Is Dental Insurance Medicare Considered Supplemental?

Posted by:  :  Category: Medicare

The cost of a supplemental dental insurance plan will depend on the amount of coverage offered. The basic plans will cost between $25 and $50 a month, for which you would be expected to make monthly or biannual payments. More expensive plans can cost between $50 and $100 a month, but include expensive dental procedures and the largest selection of dentists. Knowing what type of care you require will help finding the insurance to fit your budget.
Source: seniorcorps.org

Video: Dental Insurance Commercial for Folks on Medicare

Medicare Open Enrollment: More is better

For those choosing Original Medicare, the benefit package continues to grow stronger and provide greater value. For example, EVERYONE with Medicare has access to a variety of preventive services and screenings, most at no cost to them when furnished by qualified and participating health care professionals. This includes things like diabetes and cancer screenings, and a yearly “wellness” visit. During the first 9 months of this year, over 20 million people with Original Medicare received at least one preventive service at no cost.
Source: medicare.gov

Through Medicare Supplemental Insurance Illinois Residents Save Money

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Source: businesslistingnow.com

Anthem Blue Cross Blue Shield Medicare Supplement Plans Are Affordable…

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

Services Insurance : What Dental professional Solutions Are Protected by Medicare?

To be covered, such procedures must be done on an in-patient basis, and as aspect of therapy of the larger healthcare problem, and simultaneously. Examples of oral costs that have no coverage would be:     The care or therapy of teeth or components assisting the teeth as a main service     Elimination or replacement of teeth as a main service     The planning of the mouth for dentures     Elimination of teeth in an contaminated jaw     The repair of any assisting components including all parts of the gum area, teeth origins and their protecting, and the alveolar bone which forms the teeth plug. Medicare related programs take oral therapy into some consideration. Privately paid oral costs are considered by Centers for Insurance coverage & State medicaid programs Solutions in determining a individual’s out of pocket healthcare costs. Medicare Medical Savings Records (MSA) can be set up which may cover oral costs. Individuals do not make remains to such accounts. Funds are added only from your Insurance coverage consideration. Such accounts are totally managed with a insurance deductible that must be met from Insurance coverage determining costs before the consideration can be used. Insurance coverage chooses the bank where the consideration is created, and payments from the consideration are usually made via charge cards. Although some costs from MSAs are subject to taxes, oral costs are not.
Source: blogspot.com

4 Seniors: Drill into dental costs

Dental School: Dental care at a local university can be a 1/3 of the cost versus treatment at a practice, but, it can also take twice as much time. The work comes from students under the supervision of dentists, like those you can find at the University of Oklahoma College of Dentistry.
Source: kfor.com

Common health insurance questions answered: What is medicare advantage?

Private companies, such as Blue Cross Blue Shield Michigan and Blue Care Network, contract with Medicare to offer these plans to individuals who purchase their own coverage and through employer and union groups. Medicare beneficiaries who buy their own coverage have many plan options to consider. Insurers often offer several different benefit plans with various benefit levels and monthly premiums. They include extras to make their plans more attractive to prospective members. Some enhancements to look for are:
Source: ahealthiermichigan.org

5 Services Medicare Won’t Pay For

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Source: webmd.com

Medicare Advantage Plans Can Lower Overall Expenses

Here are some additional important factors to consider before selecting a MAPD. First, again it should be stated that most Medicare Advantage plans have a network of doctors and hospitals and unless you are selecting a PPO plan must use the providers in the network except in cases of emergency treatment. Next, most HMO Advantage plans require your main (primary) doctor to refer you to any other doctor in the network. Again, most require this referral practice but there are a few “Open Access” plans that are still HMO’s however don’t require the selection of a primary care doctor or referrals to seek medical care.
Source: medicareinsurancetexas.com

Alliance Of Medicare Providers Urge Link Between Payment Changes, Quality

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSModern Healthcare: AMA Continues Fight Against ICD-10 Mandate The American Medical Association reaffirmed its commitment “to vigorously work” against the nationwide adoption of ICD-10 diagnostic and procedural codes while evaluating the feasibility of skipping directly to ICD-11 codes, which are expected to be introduced in 2015. The AMA House of Delegates adopted a resolution at its annual meeting in Chicago this summer to weigh skipping ICD-10 and debated the issue again Monday during its interim meeting in Honolulu after two related resolutions were put on the meeting’s agenda. A resolution introduced by the Florida delegation cited an $80,000-per-physician implementation cost for ICD-10 and noted that — for all its complexity — ICD-10 does not include codes for genomic information (Robeznieks, 11/13).
Source: kaiserhealthnews.org

Video: Apply for Medicare | Medicare Sign Up

FR&R Home Health Bulletin: Update to Medicare Reimbursement Rates for Vaccinations for Home Health Agencies

For a seasonal flu or pneumococcal vaccination, there is an administration component and vaccine component to be billed to Medicare Part B.  The administration is billed using Bill Type 34X, Revenue Code 0771, Diagnosis Code V04.81 for influenza vaccination, V03.82 for pneumococcal vaccination or V06.6 for both influenza and pneumococcal vaccinations, and HCPCS Code G0008 for influenza administration and HCPCS Code G0009 for pneumococcal administration.  Reimbursement is based on the Hospital Outpatient Prospective Payment System (OPPS) amounts and is subject to the lower of the fee schedule amount or billed charges.  If the charges are less than the fee schedule amount below, then reimbursement will be at the lower charged amount.  
Source: frrcpas.com

New 3.8% Medicare Tax on Investment and Unearned Income Beginning in 2013

St. Louis, MO 63101 New 3.8% Medicare Tax on Investment and Unearned Income Beginning in 2013 Starting January 1, 2013, a new 3.8% Medicare1 tax will apply to the investment and “unearned income” of individuals, trusts and estates. The tax is intended to apply to income exempt from the regular FICA or self-employment taxes. Avoiding or reducing the impact of this new 3.8% tax will require sophisticated tax planning both pre-and post-January 1, 2013. However, it may be difficult to reduce the impact of this new tax, especially for taxpayers with significant amounts of investment and unearned income. The last part of this memorandum describes certain tax planning ideas that may be suitable for taxpayers depending on their particular tax and economic status. Specifically, beginning January 1, 2013, a new 3.8% Medicare tax will apply to the lesser of a taxpayer’s (i) net investment income or (ii) the excess of the taxpayer’s modified adjusted gross income (MAGI) over a threshold amount. MAGI in the case of an individual generally equals an individual’s adjusted gross income with certain technical adjustments. For married individuals filing joint returns, the threshold amount is $250,000 and for single individuals the threshold amount is $200,000. In the case of a trust or an estate, the tax is imposed on the lesser of (i) “undistributed” net investment income or (ii) the excess of adjusted gross income over the dollar amount at which the highest income tax bracket applicable to a trust or estate begins (currently $11,650). Therefore, the low limits at which the tax can apply will force trusts and estates to pay particular attention to the tax. However, simple trusts that provide only for distributions of current income, and whose terms require all current income to be distributed, will avoid the new tax (although the trust beneficiaries may not). Also, the new tax does not apply to trusts where all unexpired interests are devoted to charitable purposes. For all taxpayers, the most important part of the new tax is the definition of “net investment income.” Net investment income is generally defined as investment income reduced by properly allocable deductions. Investment income generally will include all of the following:  Interest, dividends, annuities, royalties and rents (with certain exceptions).  Capital gain from the sale of stocks, bonds and other securities.  Income from a trade or business that is a “passive activity” with respect to the taxpayer and conducted by an entity taxed as a partnership, limited liability company or S corporation. Net gain from the sale of an interest in a partnership, LLC or S corporation to the extent attributable to a trade or business which is a “passive activity” with respect to the taxpayer.  Income from the trade or business of trading in financial investments or commodities. In general, an activity is passive with respect to a taxpayer if the taxpayer does not “materially participate” in the trade or business. Material participation is determined under the passive loss rules and can involve a highly complex analysis. In general, working in the business more than 500 hours a year will avoid passive treatment, but other more liberal tests may also be satisfied, some of which depend on the ownership structure and others that require as few as 100 hours of annual participation. Some additional examples of income subject to the new tax include taxable distributions from mutual funds and the taxable portion of gain recognized upon the sale of a primary residence. Equally important are the categories of income generally exempt from the new tax:  Income or gain from a trade or business conducted by a partnership, LLC or S corporation to the extent the trade or business is not a passive activity (except to the extent the trade or business earns investment income, e.g., on working capital).  Distributions from tax-qualified pension and profit sharing plans and IRAs, although they may increase MAGI.  Tax-exempt interest.  The portion of the gain from the sale of a primary residence that is excluded from income.  Income and gain already subject to the tax on self-employment income. Thus, income and gain from a business which is not a passive activity to the taxpayer will not be subject to the new tax. However, except in the case of an S corporation, earned income from a passthrough entity that is not a passive activity will be subject to an increase in the existing Medicare surcharge (the tax on self-employment income) from 2.9% to 3.8%. In general this tax increase will affect taxable income exceeding $250,000 for married taxpayers and starts in 2013. The amount of the new tax will have to be taken into account in figuring a taxpayer’s quarterly estimated tax payments and the tax is non-deductible. Income Tax Planning Ideas While not intended as a complete list, the following are some planning ideas to consider to reduce the impact of the new tax:  Invest in tax-exempt bonds.  Accelerate into 2012 any investment income that would otherwise be subject to the new tax in 2013, e.g. accelerate the sale of stocks and bonds.  Defer unrealized capital losses to 2013 to offset capital gains subject to the new tax.  Increase contributions to tax-qualified plans rather than investing outside such plans (although distributions from such plans may increase MAGI). Also, note that this technique may be less attractive if the current lower rates on dividends and capital gains on assets held outside such plans are extended by legislation. Harvest passive losses in future years to offset passive income and gains (although the ability to do so will depend on IRS interpretations).  Revisit ownership structures that affect the treatment of an activity as passive.  To the extent an entity provides for tax distributions to its members, partners or shareholders, consider adding the new tax as an additional distribution, if appropriate. Of course, any tax planning should also make sense from an investment and economic perspective. For example, trade-offs may exist: classifying a taxpayer’s trade or business activity as active rather than passive will avoid the new tax from being imposed on the taxpayer’s income and gain from the business. But the switch from active to passive activity will also prevent a taxpayer’s reclassified passive losses from offsetting income and gain from the trade or business. Please note that the IRS has not yet issued any guidance on a variety of interpretive questions and that all of the above is subject to modification depending on such guidance. Some of the issues that should be addressed in the guidance include the following:  How to allocate expenses in figuring net investment income.  Can pre-2013 passive losses be used to offset post-2012 passive income otherwise subject to the new tax?  In the case of real estate professionals whose rental income is generally treated as not passive, how will rental income be treated as derived in the “ordinary course of a trade or business” (which would exempt rent from the new tax)?  In the case of trusts, how will the trust determine whether it is “participating” sufficiently in an activity so as to avoid causing the activity to be passive (which would exempt the trust from the new tax? Will the services of employees and agents be attributed to the trustee?  In the case of a trust that receives multiple classes of income, how will the trust determine which type of income is “undistributed” net investment income subject to the new tax? In the meantime, taxpayers potentially affected by this new tax should consult their tax advisers. ______________________ 1 Although the legislation appears in the provisions of the Internal Revenue Code dealing with Medicare taxes, the receipts from the new tax will not be used to fund Medicare but will be added to the general tax revenues of the government. The tax was enacted as part of the Obama healthcare legislation. If you have questions on this or any tax issue, you may contact your Thompson Coburn attorney or one of the attorneys listed below: Scott Bieber 312-580-2206 sbieber@thompsoncoburn.com Edward J. Buchholz 314-552-6377 ebuchholz@thompsoncoburn.com Thomas R. Corbett 314-552-6022 tcorbett@thompsoncoburn.com Stephen E. Cupples 314-552-6027 scupples@thompsoncoburn.com Georgia Loukas Demeros 312-580-2303 gdemeros@thompsoncoburn.com Laura M. Duncan 314-552-6312 lduncan@thompsoncoburn.com Steven B. Gorin 314-552-6151 sgorin@thompsoncoburn.com Jodie E. Distler Hanzlik 312-580-2310 jdistlerhanzlik@thompsoncoburn.com Lawrence P. Katzenstein 314-552-6187 lkatzenstein@thompsoncoburn.com Katherine G. Knapp 314-552-6357 kknapp@thompsoncoburn.com Jason P. Thein 314-552-6562 jthein@thompsoncoburn.comThompson Coburn LLP Chicago
Source: jdsupra.com

The Hunt is Afoot For Medicare Part D

You can complete an easy-to-use online application for Extra Help at www.socialsecurity.gov. Click on Medicare on the top right side of the page. Then click on “Get Extra Help with Medicare Prescription Drug Plan Costs.” To apply by phone or have an application mailed to you, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and ask for the Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020). Or go to your nearest Social Security office.
Source: patch.com

farmdocdaily: Farms and the New 2013 Medicare Tax Increases

The total amount of capital gain and depreciation recapture is $365,000 ($300,000 + $50,000 + $15,000). Samantha did not materially participate in the farming activity for 2013. She worked full-time as a stockbroker. In addition to paying capital gains tax on the $300,000 gain on the sale of the farmland, she will also pay the 3.8% Medicare tax on some or all of that capital gain and on the depreciation recapture amount on the assets sold. The total amount of Medicare tax she will pay on the transaction depends upon her income from other sources and how much income she has over the $200,000 threshold for a single filer that applies once her other income and the income from the farm sale are reported. If Samantha has $200,000 or more income from her stockbroker position, the 3.8% Medicare tax will apply to the entire capital gain and depreciation recapture amount. Her total amount of the new Medicare tax will be $13,870 (3.8% X $365,000). If she has under $200,000 of income from other sources, only part of the farm sale transaction (that amount in excess of $200,000 of income) will be subject to the new 3.8% Medicare tax.
Source: illinois.edu

When can you apply for Medicare??

By using this Website, you agree to abide by our Terms and Conditions (the "Terms"). This notice does not replace our Terms, which you must read in full as they contain important information. You must not post any defamatory, unlawful or undesirable content, or any content copied from a third party, on the Website. You must not copy material from the Website except in accordance with the Terms. This Website gives users an opportunity to share information only and is not intended to contain any advice which you should rely upon. It does not replace the need to take professional or other advice. We have no liability to you or any other person in respect of any content on this Website.
Source: australiaforum.com

My Experience Applying for Medicare Online

Once submitted you are advised: “Thank you! Your data has been received and we are working to process your request. You will be able to check the status of your action online in 5 business days. To check the status, go to http://www.socialsecurity.gov. You will need to enter your Confirmation Number to get status information, so please put this number in a safe location. We hope you found our internet application convenient to use and easy to understand.” Well, we three found the online application process both convenient and easy. I applaud Social Security for an excellent implementation and the person-to-person customer service I received when I had a question.
Source: medicarebenefits.com

A Blog by Maryland Optometric Association President John L Burns O.D.: Meaningful Use.. Glasses after Cataracts with Medicare

Posted by:  :  Category: Medicare

Judy by Thomas HawkOptometrists who wish to provide eyeglasses for cataract patients under Medicare are subject to a new durable medical equipment prosthetics, orthotics and supplies (DMEPOS) registration fee every three years, according to the AOA Advocacy Group.  As reported in AOA publications previously, the fee was put in place in March 2011 over the objections of AOA and other physician organizations when the Centers for Medicare & Medicaid Services (CMS) decided to treat all DMEPOS suppliers as institutional fraud risks.
Source: blogspot.com

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

Confetti Wine Glasses, Medicare Enrollment This Week

Craft your possess set of 4 confetti booze eyeglasses to give as a present or use for your holiday interesting on Saturday, Dec 8 from 1 p.m. – 3 p.m.. Samples will be on arrangement during a Library. Class is singular to 20 participants. Registration compulsory and can be finished during a Circulation desk. Friends registration starts Nov. 11 – price is $15. General open registration starts Nov. 18 – price is $18.
Source: web-info-12.info

Highmark change in Medicare eye exam coverage irks some

• Clairton claims WPIAL Class A title with 60th straight win • Shoppers flock by thousands to Western Pennsylvania stores, malls for Black Friday • Clashes in Egypt as Morsy defends new powers • Community corrections center Renewal steers ex-convicts to home, job • PNC YMCA Turkey Trot takes guilt off holiday menu
Source: triblive.com

How to save on prescription eyeglasses

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

Why Doesn’t Medicare Pay For Hearing Aids Or Eyeglasses?

Hearing aids are elective to, just like glasses. Patients are responsible for 100% of the bill. However Medicare, in certain circumstances, will cover the cost of a prosthetic device. Often though, the cost of prosthetics far outweigh the costs of a hearing aid. This elective also extends to routine hearing tests, which are also the responsibility of the Medicare patient. Regulations vary by the state however, so there may be some exceptions to the contrary. Though most states operate under the same mindset. One exception, though limited, is coverage based on an advantage plan; a secondary premium insurance add on.
Source: seniorcorps.org

The Medicare Coach: A Breakthrough In Vision Correction

The majority of Medicare patients opt for the Traditional standard procedure because Medicare and their supplement insurance pay for it. Below is a breakdown of costs for Traditional cataract surgery in the Midwest. I called the billing department of a large eye surgery center located in Kansas, and was told that patients can expect co-pays from $750-$1000 for Traditional surgery which are usually paid by their supplemental insurance. However, for lens implants, the patients will pay cash because Medicare considers these procedures as a luxury and not a medical necessity.
Source: themedicarecoach.com

How to Purchase Glasses with AMD

For many people, using yellow, orange, and brown lenses is suggested by AMD.org to improve contrast vision and make it easier to see things like steps and curbs. The site, a macular degeneration partnership of the Discovery Eye network, recommends that people with specific types of color vision problems may benefit from wearing a green or blue lens as well. Eye care practitioners who specialize in low vision problems are excellent sources for finding the best style lenses for macular degeneration.
Source: suite101.com

Does Medicare Call Your House?? Or is this Medicare Fraud?? » Toni Says

I have a problem and I need your help.  I am a 79 year old female who lives alone in Meyerland. Yesterday, a representative from Medicare called me asking all types of personal questions. I told them, I did not give personal information over the phone.  I’m concerned this could be a scam, but then if it was Medicare, I’m concerned I could have made a mistake.  Can you please advise me what I should do or where I could call to see if Medicare is trying to contact me?  Thanks in advance…Alice from Houston,TX
Source: tonisays.com

Doctors billing Medicare for patients’ unneeded, expensive tests

(NaturalNews) With all the outcry by politicians and the public over skyrocketing healthcare costs, maybe it’s time to take a look at how some doctors are running up patients’ bills for unneeded tests. A new study just published in Online First by Archives of Internal Medicine, a JAMA Network publication, concludes that diagnostic tests are frequently repeated on Medicare beneficiaries when there’s absolutely no compelling medical reason. It seems obvious the only other explanation is for physicians to make more money by billing Medicare numerous times for repeated tests for the same patients. H. Gilbert Welch, M.D., M.P.H., of Dartmouth College in Hanover, New Hampshire, and colleagues looked at patterns of repeat testing in a longitudinal study of Medicare beneficiaries. In all, they picked five percent of patients’ records at random from the 50 largest metropolitan statistical areas. “We examined repetitive testing for six commonly performed diagnostic tests in which repeat testing is not routinely anticipated. Although we expected a certain fraction of examinations to be repeated, we were struck by the magnitude of that fraction: one-third to one-half of these tests are repeated within a three-year period. This finding raises the question whether some physicians are routinely repeating diagnostic tests,” the authors noted in their paper. For example, among Medicare beneficiaries undergoing an echocardiography to examine their hearts, over half — 55 percent — had a second test within three years. Nearly half of imaging stress tests were also repeated in fewer than three years and so were about 50 percent of pulmonary function tests. About 46 percent of those having CT scans of the chest were repeated, 41 percent of bladder examinations by cystoscopy. About 35 percent of the beneficiaries were subjected to repeat upper endoscopies (exams of the digestive tract with a tube) within three years, too. So what’s so bad about this? Frequently repeating these high tech, expensive diagnosis tests in situations when there is no medical need, drives up Medicare costs (although, of course, it can put more money in the pockets of doctors.) But there’s also a health risk to patients subjected to over-done testing. “This has important implications not only for the capacity to serve new patients and the ability to contain costs but also for the health of the population,” the authors of the paper concluded. “Although the tests themselves pose little risk, repeat testing is a major risk factor for incidental detection and over-diagnosis.” That means people with no health problems can end up being subjected to anxiety over a diagnosis they should never have been given — to say nothing of potentially dangerous side effects from treatment for a “condition” that is harmless or non-existent. In an accompanying commentary, Jerome P. Kassirer, M.D., of Tufts University School of Medicine, Boston, and Arnold Milstein, M.D., M.P.H., of Stanford University School of Medicine stated: “After decades of attention to unsustainable growth in health spending and its degradation of worker wages, employer economic vitality, state educational funding and fiscal integrity, it is discouraging to contemplate the fresh evidence by Welch et al of our failure to curb waste of health care resources.” The new report is more evidence of a phenomenon Natural News has reported on in the past — doctors subjecting patients to inappropriate and downright unnecessary tests, apparently for money. For example, a study by University of California at San Francisco (UCSF) researchers found unneeded, expensive mammograms are being pushed on elderly women who are incapacitated from Alzheimer’s disease or other forms of dementia, especially if the women have savings or assets of $100,000 or more. Sources: http://archinte.jamanetwork.com/article.aspx?articleid=1392496 http://archinte.jamanetwork.com/article.aspx?articleid=1392495 http://www.naturalnews.com/028095_mammograms_Alzheimers.html
Source: naturalnews.com

MEDICARE OPEN ENROLLMENT ENDS DECEMBER 7

Posted by:  :  Category: Medicare

ATTENTION MEDICARE BENEFICIARIES: Medicare Open Enrollment allows beneficiaries to switch, add or drop a Medicare Advantage Plan. This can be a challenging and confusing process and I want to offer my services to those seeking to navigate the process. I am a health agent certified to represent major private insurers with Medicare contracts and welcome the opportunity to provide guidance.
Source: patch.com

Video: Georgia Health Insurance Medicare

Experts debate future of Medicare in AARP event

In the videoconference, Stuart Butler of the Heritage Foundation and Henry Aaron of the Brookings Institution agreed on at least a couple of points: that Medicare beneficiaries should have a cap on their out-of-pocket spending, and that high-income seniors should pay higher premiums than lower-income people.
Source: georgiahealthnews.com

Medicare Open Enrollment Ends December 7

December 7 is the last day of Medicare Open Enrollment when you can switch, drop or add a Medicare Advantage Plan (Part C) and Prescription Drug Plan (Part D).  The decision making process can be a confusing and challenging one and as a Health Agent, certified by the Center For Medicare and Medicaid Services to represent major private insurer’s with Medicare contracts, I welcome the opportunity to provide assistance to Beneficiaries and those “aging-in” to Medicare.
Source: patch.com

Medicare Open Enrollment Ends December 7

December 7 is the last day of Medicare Open Enrollment when you can switch, drop or add a Medicare Advantage Plan (Part C) and Prescription Drug Plan (Part D).  The decision making process can be a confusing and challenging process and as a Health Agent, certified by the Center For Medicare and Medicaid Services to represent major private insurer’s with Medicare contracts, I welcome the opportunity to provide assistance to Beneficiaries and those “aging-in” to Medicare.
Source: patch.com

Eligible Georgia Retirees Switching to Medicare Advantage Plans

What Does the Change Really Mean for My Doctors? It was detailed in July 15th letter that your doctor (provider) would need to accept the changes in the plan to accept the MA terms. From all the research and discussions that I have had with both doctors and insurance vendors, it does not seem like there will be many changes they believe (view the letter with all enclosures by clicking here). There are no networks. You may see any provider that accepts Medicare and is willing to accept CIGNA/UHC’s terms and conditions. The really important point to make is to have your provider agree to accept the new plan changes (information on the plan was given in the July 15 letter). Along those lines, I have received a few emails talking about the problems with finding Medicare Advantage doctors. Numerous articles have said that the vast majority of doctors will not refuse Medicare or Medicare Advantage from current patients – they wish to continue the relationship. Some doctors may or may not accept new patients, but a study by the Center for Studying Health System Change found that nearly 75% of doctors accepted all or most new Medicare patients in 2008 (Study: Most Physicians Still Accepting Medicare Patients, Fierce Health Finance). How Much Will This Cost Me? First, remember that the State of Georgia is subsidizing your coverage by nearly 75% of the total costs. This is one of the benefits that was “given” to you, so if you were to opt out of the MA plan, it will cost you hundreds of dollars per month for the same coverage. In other words, unless you feel like you have no other option and money to burn, opting out is not an option… (who has money to burn??) The good news about the changes is that it will actually save you money every single month for your coverage. Currently, a PPO covered participant pays $32.90 for single coverage ($142.40 for family). The standard option MAPD PFFS plan will cost $19.30 for single coverage and $38.60 for family coverage (all dependents eligible for MA plan). A mix of eligible and non-eligible Medicare participants in family coverage will have higher costs, but that is to be expected. The premium coverage option for the MAPD PFFS plan will cost $59.30 for a single and $118.60 for a family (all dependents eligible for MA plan). The benefits here are a lower out-of-pocket maximum, lower hospital costs, reduced co-pays, and a better prescription drug benefit. The choice is yours, but weigh the costs by looking at your 2008 and 2009 medical expenditures. The standard plan could cost you more based on your needs… (Check the July 15 letter above to compare the coverages on the Plan Summary enclosure) If you want to check out the retiree rates as set by the SHBP, please click this link to open the PDF. What If I Don’t Choose? According to the information sent with the July 15 letter, “If you are not enrolled in a MAPD PFFS option and do not make an election during the ROCP, your coverage will roll to the MAPD PFFS option of the healthcare vendor you are currently covered. Kaiser members who do not make an election will default to the CIGNA Medicare Access Plus Rx (PFFS) – Standard Plan.” Conclusion Any change is tough to accept in anything… especially medical coverage. The unknown is more of a worry than the known even when it may be better. In five years, few people may even remember this change unless there are real problems. If that starts to happen though, you can almost be assured that the SHBP and its vendors will try to make things right. The State Health Benefit Plan covered 693,716 people as of September 1, 2009, and that is far too big a number to think that they will just accept mediocre results. Try to work with your doctors and try to work with the insurance vendors. The vendors are there to help, so let them help. Both CIGNA and UHC told me that if a doctor is not accepting the plan after you discuss it with them, get the vendor involved. They may be able to help explain it from an ease of use and payment perspective. Just a hint the vendors gave me.
Source: theeducatorsretirement.com

What Are the Medicare Eligibility Requirements?

Once reaching the age of 65 years old a person qualifies for medicare. One must also be a US citizen or a permanent legal resident. One of the last requirements is having paid into the medicare system while working. The general rule is having paid into the social security system with approximately 10 years of work, or 40 credits. An individual may also qualify off of their spouses working if necessitated. The spouse must be at least 62 and the qualifying individual must still meet the 65 year requirement. With additional proof an individual may also qualify based on the work benefits of a deceased or divorced spouse.
Source: seniorcorps.org

A Different View about Obama’s Medicare “Actual Facts”

The Affordable Care Act assumes deep reductions in payments to doctors, hospitals, nursing homes, and Medicare Advantage program, totaling $716 billion over ten years. By paying providers less, the trust fund may last a bit longer, but it means seniors will have a harder and harder time finding a doctor to see them as they drop out of the program or stop taking new Medicare patients. The law may not explicitly cut benefits, but it certainly will impact access to care. What good is a Medicare card if you can’t find a doctor? That is precisely the problem that patients on Medicaid — the program for lower-income Americans — face today, forcing them to go to hospital emergency rooms for even routine care. Do seniors want that?
Source: georgiapolicy.org

Does medicare cover eye exams

Posted by:  :  Category: Medicare

Visionservices factsheet icn907165R1Medicare Vision ServicesFact SheetOverview many MA plans12Medicare Covered Vision 907165November 20112Other Vision Covered Services Glaucoma screening can be obtained once every DIDPLOLVRURIODXFRPDRDUHIULFDQaged 65 and olderGlaucoma screening consists cover eyeglasses or contact lensesAdditionally in patients and is also intended to provide near Policy for AC IOL and PC eyeglasses or contact lenses eyeglasses or contact nor contact lenses n Source: Does medicare cover eye exams
Source: wordpress.com

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

Highmark change in Medicare eye exam coverage irks some

• Shoppers flock by thousands to Western Pennsylvania stores, malls for Black Friday • Clashes in Egypt as Morsi defends new powers • Community corrections center Renewal steers ex-convicts to home, job • PNC YMCA Turkey Trot takes guilt off holiday menu • Trib Cup: GCC girls soccer lives up to aspirations
Source: triblive.com

How to save on prescription eyeglasses

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

Obamacare – 2013, Plus Cyber Security Tips

The health Flexible Spending Account (FSA) is capped at $2,500, but indexed to inflation. Many used this to pay for their family’s health expenses such as medical insurance, co-pays, and over-the-counter cold and other items such as band-aids, pain relievers, antacids, and children’s vitamins. Other expenses the FSA is used for includes those not covered by their insurance, including hospital stays, dental visits, nursing care, as well as expenses of special needs children such as education. For 2012 and prior, there was no federal limit, although many employers did set a cap.
Source: sheepsheadbites.com

Why Doesn’t Medicare Pay For Hearing Aids Or Eyeglasses?

Hearing aids are elective to, just like glasses. Patients are responsible for 100% of the bill. However Medicare, in certain circumstances, will cover the cost of a prosthetic device. Often though, the cost of prosthetics far outweigh the costs of a hearing aid. This elective also extends to routine hearing tests, which are also the responsibility of the Medicare patient. Regulations vary by the state however, so there may be some exceptions to the contrary. Though most states operate under the same mindset. One exception, though limited, is coverage based on an advantage plan; a secondary premium insurance add on.
Source: seniorcorps.org

Does Medicare Pay for Prescription Sunglasses?

There can be an exception to this if you receive your Medicare coverage through a managed care plan, called a Medicare Part C Medicare Advantage plan, instead of directly with Medicare through traditional Part A and Part B. Some of these Medicare Advantage HMOs and other managed care plans offer coverage that is broader than traditional Medicare, including some coverage for eyeglasses in certain circumstances. If you belong to one of these Medicare managed care plans, contact the plan administrator to find out if the plan covers eyeglasses and if so, what the coverage might be in your case. Or you could ask your doctor’s office to check with the managed care plan for you.
Source: caring.com

Medicare coverage of glasses after cataract surgery

Deluxe Frames are frames that cost more than the Standard Frame coverage.  For example if a frame selected costs $80.00 then the deluxe frame fee would be ($80.00 – $60.72) = $19.28.  Medicare does not cover this portion of the amount and the patient is due this amount.  The jargon Medicare uses is that this item is “noncovered.”  Medicare gives you the freedom to choose any frame you desire that your eyewear provider can provide.  The Medicare deluxe frame policy allows patients to choose from any frame and have part of their Medicare coverage help defray the expense of these frames.
Source: guthrieeyecare.com

Medigap Advisors Greet Record Medicare Annual Enrollment with New Type of …

As record numbers of boomers sign up for Medicare Advantage plans during annual enrollment, the need for customer service has never been greater due to volume and plan complexity. This year, Health and Human Services found most counties offer an average of 26 Advantage plans that may have different requirements and benefits. All must provide standard Part A and B benefits, but many expand on original Medicare. The extra benefits range from help with dental care, eyeglasses, and hearing aids, to memberships at health clubs. To meet the challenge, Medigap Advisors offers a new experience in customer service.
Source: medigap.ca

Get your practice ready for patient portals, care summaries

Although the CMS prefers that summary of care records be transferred electronically, agency officials acknowledge that the necessary technological infrastructure may still be under development in many parts of the nation. Therefore, health care professionals and hospitals will also have the option of either sending a paper copy of the summary of care record to the next provider or having the patient deliver the summary care record to the next provider themselves. However, a certified EHR system must be used to generate the care summary and record whether it was given directly to the provider or given to the patient to deliver to the provider.
Source: newsfromaoa.org

Medicare Insurance: Medicare, Medicaid and Eyeglasses Coverage

If you qualify for extra help from Medicaid you need to check with them to see what is available to you. You may call 211 and you will be connected to a Medicaid representative. If you have trouble connecting you may call 1-877-541-7905. You may also go online to www.211texas.org to search for the phone number to your local Medicaid office using your home zip code.
Source: medicareanswersfromconnie.com

Single Payer Healthcare (Medicare For All)

Posted by:  :  Category: Medicare

Example:   No employee at TOYOTA has any health benefits OR any health insurance.   No one.   This represents a big savings for TOYOTA.  As a result,  they can make and sell their cars for less on the global market.  Big Dumb American companies pay HUGE amounts for employee health care,  health insurance, health benefits….etc.    As a result,  American cars cost MORE per unit.   All American stuff costs more per unit for the exact same reason.  Because of built in health care cost for the employees.     This means LESS growth.  Less sales.   Fewer jobs.   Less new hires.   It’s tragic.      Corporations should not be forced to pay for America’s health care.  America should pay for America’s health care.   Corporations have their own problems to deal with.    FACT:  So called “Health Insurance”  does not even insure anyone’s health.  They protect your assets.  Your stuff.     Not you.  Not your health.   So called “Health Insurance” corporations cannot diagnose anything. They cannot prescribe anything.  So called “Health Insurance” corporations cannot treat any illness.   They just collect all the money and keep it.  They insure nothing. They protect nothing. They only take all your money…. and keep it. 
Source: occupyunionsquare.net

Video: Stephanie Cutter: Medicare Whiteboard

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

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

McMahon and Murphy Tangle Over Medicare, Jobs 

Ann-Marie Adams Bank of America car accident Census 2010 Census 2010 and Hartford Commentary Congressional Black Caucus Dan Malloy Education FOODSHARE foreclosure gas prices Gov. Dannel P. Malloy Gov. Jodi Rell Hartford Hartford Board of Education Hartford City Council Hartford Mayor Pedro Segarra Hartford Police Hartford Public Library Hartford Public Schools Hartford Shooting Health homicide Housing Jamaica jr. latinos Mayor Eddie Perez Mayor Eddie Perez on Trial Mayor Pedro Segarra Michelle Obama police Police Arrests President Barack Obama Race and Culture recession Snow Storm in CT Tea Party The Hartford Guardian Uconn Huskies unemployment WeekEnd Movie Review Wells Fargo Youth
Source: thehartfordguardian.com

Report: Budget cuts could cost thousands of Arizona healthcare jobs

1. California 50,785 2. Florida 35,827 3. Texas 32,172 4. New York 31,801 5. Pennsylvania 24,201 6. Ohio 20,175 7. Illinois 19,593 8. Michigan 17,639 9. North Carolina 15,912 10. New Jersey 14,126 11. Georgia 13,271 12. Virginia 12,208 13. Massachusetts 11,284 14. Tennessee 11,279 15. Indiana 10,718 16. Missouri 10,667 17. Washington 10,388 18. Arizona 9,863 19. Wisconsin 9,703 20. Alabama 9,010
Source: cronkitenewsonline.com

Democracy Corps: Voters Want Jobs, Not Deficit Reduction

If you’ve been listening, President Obama has been saying all along that he intends to get his debt deal with the Republicans — and so have his surrogates. Pay attention, because now they’ll be ramping up the Grand Bargain. We don’t know yet if they will attempt to push it through in the lame-duck session, or whether they kick it down the road until after the next session of Congress. But it will happen, so be prepared to fight.
Source: crooksandliars.com

Smart Business Incorporation

Paying Self Employment Tax is a big financial hit for many people. You can minimize that tax, though, in the right business structure. You can even avoid it entirely on part of your income, in the right business structure. But sole proprietorships and general partnerships don’t qualify for this relief. If you operate in either of these structures, you can’t escape Self Employment Tax. In the self-assessment exercise (you’ll find at the end of this eBook), we ask you to take a look at line 56 on your most recent personal tax return. If there’s an amount in it, divide that in half. The amount you come up with is about what you’ll save every year moving over into a good business structure. It’ll actually be a bit less, but for the sake of this argument, go with the half. Depending on how much you’re paying in self-employment tax, incorporating might be one thing you can do right now, to save money.
Source: smartbusinessincorporation.com

Medicare Cuts Could Threaten NJ Jobs, Says New Report

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

The Impact of the Medicare Sequester

Physicians have become accustomed to uncertain Medicare rates, Dr. Lazarus states. Yearly scheduled cuts under the sustainable growth rate formula have threatened to lower payments for Medicare services for the past decade. On Jan. 1, 2013, the SGR will lower rates by an estimated 27% unless Congress overrides the reduction with a temporary payment freeze or slight increase. Sequestration would implement reductions separate from that process. “This 2% possible cut adds another level of uncertainty,” Dr. Lazarus said. “We hear from physicians all around the country about their concerns about this. They are trying to make decisions about whether they can continue to treat Medicare patients. It’s a concern of ours, particularly in terms of access to care for Medicare patients.”
Source: physicianlicensing.com

Hospice Provider Pays $1.3M To End Medicare Fraud Suit

A South Carolina hospice has agreed to pay $1.29 million to settle a qui tam False Claims Act suit alleging that the company billed Medicare for unnecessary end-of-life care, the U.S. Department of Justice said Tuesday. Read More…
Source: lexisnexis.com

Senior Care in North Richland Hills, TX: Open Enrollment for Medicare –Now through Dec 7, 2012

Posted by:  :  Category: Medicare

Medicare Corner, Dairy Queen, Lockhart, TX by adam*bWould 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: shshomecare.net

Video: Medicare Supplements in Texas: What to Look For When Choosing a Plan

Can I Lose Medicaid by Receiving Social Security Disabiltity? » Toni Says

            I am 58 years old and in April of 2010, I was diagnosed with stage IIIA metastatic breast cancer.  I was unemployed at the time.  The Rose in Houston qualified me under Medicaid (Breast/Ovarian cancer program through the State of Texas).  I was referred to MD Anderson for treatment.  I have undergone chemotherapy and mastectomy.  I will be starting radiation next week.
Source: tonisays.com

TX Register Updates: 9/13 Hearing, Medicare Equalization

HHSC intends to submit Transmittal Number 12-035 to the Texas State Plan for Medical Assistance, which would exempt emergency ambulance transports and hospital-to-hospital transport services from Medicare Equalization to allow Medicaid to make higher cost-sharing payments. For more information, see the Texas Register.
Source: garloward.com

Dr. Patel Opens new San Antonio Medicare Clinic

Texas Bariatric Specialists (TBS) focuses on delivering long-term weight loss solutions, and is committed to providing quality, compassionate care with the most advanced, safest and medically effective weight loss options available for their patients. Services include Lap Band, Gastric Bypass and Gastric Sleeve surgeries, as well as the revision of failed weight loss surgery. In addition, TBS offers both pre- and post-operative counseling and support through a behavioral weight loss psychologist, nutritional counseling through a certified dietician/nutritionist, a nutritional resource store, insurance concierge services and affordable financing options. Medically successful non-surgical weight loss programs are also available.
Source: texasbariatricspecialists.com

Capitol Hill Hears Message from Independent Clinical Laboratory Owners: Additional Medicare Cuts in 2013 Can Be Financially Devastating

Last week, members of the National Independent Laboratory Association (NILA) visited Senators and Representatives on Capitol Hill. The objective was to educate their elected officials about the impact that recent multiple cuts to the Medicare Part B Clinical Laboratory Test Fee Schedule is having on community-based laboratory companies. Pictured above are: (left) Dark Daily Editor Robert Michel, (center) Texas Senator John Cornyn, (right) Deborah Michel, R.N., during their meeting with the Senator. NILA members hit Capitol Hill with high energy and determination. Mark S. Birenbaum, Ph.D., and his staff at NILA helped to arrange meetings with more than 70 Senators and Representatives, or their staffs.
Source: darkdaily.com

Medicare and Medicaid Cuts Raise Concerns for Texas Seniors

There are currently at least 184 cases of meningitis in the U.S., including 14 fatalities, confirmed by the Center for Disease Control. The fungal meningitis outbreak started when steroid medication was contaminated with a fungus and the fungus was injected into the bloodstream when the shots were administered to patients. Infection has been recorded in numerous states, including Florida, Indiana, Maryland, Michigan, Minnesota, New Jersey, North Carolina, Ohio, Tennessee, Texas and Virginia and numbers are expected to increase: the incubation period can take as long as three months. According to Dr. Ilisa Bernstein, the acting director of the FDA’s Center […]
Source: lawfirmnewswire.com

Congressional Committee Calls on Feds to Curb Medicare PHI Breaches, Identity Theft

Health Subcommittee Chairman Wally Herger (R-CA) said, “This report adds to the growing chorus of voices that have highlighted the need to protect beneficiary SSNs.  While CMS agreed with the OIG recommendation that it issue a new identification number when a beneficiary’s has been compromised, actions speak louder than words.  Though years of CMS indifference and delay make me skeptical, my hope is that this report finally persuades the agency to stop use of the SSN as the Medicare identification number.”
Source: healthcare-informatics.com

Houston Doctor Arrested on Medicare Fraud Charges

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

Medicare Plan D changes available

The Area Agency on Aging will be holding several education and enrollment events: -Friday Oct 19th 10:00am-2:00pm, Swisher Memorial Medical Center, Tulia, TX -Thurs Oct 25th 10:00am-2:00pm, Farwell Care & Rehabilitation Center 305 5th Street, Farwell, TX -Friday, Oct 26th 10:00am-2:00pm, Childress Medical Center, 901 U.S. 83, Childress, TX -Mon, Oct 29th 10:00am-2:00pm, Hemphill Co. Library, 500 E. Main, Canadian, TX -Wed, Oct 31st 10:00am-2:00pm, Hereford Senior Citizens 426 Ranger, Hereford, TX -Wed, Nov 2nd 10:00am-2:00pm, Ochiltree General Hospital 3101 Garrett Dr., Perryton, TX -Mon, Nov 5th 10:00am-2:00pm, Moore County Senior Center, Dumas, TX -Thurs, Nov 15th 10:00am-2:00pm, Pampa Senior Citizens Center, 500 W. Frances, Pampa, TX -Final Medicare Part D Open Enrollment Event, Friday, Nov 30th, 9:00am4:00pm, Panhandle Regional Planning Commission, 415 W. 8th, Amarillo, TX
Source: newschannel10.com

Open Enrollment 2013: Medicare Part D Benefits Improve but Premiums an…

Posted by:  :  Category: Medicare

While Medicare Part D prescription drug plan premiums are generally expected to remain steady in 2013, this PPI Fact Sheet by Leigh Purvis and Lee Rucker finds that premiums for many popular plans will actually be considerably higher than they were in 2012. Many plans are also increasing cost-sharing and their reliance on utilization management tools for covered prescription drugs. Medicare beneficiaries should closely examine their 2013 prescription drug plan choices during open enrollment for Part D.
Source: aarp.org

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

My Experience Applying for Medicare Online

Once submitted you are advised: “Thank you! Your data has been received and we are working to process your request. You will be able to check the status of your action online in 5 business days. To check the status, go to http://www.socialsecurity.gov. You will need to enter your Confirmation Number to get status information, so please put this number in a safe location. We hope you found our internet application convenient to use and easy to understand.” Well, we three found the online application process both convenient and easy. I applaud Social Security for an excellent implementation and the person-to-person customer service I received when I had a question.
Source: medicarebenefits.com

Eight mistakes to avoid during Medicare enrollment

5) Ignoring long-term care needs. According to an Opinion Research survey sponsored by PlanPrescriber.com, paying for long-term care is a top concern for baby boomers. Original Medicare will only pay for care in a skilled nursing facility for up to 100 days, and beneficiaries typically have to pay for a portion of those costs out-of-pocket. And, in most cases, Medigap plans will only cover out-of-pocket costs for services that are also covered by Medicare. So, once Medicare stops paying, your Medigap plan will stop filling in the gaps. But, long-term care insurance is available to help fill in the gaps.
Source: benefitspro.com

You Can Apply For Medicare Online

The nice thing about applying online is that you do not need to wait for an appointment.  You can fill out your application when you are ready from your own home.  As you are filling out your application, you may save it at any time during the application process and finish it when you are ready, so you do not have to worry about possible interruptions.  The web site is very secure, so your information is protected.  Once you complete the application, you will receive a receipt and an application number so that you can log in anytime to check your application status.
Source: americaninsuranceforexpats.com

The Hunt is Afoot For Medicare Part D

You can complete an easy-to-use online application for Extra Help at www.socialsecurity.gov. Click on Medicare on the top right side of the page. Then click on “Get Extra Help with Medicare Prescription Drug Plan Costs.” To apply by phone or have an application mailed to you, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and ask for the Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020). Or go to your nearest Social Security office.
Source: patch.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

PECOS: A Medicare Benefit for your Practice

Henderson Medical Billing Solutions LLC is an outsourced Medial Billing and Practice Management service located in Murrieta, California.  Henderson Medical Billing Solutions provides medical billing services to solo providers to mid-level practices throughout the United States.  Henderson Medical Billing Solutions offers Full Practice Management, Medical Billing, HIPAA Compliance Auditing and Training to medical and non-medical providers.  In addition, Henderson Medical Billing Solutions offers Accounts Receivables Recovery and New Practice Start-Up services.  Our staff includes certified practice managers and billers who are committed to the success of increasing provider revenue reimbursement.  To learn more about how we can maximize revenue and increase your practices productivity Contact us today.
Source: hendersonmbs.com

WASHINGTON: Medicare premiums going up $5 a month for 2013

Obama’s health care law reined in Medicare spending by curtailing payments to hospitals, insurers, drug companies and other service providers. Democrats want to focus the next round of cuts on providers, particularly pharmaceutical companies. But Republicans are looking for more significant changes in the program, such as increasing the eligibility age to 67.
Source: heraldonline.com

WellPoint Q1 2011 Results: Medicare Advantage Growth & Online Sales

Interestingly though, there are only a couple mentions of WellPoint’s Medicare (Senior) business on their most recent earnings call.  First, WellPoint saw higher than expected growth in their Medicare Advantage enrollments.  For those of you who sold their plans, WellPoint’s enrollment growth was probably a no brainer.  Their Medicare Advantage plans were extremely competitive in states like California, Ohio, Virginia, and New York.  Below is a quote from the call:
Source: wordpress.com

Medicare Part D Counseling Offered

“The amount of coverage offered for medications and medical services varies from company to company.  It is to your benefit to subscribe to a plan that covers those medications and services you need.  Since the Area Agency on Aging of Deep East Texas (AAADET) does not offer or sponsor any plan, we are one of the few independent sources of information and counseling available in the region,” said AAADET Program Director, Holly Anderson.  AAADET Benefits Counselors will ask questions about your health and prescriptions.  Based on the information you supply, they can tell you which program would benefit you the most.
Source: countylifeonline.com

Maine Seeks To Cut Medicaid Eligibility

Posted by:  :  Category: Medicare

Uninsured Direct-Care Workers by Geographical Region, 2007-2009 by PHInational.orgLePage argues that that the Affordable Care Act’s so-called “maintenance of effort” requirement went out the window with June’s Supreme Court decision. The provision prevented states from changing Medicaid eligibility levels before the Medicaid expansion occurred in 2014. (The concern was that states would remove beneficiaries from the Medicaid rolls knowing that when expansion occurred, those people would be allowed back on but the federal government would pay a much larger share of their expenses under the new law.) Now that the court has made that Medicaid expansion optional, LePage argues, Maine is no longer locked into the state’s Medicaid eligibility levels that were in effect when the federal health law was passed in 2010.
Source: kaiserhealthnews.org

Video: Example of Medicaid Eligibility for a Typical Couple

Economist’s View: The Effects of Medicaid Eligibility

This is from the NBER: Saving Teens: Using a Policy Discontinuity to Estimate the Effects of Medicaid Eligibility, by Bruce D. Meyer, Laura R. Wherry, NBER Working Paper No. 18309, Issued in August 2012: [Open Link to Paper]: This paper uses a policy discontinuity to identify the immediate and long-term effects of public health insurance coverage during childhood. Our identification strategy exploits a unique feature of several early Medicaid expansions that extended eligibility only to children born after September 30, 1983. This feature resulted in a large discontinuity in the lifetime years of Medicaid eligibility of children at this birthdate cutoff. Those with family incomes at or just below the poverty line had close to five more years of eligibility if they were born just after the cutoff than if they were born just before. We use this discontinuity in eligibility to measure the impact of public health insurance on mortality by following cohorts of children born on either side of this cutoff from childhood through early adulthood. We examine changes in rates of mortality by the underlying causes of death, distinguishing between deaths due to internal and external causes. We also examine outcomes separately for black and white children. Our analysis shows that black children were more likely to be affected by the Medicaid expansions and gained twice the amount of eligibility as white children. We find a substantial effect of public eligibility during childhood on the later life mortality of black children at ages 15-18. The estimates indicate a 13-18 percent decrease in the internal mortality rate of black teens born after September 30, 1983. We find no evidence of an improvement in the mortality of white children under the expansions.
Source: typepad.com

Report: Expanding Medicaid eligibility would help Arizona

The group held a news conference to discuss a report that examined three options for Medicaid under the federal health care law. The others were maintaining the current policy, which froze enrollment for childless adults as the state struggled with budget deficits, and restoring coverage for everyone up to 100 percent of the poverty line.
Source: cronkitenewsonline.com

What the Medicaid Eligibility Expansion Means for Women

The Medicaid eligibility expansion is a crucial part of the health care law. Starting in 2014, 15 million uninsured Americans, including 7 million women will be newly eligible for Medicaid coverage.  Medicaid is an effective program that has the potential to improve the health and economic wellbeing of millions of American women while at the same time saving states money and creating jobs. Medicaid is and will continue to be a crucial source of health care for low-income women in America and it is vital to women’s health that states move forward with the Medicaid eligibility expansion. In this issue brief, we will examine why the current Medicaid program is important to women and why the Medicaid expansion is a good deal for women and states.
Source: freakoutnation.com

More Problems for Medicaid Enrollees Under the Affordable Care Act

American Medical Association cancer CBO consumer driven health care diabetes doctors drugs electronic medical records email emergency room EMR ER exercise FDA genetics Health Care Access Health Care Costs health care quality health insurance health IT health policy Health Reform Health Savings Accounts heart disease hospital HSA insurance life expectancy Massachusetts Medicaid Medicare medicare advantage NHS ObamaCare obesity pay for performance public option SCHIP seniors socialized health care Social Security stimulus tax unemployment Uninsured
Source: ncpa.org

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

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

Pregnant Women’s Medicaid Eligibility After 2014 – What’s the Minimum?

Affordability affordable care act August 17 Directive block grant Center for Children and Families children Children’s Health Insurance Children’s Health Insurance Program children health Childrens health coverage CHIPRA CMS Congress Dawn Horner Enrollment Federal Health Policy Georgetown Center for Children and Families Georgetown University Center for Children and Families Georgetown University Health Policy Institute Georgetown University Health Policy Institute Center for Children and Families Health Care Costs health insurance Health Insurance Exchange health reform HHS insurance Joan Alker Jocelyn Guyer Joe Touschner Liz Arjun maintenance of effort Martha Heberlein medicaid National Health Reform Obama Obamacare pre-existing conditions SCHIP Senate Finance Committee state budget State Health Policy the Exchange Tricia Brooks Uninsured uninsured children
Source: georgetown.edu

A Look at Home Ownership & Medicaid Eligibility

Elder law attorneys are asked many questions about Medicaid eligibility and indeed, this government program is widely utilized by senior citizens around the country to pay for long-term care. Statistics that have been compiled by the Kaiser Family Foundation indicate that some seven out of every 10 individuals who are residing in nursing homes in America are Medicaid recipients.
Source: myestateplan.com

GAO: Medicaid eligibility screening for long

All 50 states have conducted data matches with the Social Security Administration when verifying a Medicaid applicant’s assets, according to a Government Accountability Office report released Monday. But as of 2011, no state had enacted a 2009 law requiring states to implement an electronic verification system, according to the GAO. The degree to which states used other asset verification processes — such as reviewing earned income, unearned income, financial and investment resources — was not consistent across states.
Source: mcknights.com

Fighting Collection Agency Debt: Medicaid Divorce and Your Eligibility for Health Care

First of all, we aren’t talking about protecting assets. That’s a whole ‘nother ballgame. We are simply talking about dissolving a marriage in order to qualify for government health care services. I will try to restrain myself from ranting about lack of cost control in the health care industry and the highway robbery that a single doctor’s visit has become (grumble). In a Medicaid divorce, both spouses file for an uncontested divorce granting the majority of property to the healthy spouse. They fill out the paperwork and  file the divorce themselves to save money. Filing fees for an uncontested divorce can range from less than $100 to over $300 depending on your state. Now that I’ve started looking around, I even see attorneys publicly recommending this option for cash-strapped consumers who can’t afford to seek the medical care they or their children so desperately need.
Source: blogspot.com

Wyoming Lawmakers Looking At Medicaid Eligibility

The Associated Press reports that a bill under development would put into state statute guidelines for receiving the health care assistance for the needy. The bill does not address expanding Medicaid as part of the new federal health care law.
Source: kowb1290.com

Medicare open enrollment: What’s the best Medigap policy?

Posted by:  :  Category: Medicare

The difficulty for consumers is that the nature of Medigap makes it a lot harder to shop for than Medicare Advantage. Here’s why. Medicare Advantage plans are regulated and overseen on a national level. Medicare routinely collects all kinds of information on them about customer satisfaction and quality of care. In addition, the premium of a specific Medicare Advantage plan is the same for each customer. As a result, it’s possible (as I explained yesterday) to go to Medicare.gov and compare Medicare Advantage plans in detail, including quality ratings and price. It’s also why we can publish rankings of Medicare Advantage HMOs and PPOs through our partnership with the National Committee on Quality Assurance.
Source: consumerreports.org

Video: Learn About Medigap Plans

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Medicare.gov/Medigap: Find Medicare Medigap Policy in Your Area

In order to fill the gaps in Original Medicare Plan coverage, Medicare supplement insurance, also called Medigap policy is sold by private insurance companies. In fact, Medicare Medigap Policy can assist you in paying some of the health care costs that Original Medicare does not cover such as co-insurance, co-payments and deductibles. Check out a comprehensive list of Medicare Medigap policies in your area just by opening Medicare.gov/Medigap website. There are several Medicare Medigap Policies to select, so go through the list carefully and decide according to your basic needs and especially your budget.
Source: webswiki.com

Health Law Prompts Review Of Some Medigap Plans; Defining Who Gets Dependent Status

Your plan and Plan C are the most popular Medigap plans, chosen by nearly two-thirds of beneficiaries. Those are also the policies that provide significant “first dollar” coverage: they pay the deductibles for both the hospital and outpatient portions of the traditional Medicare program (Parts A and B) as well as the 20 percent coinsurance required for doctor visits, and cover other services as well. People with these supplemental plans may pay virtually nothing for medical services beyond their premiums.
Source: kaiserhealthnews.org

Medigap Plans and the Affordable Health Care Act

Medicare does not cover every type of medical expense or treatment. For this reason many senior citizens feel they should choose MA (Medicare Advantage) private plans for insurance. This is because they feel Medicare Medigap plans may be too expensive. Mistakenly too many seniors think the MA plans are best because they low, or even zero monthly premiums. The MA plans also frequently cover prescription drugs, vision and other problems. The problem is that all MA plans have many hidden charges that come out of the wallet of those trusting seniors. In some cases these unexpected costs can add up to many thousands of dollars.
Source: seniorcorps.org

Medigap Vs. Advantage plans

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