One thing to keep in mind is that there are a few of the plans that were discontinued and those were E, H and J. During the month of March in 2010 is when this plan ended, and now you can find A-F, which would equal 11 of the plans that are still available. Each plan is different and unique. Below is a list of what some of these plans are:
Source: ccardzone.com

Faultline USA: Breaking: Medicare Supplemental Insurance Premiums Skyrocketing

When Billy signed on with United Mutual of Omaha, in August of 2010, the monthly premium was $92.26. In August of 2011, his anniversary date with the policy, the premium increased to $101.49, a 10% increase which was not necessarily unexpected since at that time overall medical costs were supposedly rising at about 9% per year.
Source: blogspot.com

Medicare Supplement Insurance

In 2004, Jess and Sandra heard about some exciting options for Medicare. Jess and Sandra started to learn more about the different Medicare Advantage, Medicare Supplement, and Part D prescription plans. As Sandra puts it, “They dove into the senior market heavily; it just exploded.” Jess and Sandra have become experts in the Medicare marketplace. The demand was great back then and continues to be to this day. Sandra said, “We are certified with every company that does business here in Indiana. 80% of what we do is Medicare focused.” The annual election period is October 15 to December 7 for Medicare. “Every participant can change their current plan with Easy Street,” said Jess. Jess and Sandra look at many options to find the right plan to match each client’s needs.
Source: atcentergrove.com

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

The Benefits of Having a Medicare Supplemental Insurance Plan

Healthcare has been a long debated topic throughout modern American history. From debates over how to take care of our elderly after retirement to the recent changes in the healthcare law, there has been much to consider for everyday Americans, particularly those who take advantage of Federal benefits. The fact remains that while programs like medicare are an important aspect of post retirement life, they have become watered down over the years and simply do not cover all of the bases that they once did. Fortunately, for those who go through programs such as medicare for their healthcare needs, supplemental benefits are available to cover any unforeseen costs that medicare will not. Companies such as medicare insure phoenix az specialize in this supplemental form of insurance, providing a wide range of options to people interested in additional benefits. Below are a few reasons why supplemental insurance might be a good idea for you.
Source: ioliamo.org

Flash of Genius: Medical Matters: URGENT: WPS J8 MAC Medicare change starts at 2:00 Thursday 7/12/2012

Posted by:  :  Category: Medicare

. WPS officially starts payor id 08202 on Monday July 16, however they have announced “Dark Days” of Friday July 13 through Tuesday July 17. A dark day is a business day during the cut-over period when the Medicare claims processing system is not available for normal business operations. System dark days may occur between the time the outgoing claims administration contractor ends its regular claims processing activities and the incoming claims administrative contractor begins its first day of normal business operations. Genius is not certain what would happen if you sent Medicare claims with the new payor id between 2:01pm Thursday through 12:00am Monday.It is possible that BCBSM or WPS might hold them until they finish their dark days and process them normally, but we do not have any confirmation from BCBSM or WPS that this actually will happen. Therefore Genius recommends you do all of your Medicare billing before 2pm on Thursday July 12.Then do no Medicare billing until July 16 or later.On July 16 go to your Insurance Code Files and change payor id 00953 to 08202. Don’t change anything else and don’t change it before July 16. Click here for step-by-step instructions for changing the payor id in THOMAS. After you have changed your payor id on July 16 or later you should be able to resume sending your Medicare claims.
Source: blogspot.com

Video: WPS Medicare

All Providers are Expected to Subscribe to WPS Medicare E

The Centers for Medicare & Medicaid Services (CMS) recognizes eNews as such an important resource that they require that all Medicare contractors (including WPS Medicare) increase provider subscribership to their Listservs every year. In addition, CMS has instructed that every Medicare provider (including physicians, nurses, and billing staff) should be subscribed to eNews. It is a common belief that only one provider in an office can be subscribed to WPS Medicare eNews; however, CMS and WPS encourage and expect ALL Medicare providers to subscribe to eNews.
Source: mi-osteopathic.org

WPS Message for Indiana and Michigan ProvidersHall Render

Wisconsin Physicians Service (WPS) will soon begin to serve as the Medicare Administrative Contractor (MAC) for Jurisdiction 8, which includes the states of Indiana and Michigan.  According to listserve communications, Indiana Part A providers and Michigan Part A providers will transition to WPS effective July 23, 2012.  Indiana Part B suppliers will transition to WPS effective August 20, 2012.  WPS is currently the Part B contractor for Michigan suppliers.
Source: hallrender.com

Be Prepared! Medicare Changes May Cost You Money!

Medicare changes are frequent and may cost you money if you are not aware of recent changes.  WPS Medicare sends out a weekly eNews Listserv with the most current information you and your staff need to know.  Register for Medicare eNews by selecting the link in the top right corner labeled “eNews”.
Source: wordpress.com

Wpsmedicare.com: Medicare @ SEOValidator.Net

Wpsmedicare.com has #608,846 traffic rank in world by Alexa. This domain registered on 2004-09-17. It reaches roughly 785 unique users each day. Visitors to the site view an average of 2.4 unique pages per day. Estimated daily time on site 1:43 seconds. It has an average of 4,340 pages indexed in major search engines like Google™. There are an average of 201 links pointing back to wpsmedicare.com from other websites. Wpsmedicare.com has the potential to earn $16 USD in advertisement revenue per day. If the site was up for sale, it would be worth approximately $5,652 USD. Out of the 30 unique keywords found on wpsmedicare.com, “medicare part b” was the most dense. Wpsmedicare.com is hosted in Stoughton, WI, 53589, United States and links to network IP address 12.181.161.29. This site has Google PageRank™ 5 of 10. At the DMOZ open directory project we found no listing for this site.
Source: seovalidator.net

Wpsmedicare.com Estimated Value N/A

The data contained in GoDaddy.com, LLC’s WhoIs database, while believed by the company to be reliable, is provided “as is” with no guarantee or warranties regarding its accuracy. This information is provided for the sole purpose of assisting you in obtaining information about domain name registration records. Any use of this data for any other purpose is expressly forbidden without the prior written permission of GoDaddy.com, LLC. By submitting an inquiry, you agree to these terms of usage and limitations of warranty. In particular, you agree not to use this data to allow, enable, or otherwise make possible, dissemination or collection of this data, in part or in its entirety, for any purpose, such as the transmission of unsolicited advertising and and solicitations of any kind, including spam. You further agree not to use this data to enable high volume, automated or robotic electronic processes designed to collect or compile this data for any purpose, including mining this data for your own personal or commercial purposes. Please note: the registrant of the domain name is specified in the “registrant” field. In most cases, GoDaddy.com, LLC is not the registrant of domain names listed in this database. Registrant: Wisconsin Physicians Service Insurance Corporation Registered through: GoDaddy.com, LLC (http://www.godaddy.com) Domain Name: WPSMEDICARE.COM Domain servers in listed order: NS1.BINC.NET NS2.BINC.NET For complete domain details go to: http://who.godaddy.com/whoischeck.aspx?domain=WPSMEDICARE.COM
Source: widestat.com

Medicare Annual Wellness Visit

Answer: See page nine of Transmittal 134: It clearly states who a medical professional is. It seems to leave the door open for some “incident-to” type services such that a nurse or someone without an NCI could perform these services. Indeed, the Medicare Administrative Contractor (MAC) WPS has said that these services can be carried out by an LPN under direct physician supervision, present in the office suite, and CMS in Baltimore has said that these were “intended to be collaborative.” That said, I would get something in writing from your local carrier or MAC before I went down that road.
Source: physicianspractice.com

How doctors and hospitals have collected billions in questionable Medicare fees

Medicare has emerged as a potent campaign issue, with both Barack Obama and Mitt Romney vowing to tame its spending growth while protecting seniors. But there’s been little talk about some of the arcane factors that drive up costs, such as billing and coding practices, and what to do about them.  Our 21-month investigation documents for the first time how some medical professionals have billed at sharply higher rates than their peers and collected billions of dollars of questionable fees as a result. 
Source: publicintegrity.org

Pitfalls in Billing Pharmaceuticals to the Medicare Program

It is clear there are multiple pitfalls for the compliant billing of pharmaceuticals to Medicare Part B. Hospitals need to ensure, to the extent possible, that their pharmacy CDM is accurate with correct HCPCS and revenue codes, that unit conversion modules or tables are set up correctly, that self-administrable drugs have been identified as such and revenue code fields are set to toggle between 637 and 250 based on bill type. Noncovered drugs should be billed to the patient, not Medicare. Drugs integral to the procedure should be set up as supply items, not billed as noncovered. Nursing documentation, including that on an electronic medication administration record, should indicate date, time and nurse responsible for administration and the amount of drug given—and wasted—if any. Only wasted drugs in single-dose vials can be billed to the program and only if documentation in the medical record meets the requirements. 
Source: bkd.com