Cigna Acquires Medicare Advantage Plans From Humana Covering 3,500 in Texas

Posted by:  :  Category: Medicare

The federal government required Humana to sell the Medicare Advantage plans as part of approval for buying Arcadian Management Services. Cigna will offer the new customers Medicare Advantage plans through its subsidiary HealthSpring, which the Bloomfield-based health insurer acquired in January for $3.8 billion.
Source: courant.com

Video: Cigna Plans to Sell 15 Million Shares to Fund Purchase

Insurer Cigna to buy HealthSpring for $3.8B

Cigna is the fourth-largest commercial health insurer based on enrollment, trailing WellPoint Inc., UnitedHealth Group Inc. and Aetna Inc. It operates health care, group disability and life segments in the U.S. The insurer also has a growing international segment that sells individual insurance in several countries and operates an expatriate business that covers people living outside their home countries.
Source: ourbusinessnews.com

Cigna Management Discusses Q3 2012 Results

Sure, Scott. A few points. As we noted in our prepared comments, for 2013, given the momentum we continue to build through ’11 and ’12, our broad expectations are that we will grow revenue as well as earnings. And I’d ask you to step back and think about some of our capabilities to enable us to do that in this really challenging environment, and then I’ll comment on national accounts. First, our broad funding capabilities in the United States are very helpful, as employers of all sizes are looking for the most effective way to align their incentives and engage their employees. Secondly, our broad portfolio of specialty capabilities, health improvement and productivity capabilities continue to be a strong add to us. Third, we now have a very well-positioned Medicare Advantage portfolio of businesses. And fourth, our International portfolio of businesses will be extremely helpful to us as we step into 2013. As it relates to national accounts, the national account selling season, it’s sufficiently complete. There’s always some open switches that are in front of us. As we sit here today, we would expect for our national accounts, which we define as commercial employers with 5,000 or more employees that are multistate, so we define it more narrowly than some define it. For that marketplace, we’d expect at this point in time, overall, a good retention rate. We had an outstanding retention rate in 2012. We expect a very good retention rate in 2013. At this point in time, we see less business as having moved in either direction. So the net effect of that is we’re expecting that we will keep share or maintain share in aggregate in the national segment. We view the national segment as a shrinking segment if you track the employer profile. So that’s about a 2% shrinkage factor that we expect exists in the overall national account marketplace because of the employment pattern, and we expect to maintain share in that environment. The last thing I’d add is we expect to further grow revenue and further grow our specialty penetration in that portfolio based on the focus of repositioning that book of business.
Source: seekingalpha.com

Cigna HealthCare of Arizona Highest Rated Medicare Plan in Arizona

PHOENIX – Oct. 30, 2012 – The Centers for Medicare & Medicaid Services (CMS) recently released the results of its Five-Star rating system, which measures clinical quality and performance benchmarks for Medicare Advantage plans. Cigna HealthCare of Arizona achieved the highest overall rating in Arizona with 4.5 stars out of five stars. Scores are based on more than 50 performance measures that are collected through three surveys: HEDIS (Healthcare Effectiveness Data and Information Set), CAHPS (Consumer Assessment of Healthcare Providers and Systems) and HOS (Health Outcomes Survey)
Source: prsync.com

OPINION: 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: publicintegrity.org

Cigna (CI) And Aetna (AET) Create Acquire And Develop Businesses To Meet Growing Health Care Needs

Boxer says CI‘s technology is key to meetings the company’s goals, and he says the company’s HealthEview is a central strategy. “This application takes an individual’s health and risk factors, and applies a powerful set of algorithms that allows us to better manage health and deliver the right care in the right setting. Then we have a set of care coordinators using this application to conduct proactive outreach,” he said.
Source: healthcaretechnologyonline.com

Goon Review Cigna Provides Medicare Advantage Plans For Senior Citizens

Cigna is a well-known insurance carrier for quit some time and they’ve made it their responsibility to provide a selection of health care insurance plans like Medicare Advantage Plans intended for senior citizens in the United States. It is frequently tough for seniors who might have quite a few health conditions to obtain good insurance coverage but they would have the capacity to through Cigna. Together with offering a selection of health care coverage the firm likewise has a legal contract with the government to provide Medicare plans to seniors. Due to this they’re able to offer a number of helpful Medicare plans that an individual who is eligible for the government assisted insurance will be able to select.They not only provide your health coverage they likewise provide your medical care through Cigna Medical Group (CMG). By providing health coverage and medical care together you are able to build a solid connection with your medical doctor and your care team – experts that are committed to aiding you get the most out of your health so you can get the most out of life. And along with their CMG staff you gain access to an extensive network of more than 4000 specialists in the community – find out about medicare plans with Cigna.To start with Cigna offers Medicare prescription medication plans. As everyone knows prescription medications could be very costly. A few of the medicines could cost more than one hundred dollars a month. Numerous senior citizens have to take several medications each day and that can cost more than a fixed income could afford. Cigna offers two different prescription medication plans that you can take into consideration. The details of the two are below.Cigna Medicare RX Basic would go in conjunction with most parts of Medicare and it’s obtainable in every state of the nation. The plan has a selection of valuable benefits. For instance it does not include a deductable that will keep you from having to pay with your own money. Furthermore it would continue to pay for prescriptions even through the Medicare donut hole which will cut off most healthcare coverage. Generally generic medication through this plan would cost nothing out of pocket. Cigna Medicare Select Plus Rx is only included in the state of Arizona and it will work just with Medicare HMP plans. With this option you will actually get some healthcare together with prescription medications. The plan doesn’t have any monthly cost and it has no deductibles to reach. Prescriptions are available at a discount and the plan would even help to pay on physician’s appointments.In addition to these two prescription plans Cigna likewise offers Medicare Advantage Plans. They just recently eliminated the option of the HMO plans yet others are available to people who qualify for Medicare. Not all of these plans are available in every state so it would be important to research precisely what is available in your state before determining if these plans are best for you.
Source: fc2.com

Should You Invest in This Healthcare Takeover?

WellPoint purchased AMERIGROUP Corporation (NYSE:AGP) for almost $4.5 billion, in a deal that makes the combined companies the largest private Medicaid enterprise by membership. WellPoint is expecting operating revenues to rise almost 2% in 2012, and operating EPS of $7.45 compared to 2011’s $7.00 total. However, the company’s CEO did step down a month ago, in part due to several large investors being disappointed over company execution. AMERIGROUP is expected to increase premium revenues by 40% in 2012, driven by expansion in existing markets and entry into Louisiana, expansion in Texas and the May 1st acquisition of Health Plus. Health benefits costs are expected to rise to 86% of premium revenues (health benefits ratio), from 2011’s 83.7% mark.
Source: insidermonkey.com

Cigna: A Lot Riding On Managed Medicare

Higher debt levels of 60% of equity — the worst amongst its peers in our table above, has crimped profits and hurt its chances for further acquisitions. This industry, which is characterized by cut throat competition and little product differentiation, needs further consolidation and Cigna’s comparatively lower cash hoard makes acquisition led growth difficult in the future.
Source: seekingalpha.com

Senior Benefit Services, Inc.

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSEffective November 10, 2012 on new business & January 1, 2013 in force business for Gerber 2010 Modernized Medicare Supplement plans in Idaho and Medicare Supplements and SELECT plans in Utah. The Rate Adjustments will affect plans  A, B, and C.
Source: srbenefit.com

Video: How to Find Best Medicare Supplement Rates In Florida

Medicare Supplement Insurance Coverage

For what ever purpose, your tooth, eyes, and ears are not viewed as components of the physique that are coated where well being insurance is worried.  As a result, since they are excluded from almost all overall health insurance strategies, the only way to get coverage for these important places of remedy is with individual dental insurance policy, eyesight insurance, and listening to insurance coverage ideas.While hearing insurance policies programs are rare, MWG Insurance policy Mall can help you discover a dental plan and/or a vision plan within your funds.The individual ideas support to go over yearly consultation costs as properly many treatments and/or methods.Even though person insurance policies plans are normally a lot more costly than family members or group ideas, by employing some of the greatest firms in the industry, MWG Insurance coverage Mall gives each specific dental and person eyesight ideas for you and your family at the most competitive rates readily available.
Source: hugohosting.com

fri9nds: On Line Medicare Supplement Insurance Rates

The program Y can pay your Medicare Part B deductible and your Medicare Part A deductible. In other words, Medicare will pay 80% of your charges and your complement will get the rest of the 20%. You need to rarely have any medical bills out of your wallet.
Source: fri9nds.com

How Can I Get The Best Medicare Supplement Rates?

While some people opt for a higher deductible, could you realistically pay the bills should an extended stay be deemed necessary? Would a lower deductible be more beneficial? Also, a secondary policy does not ensure a co-pay will not still exist. Even after your deductible has been met you may have to pay a small balance to doctors and facilities that do not accept assignment.
Source: seniorcorps.org

Buying a Medicare Supplement

The information contained in this report does not purport to be a complete description of the developments referred to in this material. The information has been obtained from sources considered to be reliable, but we do not guarantee that the foregoing material is accurate or complete. Any information is not a complete summary or statement of all available data necessary for making an investment decision and does not constitute a recommendation. Any opinions are those of Medicare.gov and not necessarily those of RJFS or Raymond James.
Source: formanis.com

Medicare Supplement Insurance Plans & Rates

a%3A15%3A%7Bs%3A18%3A%22allow_email_notify%22%3Bs%3A3%3A%22yes%22%3Bs%3A8%3A%22approval%22%3Bs%3A4%3A%22auto%22%3Bs%3A10%3A%22blurbCount%22%3Bs%3A1%3A%225%22%3Bs%3A17%3A%22fb_twitter_notify%22%3Bs%3A2%3A%22on%22%3Bs%3A7%3A%22options%22%3Bs%3A257%3A%2275c92e93a656ab51c524dacdc9780076%2CAnthem+Blue+Cross%2Caee9856fff3600da1c9b15283b5bed71%2CBlue+Shield+of+California%2Cb70fdb7dcf69c7709dfb43bfa05dd9df%2CHealth+Net%2C23e26d2db7849d6a7b827c25c2df80d1%2CUnited+of+Omaha+Mutual+of+Omaha%2Cece9d6f84775425f5cdd1c453118f8ce%2CAetna%22%3Bs%3A6%3A%22period%22%3Bs%3A1%3A%220%22%3Bs%3A5%3A%22photo%22%3Bs%3A16%3A%221337795452-a.jpg%22%3Bs%3A11%3A%22photo_label%22%3Bs%3A25%3A%22Medicare+Supplement+Plans%22%3Bs%3A10%3A%22photo_link%22%3Bs%3A49%3A%22http%3A%2F%2Fwww.medicaresupplementplans.com%2Fplans.html%22%3Bs%3A9%3A%22photo_url%22%3Bs%3A55%3A%22draft_lens19500704module159300754photo_1337795452-a.jpg%22%3Bs%3A12%3A%22requireLogin%22%3Bs%3A5%3A%22false%22%3Bs%3A9%3A%22sendEmail%22%3Bs%3A2%3A%22no%22%3Bs%3A12%3A%22showComments%22%3Bs%3A3%3A%22yes%22%3Bs%3A10%3A%22showPhotos%22%3Bs%3A3%3A%22yes%22%3Bs%3A9%3A%22stripHTML%22%3Bs%3A3%3A%22yes%22%3B%7D
Source: squidoo.com

Many Blue Medicare Supplement Rates are Lowered for 2012

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Source: richdayhealthplans.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

Medicare, Abortion Grab Attention In Some House, Senate Races

Posted by:  :  Category: Medicare

gutted bag by jason.odonnellPolitico: 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

Video: Health Insurance in Indiana

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 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

Indiana Farm Bureau Offers New Medicare Supplement Plans Benefit

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Source: hoosieragtoday.com

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

Social Security and Medicare : Indiana Personal Injury Lawyers

So, if you are not eligible for Medicare, what are your options?  Most people who are eligible to receive funds from the SSI program are eligible for Medicaid.  So what is the difference.  The two programs, Medicare and Medicaid are two distinct medical insurance programs.  They are operated by distinct government offices.  Medicare is a strictly federal program and is based on your contributions during your working life.  Medicaid is a State run program.  It consists mainly of federal dollars, with some contribution by the State. It is a need based program.  This means that if you fall below a predetermined income level, and asset level, you are likely eligible for Medicaid.  There are several restrictions on Medicaid, as there are in cases involving SSI.  One such restriction is the amount of assets you are allowed to have.  This is a very low number, and if your assets are above this number, you will have to spend these assets down prior to your eligibility for Medicaid.
Source: youngandyoungin.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

CMS officials issue reminder on Medicare secondary payer laws

Posted by:  :  Category: Medicare

DC Voting Rights by dbkingParticipating Medicare providers, physicians, and other suppliers must not accept from beneficiaries any co-payments, coinsurance payments, or other payments, for services rendered when the primary payer is an employer-managed care organization (MCO) insurance plan, or any other type of primary insurance such as an employer group health plan, U.S. Centers for Medicare & Medicaid Service (CMS) officials warned in a new Medicare Learning Network (MLN) Matters® article last month.
Source: newsfromaoa.org

Video: Billing Medicare as Secondary Insurance

Ohio Workers’ Comp Settlements & Medicare

 In Ohio attorneys for injured workers are normally paid a contingent fee on settlements of workers’ compensation claims.  The attorney fee (typically between 25 percent and 40 percent) is charged on the gross amount of the settlement.  The question has been raised as to whether an attorney can charge a contingent fee on the medical portion (MSA portion) of the settlement.  In Ohio there is no prohibition on an attorney charging a contingent fee on the medical portion of a settlement.  Rule 1:5 of the Rules of Professional Conduct permits a reasonable contingent fee with no restriction regarding the medical portion of a settlement. At least one court decision directly addressed this issue. In Hinsinger v. Showboat Atlantic City, 2011 N.J. Lexis 96 (January 21, 2011), the issue was whether the CMS regulations and directives permit an attorney to recover fees for a judgment or settlement obtained on behalf of a client from the Medicare set-aside itself.  The court held that the attorney could recover fees from the MSA.  The court recognized the value of the legal services of the attorney in achieving the entire settlement including the MSA portion of the settlement.  Keeping in mind that the attorney fee must be reasonable, I have been unable to find any prohibition to an attorney charging a contingent fee on the MSA portion of an Ohio workers’ compensation settlement.
Source: hnb-law.com

Where Do We Stand On the Tenth Anniversary of the Medicare Secondary Payer Industry

The Patel memo resulted in a lot of frenzy and confusion, with attorneys and many others in the property and casualty industry coming to believe that CMS approval was required by law, while others, such as Jennifer C. Jordan, Esq., General Counsel at
Source: lexisnexis.com

Rockford Mutual News: Medicare Secondary Payment Bill Moves Forward; Enjoys Wide Support

A House panel today reported out legislation that would streamline enforcement of the Medicare Secondary Payment program. The legislation, H.R. 1063, is the SMART Act, or The Strengthening Medicare and Repaying Taxpayers Act.  read more..
Source: blogspot.com

House Panel Approves Changes to Medicare Secondary Payer (MSP), Medical Loss Ratio Rules : Health Industry Washington Watch

On September 20, 2012, the House Energy and Commerce Committee approved by voice vote H.R. 1063, the Strengthening Medicare and Repaying Taxpayers (SMART) Act. The legislation would make a series of procedural changes to MSP rules intended to “speed up the process of returning money to the Medicare Trust Fund while reducing costly legal barriers for both large and small employers.” The panel also approved on a 16-14 vote H.R. 1206, the Access to Professional Health Insurance Advisors Act. The legislation would amend the Affordable Care Act’s (ACA) health insurance medical loss ratio (MLR) rules to exclude from the calculation of the MLR certain commissions paid to independent insurance brokers and agents. H.R. 1206 also would require HHS to defer to a state’s determinations as to whether enforcing the MLR requirement will destabilize their respective individual or small group health insurance markets. Neither bill has been considered by the full House to date.
Source: healthindustrywashingtonwatch.com

Data About Medicare Supplemental Insurance coverage Protection

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Source: fluxfeatures.com

What Is The Benefit And Features Of Medicare Supplemental Insurance Texas Compared With Other Plans

Insurance is becoming intended to deal with any damage or risk of lifestyle, developing, property, valuables, and so on and it is being paid towards the insured or towards the nominee as no matter what relevant. The insurance is usually a mixture of group savings exactly where quite a few utilised to discuss a smaller amount of premium and made use of to reveal the risk of any 1 among the group which concept developed and it is getting completed as company by numerous monetary businesses. The kinds of insurance are lifestyle, health-related, theft, transit, hearth, and so on and also the most well-liked is life and health care insurance exactly where this covers the life of the insured and utilised to pay the sum assured at the time of maturity and at the level of danger. Healthcare insurance coverage is becoming offered a whole lot when compared to lifestyle insurance coverage, as the health-related insurance coverage is being designed in a way that it addresses a lot of the medical expenditures from the insured. The new plan in health-related insurance coverage is http://www.texasmedigapinsurance.com/medicare-supplemental-insurance-texas, that is getting regarded as as extra insurance which addresses nearly all varieties of medical expenses at the hospital or for your stop by to medical doctor. Largely the health-related insurance only addresses 80% in the expenditures billed to insured plus the rest has to be paid by the insured, and also there could be deduction and this kind of is instantly deducted. To discover the best medicare supplement insurance Texas 1 can evaluate the top estimates provided from the providers within the medical insurance coverage company and can choose the most effective depending on the estimate, premium, community hospitals, diseases coated, and also other terms and situations, by this according to the quantity of amenities provided and by evaluating the top quality using the quantity insured it will be most effective to return to your summary to select the very best medical insurance provider in and about Texas region.
Source: wordpress.com

Medicare Secondary Payer and “Future Medicals” A Movement Toward a Standardized Process?

CMS states that its interests should be considered in every settlement where the claimant, “reasonably anticipates receiving, or should have reasonably anticipated receiving Medicare covered…services after the date of “settlement…”.  To accomplish this purpose, CMS proposes options  ranging from absolute exemptions on one end of the spectrum (i.e., CMS defined a set of circumstances in which no further action would be necessary / no “set aside” required) to alternatives on the other end of the spectrum that involve a) the beneficiary paying for all future injury-related care out of his/her settlement proceeds until they are exhausted or b) submitting a proposed Medicare Set Aside arrangement (similar to the current process in workers’ compensation).With regard to the latter options, it is important to note that CMS acknowledges that perhaps thresholds could be established (i.e., a dollar amount below which no action is necessary even if one of the other exemptions do not apply).
Source: dritoday.org

Why Medicare Supplemental Insurance Is Good

When I retired, I thought  Medigap insurance would take care of all of my medical bills I had, but it is rather hard to keep up with my medical bills. This is when I decided to start to explore the basics of the Medicare supplemental insurance plans which are available to me. Once I did this, I knew I would get one of these plans to help me save quite a bit of money on any of the doctor bills I had. Without this I would have problems in paying my medical bills because of the amount of money I owed on just one hospital stay, let alone on any future medical bills.
Source: exportscience.org

Simplee Adds Medicare Support In Its Quest To Become The Mint.com Of Your Health Care Expenses

Simplee, which had already provided coverage for 80% of insurers in the U.S., says its platform will help Medicare patients wade through the complex maze of claims and benefits. This becomes especially complicated for the many beneficiaries who are covered under secondary insurance, because health care claims go through the separate insurance companies for payment. That makes it hard for Medicare patients to get a simple picture of their disparate claims, bills, and benefits, which in turn could make them vulnerable to missed benefits.
Source: fastcompany.com

THE MEDICARE SECONDARY PAYER RECOVERY PORTAL, A NEW ONLINE SELF

The Centers for Medicare & Medicaid Services (CMS) have implemented a new web-based tool that was created to assist parties resolve liability insurance, no-fault insurance, and workers’ compensation Medicare recovery cases. The tool is called the Medicare Secondary Payer Recovery Portal (MSPRP) and it provides users with the ability to access case specific information over the Internet, replacing written communication and the necessity of placing calls to a Medicare Secondary Payer Recovery Contractor. The MSPRP will allow users to perform various activities, including submitting proof of representation or consent to release documentation, requesting conditional payment information, disputing claims included in a conditional payment letter, and submitting case settlement information.
Source: themedicarespa.com

Medicare Secondary Payer (MSP) Program: Proposed Rules for the Treatment of Funds Intended for Future Medical Expenses 

[1] See 77 Federal Register 35917 (June 15, 2012), [CMS–6047–ANPRM].  [2] See section 1862(b) of the Social Security Act (the Act), 42 U.S.C. §1395y(b)(2)(Medicare Secondary Payer Program) http://www.ssa.gov/OP_Home/ssact/title18/1862.htm. [3] 42 U.S.C. §1395y(b)(2)(B). [4] 42 U.S.C. §1395y(b)(2)(B)(i). [5] 42 U.S.C. §1395y(b)(2)(B)(iv). [6] 42 U.S.C. §1395y(b)(2)(B)(iii). [7] For information about CMS activity related to MMSEA, see http://www.cms.gov/Medicare/Coordination-of-Benefits/MandatoryInsRep/index.html?redirect=/mandatoryinsrep/. [8] See §111, 42 U.S.C. §1395y(b)(8). [9]  See 42 U.S.C. §1395y(b)(8)(B). [10]  See 42 U.S.C. §1395y(b)(7). [11] See, Reporting Workers Compensation case information: https://www.cms.gov/Medicare/Coordination-of-Benefits/WorkersCompAgencyServices/reportingwc.html; set-aside arrangements: https://www.cms.gov/Medicare/Coordination-of-Benefits/WorkersCompAgencyServices/wcsetaside.html; coordination of benefits: https://www.cms.gov/Medicare/Coordination-of-Benefits/WorkersCompAgencyServices/WCMSAP.html. [12] In commenting, please refer to file code CMS–6047–ANPRM. CMS will not accept comments sent via FAX. Comments may be submitted electronically to http://www.regulations.gov; via regular mail (Attention: CMS–6047–ANPRM P.O. Box 8013, Baltimore, MD 21244–8013); express or overnight mail (Attention: CMS-6047-ANPRM, Mail Stop C4-26—5, 7500 Security Boulevard, Baltimore, MD 21244-1850; or by hand or currier (Room 445– G, Hubert H. Humphrey Building, 200 Independence Avenue SW., Washington, DC 20201., telephone (410)-786-1066 in advance of delivery by hand or currier.)
Source: medicareadvocacy.org

Gould & Lamb to Host Medicare Secondary Payer Compliance Breakout :Gould & Lamb

Program Moderator, Bret Cade, Executive VP of Sales at Gould & Lamb, LLC will lead the day long seminar. Planned presentations include Medicare Secondary Payer Act 101: The Reader’s Digest Version by Roy Franco, Esq., Principal at Franco Signor, LLC, The Eye in the Sky: Mandatory Insurer Reporting by Scott Huber, Vice President of Information Technology at Gould & Lamb, LLC and Jeff Gurtcheff, VP and General Manager at PMSI, Render Unto Caesar What is Caesar’s: Conditional Payments  Resolution by Wanda Reas, Esq., Partner at Znosko & Reas, P.A. and John Cattie with the Garretson Resolution Group, So Let It Be Written, So Let It Be Done: A Legislative and Case Law Update by Mark Popolizio, Esq., Senior Legal Counsel at Crowe Paradies and Roy Franco, Esq., Principal at Franco Signor, LLC, Seeing the Forest Through the Trees: MSA/LMSA Trends by Rafael Gonzalez, Director of Medicare Compliance & Post Settlement Administration at Gould & Lamb, LLC, Celia Mendez, Esq., Mediator & Attorney at Moreland & Mendez, P.A., and Cynthia Sage, Esq., Corporate Counsel at FCCI Insurance Group. The program will end with MSP Compliance in the Real World: A Roundtable Discussion where all of the previously mentioned speakers will be joined by Skip Brechtel, Chief Technical Officer at CCMSI, Wade McGuffey, Esq., of Goodman, McGuffey, Lindsey & Johnson, LLP, and the Honorable David Langham, Deputy Chief Judge of Workers’ Compensation Claims.
Source: themedicarecomplianceblog.com

Medicare Supplement Insurance Coverage

Posted by:  :  Category: Medicare

For what ever purpose, your tooth, eyes, and ears are not viewed as components of the physique that are coated where well being insurance is worried.  As a result, since they are excluded from almost all overall health insurance strategies, the only way to get coverage for these important places of remedy is with individual dental insurance policy, eyesight insurance, and listening to insurance coverage ideas.While hearing insurance policies programs are rare, MWG Insurance policy Mall can help you discover a dental plan and/or a vision plan within your funds.The individual ideas support to go over yearly consultation costs as properly many treatments and/or methods.Even though person insurance policies plans are normally a lot more costly than family members or group ideas, by employing some of the greatest firms in the industry, MWG Insurance coverage Mall gives each specific dental and person eyesight ideas for you and your family at the most competitive rates readily available.
Source: hugohosting.com

Video: Medicare Benefits Made Clear: News, Reform & Obamacare Exposed!

Medicare Supplemental Insurance Comparison Website Announces Brand

A 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

Do You Need Medicare Supplemental Insurance?

One huge benefit of a Medicare supplemental insurance plan is that it will not be nearly as expensive as a traditional plan. After all, the supplemental insurance will not have to cover all of your bills. This reduces the risk by reducing the total amount of money that you will need. Even though you will feel like you are getting a high level of coverage, the insurance company will not feel the same pressure. For example, perhaps you have $10,000 worth of bills and Medicare will only pay for $8,000. The insurance plan merely has to pick up the extra $2,000. Therefore, you can pay as much as you would for low level coverage, but you will get a much better service.
Source: loneframe.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

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: What Is Medicare Supplemental Insurance?

Medicare is an entitlement program created by the federal government as its principal health care plan for seniors. To qualify for Medicare all you need to do is reach the age of 65, become permanently disabled or have end stage renal disease. Medicare was originally created to help our elderly with the burden of paying for health care. Medicare is not free however; recipients pay a monthly premium as well as portion of the cost of services they receive as a co-payment or deductible amount.
Source: blogspot.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

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

Daily Kos: Elderly will be hit hard by Romney’s Medicare, Medicaid plans

Posted by:  :  Category: Medicare

George W. Bush by cliff1066™As it turns out, what we know for sure about Mitt Romney’s assault on senior citizens may pale compared to what we don’t. Romney, after all, has promised to magically offset $5 trillion in tax cuts and $2 trillion in new defense spending over the next decade by closing as yet unnamed tax credits, deductions and deductions. But among Uncle Sam’s $1.1 trillion in annual tax expenditures are a host of tax breaks for the elderly. That figure is forecast to hit almost $1.4 trillion by 2015. While the home mortgage and health expense deductions top that list, untaxed Social Security benefits will reach $44 billion annually in three years. And that’s just one example. Mitt Romney has called for raising the retirement age to 67 for those now 55 and under. (In his 2008 campaign, Romney supported President Bush’s proposal to privatize the retiree pension system.)
Source: dailykos.com

Video: Paul Ryan Talking Medicare in Florida

Ryan Vows to Protect Medicare at Florida Retirement Community

Betty Ryan Douglas was on stage with her congressman son Saturday at the world’s largest retirement community as the Republican campaign tried to blunt withering criticism from President Barack Obama and his allies. The Democratic team charges that presidential candidate Mitt Romney and Ryan would gut programs for older people.
Source: theroot.com

Medicare Enrollment in Florida

You can go online to request they contact you by clicking here or call them at 1-800-963-5337 to request an appointment with a SHINE volunteer.  If you cannot locate one in your county (or it’s taking too long for them to get back to you), you can request an appointment with someone in an adjacent county.  Also, visit SHINE’s website for community events going on in your county now through December 7
Source: ohalllaw.com

Divided, but along which lines?

A political consultant, writer and family man, Jason Stanford has been living in Texas since they chose George W. Bush over Ann Richards, and he won’t let them forget it. He is the co-author of “Adios Mofo: Why Rick Perry will make America miss George W. Bush,” writes a syndicated column for Cagle Cartoons and blogs for The Huffington Post.
Source: jasonstanford.org

Two South Florida Doctors Sentenced to 10 Years in Prison for Medicare Fraud

Tag Words: Medicare, Medicare audits, Medicare fraud, termination of Medicare billing privileges, Centers for Medicare & Medicaid Services (CMS), corrective action plan (CAP), request for reconsideration, physicians, medical groups, medical practices, fraud prevention, Medicare number revocation, Medicare termination, OIG special agents, FBI, Medicare Fraud Strike Force, defense attorney, defense lawyer, Florida defense attorney, Florida Medicare lawyer, Florida Medicare attorney
Source: thehealthlawfirm.com

Detailing Medicare’s 2013 Doc Pay Schedules: Home Health Flat, Primary Care Up

Medpage Today: Medicare Sets 2013 Physician Fee Schedule Family physicians will receive up to a 7 percent boost in Medicare payments in 2013, and other primary care providers will receive 3 percent to 5 percent more, under a final rule announced Thursday by the Centers for Medicare and Medicaid Services (CMS). Much of the increase in the physician fee schedule reimbursement will come from new added payments for coordinating a patient’s care in the 30 days following a hospital or skilled nursing facility stay. Under the rule, providers will for the first time receive a separate payment to help a patient transition back to the community following a discharge. The American Medical Association (AMA) said it was pleased that the transition payments — which were suggested by a work group that the association participated in — had been adopted (Pittman, 11/1).
Source: kaiserhealthnews.org

Senior Care in Gulf Breeze, FL: 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: homecarenwfl.com

Whistleblower Alleges Overbilling Of Medicare By Florida Hospice

Douglas Stone was an executive at the Hospice of the Comforter, based in Altamonte Springs, when he learned that the company was overbilling Medicare for patient stays. He filed a whistleblower lawsuit alleging Medicaid/Medicare fraud against the Florida nursing home a year ago; the U.S. Department of Justice recently intervened and will now be pursuing the Medicare fraud claims.
Source: federalwhistleblowerlawyers.com

Medicare, Health Law Are Common Themes In House And Senate Races

Posted by:  :  Category: Medicare

peace by MBK (Marjie)The Associated Press/Wall Street Journal: Spending By Outside Groups Rocks Many House Races Rep. Dan Lungren knows what it’s like to have a big bull’s eye plastered on his back. The Democratic Party and labor and environmental groups have spent $4.7 million on TV commercials and other efforts to unseat the nine-term Republican congressman from California. That makes him one of the biggest targets of outside groups, which are throwing unprecedented sums of money into House races this year. “I don’t recognize the person they’re portraying,” Lungren said about the ads that paint him as an ally of Wall Street and enemy of Medicare and abortion rights. He added, “Yeah, these ads have a considerable impact” (10/27).
Source: kaiserhealthnews.org

Video: Medigap Insurance Supplement in Missouri by 1-800-MEDIGAP®

Dean of University of Missouri

The radiologists, Dr. Kenneth Rall and Dr. Michael Richards, are alleged to have billed Medicare for radiologic studies that only residents read; the two attending radiologists did not over read the studies yet billed Medicare as if they had. It is unclear how much money the department accepted from Medicare as a result of these practices or how long ago the alleged fraudulent practices began. Dr. Rall was the chairman of the department of radiology until December 2011, when he resigned because of these issues. A month after his resignation, the Columbia Tribune also discovered that 62.5% of imaging studies within the department did not have legitimate physician orders.
Source: pathologyblawg.com

Seniors: Check Your Medicare Part D Plan Annually

Sandy Dailey of CLAIM, or Community Leaders Assisting the Insured of Missouri says a review is not just for those new to the prescription drug program. Insurance companies may change their drug coverage from one year to the next, so everyone is encouraged to evaluate their options annually.
Source: khmoradio.com

Senior Medicare Patrol Alert

If you have experienced any of the behaviors listed above, please call the Missouri SMP (Senior Medicare Patrol) at 1-888-515-6565.  The Missouri SMP has trained staff and volunteers who work with CMS and the Missouri Department of Insurance to report complaints of inappropriate behavior and assist beneficiaries in making informed decisions about their healthcare coverage.
Source: ma4web.org

Missouri Bus Tour Protesting Cuts in Veterans’ Benefits, Medicare & Social Security to Travel State

“There are 47 percent of the people who will vote for the president no matter what. All right, there are 47 percent who are with him, who are dependent upon government, who believe that they are victims, who believe the government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you-name-it. That that’s an entitlement. And the government should give it to them.”
Source: patch.com

USDOJ: Missouri Hospital System Agrees to Pay $9.3 Million to Resolve False Claims Act and Stark Law Violations

Freeman Health System, a healthcare provider and hospital system located in Joplin, Mo ., has agreed to pay $9,316,139 to resolve allegations that it violated the Stark Law and the False Claims Act by knowingly providing incentive pay to physicians in a manner that violated federal law, the Justice Department announced today.    The Stark Law forbids a hospital from billing Medicare for certain services referred by physicians that have a financial relationship with the hospital.   A prohibited financial relationship includes an agreement between a hospital and a physician to compensate a physician based on the volume of the physician’s referrals or the revenue realized through those referrals.   Freeman disclosed to the United States Attorney for the Western District of Missouri that a number of its physicians were eligible for incentive compensation that may have taken into account the value and volume of their referrals.   Based on its investigation of Freeman’s disclosures, the United States alleged that Freeman knowingly compensated some of its physicians in a manner that violated the Stark Law.   Specifically, the United States alleged that Freeman provided incentive pay to 70 physicians employed at clinics operated by the health system based on the revenue generated by the physicians’ referrals for certain diagnostic testing and other services performed at the clinic, and that this financial arrangement created an incentive to refer patients for such procedures. “Today’s resolution underscores our commitment to ensure that health care decisions are based on the best interests of patients rather than the personal financial interests of referring physicians,” said Stuart F. Delery, Acting Assistant Attorney General for the Department’s Civil Division. “The Department of Justice encourages companies to disclose potential violations of law, as was the case here .” “Our priority is protecting the patients,” said David M. Ketchmark, Acting United States Attorney for the Western District of Missouri. “These laws are intended to ensure that physicians make referrals for health care services based solely on the medical needs of their patients rather than any financial incentives. These laws also protect the integrity of the government-funded health care benefit programs.” This resolution is part of the government’s emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover $10.1 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 are over $13.8 billion.   This case was handled by the Department of Justice’s Civil Division, the United States Attorney’s Office for the Western District of Missouri, the Office of Inspector General of the United States Department of Health and Human Services, and the FBI.   The claims settled by this agreement are allegations only, and there has been no determination of liability. Contact: Department of Justice Main Switchboard – 202-514-2000 Reported by: US Department of Justice
Source: 7thspace.com

AHA Sues HHS, Says Medicare is Refusing to Pay for Necessary Care

The hospitals contend that HHS is refusing to reimburse hospitals when in hindsight it determines the care could have been provided in an outpatient facility or department rather than the inpatient part of the hospital. The hospitals argue that physicians are the ones who decide whether to admit a patient to the hospital, and complications such as age and chronic conditions play a factor in the decision.
Source: ihealthtran.com

When It’s Time To Buy Health Insurance: All You Need To Know

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSRead the handbook your health care provider gives you when you sign up. You may need to know about certain benefits if you get sick in the future. When you purchase health insurance, you’ll receive a manual that provides you with in-depth details about your policy. In order to fully comprehend the benefits and limitations of your policy, you need to carefully read the entire booklet. This might seem boring or overwhelming, but you never know when you’ll need to take advantage of particular benefits.
Source: posterous.com

Video: Is Freedom Blue PPO a Medicare Supplement?

Anthem Extras Package Now Available In Virginia…

Based in beautiful Jackson Hole, Wyoming, we currently market health insurance in 18 different states from our website IndividualHealth.com. I have worked in the domestic and international markets for most of my adult life. Recently we launched a newly revamped website www.tetonmarketing.com which has a primary focus on music and Native American Flutes and hand crafted items made in Wyoming. Check it out! I want the Insurance Simplified Blog to be a place you can visit from time to time and read about real world issues that individuals and families face daily. Our parent website IndividualHealth.com we like to think of as a virtual brochure. But with the blog I want to talk about the topics behind the brochure. Also check out our blog www.JacksonHoleTim.com which is “All Things Wyoming, Everything Jackson Hole” . If you love the Yellowstone basin this is blog for you! Then when you are ready check out our new Social Network site Jacksonholetim.ning.com – this is a place you can connect with other who visit and live in Wyoming. And finally we have just launched another new blog. Jackson Hole Tim (www.jacksonholetim.com) is a new place to visit that talks about “All things Wyoming, Everything Jackson Hole”. I hope you find these blog helpful.
Source: wordpress.com

Anthem Medicare Supplement Rates Connecticut 2012 « Insurance News from Crowe & Associates

The Anthem Blue Cross Blue Shield Supplements for 2012 are attached to the posting. The rates are competitive with most carriers but are slightly higher than the AARP lines of Supplements. The Anthem High deductible F supplement is a very strong offering that should be considered by anyone with a Medicare Supplement in Connecticut. AARP does not currently offer a high deductible F in Connecticut. Look at other posts on our blog for additional information on the High Deductible F plan.
Source: croweandassociates.com

Update Regarding Anthem Medicare Supplement Rate Adjustments in Colorado

The state of Colorado has approved a move by Anthem Blue Cross Blue Shield to keep rates for its Medicare Supplement plans the same in 2010 as they were in 2009. Accordingly, there will be no rate change for Anthem Medicare Supplement plans available in Colorado. However, Anthem Blue Cross Blue Shield does remind customers that there is no rate guarantee for new businesses. More information about rate adjustments Rate adjustments for Medicare plans are common and are seen as necessary by health insurance providers for several reasons. One of the most common reasons for rate adjustments has to do with the increase in deductibles and coinsurance amounts from the Center for Medicare and Medicaid Services that became effective on January 1, 2010. As of January 1, 2010, CMS increased the Medicare Part A deductible from $1,068 to $1,100. Part A coinsurance amounts increased from $267 to $275 per day for hospital stays from the 61st day in the hospital through the 90th day in the hospital. The coinsurance rate increase from $534 to $550 per day for the 60 lifetime reserve day. Also, coinsurance for Skilled Nursing Facility Care increased from $133.50 per day to $137.50 per day for days 21 through 100. There were also changes to Medicare Part B deductibles; the deductible amount will increase from $135 to $155 per month and the premium rate will increase from $96.40 to $110.50 per month. There will be no corresponding increase in Social Security benefits in 2010 to help cover the cost of the increased rates. Also, based on income filing status, the CMS has set a higher Medicare Part B premium rate for higher-income participants and couples. Again, Anthem Blue Cross Blue Shield subscribers may have the same rates in 2010 as they had in 2009 because of Anthem’s choice to forgo the rate increase. According to Blue Cross Blue Shield, instead of increasing cost of coinsurance and deductibles to customers, Anthem Blue Cross Blue Shield plans will cover these increases as long as the plan already covers deductibles and coinsurance amounts. As a result, the amount of money that Anthem pays out to health care providers in benefits for its participating members will increase. Another reason that many rates for health insurance plans increase is become of the increased cost in providing health care services. This cost correlates to an increase in the number of Medicare beneficiaries who also enroll in Medicare Supplemental insurance plans. According to Anthem Blue Cross Blue Shield, the health insurance provider received the cost and use of its Medicare Supplemental insurance benefits and determined that they do not need to change the premiums for the plans for Colorado residents yet. The move to keep the rates the same as they were in 2009 will help to save Anthem Medicare Supplemental insurance plan members money. Medicare Supplemental insurance helps to cover the doughnut hole coverage gap that applies to many individuals enrolled in traditional Medicare plans. With Supplemental insurance, participants can have increased coverage even when traditional Medicare plans do not provide adequate coverage for their healthcare services or products. Medicare beneficiaries should work with an experienced Medicare advisor to learn more about which Medicare Supplemental insurance plans are right for them.
Source: submityourarticle.com

Medicare Supplement companies

The state of Colorado has already authorized a move with Anthem Azure Cross Blue Shield to keep rates because of its Medicare Supplement plans the same in 2010 as these were in 2009. Appropriately, there appears to be little rate change for Anthem Medicare Supplement plans found in Colorado. However, Anthem Azure Cross Glowing blue Shield does prompt shoppers there is no rate guarantee for unique businesses. More info about rate changes Speed adjustments for Medicare plans are really typical and they are spotted because needed with health insurance services for several factors. The most common grounds for speed adjustments may need to do with the increase in deductibles and coinsurance levels from the Center for Medicare as well as Medicaid Solutions. CMS increased the Medicare Element A deductible from $1,068 to $1,ABSOLUTELY. Element A coinsurance amounts increased from $267 to $275 everyday for medical center remains from the 61st day within the medical center through the 90th day within the hospital. The coinsurance speed increase from $534 to $550 a day for the 60 lifetime reserve day. Moreover, coinsurance for Skilled Breastfeeding Facility Proper care increased from $133.50 daily to $137.50 per day for days 21 through 100. There had been also changes to Medicare Piece B deductibles; the deductible amount will increase from $135 to $155 per month and then the premium pace definitely will increase from $96.40 to $110.50 per month. There appears to be no corresponding increase in Personal Security benefits in 2010 to help cover the price of the increased rates. Additionally, based upon money submitting status, the CMS has poised a higher Medicare Piece B premium pace for higher-income participants and partners. Once again, Anthem Blue Cross Azure Protect customers might have the same rates because of Anthem’s choice to forgo the rate increase. According to Blue Cross Blue Shield, rather of increasing cost of coinsurance and also deductibles to customers, Anthem Blue Cross Blue Protect plans will take care of these increases because long as the program already covers deductibles and also coinsurance amounts. Since a happen, the amount of money that Anthem pays out to health related services in advantages because of its participating subscribers definitely will increase. Another cause that many rates for medical insurance plans increase is become of the increased are priced at in providing healthcare solutions. This are priced at correlates to an increase in the quantity of Medicare beneficiaries whom also enroll in Medicare Supplemental insurance plans. According to Anthem Glowing blue Cross Glowing blue Protect, the wellness insurance provider received the cost and employ of its Medicare Supplemental insurance policies advantages and additionally determined that they do definitely not must change the premiums for the plans for Colorado citizens but. The move to keep the rates the exact same since the two were in 2009 can help to save lots of Anthem Medicare Supplemental insurance policies structure customers funds. Medicare Supplemental insurance coverage really helps to cover the doughnut hole coverage difference which applies to many people enrolled in traditional Medicare plans. With Supplemental insurance, players can have increased coverage even if traditional Medicare plans do definitely not offer adequate coverage with regards to their medical solutions or perhaps items. Medicare beneficiaries must work with a great experienced Medicare advisor to learn more info on that Medicare Supplemental insurance plans are appropriate for them. Medicare Supplement companies
Source: bravejournal.com

Medicare Supplement plans to receive rebates

[…] Independent agent for health and life insurance in northern California. CA LIC. 0H12644. Focusing on families, individuals, self employed and small business. Representing several insurance carriers including Medicare Advantage and Part D Plans. Life insurance, final expence and funeral trusts. My pledge to my clients: 1. I respect your time and decisions. 2. I will not try to sell you something you do not want or need. 3. I will not call you after 5pm unless you ask me to.Source: insuremekevin.com […]
Source: insuremekevin.com

Anthem Blue Cross Medicare Supplement Plans

advantage Benefit coinsurance com Complement cost cowl firm health information insurance medical health insurance medical insurance plan Medicare medicare beneficiaries medicare benefit medicare drug plan medicare insurance medicare part c medicare part d medicare plan medicare protection medicare supplement medicare supplemental insurance medicare supplement insurance medicare supplement plan medicare supplements Medigap medigap plans number person personal insurance coverage plan premium prescription prescription drug coverage Protection provider Safety sixty Social state supplement supplemental medicare insurance website
Source: fluxfeatures.com

Medicare in Las Vegas, NV: Anthem Preferred PPO Is Leaving Las Vegas in 2013

In 2013, the Anthem Preferred PPO Medicare Advantage (MA) Plan will no longer be available in Clark County.  If you are a member of the Anthem PPO, you must choose another option before December 31, 2012, or you will go back to original Medicare on January 1, 2013. The fact that this plan is not continuing may be disconcerting, but it may also be a good opportunity.  If you have been denied a Medicare Supplement in the past due to health reasons, you can no longer be denied.  In other words, if you are on Anthem PPO right now, you have a guarantee issue right for a Medicare Supplement in 2013. As an Anthem member, you have two options:
Source: suncityfinancial.com

Medicare Advantage: Anthem Medicare PPO Alternative in Las Vegas, NV

The second option is to upgrade to a Medicare Supplement.  Because your plan is not renewing, you have the guarantee issue right to a supplement.  You cannot be denied for health history.  The monthly cost will be higher than that of the PPOs, but a supplement will give you freedom to see any doctor that accepts Medicare and you will no longer have co-payments if you select a Medicare Supplemental Plan F.
Source: suncityfinancial.com

Anthem Medicare Supplement Insurance Quotes in Ohio

In order to qualify, individuals must switch from an existing supplemental policy to a new  Anthem plan with equal or lesser coverage.   This means if you currently own Plans F or J, you can switch to a modernized Plan F (Plan J is no longer for sale as of June 2010) with no health questions asked.   Likewise, you could switch from Plan G to Plan G or Plan N to Plan  N, etc.
Source: ohioinsureplan.com

Health Care Frauds & How to Avoid Them

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 marsmet524Scams are widespread in our society, and nowhere is it more common than in the health care industry. Medicare and health insurance fraud is a major problem and it costs everyone. The FBI lists health care fraud as one of the most prevalent scams affecting senior citizens. Many senior citizens on fixed incomes rely on their Medicare and supplemental health insurance. Sadly, that is where many of the elder fraud scams originate. You can avoid these scams by recognizing them for what they are, and you can save yourself anxiety and money.
Source: wordpress.com

Video: Canvas-CMS1500-HEALTH-INSURANCE-CLAIM-FORM Black Berry.mp4 – Mobile App – GoCanvas.com

NFCC Financial Education Blog

Eligibility. Medicare provides health care benefits to people age 65 and older and those under 65 with certain disabilities or end-stage renal disease. For most people, the initial enrollment period is the seven-month period that begins three months before the month they turn 65. If you miss that window, you may enroll for the first time between January 1 and March 31 each year, although your coverage won’t begin until July 1. To apply for Medicare online, visit this site.
Source: nfcc.org

Medicare claim form cms1500

08 1500 health insurance claim1aINSURED146S IDNUMBERFOR PROGRAM IN ITEM 14INSURED146S NAME Last Name First Name Middle InitialaINSURED146S DATE OF BIRTHcINSURANCE PLAN NAME OR PROGRAM NAME13INSURED146S OR AUTHORIZED PERSON146S SIGNATURE I authorize FHEALTH INSURANCE CLAIM BACK OF FORM BEFORE COMPLETING SIGNING THIS FORM12PATIENT146S OR AUTHORIZED PERSON146S SIGNATUREI authorize the release of any medical or other information necessaryto process this claimI Source: Medicare claim form cms1500
Source: wordpress.com

IRS Reverses Position on Deducting Medicare Premiums

The IRS Confirms the Deduction Until recently, there has been some confusion as to whether Medicare premiums paid by a self-employed individual, a partner in a partnership or a more than 2% shareholder of an S corporation qualified for this deduction.  The IRS recently confirmed in a Chief Counsel Advice (CCA) that if you otherwise qualify for the above-the-line deduction for health insurance premiums, you may be able to deduct your Medicare premiums.  The CCA concludes that all Medicare parts are insurance constituting medical care and that all Medicare premiums may be deductible – not just the supplemental medical insurance of Medicare Part B.
Source: herbein.com

Romney's Baffling Claim About Medicare Pay Cuts For Doctors

ROMNEY: And that’s for both Medicare and the Medicaid program, where the shortage of doctors has been even more acute. So how does Governor Romney back his claim? A campaign email pointed to a private survey of doctors in 2010. That survey, however, had a response rate of only 2.4 percent, and more than two-thirds of those who responded started out with a self-described somewhat or very negative view of the health law. Julie Rovner, NPR News, Washington. Transcript provided by NPR, Copyright National Public Radio.
Source: nhpr.org

Fed Budgetary Experts Demolish CBO Health Cost Model, the Lynchpin of Budget Hysteria

Long-run projections of the U.S. federal budget have played a prominent role in discussions about fiscal policy and the design of major transfer programs for several decades. The projections typically show large fiscal imbalances owing to ramping up of retirement and health care costs relative to GDP. Health care costs are the key factor in these projections for two reasons. First, in current projections they are the prime source of growth of spending as a share of GDP. Second, they are the most uncertain part of the forecast. For example, the Congressional Budget Office’s most recent long run outlook shows spending on Medicare and Medicaid, the governments health programs for the old and poor, respectively, rising from 4.1 per cent of GDP in 2007 to 19.1 per cent of GDP in 2082.1 By contrast, Social Security benefits (the government’s main old-age pension program) increase only 2 percentage points, from 4.3 per cent of GDP in 2007 to 6.4 per cent in 2082. Another analysis by CBO suggests that an 80 per cent confidence band around the Social Security projection would be from 51⁄2 to 91⁄2 per cent of GDP.2 CBO did not present similar calculations for health spending; instead, they projected health spending under three different assumptions about the rate of growth of age-adjusted health care spending in excess of per capita income. Their projections show health spending ranging from 7 to nearly 40 per cent of GDP by 2082.
Source: nakedcapitalism.com

Court: You Can Appeal Medicare Decisions About Hospice Services

That’s a victory of sorts, because it makes it clear that beneficiaries have the right to challenge a hospice provider’s refusal to provide a service that a doctor deems necessary, Mr. Deford said. But it’s disappointing because it doesn’t ensure that people receive a notice of their right to appeal when they enter hospice care, or that any mechanism exists for expedited appeals – an important protection for people who are dying.
Source: nytimes.com

NFCC Financial Education Blog

Posted by:  :  Category: Medicare

Rogue Magazine (October 1964)  Volume 9 Number 5 - Water Balloons ...item 1.. routinely use devious devices -- wears us down like rabid trial lawyers until we give in (August 15, 2011 / 15 Av 5771) ... by marsmet542Eligibility. Medicare provides health care benefits to people age 65 and older and those under 65 with certain disabilities or end-stage renal disease. For most people, the initial enrollment period is the seven-month period that begins three months before the month they turn 65. If you miss that window, you may enroll for the first time between January 1 and March 31 each year, although your coverage won’t begin until July 1. To apply for Medicare online, visit this site.
Source: nfcc.org

Video: How Medicare Works

How Medicare Advantage Works

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Source: ncpa.org

Baby Boomers and Medicare Myths

enroll in Medicare any time after you turn 65, without penalty – Medicare has a seven month “Initial Enrollment Period” (IEP) when people first become eligible to enroll into Medicare Part A and B, either based on a disability or when they “age in” to Medicare at age 65. IEP starts 3 months prior to the month of Medicare eligibility and ends 3 months after the month of eligibility. There are some exceptions, for instance, if you’re still working and covered by an employer. But, generally people who miss the IEP could be required to pay late enrollment penalties.
Source: ehealthinsurance.com

How Medicare Advantage Works

I pose that the main reason this result occurs is “upcoding” by MA plans. Medicare bases MA beneficiary health status on the diagnosis codes submitted by MA plans. FFS providers typically have less of an incentive to extensively document all of a beneficiary’s health conditions…MA plans, on the other hand, receive more money the more diagnosis codes they document. Thus, when FFS beneficiaries switch to MA plans, their risk scores increase even if their true health status changes little or not at all.
Source: healthworkscollective.com

Medicare Enrollment Arrives – Tips On Medicare Plans

Take stock of your health needs for the coming year. Go back to the drawing board and think through what you really need from your Medicare plan. What kinds of care do you need? Do you anticipate any procedures or tests? Which doctors do you want to see and how often? What prescriptions do you take? What can you afford to pay? Make a list.
Source: allsup.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

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

How Medicare Works: Does Medicare pay for nursing homes or long

Long-term care is generally not covered by Medicare. Most long-term care is considered to be custodial care (nonskilled personal care), such as help with bathing, getting dressed, eating and moving around. Medicare does not pay for custodial care. Most nursing home care is considered to be custodial care, so it is not covered by Medicare. One of the few times it is available is if a beneficiary requires skilled care. A hospice patient on Medicare may be moved to a Medicare-approved nursing home if respite care is needed (when a caregiver needs a break).
Source: howmedicareworks.com

How Do Medicare And Health Insurance Work Together?

Medicare works with employer insurance in a few different ways. Most people with employer insurance enroll in Medicare Part A because it requires no premium. Medicare Part B requires a premium. The part(s) of Medicare you need will depend on your employer. If your employer has fewer than twenty employees then you will need both Parts A and B for adequate coverage. If your employer has more than twenty employees then your employer would be the first payer. This means that you should enroll in Part A (at no cost to you). For specifics of your employer coverage and how it works with Medicare contact the proper administrator at your job.
Source: seniorcorps.org