Choose your Medicare plan carefully

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 marsmet524By Jeffrey White Medicare/Medicare Advantage plans are open to change enrollment now through December 7.  As a result, you have probably seen advertisements for many Medicare Advantage plans. There are several options in our market area if you decide an Advantage plan is right for you. But don’t assume because it’s an AARP-endorsed company, that it’s the best possible choice for you. What you need to know is which providers belong to the plan’s network.  A doctor or hospital “in network” is one that negotiates a formal contract and provisions for reimbursement.  This is important because, if you receive services from a doctor or hospital out-of-YOUR-network, you may find yourself with less coverage and paying much more out-of-pocket than you bargained for! Medicare Advantage plans are not supplemental plans, they actually replace traditional Medicare. Sometimes called “Part C” or “MA Plans,” a Medicare Advantage Plan is another health plan choice you may have as part of Medicare. They are offered by private insurance companies and provide all of your Part A (hospital insurance) and Part B (medical insurance) coverage. Medicare Advantage Plans pay for all of the services that Medicare covers, including emergency and urgent care. These plans are NOT supplemental coverage, but they may offer extra benefits, such as vision, hearing, dental and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). Although participating insurance companies must follow rules set by Medicare, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services. For instance, you may need a referral to see a specialist or you may be required to go only to doctors or facilities that belong to the plan for non-emergency or non-urgent care. Or you may be required to obtain prior approval for certain procedures to avoid higher costs. If you are treated by a doctor or hospital that doesn’t belong to the plan, your services may not be covered or your costs could be higher. Since not all Medicare Advantage Plans work the same way, it’s important to find out the rules and costs of a plan — and if your doctors and hospital are in the plan’s network of providers — before you sign up. In most cases, you’re enrolled in a plan for a year and cannot change plans until the next open enrollment, which could be up to one year later. Insurance companies offering Medicare products may say you are free to choose any doctor or hospital, but some fail to let you know that you may pay more for medical care by providers (doctors and hospitals) not in their network. If you are already in a plan and do not select a different insurance company, you will be automatically re-enrolled in your current plan. Be aware, the plan’s rules and participants can change each year, so you’ll need to confirm your health care providers are still part of the insurance company’s network. Beaufort Memorial Hospital participates in five Medicare Advantage Plans. They are: • Medicare-Ambassador PPO (MCR Advantage plan under America’s 1st Choice) • Medicare-Blue (MCR Advantage PPO plan) • Medicare-Humana Choice PPO (MCR Advantage PPO plans) • Medicare-Humana Gold Choice PFFS (MCR Advantage plan) • Medicare-Patriot PFFS (MCR Advantage plan under America’s 1st Choice) To find out more about plans available in the area, go to www.medicare.gov and enter your zip code. If you want more information about Beaufort Memorial’s participation in a specific Medicare Advantage Plan, visit www.bmhsc.org or call Robin Poehnert at 522-5794. Remember, you only have until December 7 to choose a different Medicare Advantage plan, or you may choose to switch back to traditional Medicare. Whichever you choose, make sure you know what you are getting before you sign up and that you understand the implications and requirements of joining a particular Medicare Advantage plan. Jeffrey White is Senior VP and CFO at Beaufort Memorial Hospital.
Source: yourislandnews.com

Video: What Is Medicare Advantage?

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

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

Medicare Advantage Future

It appears that the Advantage plans eventually will be limited to lower incomes where it will be based on people on medicaid or dual eligible. It simply can’t go to the way of having one area in the country offer it and not in others. Can this be unconstitutional? Insert from the congress blog:The candidates’ positions on Medicare Advantage – The Hill’s Congress Blog "Medicare Advantage plans are paid based on a legislative formula, and any payments they receive above what is necessary to provide the basic Medicare benefit must be provided to the beneficiaries of the plans in the form of expanded benefits, such as lower deductibles and copayments for services. Once the election is over and the artificial and temporary bump-up in payments is terminated, as it inevitably will be, the Medicare Advantage plans will be forced to pare back benefits, and enrollment in the plans will drop." "This should not be surprising. The traditional Medicare fee-for-service insurance is an extremely inefficient model. There is no incentive for either the providers or the enrollees (most of whom have supplemental coverage beyond Medicare) to control the use of services. Thus, the volume and intensity of service use rises dramatically each year. Moreover, there is no coordination among those providing medical services to the patients, which leads to fragmented and low-quality care in too many instances." Since traditional med sups are considered inefficient in controlling costs and the fact the president wants to cut spending on advantage plans it leaves a big gap of uncertainty of which way we go with medicare. I would hope we get rid of the political animal and try to come up with the most efficient way to run medicare for future generations to come as the country ages. What is your take?
Source: insurance-forums.net

Medicare Targets Health Plans With Low Ratings

Medicare officials are encouraging 525,000 beneficiaries to switch out of these 26 Medicare Advantage and drug plans that have received low ratings for three consecutive years and enroll in better plans for next year. The poor performing plans will have this warning symbol next to their names on Medicare’s plan finder website to steer shoppers to other plans.
Source: kaiserhealthnews.org

How much does Medicare Advantage cost?

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

Obamacare ‘Surprise’ Threatens Access to Medicare Advantage Coverage, AMAC Charges

The Association of Mature American Citizens [http://www.amac.us] is a vibrant, vital and conservative alternative to those traditional organizations, such as AARP, that dominate the choices for mature Americans who want a say in the future of the nation.  Where those other organizations may boast of their power to set the agendas for their memberships, AMAC takes its marching orders from its members.  We act and speak on their behalf, protecting their interests, and offering a conservative insight on how to best solve the problems they face today.
Source: amac.us

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

What Is Medicare Advantage Insurance?

What is Medicare Advantage insurance? Now that you can answer that basic question, let’s explore Medicare Advantage further so you can see how well it can go above traditional Medicare. The types of additional benefits offered may include vision care, health and wellness programs, hearing and dental. The dental benefit cannot be underestimated as traditional Medicare only covers dental services when they are deemed essential to the maintenance of your health or critical to the success of a non-dental operation. However, things such as prescription drug coverage, routine dental checks, fillings, cleaning or basic preventative maintenance are not covered under traditional Medicare. Some Medicare Advantage plans do offer that benefit. In fact, some Medicare Advantage plans offer coverage which competes directly with the combined coverage of traditional Medicare plus a Medicare Supplemental Insurance policy.
Source: seniorcorps.org

Obama administration hides Medicare Advantage cuts in demonstration project

“Over the next few years the Affordable Care Act cuts about $156 billion worth of subsidies from Medicare Advantage plans,” Herrick said. “Nearly one in four seniors are enrolled in a Medicare Advantage plan. Half of these may lose their plans, as plans that are no longer profitable close due to the budget cuts. However, millions of seniors being thrown off their private Medicare plans in an election year is not something that’s welcome by the Administration.
Source: consumerinsuranceguide.com

State Highlights: Texas Pursues Some Medicaid Providers

Posted by:  :  Category: Medicare

Beneath Highway 90 bridge, Richmond, Texas 1018091117BW by Patrick FellerCalifornia Healthline: ‘California’s Budget Situation Has Improved Sharply’ Yesterday’s long-term budget forecast for sunnier skies in California by the Legislative Analyst’s Office could also mean good things for the state’s health care programs, according to the LAO and health experts. … The state still faces a $1.9 billion deficit for the fiscal year 2013-14. … It is unlikely any previous cuts to health care programs would be restored, [Anthony Wright, executive director of Health Access California said] … “The big risk with [implementation of] the Affordable Care Act was the state’s fiscal uncertainty. So this should help that, as well” (Gorn, 11/15).
Source: kaiserhealthnews.org

Video: What Does Texas Medicaid Pay For?

The Medicaid Problem in Texas

Although conservatives are rightfully disgusted with the Supreme Court’s ruling on ObamaCare, one aspect of the Supreme Court’s decision which was at least a step in the right direction is that it threw out the mandates to expand Medicaid coverage and set up state health insurance exchanges. Governor Perry has been quick to reject this now optional portion of the law, aligning Texas with several other states standing up to ObamaCare.
Source: texasgopvote.com

Texas Medicaid Recipients Call For Full Funding

Lawmakers cut Medicaid programs last year and underfunded the program by $4.8 billion. When the Legislature meets next year, they have until March to make up the budget deficit. Medicaid is a joint federal-state program that provides health care to the poor, disabled and the neediest elderly Americans.
Source: cbslocal.com

Medicaid Expansion in the News

The new, updated analysis…shows that if all states were to expand their programs, state Medicaid spending nationally would rise by $76 billion from 2013 to 2022, an increase of less than 3 percent, while federal Medicaid spending would increase by $952 billion, or 26 percent. As a result, an additional 21.3 million individuals could gain Medicaid coverage by 2022 and, together with other coverage provisions of the ACA, that would cut the uninsured by almost half (48%).
Source: garloward.com

Christianity Today Gleanings: Court Says Texas Can Ban Medicaid Funds To Planned Parenthood

At Christianity Today, we’re constantly tracking important developments in the church and the world. Often we use our network of reporters around the world (and for that, visit our main site). But we also monitor other news outlets, bloggers, newsmakers’ social media feeds, and countless other information streams. Gleanings compiles the most urgent and interesting items we’ve found, explains why you need to know about them, and gives you the background you need to understand them. It’s our snapshot of what God is doing in the world, hour by hour.
Source: christianitytoday.com

Whistleblower helps end $20 million Medicaid fraud in Texas

We’ve discussed previously how Texas has led the way in blowing the whistle on Medicaid fraud. Since 1991, $354 million has been recovered in Texas from pharmaceutical companies alone. A main reason our state has been so good at holding these fraudsters accountable is that whistle-blowing has been incentivized by allowing whistleblowers to receive between 15 and 25 percent of the settlement.
Source: rustytuckerlaw.com

Livingston Parish changes employee health insurance plan

Posted by:  :  Category: Medicare

Maryland Health Insurance Plan Federal Press Announcement by MDGovpicsLandrum, along with about 140 other parish employees, had full coverage health insurance for themselves and their immediate family members but thanks to a council vote, that will soon change to 100 percent coverage for employees but only 50 percent for spouses and dependants.
Source: wafb.com

Video: What a Single Payer Health Insurance Plan Looks Like

Is a high deductible health plan right for me?

Well, the fact is that there’s no one health insurance plan that’s best for everyone. For example, some people value preventive medical care more than anything; others only want coverage that’s there for them in an emergency. Young people might need a different kind of protection than older people. Finding the right match for your needs isn’t easy.
Source: ehealthinsurance.com

Insurance Commissioner Mike Chaney Sends Health Insurance Plan To Feds

Sam is the community engagement editor at The Clarion-Ledger, where he also leads a team of reporters covering the big stories of the day in Mississippi and the metro area. He has served as editor and publisher of several Mississippi and Alabama newspapers. Sam lives in Florence with his wife, three kids, a cat and a goldfish. During football season, he’s ringing cowbells on Saturdays and watching the Pats on Sundays. During baseball, he’s hoping for one more miraculous season led by Big Papi’s bat. And during basketball season, he catches up on TV. 
Source: clarionledger.com

City Employees, Retirees Caught Abusing Health Care Plan

Okay, I am not a crook(!!!!!!!!!!!!!), consider myself smart enough, really don’t have a twisted mind (although a few friends may disagree), and don’t think I’m jumping to an extreme conclusion. And I did not say I admire what this person did. I just know that I would do anything to save the life of my child. If that’s what you consider to be "weak thinking" then I am guilty. It’s unfortunate that the lack of affordable health care in this country forces people to make these kind of choices. I don’t think these are "dumb political talking points", but rather real, human, heart-breaking issues that many people are facing. You may now resume your insults and name-calling.
Source: patch.com

AMA: Alabama has the least competitive health insurance market in the nation (UPDATED)

“Blue Cross’ profit margins for the last 5 years have averaged less than one cent on the dollar, reflecting our goal of delivering value to our customers,” said Mackin, vice president of Corporate Communications and Community Relations. “We return over 90 cents in healthcare benefits for every dollar received from our customers, and our 7 percent admin expense ratio is one of the lowest in the country and second among the 38 Blue Cross Blue Shield Plans.”
Source: al.com

How’s That Obamacare Waiver Workin’ Out for Ya?

“There’s no such thing as a free lunch” is a race-neutral truth. But economically illiterate Obama supporters have now called for boycotts of these businesses and accused them of vengeful “racism” against the president. Instead of sympathy and gratitude for private businesses trying to do right by their workers, customers and shareholders, the corporate-bashers inundated Twitter this week with profanity-laced condemnations of the restaurant service industry. One protester tweeted: “@Applebees Your CEO is a racist piece of (redacted), he not hiring because Obama was elected…U WILL LOSE CUSTOMERS.”
Source: townhall.com

New Guidance for Employers and Insurers on the Implementation of Health Care Reform

Essential health benefits must be equal to the benefits offered by a typical employer plan.  The rule sets the definition of essential health benefits by state, based on a state-specific benchmark plan.  This rule allows states to select the benchmark plan from certain identified plan options within the state.  The benchmark plan options include: (1) the largest plan by enrollment in any of the three largest products in the state’s small group market; (2) any of the largest three state employee health benefit plans options by enrollment; (3) any of the largest three national Federal Employees Health Benefits Program (FEHBP) plan options by enrollment; or (4) the largest insured commercial HMO in the state.  If the state does not select a benchmark plan, HHS will make the selection as the largest small group product in the state.
Source: basusa.com

States get more time for health exchange plans

ozzie not much actually… it can be digitally run for extremely cheap.. Thats how you do it with federal employees. Its actually amazingly cheap. And the insurance company choices and all the plans within those companies are available to you. You know those awesome plans everyone complains about federal employees having and not them? Well guess what, now you get them too. And you get the buying power of your entire state or even nation depending on the particular plan you get. Not just the buying power of your company. Youll save a buttload, plus have amazing healthcare for once. For a single individual, its about 30 bucks every 2 weeks to 60 bucks every 2 weeks depending on what plan you want. Family youll pay about 300 a month for the top, or for the savings account types, 100-200 depending, and its deducted from your taxed part of your income, so youll barely see any of that come from the actual take home pay part of your paycheck. Its actually really fancy, and really cheap, and on top of that even tax deductable from there.
Source: nbcnews.com

Choosing a Health Insurance Plan?

You should take advantage of a new consumer benefit to help you compare health insurance plans. Beginning September 23, 2012, all private insurers must describe their health policies in a same way. Here’s an example of the first page of this description, so you know what to look for.
Source: consumersunion.org

Poll: How healthy is your health insurance plan?

Kellie Lunney covers federal pay and benefits issues, the budget process and financial management. After starting her career in journalism at Government Executive in 2000, she returned in 2008 after four years at sister publication National Journal writing profiles of influential Washingtonians. In 2006, she received a fellowship at the Ohio State University through the Kiplinger Public Affairs in Journalism program, where she worked on a project that looked at rebuilding affordable housing in Mississippi after Hurricane Katrina. She has appeared on C-SPAN’s Washington Journal, NPR and Feature Story News, where she participated in a weekly radio roundtable on the 2008 presidential campaign. In the late 1990s, she worked at the Housing and Urban Development Department as a career employee. She is a graduate of Colgate University.
Source: govexec.com

Pharma Gains from Rule On Health Insurance Benefits

HHS responded by changing the rule so that plans now will have to cover the range of drugs offered through the “benchmark” insurance plan selected by the state, which generally is the largest commercial plan offered to small businesses in that market. And most small group plans, according to research by Avalere Health, cover more than one drug per class. Although the specific coverage policy will vary among the states, the one-drug-per-class standard becomes a minimum for setting drug coverage – not the norm. The HHS proposal includes a guide for insurers to calculate the drug list count of the applicable benchmark plan, with an eye to achieving an accurate assessment of chemically-distinct drug entities.
Source: pharmexec.com

State Roundup: Big Insurance Premium Hikes Sought In Calif., Conn.

Posted by:  :  Category: Medicare

House Republican Press Conference on Health Care Reform by House GOP LeaderCT Mirror: As Enrollment Falls, Charter Oak Health Plan Premiums Rise Because she’s self-employed, Donna Faulknor spent years buying her own health insurance. She figures she’s paid more for coverage than her mortgage. But when the premiums hit four figures for a plan with a $10,000 deductible, she and her husband joined the ranks of Connecticut’s uninsured. Eventually, they turned to the state’s Charter Oak Health Plan, which offered coverage for $307 a month. She dropped the plan when the monthly cost rose to $446 last fall, but a health scare convinced her it was worth struggling to pay for the program. Now the state is again raising the monthly cost (Levin Becker, 11/27).
Source: kaiserhealthnews.org

Video: Impact of Your Lifestyle on Your Health Insurance Premiums – SmarterWithMoney

Health Insurance Exchanges May Be Too Small to Succeed

Ultimately, economic theory predicts that the effect of insurance exchanges on insurance premiums will depend on two offsetting factors. On one hand, smaller, less-consolidated insurance companies may have less bargaining power with large hospitals, physician groups and pharmaceutical companies, which traditionally command substantial market power. Reimbursements to these parties, as well as costs to insurers, may rise in a fractionated market, and if so, these costs would be passed on to consumers as higher premiums. On the other hand, exchanges may inject competition into the marketplace, reducing premiums as even the smallest insurer can market its plans, forcing larger insurers to lower their premiums to remain competitive. Which theoretical effect will dominate in reality is an open empirical question with important policy implications.
Source: nytimes.com

Health Insurance Premiums Rise for Individual Consumers : The Freeman : Foundation for Economic Education

Lewis Andrews explains how tight immigration controls leave innocent people vulnerable to human traffickers; Warren C. Gibson explores one of Mises’s most important principles, Isaac Morehouse uses fantasy football to illustrate a fundamental economic concept; Sandy Ikeda discusses how market inefficiencies create value; and much, much more.
Source: fee.org

Health insurance exchanges may be too small to succeed

In imperfect health care markets, competition can be counterproductive. The larger an insurer’s share of the market, the more aggressively it can negotiate prices with providers, hospitals and drug manufacturers. Smaller hospitals and provider groups, known as “price takers” by economists, either accept the big insurer’s reimbursement rates or forgo the opportunity to offer competing services. The monopsony power of a single or a few large insurers can thus lead to lower prices. For example, Glenn Melnick and Vivian Wu have shown that hospital prices in markets with the most powerful insurers are 12 percent lower than in more competitive insurance markets.
Source: pnhp.org

Want to Save Health Care Costs? Then Subsidize Smoking

OK. Higher premiums might be justified on the grounds that before the smokers and the hefties shuffle off this mortal coil, they may increase the costs of an individual health insurer in advance of enjoying the delights of Medicare. But for those folks who are forever insisting that the whole country adopt a single payer (government) plan because it will allegedly save money, the evidence suggests that they really might want to look into subsidizing cigarettes and carbs.
Source: reason.com

Group health insurance premiums rising faster than wages

Census statistics show that there was a slight drop in the number of people without medical coverage of any kind in 2011. While 50 million people went without insurance in 2011, the figure declined to 48.6 million in 2011, as did the percentage without coverage — from 16.3 percent in 2010 to 15.7 percent in 2011. Those with medical coverage climbed to 260.2 million in 2011 from 256.6 million in 2010; that breaks down to 84.3 percent of the population with insurance in 2011, contrasted with 83.7 percent the previous year.
Source: insurance.com

How Will Health Reform Affect My Insurance Costs?

The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.
Source: webmd.com

Health insurance premiums set to rise

According to the newspaper, the premium rise will be crucial because it sets the base premium for a major 2014 policy change, when the government will stop increasing the 30 per cent private health insurance tax rebate in line with health fund premium rises.
Source: bigpondnews.com

Many Unaware of New Coverage Options Under Health Care Reform Law

Where does the Government get this “subsidy” money to pay for free healthcare for 15+ million people. Is it Magic? Or is this just another reason for the Government to raise more taxes on the middle income and small business owners in Anerica and reduce them all to a common poverty level? How about some answers from our Liberal friends who seldom are looking for real answers. How about going from $17 Trillion in debt to $25 Trillion in debt? That sounds like a good Liberal answer!
Source: californiahealthline.org

How and Where Do I Get Medicare Insurance Quotes?

Posted by:  :  Category: Medicare

CorettaScottKing_WinonaBartonBallentine3 by Mark TribeNot all insurance agents can provide this type of insurance. For example, do not call your friend who sells car insurance, he will not be licensed to sell Medicare insurance. When you find an agent who specializes in this area, ask for an appointment to set down with him so he can explain how all the plans work. You may want to add a prescription plan if you take a lot of medications. Your agent can help you deicide and he will give you Medicare insurance quotes for you to consider. This can be done anytime of the year, but in the fall is time for open enrollment and you may be able to save some money by getting your Medicare insurance quote during this time period.
Source: seniorcorps.org

Video: Medicare Quotes

Elisabete Jacinto finishes the Moroccan Rally on the podium

On reaching Zagora, the Portuguese race driver made a general survey of the competition: “Fortunately everything went on well, and we are very happy. Of course this good classification is due to my team’s excellent work. With expertise and imagination, the assistance solved all the problems which we had to face, and José Marques, though having suffered some moments of anxiety, did an excellent navigation. A word also about Marco Cochinho, who has been doing a brilliant maintenance work, which has enabled us to finish all the races. Now we are heading home with an enormous list of tasks to complete before Africa Eco Race. This is also a rally which is supposed to have a high competitive level, and we want to be well prepared”, she concluded.
Source: rallyraid.net

Reasonable Medicare Supplement Insurance Quotes

On-line reputation management has turned into an extremely hot business within the Seo marketplace. As people are more savy regarding the world wide internet and make use of search engines like Google to investigate businesses in addition to goods and services it’s much more important than ever prior to to preserve a tidy reputation online. “One from the troubles with on-line critiques will be the reality that a lot of them aren’t actually legitimate. Anybody can anonymously signup on a web site to post anything whether or not it’s correct or false. A competitor can effortlessly submit bogus comments as well as compose phony rip-off reports on websites online deliberately damaging their competition”, explained Porter.
Source: scoop.it

Free Insurance Agent Websites And Medicare Quote Engine For Professionals

A new alliance dedicated to insurance agents is all set to revolutionize the insurance industry, by offering a first of its kind networking website solely dedicated to insurance agents where they will have access to a free Medicare supplement quote engine, along with real leads. In essence, a platform where they can build their consumer network socially.
Source: trailer-trash.tv

What Medicare Needs is a Consumer

Medicare’s cuts will be implemented by changing the way fees for the diagnostic procedures are calculated. Instead of reimbursing neurologists for each nerve analyzed, the new billing codes will henceforth bundle multiple nerve-conduction tests into a single fee. The Obama administration claims that under the current system Medicare has been paying too much for neurologists’ overhead costs. But the American Academy of Neurology, in an advisory to its members, warns that the cuts will devastate “neurology practices large and small, many of which rely on these services to meet their bottom line.” Patients will be hurt as well: As Medicare squeezes neurologists, seniors’ access to neurological care will dwindle.
Source: townhall.com

Choosing Medicare Health Insurance for Seniors

Medicare Advantage Plans (Part C) provides Part A and Part B coverage, but this coverage is provided by private insurance companies that have been approved by Medicare. Because private companies provide this coverage, additional benefits may be available. Additionally, the amounts charged for various services may differ between providers. Part C plans may have networks, and the beneficiary will have to utilize the services of providers in the plan’s network. Prescription drug coverage is often included in this plan. Beneficiaries of Medicare Part C do not need to purchase Medigap coverage.
Source: insr4u.com

Evaluate Quotes on Medicare Supplement Insurance

Every single strategy, Prograde supplements A through L, has a distinct set of advantages. Each and every insurance business decides for itself which of the A via L policies it wants to sell. An insurance business ought to, nonetheless, sell program A if it sells any other Medicare supplement insurance program. The positive aspects in plans A via L differ, but they are the very same for any insurance coverage firm. That is, program A has a diverse set of rewards from program B, but plan A has the same benefits no matter who sells it. Nevertheless, diverse insurance coverage organizations can charge diverse premiums. So, even though plan A has the exact same rewards no matter who sells it, distinct insurance coverage businesses can charge various premiums for a strategy A policy.
Source: nyconnexions.com

Stakeholders Prepping for Lame

Posted by:  :  Category: Medicare

Our colleague Meghan McCarthy reports (for members) on how stakeholders are gearing up for a lame-duck fight over the doc fix: Members of Congress are familiar with the headache known as the “doc fix”; they have regularly been putting off pay cuts to Medicare doctors under the flawed “sustainable growth rate” formula for the past decade. But the added workload at the end of this year makes the challenge of staving off a 30 percent Medicare pay cut in 2013 all the more difficult. …  “I don’t see any kind of permanent fix under any circumstances,” said Julius Hobson, a lobbyist for Polsinelli Shughart who used to run the American Medical Association’s lobbying shop, in an interview. “It is all temporary fixes to get it into next year, if we can even get that. What happens if we have the same gridlock we have now? That’s a formula for doing nothing.” The National Association of Public Hospitals and Health Systems is so concerned about the lame-duck period that they’ve decided to get their constituents pounding doors in person on the Hill this December. “We’ve already booked hotels,” said Shawn Gremminger, NAPH assistant vice president, in an interview. “We don’t usually do post-election fly-ins, but this is one of those cases where we think it’s worth doing it.”
Source: nationaljournal.com

Video: Paul Ryan on Health Care Fiscal Train Wreck

Explaining the Origin of the Fiscal Threat

The coincidental: The measures from the 2011 deal are set to take effect at the same time as the changes to jobless benefits, the alternative minimum tax adjustment and the Medicare “doc fix,” and the expiration of the Bush tax cuts — a confluence that the two parties did not fully expect back in August 2011. The nation will also reach its debt ceiling in January, creating additional uncertainty. Accounting maneuvers by the Treasury Department could push that deadline to March, but Mr. Obama wants a debt-limit increase as part of any deal, adding another item to the agenda.
Source: nytimes.com

Will Republicans Bargain Away Entitlement Reform in the Fiscal Cliff Deal?

More to the point, the possible savings from reducing Medicare spending on the wealthy are quite slim. According to Reynolds, denying Medicare benefits to the top 1 percent of earners would save just 1 percent, at most, out of Medicare’s budget. And if the wealthy were denied benefits entirely, Medicare would actually lose the money raised from their higher premiums. At best this sort of meaningless means testing would provide Republicans with a fig leaf to cover a deal to raise tax revenues. But it wouldn’t fix Medicare. It wouldn’t fix the budget. It wouldn’t fix much of anything.
Source: reason.com

Obama signs Medicare doc fix

Providers can breathe a sigh of relief (at least temporarily), as President Obama on Wednesday signed legislation (H.R. 3630) that includes a 10-month doc fix, averting a 27.4 percent reduction in Medicare reimbursement rates for the rest of the year, California Healthline reported. Originally slated to start March 1, the proposed reimbursement cuts had providers biting their fingernails as they waited for a decision on the Medicare cuts. After a rare compromise between Republicans and Democrats last week, the bill passed through the House and then Senate, making its way to the President’s desk. To fund the $18 billion doc fix, the agreement includes health-related offsets that would save $21.2 billion over the next ten years. However, as FiercePracticeManagement reported, the fix is only temporary–and many physicians are fed up with the lingering uncertainty. Article
Source: fiercehealthcare.com

Congressman proposes 'doc fix' extension

The Medicare payment formula for physicians’ services — which is known as the Sustainable Growth Rate — is used to make sure that annual increases in the expense per Medicare beneficiary do not exceed the growth of the gross domestic product. But because it’s only a temporary “doc fix,” Congress has had to act every year recently to stave off a 30% reduction in Medicare physician payments.
Source: mcknights.com

Health Care, Medicare Will Pose Major Challenges To The Winner

Posted by:  :  Category: Medicare

Medicare for All! by juhansoninMedpage Today: Obama Wins If Health Care Is Key Concern Voters who walk into a polling place with health care on their minds are likely to cast their votes for President Obama, according to a report by a group of Harvard health policy analysts. For example, among likely voters who say that “healthcare and Medicare” are the most important issues in their vote, 41 percent said they were much less likely to vote for a candidate who supported repealing all or part of the Affordable Care Act (ACA), as Mitt Romney has said he would do, according to Robert J. Blendon, ScD, of the Harvard School of Public Health, and colleagues. “Health care is playing a greater role in this presidential election than in many other recent ones,” they noted in a special report published online in the New England Journal of Medicine (Frieden, 10/12).
Source: kaiserhealthnews.org

Video: ‘Fiscal Cliff’ Revives Higher Medicare Age Talks

What Medicare Needs is a Consumer

Medicare’s cuts will be implemented by changing the way fees for the diagnostic procedures are calculated. Instead of reimbursing neurologists for each nerve analyzed, the new billing codes will henceforth bundle multiple nerve-conduction tests into a single fee. The Obama administration claims that under the current system Medicare has been paying too much for neurologists’ overhead costs. But the American Academy of Neurology, in an advisory to its members, warns that the cuts will devastate “neurology practices large and small, many of which rely on these services to meet their bottom line.” Patients will be hurt as well: As Medicare squeezes neurologists, seniors’ access to neurological care will dwindle.
Source: townhall.com

Healthcare Bill and Its Impact on Medicare

Additionally, because of reduced payments and services covered by the bill, the Congressional Budget Office estimates that Americans will see a 5 billion price increase in doctors’ fees for those doctors who treat Medicare patients. With only a percentage of those fees being covered by Medicare, patients themselves will have to make up the difference out of their pockets. TRICARE (the military healthcare program) beneficiaries would see an increase in fees by about billion for non-military physicians who see patients enrolled in the TRICARE program.
Source: blogspot.com

Ulcer bug may affect weight loss surgery

PARI Pharma focuses on the development of aerosol delivery devices and drug development for therapies to promote inhaled aerosols in which complete drug and device can be optimized jointly. Based on PARI 100 years of history working with aerosols, PARI Pharma develops treatments for pulmonary administration and nasal delivery platform on measurement uncertainty, as eFlow and vibrate technologies. PARI Pharma has several clinical development programs ongoing, either partners or on its own initiative, cystic fibrosis, COPD, respiratory syncytial virus , and treatments for lung transplant patients among other indications. PARI Pharma, a company PARI Medical Holding, is close to Monaco, Germany, with a significant presence in the United States.
Source: yerbabuenainstitute.org

Medicare encourages preventive healthcare :: The Valley News

Disclaimer The Valley News has tightened its policy regarding comments. While we invite you to contribute your opinions and thoughts, we request that you refrain from using vulgar or obscene words and post only comments that directly pertain to the specific topic of the story or article. Comments that are derogatory in nature have a high likelihood for editing or non-approval if they carry the possibility of being libelous. The comment system is not intended as a forum for individuals or groups to air personal grievances against other individuals or groups. Please, no advertising or trolling. In posting a comment for consideration, users understand that their posts may be edited as necessary to meet system parameters, or the post may not be approved at all. By submitting a comment, you agree to all the rules and guidelines described here. Most comments are approved or disregarded within one business day.
Source: myvalleynews.com

Is a Medicare MSA Plan Right For You?

Posted by:  :  Category: Medicare

MSA plans cover everything that Original Medicare Plans A and B cover, and in addition often have extra coverage, such as dental, vision, and long-term care. However, they do not cover prescription drug benefits, so if you want this coverage you must enroll in Medicare Plan D. You can use your MSA funds tax-free for your Medicare Plan D premium and copayments, and your extra benefits, but only Medicare Plan A and B expenses count towards your deductible.
Source: medicareecompare.com

Video: Part D Medicare by 1-800-MEDIGAP

What Are Medicare Advantage Plans?

All MA Plans provide Parts A and B insurance coverage. Some MA Plans include extra coverage for vision, dental, hearing and wellness programs. Medicare Part D is covered by most MA Plans, too. Medicare pays a fixed amount to private insurance providers of Medicare Advantage Plans. These insurance companies must follow Medicare rules, but can set out-of-pocket fees based on their expenses. MA Plans may require their clients to use certain doctors, medical care facilities and suppliers.
Source: seniorcorps.org

Understanding Your Options: What is Best for You? Medicare Advantage Plan or Medicare Supplement and Part D Drug Plan?

If you have a Medigap policy and join a Medicare Advantage Plan (like an HMO or PPO), you may want to drop your Medigap policy. Your Medigap policy can’t be used to pay your Medicare Advantage Plan copayments, deductibles, and premiums. If you want to cancel your Medigap policy, contact your insurance company. In most cases, if you drop your Medigap policy to join a Medicare Advantage Plan, you won’t be able to get it back. If you have a Medicare Advantage Plan, it’s illegal for anyone to sell you a Medigap policy unless you’re switching back to Original Medicare. Contact your State Insurance Department if this happens to you. If you want to switch to Original Medicare and buy a Medigap policy, contact your Medicare Advantage Plan to disenroll.
Source: indoamerican-news.com

Is HSA health insurance a good option for me?

Yes! Monies that aren’t used remain in your account and are carried forward. Interest and other earnings on funds in your HSA account are tax-free. Distributions from these accounts are also tax-free if used to pay for qualified medical expenses. In addition, an HSA account is “portable,” staying with you if you leave your employer or cease working.
Source: healthinsuranceproviders.com

What is Medicare Advantage?

•    A Medical Savings Account (MSA) Plan combines a high deductible health plan with a bank account. Medicare deposits money into the account (usually less than the deductible). You can use the money to pay for your health care services during the year. You will then also have to pay out of pocket for care, until the MSA plan deductible is met, after which plan coverage begins. MSA plans may or may not have contracted providers, but MSA plans cannot restrict access to a network of doctors, facilities or suppliers.
Source: onesourcebenefits.com

2010 Medicare Advantage Plans

Not as popular as other Advantage Plans, MSA Plans have two parts; a high deductible and a bank account. Medicare gives the plan a sum of money and a portion is deposited into the bank account. Because the sum is usually less than your deductible, you will have out-of-pocket costs until you reach your deductible. Money spent for covered services counts toward your deductible and once the deductible is met, the plan pays for your covered services for that year. Unused funds in your bank account roll over to the following year. MSA Plans do not include drug coverage and a stand alone plan will need to be purchased. You do not need a referral and can choose your own providers.
Source: myplannedretirement.com

Medicare Part C: Medicare Advantage Plans

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Source: odsmedical.com

Q&A: Medicare open enrollment too often overlooked

Medicare does not cover everything. You still have to pay out of pocket. This year, the Part A deductible is $1,156 if you go in the hospital. For Part B, there’s a $140 deductible, plus 20 percent of everything over that. If you have outpatient therapy for cancer, it could be $10,000 a month, so your share would be $2,000. It can really add up to big money.
Source: sltrib.com

SmartMetric launches biometric USB keyring for medical information

Posted by:  :  Category: Medicare

MEDFLAG 2010, Kinshasa, Democratic Republic of Congo, September 2010 by US Army AfricaAdam Vrankulj is a writer for BiometricUpdate.com. His background consists of online news writing, editing and content marketing. Adam has written for CBCNews.ca, BlogTO and was the editor and curator for the nextMEDIA and CIX Source publications. He has a degree in journalism and is passionate about science, technology and social innovation. Contact Adam, or follow him at @adamvrankulj
Source: biometricupdate.com

Video: Thyroid Disease : Medical Information on the Thyroid

Top 10 Health & Medical Information Websites

Note: The Experian Hitwise data featured is based on US market share of visits as defined by the IAB, which is the percentage of online traffic to the domain or category, from the Experian Hitwise sample of 10 million US internet users. Experian Hitwise measures more than 1 million unique websites on a daily basis, including sub-domains of larger websites. Experian Hitwise categorizes websites into industries on the basis of subject matter and content, as well as market orientation and competitive context. The market share of visits percentage does not include traffic for all sub-domains of certain websites that could be reported on separately.
Source: marketingcharts.com

Regenstrief Institute and Merck launch unique post

February 16, 2010 — In an essay in the February 2010 issue of Health Affairs, a special issue of the journal devoted to global e-health, William Tierney, M.D., of Indiana University School of Medicine and the Regenstrief Institute, and colleagues, who like Dr. Tierney have significant experience in the development of workable health information technology systems in low-income countries, identify critical steps toward allowing developing countries to cross the “digital divide” to realize the full potential of e-health to improve the quality and efficiency of their health care systems.
Source: iu.edu

PennDOT medical information programs to aid drivers, emergency workers

The Yellow Dot program will allow drivers to store medical information and emergency and medical contacts in their vehicle glove compartment. A yellow dot sticker on the vehicle’s back window alerts emergency responders to check for the information.
Source: goerie.com

When I apply for life insurance, what happens to my medical information I provide?

If the insurance company wants to share any other information about you or your medical exam, they will have to obtain written permission. That means you cannot accidentally give them permission by saying, “Go ahead,” or something similar. Your medical information is protected because you have to sign a waiver or release form. However, read the forms you are given carefully, because the insurance company may include this type of waiver as part of the regular application process.
Source: usinsurancenet.com

QRide sticker contains your vital medical information

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Source: qrcodetracking.net

Keynote: John Mattison, MD – Chief Medical Information Officer, Kaiser Permanente

He joined the SCAL region of Kaiser-Permanente in 1989, and was appointed as Assistant Medical Director and Chief Medical Information Officer (CMIO). He directed the largest and first deployment of KP HealthConnect, Kaiser-Permanente’s revolutionary program to improve the quality and safety of healthcare through the use of information technology. The program supports the largest region of Kaiser-Permanente with more than 3 million patients and is used by over 5,000 physicians in 13 hospitals and 140 clinics. Kaiser Permanente has been recognized as the national leader for both outpatient and inpatient systems, leading the country for hospitals awarded with the top HIMSS level 7 designation, and receiving the prestigious Davies Award in 2012.
Source: wirelesshealth2012.org

Medicare Agency Rules in favor of Patient Access to CRNA Care

Posted by:  :  Category: Medicare

Dr. Donald Berwick by Talk Radio News ServiceEven though Missouri CRNAs have had a temporary regulatory setback regarding the provision of Chronic Pain services under fluoroscopy, this is excellent news for our brothers and sister across the nation providing chronic pain care to rural, senior, and economically disadvantaged Americans! This is one more piece of evidence to permanently end the Missouri restriction.
Source: moana.org

Video: Josephine Colson from Medicare Local (Inner Eastern Melbourne) talks with Salsa Digital

Medicare Part A, Medicare Advantage Plans

: Medicare Part A covers certain skilled nursing care services needed daily in a skilled nursing facility for up to 100 days. In order to have the nursing facility covered, your doctor must decide that you need daily skilled care given by, or under the direct supervision of, skilled nursing or rehabilitation staff. It is important to note that this is in-home care only. For patients who go to a nursing facility 5 or 6 days a week for rehabilitation services only, the care is considered daily care.
Source: bradeninsurance.com

Area Agency on Aging Presents ‘Medicare Changes Everyone Needs to Know’

Join the Area Agency on Aging from 10-11 a.m. on Tuesday, Nov. 20 at the Troy Community Center for this session on the changes to Medicare, the Part D drug plans, and how the Affordable Care Act will change Medicare in 2013.  Reservations are not required. 
Source: patch.com

Health IT – Combating Medicare Fraud

In a recent opinion piece in The Washington Post, executives with the Center for Public Integrity argued that doctors are increasingly billing Medicare office visits using higher codes, a practice called upcoding or code creep.  The authors go on to suggest that Electronic Health Records (EHR) will only increase this type of fraud and abuse by providers because “…the software makes it easier for providers to quickly create documentation for charges.”
Source: lexisnexis.com

AHA Sues Medicare Over Audit Program Aimed At Trimming Improper Payments

The Wall Street Journal: Hospital Association Sues Medicare Agency Over Payments Blocked By Audits The American Hospital Association sued the agency that oversees Medicare, saying an audit program is depriving hospitals of reimbursements for care they provide. … According to the suit, many hospitals have faced rulings by the auditors that care provided and billed on an inpatient basis should have been performed in an outpatient setting. Hospitals are then forced to return the money paid for the services. Even in cases in which the auditor didn’t dispute the need for the care, but simply its venue, hospitals were not able to get paid for the services at outpatient rates, the suit said, costing them hundreds of millions of dollars (Mathews, 11/1).
Source: kaiserhealthnews.org

Medicare proposals shift cost to retirees

Where does that leave consumers like Celsi? Most premium-support proposals would exempt those about to turn 55 from changes. Although the average beneficiary in traditional Medicare currently gets free hospital insurance, he or she already has significant out-of-pocket expenses, including about $100 for outpatient coverage under Part B, co-payments or about $177 a month for a supplemental plan to cover co-pays and deductibles, and $33 a month on average for a drug plan under Part D.
Source: punchng.com