Medicare Part A Hospice Care

Posted by:  :  Category: Medicare

Raging Grannies: No Private Parts by Grant NeufeldThis post was written by Jim Blazer, Executive V.P. of Bermel, Inc.  Since joining Bermel, Inc. 18 years ago, Blazer has led the company in its steady expansion. He is recognized for managing one of two major US hospital networks for Medicare Select. Bermel, Inc’s Medicare Select Supplements significantly reduce the premium outlay for policyholders.
Source: medicareecompare.com

Video: Guide to Medicare Part A and Part B

Medicare Part B Premiums Up $5 Per Month Next Year

CQ HealthBeat: Medicare Part B Premium Increase Modest For 2013 With health care inflation relatively stable, officials at the Centers for Medicare and Medicaid Services released rules Friday that include a $5-per-month increase in Medicare Part B premiums and a $28 hike in the hospital inpatient deductible. The Part B premium will reach a milestone, however, topping $100 a month. The monthly payment for Part B, which covers doctor visits, outpatient hospital services, home health care and other items, will be $104.90 next year, compared to the current $99.90. And the deductible for inpatient hospital stays will go to $1,184 in 2013 from $1,156 this year. One item will be decreasing: the Part A monthly premium, which pays for inpatient hospital stays, skilled nursing facilities and some home care for about 1 percent of Medicare beneficiaries who do not automatically qualify for the program. That premium will be $441 a month, down $10 a month from this year (11/16).
Source: kaiserhealthnews.org

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

Monthly Premiums for Medicare Part B Set To Increase Slightly in 2013

Meanwhile, premiums for Medicare Part A — which pays for inpatient hospitals, skilled-nursing facilities and some home health care services — will decline by $10 to $441 in 2013. Part A deductibles will increase by $28, from $1,156 last year to $1,184 in 2013 (Zigmond,
Source: californiahealthline.org

Ask The Experts: Retirement

Q. My husband retired in CSRS at age 55. He will turn 62 in January and plans to collect his Social Security benefits then. He has BCBS federal basic family plan, which includes me. Is he required to accept Medicare Part A? If so, how does that affect my coverage? I am not collecting any retirement or Social Security benefits at this time, as I am just now 60.
Source: federaltimes.com

Medicare open enrollment: Did Obamacare secretly increase Part B premiums?

Here’s what’s happening. The 2003 law that set up these high-income premium surcharges also stated that the income thresholds were to increase every year to account for general inflation. But the Affordable Care Act freezes the thresholds at their current level through 2019, which will over the next six years snare more and more beneficiaries as incomes in general rise (or at least we hope they do). The Kaiser Family Foundation estimates that by 2019, about 14 percent of Medicare beneficiaries will be paying these higher premiums.
Source: consumerreports.org

Medicare fees rise for 2013

After putting in some of my hard earned wages and our goverment “at work” borrowing it, Social Security should not be cut. Our president and congress continue getting their same salary for life while some of us are barely keeping our heads above water. These politicians should only be paid when they are in office and limited to the time they are working for us. They miss votes, get paid for public appearances, write books, campaign, travel all over, appear on TV shows and we are paying those costs plus their salary. Even with my 401K, it is a struggle. I was a casualty of the crash. Too young to afford to retire and too old to find another job in a difficult market. I had to go on Social Security as soon as I was eligible. My $950 a month doesn’t cover my expenses but I can’t do without it. Gas, groceries, taxes, have all gone up but my benefit keeps shrinking. Being a woman and being paid less than my male counterparts hurts me more now than it did when I was working. Change was for the worst and I’m certainly not moving forward!
Source: bankrate.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

AARP Statement on 2013 Medicare Part B Premium Increase

AARP is a nonprofit, nonpartisan organization, with a membership of more than 37 million, that helps people 50+ have independence, choice and control in ways that are beneficial to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates. We produce AARP The Magazine, the definitive voice for Americans 50+ and the world’s largest-circulation magazine; AARP Bulletin, the go-to news source for the 50+ audience; AARP VIVA, a bilingual lifestyle multimedia platform addressing the interests and needs of Hispanic Americans; and national television and radio programming including My Generation and Inside E Street. The AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. AARP has staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Learn more at www.aarp.org.
Source: aarp.org

Kenneth Rijock’s Financial Crime Blog: ALERT FOR 86 MEDICARE FRAUD FUGITIVES IN FLORIDA

Posted by:  :  Category: Medicare

George W. Bush by cliff1066™A US law enforcement agent has publicly disclosed, during an interview, that there are eighty-six Federal fugitives, all believed to be in the South Florida area, who are wanted on charges of Medicare Fraud. Some of these individuals are also accused of money laundering. This is of relevant interest to compliance officers at South Florida financial institutions, and broker-dealers, because many of there fugitives have defrauded the United States out of millions of dollars in Medicare payments, and therefore have substantial assets. You are advised to look carefully at new customers who fit the following profile: (1) High net worth individuals or closely-held corporations with larger amounts of cash to deposit. (2) Dominican or Cuban nationality, or Cuban-Americans who are resident in Florida. (3) Little or no prior credit agency history. (4) Present or prior health care industry connections or involvement. (5) Medical supply store owner or operator. (6) Individuals who have been resident in the United States for a short period of time. Many medicare fraudsters import front men from the Dominican Republic, or the Republic of Cuba,  and return them to their native countries after the fraud has been successfully perpetrated. Is he totally monolingual, with no English-speaking ability ? If so, he may be a recent arrival. Does he exhibit regional slang in his Spanish that may indicate he is not a long-time resident of Florida ? (7) Request to deposit US Government cheques in large amounts.
Source: blogspot.com

Video: Romney Takes Medicare Message to Florida

Rubio: Ryan’s Medicare Plan Helps Romney in Florida

When Mitt Romney tapped Paul Ryan to be his vice presidential running mate, conventional wisdom dictated that Romney had put himself at a distinct disadvantage in the key battleground state of Florida, where Ryan’s controversial plan to reform Medicare wouldn’t sit well with millions of government-dependent seniors. Florida Sen. Marco Rubio isn’t buying it. In an interview with National Journal, Rubio argued that Ryan’s proposal will help — not harm — Romney’s chances of winning the Sunshine State. He predicted that older voters will support Romney and Ryan because they are trying to “save Medicare” instead of pretending that nothing is wrong with the fiscally unsustainable program. “Look, you have three million people in the state who are on Medicare — one of whom is my mom, one of whom is Paul Ryan’s mom,” Rubio said. “These are people who understand the reality of Medicare: that it’s spending more money than it takes in; that anyone who’s in favor of leaving it the way it is is in favor of bankrupting it.” Rubio praised the GOP ticket for tackling the hot-button topic of entitlement reform at a time when many politicians won’t acknowledge the problems facing the Medicare program. “They’re looking for real solutions on how to solve this,” Rubio said. “Mitt Romney and Paul Ryan are offering a way to save Medicare that doesn’t change it at all for current beneficiaries. And I think people here are going to be excited about that.”
Source: nationaljournal.com

Florida Medicare 2013 Open Enrollment

For example, suppose after running a search-providing zip code of your county in a southwestern state and you find that your current plan does not cover any vision or dental coverage, and then plans can be changed. There are other two available plans, which cover both the aspects plus limited hearing coverage. This sort of Medicare plans are of high quality ratings such as 4.5 out 5stars. This also means that Medicare is giving them an extra quality bonus which are use to augment benefits like vision-dental coverage or results in overall cost reduction of the plan, to the members.
Source: medicare-supplement-advisor.org

Obama on Medicare, space in Florida

“I want you to know, Florida, I will never turn Medicare into a voucher,” Obama told 3,050 people at the Florida Institute of Technology here. “If you work hard all your life, then you should have some basic security…  to know that it’s going to be there for you. And I have to tell you, that is going to be part of what’s at stake in this election.”
Source: politico.com

Insurer halts Medicare Advantage sales in Georgia

Public HealthHealth InsuranceHealth CostsHospitalsHealth ReformMedicaidDelivery of CareChildren’s HealthPhysiciansMental HealthSafety NetDisabilitiesCaregivingMedicareUninsuredHealth DisparitiesPrescription DrugsLong-Term CareNursesHealth QualityQuality of CarenursingRural Healthhospital
Source: georgiahealthnews.com

In Florida, Obama Talks Medicare

CNN: Medicare Takes Center Stage For Obama Campaign In Florida  In the senior-heavy coastal city of Melbourne on Sunday, President Barack Obama, armed with a new study, continued to hammer the Republican plan to reform Medicare. He highlighted a Harvard analysis, conducted by a former Obama adviser, that found seniors would pay more under the “Romney-Ryan plan,” compared to his plan, which he said will strengthen the entitlement program. Obama said GOP nominee Mitt Romney wants to “give money back to insurance companies and put them in charge of Medicare.” “Their voucher plan for Medicare would bankrupt Medicare. Our plan strengthens Medicare,” Obama told a crowd of 3,050 gathered at a sports and recreation center. “No American should have to spend their golden years at the mercy of insurance companies.” The focus on Medicare on Sunday was the latest effort by the president and his campaign to turn up the noise around the program and throw Romney off his message on jobs and the economy, especially important as the president continues to make a play for the senior vote ahead of the November election (9/9).
Source: kaiserhealthnews.org

In Florida, Biden Attacks Romney on Social Security and Medicare

Mr. Romney has said that he will pay for his across-the-board cuts in income taxes and other taxes by eliminating deductions, but he has never specified which ones. The analysis, by the Tax Policy Center, concluded that making up all the revenue lost by Mr. Romney’s tax cuts would require eliminating tax breaks, as Mr. Romney has said he would do, but not just for high earners. Households earning below $200,000 would lose 58 percent of their tax deductions – like the one for mortgage interest – the Tax Policy Center said. That would lead to higher total taxes for such households.
Source: nytimes.com

Central Florida Medicare Guide for iPad

Central Florida Medicare Guide is your one-stop, all-purpose resource for navigating the 2013 Medicare enrollment period. From health-care plans to prescription-drug plans, CFMG and the Florida Media Group’s award-winning health reporters and editors have you covered for all the plans available to Central Florida residents. Download your Central Florida Medicare Guide now!
Source: iosnoops.com

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

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

Three Florida ALF Owners Plead Guilty to Medicare Fraud Schemes

A few high-profile bankruptcies by continuing care retirement communities have made waves in the senior housing industry, and there’s more drama to come—for at least four more years, says a New York-based owner-developer of CCRCs who specializes in acquiring distressed assets. During Senior Housing News’ inaugural Senior Housing Summit, held last Thursday in Chicago, Ill.,… Read More »
Source: seniorhousingnews.com

Common health insurance questions answered: What is medicare advantage?

Posted by:  :  Category: Medicare

HOPE lives. by eyewashdesign: A. GoldenPrivate 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

Video: Medicare

Republicans Likely to Stick With Medicare Cuts Romney Criticized

Mitt Romney’s presidential campaign featured frequent attacks on President Obama for cutting $716 billion out of Medicare. Romney made ads criticizing the president for the cuts, and pegged Obama as the only president who has cut Medicare. “When you see your friends with signs that say keep your hands off our Medicare,” Romney said last year, “they are absolutely right.”Well, anyone who liked that line may be disappointed. The cuts are back. And this time it’s Republicans who are proposing them. Again. 
Source: reason.com

Medical Billing : What Is Medicare And How Can Such An Insurance Type Help?

Nowadays, the price of healthcare, pharmaceutical and insurance plan are getting very expensive. By the time you reach the age of 65 and above especially when you are planning to retire at this age, handling the costs for these healthcare related needs may not be that convenient. In order to address this, the govt is suggesting the elderly people to sign-up in a Medical wellness insurance plan protection Supplement known as Medicare supplement plan. Medicare is a healthcare program run by the govt. If you are protected by Medical wellness insurance plan protection, your healthcare costs of with regards to physician’s visit, medical center stays, medicines and other therapy. But before you can acquire of this, you must be first fit the qualification. If you are an American citizen or at least 5 years residence in the US whose age is 65 or above, you are qualified to acquire of a renters insurance plan coverage. Also, younger people might also be qualified for a renters insurance plan coverage if one has a qualifying impairment such as Lou Gehirg’s disease or a permanent renal failure. This kind of insurance plan is divided into several areas which have different protection. Aspect A which is the Hospital Coverage protects inpatient medical center care, skilled assisted living facilities, hospital care, some house medical care. Once you turn 65, you are automatically enrolled in this protection and you won’t have to pay for this. Aspect B which is the Medical Coverage helps cover reasonable and necessary healthcare solutions that are no longer protected by Aspect A. Such solutions include physician’s solutions, physical and work-related therapist solutions, laboratory and X-ray solutions, emergency vehicle solutions, out-patient medical center care, house medical care, blood and healthcare supplies, durable healthcare equipment as well as wheelchairs and medical center beds. Aspect C which is the Medical wellness insurance plan protection Advantage protects Medical wellness insurance plan protection wellness maintenance organization, preferred provider organizations, private fee for service programs, Medical wellness insurance plan protection healthcare bank account plan and Medical wellness insurance plan protection special needs programs. To acquire this, you need to have Aspect A and Aspect B since this includes additional benefits such as prescribed medication protection as well as cheaper of solutions than Parts A and B. Note that you still need to pay your per month top quality and most likely with additional per month top quality. Moreover, you may require referrals and recommendation from doctors and specialist to acquire this. Finally Aspect D which is Prescription Drug Coverage protects brand name as well as generic prescribed medications from participating drug stores. Everyone with Medical wellness insurance plan protection can be qualified for this part regardless of income, wellness or prescribed costs. However, there are a lot of things you need to consider before obtaining Medical wellness insurance plan protection. After all, there are a lot of providers out there who offer Medical wellness insurance plan protection. The only thing left to do is to make sure that the plan provider whom you will purchase this has the reputation and reliability. Moreover, make sure that the plan will best fit for you.
Source: blogspot.com

Fiscal Cliff: What Is At Stake For Medicare And Medicaid?

MARY AGNES CAREY: Right. That is definitely the balance that’s in the works. If you ask beneficiaries to contribute more, what do you ask the providers to do? For example, some ideas that are out there, they’ve been around for a while: Do you look at the fee-for-service Medicare structure on co-payments and deductibles?  Combine those into one deductible, for example, but add a catastrophic cap, which doesn’t exist in fee-for-service Medicare.  On providers: As we know, their payments will continue to increase over the next ten years, but under the health care law they’re going to do so at a slower rate.  So do you go back to providers, to hospitals, to the nursing homes, to home health care agencies, and take more from them?  And how do you balance that pain to get an equal result?
Source: kaiserhealthnews.org

Remember the $716 billion in Medicare ‘cuts’?

But the argument was burdened by some rather glaring flaws. For one thing, Romney’s criticism wasn’t true. For another, the $716 billion in Medicare savings were embraced by congressional Republicans, including Romney’s running mate, in the GOP budget plan. As Bill Clinton said at the Democratic convention, it “takes some brass to attack a guy for doing what you did.”
Source: msnbc.com

Daily Kos: Claire McCaskill on MTP: Let’s Cut Medicare Benefits

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Source: dailykos.com

Poll: Americans Overwhelmingly Oppose Raising the Medicare Retirement Age

Hopefully the combination of the idea being both unpopular and unsound will prevent it from being part of any fiscal cliff deal, but the fact that the idea is still being discussed is a perfect symbol of what is wrong with the current dialog in Washington. Politicians promoting bad and unpopular ideas are treated as serious thinkers instead of psychopaths, because advocating for needlessly hurting poor people is somehow seen as a badge of courage.
Source: firedoglake.com

Medicare Open Enrollment: So What Is Medicare Part D Anyway?

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Source: myhealthcafe.com

Medicare Advantage Fact Sheet

Posted by:  :  Category: Medicare

NEW REPORT HIGHLIGHTS MEDICARE ADVANTAGE INSURERS’ HIGHER ADMINISTRATIVE SPENDING by Leader Nancy PelosiThis updated fact sheet provides an overview of the Medicare Advantage program, describes program changes made by the new health reform law in plan participation and beneficiary enrollment, presents data on benefits and premiums, and explains changes in Medicare payments to participating plans.
Source: kff.org

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

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

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 to find Medicare Advantage seminars in Michigan

Medicare Advantage plans are administered by private insurance companies that contract with the federal government. These plans cover everything covered by Original Medicare, and they usually include Part D prescription drug coverage and extra benefits not covered by Original Medicare.
Source: ahealthiermichigan.org

Fact Check on Medicare Advantage

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

Medicare open enrollment: Will Obamacare end Medicare Advantage?

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

Sebelius Misleads the Public on Medicare Advantage

Comments are subject to approval and moderation. We remind everyone that The Heritage Foundation promotes a civil society where ideas and debate flourish. Please be respectful of each other and the subjects of any criticism. While we may not always agree on policy, we should all agree that being appropriately informed is everyone’s intention visiting this site. Profanity, lewdness, personal attacks, and other forms of incivility will not be tolerated. Please keep your thoughts brief and avoid ALL CAPS. While we respect your first amendment rights, we are obligated to our readers to maintain these standards. Thanks for joining the conversation.
Source: heritage.org

Viewpoints: Medicare Provider Cuts ‘Won’t Work'; A ‘Pamphlet Isn’t A Plan’

Posted by:  :  Category: Medicare

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations by Christiana CarePolitico: A Glossy Pamphlet Isn’t A Plan One of the benefits of having served the people of Utah in the Senate for as long as I have is that I’ve been able to work with many presidents from both parties. … Yet in this year’s historic presidential election, we have an incumbent president who either knowingly refuses to tell the American people what his plan for our nation would be if reelected … A look at the health care section is remarkable for its look backward – not forward – to ObamaCare, hardly an achievement in most people’s eyes since the president promised that it would hold down health care costs, which it’s failed to do (Sen. Orrin Hatch, 10/24). Roll Call: On Mitt Romney, Medicare And Making The Math Work The political appeal behind pledging not to touch Medicare benefits for current and soon-to-be seniors is obvious. The political appeal of attacking the president for slashing the Medicare program by $716 billion and pledging to restore it is equally obvious. The political appeal of promising to cut deficits and debt and cap government spending at 20 percent of  the GDP is also apparent. But the combination of the three is utterly inconsistent and impossible. Something has to give — the question is what. It is that question the 113th Congress will have to confront immediately if Romney wins, with no palatable answer (Norman Ornstein, 10/25).
Source: kaiserhealthnews.org

Video: Medicare Provider Enrollment 3.wmv

CMS Issues Final Rules on Medicaid, Medicare Provider Payment Rates

The payment increase applies to physicians practicing in family medicine, general internal medicine, pediatric medicine and related subspecialties, such as board certified pediatric cardiologists. The rule clarifies that primary care services delivered by medical professionals working under the personal supervision of a qualifying physician, such as nurse practitioners, also are eligible for the higher payment rate (Reichard,
Source: californiahealthline.org

Provider taxes; SNF payments increasing, state Medicaid GAO survey finds

Almost all of the provider taxes that were increased were on institutional providers, including skilled nursing facilities. States said this was to avoid cuts in service or payment rates. Within three years, the number of states implementing new or increasing existing provider taxes more than doubled, from 12 to 26. By last year, only a handful of states reported decreasing their provider tax.
Source: mcknights.com

Providers Filed 85% of Medicare Appeals in 2010

A study from the HHS Office of Inspector General (pdf) found that hospitals and other Medicare providers filed 85 percent of payment appeals at the administrative law judge level, 56 percent of which went in favor of providers, and the OIG concluded that serious improvements are needed to clarify Medicare policies. Medicare providers and beneficiaries may appeal certain decisions regarding claims for healthcare services. For example, hospitals may appeal payment recoupments from Recovery Auditors, or RACs, if they believe their actions were consistent with Medicare law and standards. There are four general levels of appeal: Level One goes to CMS Medicare Administrative Contractors, Level Two goes to CMS Qualified Independent Contractors, Level Three goes to ALJs and Level Four goes to the Medicare Appeals Council. The ALJ level is the most common platform of the four. The OIG looked at the 40,682 Medicare appeals filed to ALJs in fiscal year 2010. It found that hospitals, physicians and other providers filed 34,542 of those appeals, or roughly 85 percent. In addition, a small number of providers accounted for nearly one-third of all appeals. The OIG tagged 96 providers as “frequent filers,” meaning they filed at least 50 appeals each. One provider filed 1,046 appeals alone. For 56 percent of appeals that made it to level three, ALJs also reversed 56 percent in favor of appellants, indicating a “number of inconsistencies and inefficiencies in the Medicare appeals process,” according to the OIG’s report. The OIG had 10 recommendations for CMS and the Office of Medicare Hearings and Appeals, including more coordinated training on Medicare policies to ALJs and QICs, better identification and clarification of Medicare policies that are unclear, and digitization of appeal case files. CMS and OMHA concurred fully or in part with all of the OIG’s recommendations.
Source: beckershospitalreview.com

Providers File The Bulk Of Medicare Appeals

Medicare beneficiaries and providers can challenge the denial of a claim in several appeals stages, but the first two are decided by contractors working for Medicare who base their opinions on case files.  In the third step, which is the focus of the report, appellants have a hearing before a judge, testimony can be provided, witnesses can be cross-examined, and new evidence can be introduced.  The judges are lawyers in the Office of Medicare Hearings and Appeals, an independent agency within HHS.
Source: kaiserhealthnews.org

Benutzer:SvenST – AM Wiki

Posted by:  :  Category: Medicare

Romney Ryan Plan for Medicare and SSI by DonkeyHoteyWith the chance of a dental calamity growing over the years, Medicare has appear with certain dental strategies also. These plans address your dental requirements at affordable prices and save yourself you the immense clinic expenses you’d need certainly to spend were it not for Dental Texas Medicare plans. Certain significant options that come with the programs are as follows: They’re inexpensive. One reason why dental insurance coverage by Medicare are quickly getting reputation is that they are very affordable and could be attached also by the lower middle class strata of the society. Moreover, Medicare has released at the least 50% co-insurance transaction amounts for simple dental check-ups, root canal treatments, and hole filling treatments in per year. Hence, these ideas have become popular. They could be handled such as a family savings. Medicare features a few bill deals where you can maintain depositing reduced that would be distributed around you any moment you’ve a problem. The person whose bill exists may get the mandatory sum of cash and make certain they’ve right solutions on time at decent hospitals without worrying much in regards to the expenses involved. Comprehensive protection choices are offered. There are variety dental alternatives that are provided, when you join a dental Medicare insurance cover. If you have an elimination problem and that’s affecting your mouth and tooth, the charges will undoubtedly be borne by the company. When you yourself have a tooth problem and a mouth problem to take care of, the cost could be borne by the company, and etc, i.e. Visit This Link. Any dental casualty will be included in the organization and hence Medicare dental insurances are fantastic.
Source: andrea-maennel.com

Video: Community Health Map: Geospatial and Multivariate Visualization Tool for Medicare Data

Utilisateur:HallamRidgway269

Very first determine the kind of attention or providers that will be required, the level of training with the caregiver, and the economic insurance coverage supplied by your insurance coverage or Medicare insurance. Elderly Care offers several support groups at home care richmond va . Your physician or a place Office upon Getting older will help you evaluate your preferences and also provide you with a set of accredited companies. Additionally, Medicare rates high every one of the companies which they certify who supply seniors treatment and also conducts performance research of each and every on particular categories of patient attention. There’s also a number of professional agencies who have established stringent requirements to be able to establish top quality priate duty nurse care richmond va services that rise above minimum state and also national requirements. Two of the most highly regarded are usually: The actual Shared Commission upon Certification of Health-related Agencies as well as Local community Well being Accreditation Plan.
Source: rt74.eu

Utilisateur:RivasSpell652

Very first decide the sort of attention or services which will be necessary, the degree of instruction with the caregiver, as well as the monetary coverage given by your insurance or even Medicare insurance. Elderly Care offers numerous organizations at home care richmond va . Your physician or a location Business office upon Getting older will help you evaluate your requirements as well as will give you listing of certified companies. Additionally, Medicare health insurance ranks every one of the agencies they certify which supply elderly treatment and performs overall performance surveys of every about particular categories of individual care. There’s also several expert businesses which have established strict specifications to define quality priate duty nurse care richmond va companies that rise above minimal condition as well as nationwide specifications. 2 of the very most respectable tend to be: The Combined Percentage about Qualification regarding Health-related Organizations and Local community Wellness Qualification System.
Source: directvelo.com

Medicare Benefits Schedule (MBS) iPhone App: 25 PROMO CODES AVAILABLE & $1.99 (Normally $5.49)

Designed for Aussie health professionals (doctors, nurses, proceduralists), myMBS offers the entire Australian Medicare Benefits Schedule directly on your mobile device. Made #2 ranking in the Medical section of the Apple App Store – now comes the latest update – myMBS 3.0.
Source: com.au

Bill Baar’s West Side: Meriter officials say layoffs caused by Medicare cuts

Affordable Care Act layoffs at Meriter Hospital in Madison.  Progressive / Liberal response to providing more care, is to cut the supply of care.  The odd outcome of putting Social Engineers in Charge. On Tuesday, Meriter spokesperson Mary Reinke said in a statement that about 4 percent of the hospital’s 3,500 positions would be eliminated. That’s 140 positions cut, but 50 employees affected, because many of those positions are currently vacant. Some of those 50 employees among various departments will be offered jobs elsewhere in the company. Reinke says the layoffs are a pre-emptive move to offset cuts to Medicare reimbursements put in place by the federal Affordable Care Act. According to Wisconsin Hospital Association President Steve Brenton, the state’s 135 hospitals receive Medicare funding based on the Medicare business they take on. Brenton says Medicare is about 40 percent of most hospitals’ business. The Affordable Care Act cuts Medicare payments to hospitals across Wisconsin by about $2.6 billion over ten years. Brenton says that could mean big cuts to operating budgets at many hospitals like Meriter.
Source: blogspot.com

Medicare open enrollment: Did Obamacare secretly increase Part B premiums?

Posted by:  :  Category: Medicare

"Every citizen should be a soldier. This was the case with the Greeks and Romans, and must be that of every free state." ` Thomas Jefferson. by eyewashdesign: A. GoldenHere’s what’s happening. The 2003 law that set up these high-income premium surcharges also stated that the income thresholds were to increase every year to account for general inflation. But the Affordable Care Act freezes the thresholds at their current level through 2019, which will over the next six years snare more and more beneficiaries as incomes in general rise (or at least we hope they do). The Kaiser Family Foundation estimates that by 2019, about 14 percent of Medicare beneficiaries will be paying these higher premiums.
Source: consumerreports.org

Video: Guide to Medicare Part A and Part B

Medicare Part B Premiums Up $5 Per Month Next Year

CQ HealthBeat: Medicare Part B Premium Increase Modest For 2013 With health care inflation relatively stable, officials at the Centers for Medicare and Medicaid Services released rules Friday that include a $5-per-month increase in Medicare Part B premiums and a $28 hike in the hospital inpatient deductible. The Part B premium will reach a milestone, however, topping $100 a month. The monthly payment for Part B, which covers doctor visits, outpatient hospital services, home health care and other items, will be $104.90 next year, compared to the current $99.90. And the deductible for inpatient hospital stays will go to $1,184 in 2013 from $1,156 this year. One item will be decreasing: the Part A monthly premium, which pays for inpatient hospital stays, skilled nursing facilities and some home care for about 1 percent of Medicare beneficiaries who do not automatically qualify for the program. That premium will be $441 a month, down $10 a month from this year (11/16).
Source: kaiserhealthnews.org

AARP Statement on 2013 Medicare Part B Premium Increase

AARP is a nonprofit, nonpartisan organization, with a membership of more than 37 million, that helps people 50+ have independence, choice and control in ways that are beneficial to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates. We produce AARP The Magazine, the definitive voice for Americans 50+ and the world’s largest-circulation magazine; AARP Bulletin, the go-to news source for the 50+ audience; AARP VIVA, a bilingual lifestyle multimedia platform addressing the interests and needs of Hispanic Americans; and national television and radio programming including My Generation and Inside E Street. The AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. AARP has staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Learn more at www.aarp.org.
Source: aarp.org

Ask The Experts: Retirement

First, please review previous Q&As to see if your question already has been answered. If you cannot find the answer, submit your question to our Retirement expert at fedexperts@federaltimes.com PLEASE NOTE! Do not submit ANY questions via the Comments form. Questions submitted via the Comments form will NOT be answered!
Source: federaltimes.com

Monthly Premiums for Medicare Part B Set To Increase Slightly in 2013

Meanwhile, premiums for Medicare Part A — which pays for inpatient hospitals, skilled-nursing facilities and some home health care services — will decline by $10 to $441 in 2013. Part A deductibles will increase by $28, from $1,156 last year to $1,184 in 2013 (Zigmond,
Source: californiahealthline.org

What Medicare Part B Covers

This post was written by Jim Blazer, Executive V.P. of Bermel, Inc.  Since joining Bermel, Inc. 18 years ago, Blazer has led the company in its steady expansion. He is recognized for managing one of two major US hospital networks for Medicare Select. Bermel, Inc’s Medicare Select Supplements significantly reduce the premium outlay for policyholders.
Source: medicareecompare.com

ABCs of Medicare: What is Part B?

What does Part B cover? Part B covers medical and preventive services. Coverage rules can differ depending on whether a beneficiary has a Medicare Advantage Plan or other Medicare plan. However,  your plan must give you at least the same coverage as Original Medicare. (Original Medicare is fee-for-service coverage under which the government pays your health care providers directly for your Part A and/or Part B benefits.) Additionally, some services may only be covered in certain settings or for patients with certain conditions.
Source: nhcoa.org

Daily Kos: Claire McCaskill on MTP: Let’s Cut Medicare Benefits

Vatexia, Cartoon Peril, Chi, sceptical observer, HoundDog, dance you monster, chuco35, historys mysteries, Gooserock, divineorder, tardis10, cactusgal, eXtina, Navy Vet Terp, quill, phonegery, maryabein, winsock, wayoutinthestix, koseighty, Shirl In Idaho, prettygirlxoxoxo, stevej, LillithMc, Sunspots, countwebb, Polly Syllabic, ferg, joe from Lowell, maybeeso in michigan, RubDMC, chuckvw, blueoasis, old wobbly, ItsSimpleSimon, Grandma Susie, Egalitare, nupstateny, TAH from SLC, Observerinvancouver, ratcityreprobate, tarheelblue, zerelda, jacey, grrr, gooderservice, MarkInSanFran, artisan, Flying Goat, anodnhajo, hyperstation, ozsea1, Byron from Denver, DMiller, RFK Lives, royce, mumtaznepal, ardyess, jedennis, figbash, boomerchick, Militarytracy, MartyM, Brooke In Seattle, Chaddiwicker, psnyder, Catte Nappe, mrgavel, DBunn, fou, ctsteve, StrayCat, SoCaliana, Alumbrados, exNYinTX, KenBee, slowbutsure, IndieGuy, Sylv, VirginiaBlue, Hillbilly Dem, caliberal2001, dewley notid, CT yanqui, lcs, rmx2630, Eyesbright, Nulwee, jdld, HarpboyAK, kaliope, leeleedee
Source: dailykos.com

Finally the Medicare Part B Premium for 2013 is announced!

Since the Social Security Cost of Living Adjustment is 1.7% for 2013, this should be less than anyone’s increase in their monthly Social Security retirement benefit.  If you receive only $700 a month from Social Security (one of the lowest amounts), your Social Security benefit should increase $11.90, leaving you a small increase in monthly income after the Medicare Part B premium has been deducted from your check.   
Source: retirementeducationplus.com

OLReporter: Next Year’s Medicare Program Costs Announced

For less-wealthy recipients, the changes will be felt as smaller-than-expected Social Security increases. The Social Security COLA next year is 1.7 %. After Part B premiums are deducted, seniors receiving a $1,000 monthly benefit will see a net increase of $12, or 1.2 %; the net increase for those receiving $2,000 will be $29, or 1.45%.
Source: blogspot.com

2013 Medicare Part B premium and deductibles rise, but not by much

These and other parts of the law will result in significant savings. We estimate that the health care law will save the average person in traditional Medicare $5,000 through 2022. Earlier this year we projected that the standard premium for Medicare Part B (which covers certain doctors’ services, outpatient care, medical supplies, and preventive services) would rise by more than $9.00 a month in 2013. Today we announced that the actual rise will be lower—$5.00—bringing 2013 Part B premiums to $104.90 a month. By law, the premium must cover a percent of Medicare’s expenses; premium increases are in line with projected cost increases. Medicare Part B premiums have gone up slowly over the past five years – an average of less than 2 percent a year, or $8.50 total.
Source: quinnscommentary.com

Voters Support Certain Taxes, Oppose Raising Medicare Eligibility Age

Posted by:  :  Category: Medicare

When will we learn? Asking the ‘have nots’ if it would be fair to tax the ‘haves’ more will always yield the same answer. Furthermore, the ‘haves’ that agree with it are generally the guilt-ridden ‘haves’ who, now that they ‘have’ theirs from “exploiting” the ‘have nots’ over the years, feel perfectly justified in handing back to the ‘have nots’, money from all of the rest of the ‘haves’. The real issue here is, stop disincentivising the ‘haves’ with increased taxes in order to redistribute the ‘haves’ stuff to the ‘have nots’ and further disincentivizing the ‘have nots’ from earning their own stuff. If you don’t you soon find the ‘have nots’ having less stuff than they do today as the ‘haves’ exit the job creation market and/or move their stuff out of the country by investing in a foreign country that has a better and safer return on investment of the ‘haves’ stuff.
Source: californiahealthline.org

Video: Medicare Part 1: Eligibility and Enrollment

Daily Kos: Congressional Democrats taking hard line against raising the Medicare eligibility age

But as best as I can determine after talking to Dem aides, this isn’t on the table. It’s something Republicans want to be part of the talks but not one Dems are seriously entertaining, at least for now. Dick Durbin and other Democrats have repeatedly said raising the retirement age is off the table. Obama reportedly signaled openness to it during the 2011 debt ceiling talks, so if some on the left still want to be vigilant about this possibility, it’s understandable—after all, ultimately Dems will likely fall in line behind what Obama wants in the end. But keep in mind Obama was in a significantly weaker position last time and may not see the need to make that concession now. That the talk about holding a line against this benefit cut is coming from Durbin could be a strong indication that President Obama is abandoning this idea floated during his grand bargain talks with Boehner back in 2011, and Durbin is Obama’s closest ally in the Congress. He makes a very good point: “To think that a person would retire at the age of 64 or 65 and not have Medicare coverage until 67 raises the obvious question: These people in their mid-60s, probably with a health history, will find it difficult to buy health insurance on the open market or afford whatever is available,” Durbin said. “I want to make sure there are no gaps in coverage for those who need it the most: retired Americans who have a health history and can’t find affordable health insurance. So … let us make certain that there are insurance exchanges, good competition, and affordable health care available for those seniors.” House Democratic Leader Nancy Pelosi takes a similar position against this change, as has Senate Majority Leader Harry Reid.
Source: dailykos.com

Cost Of Raising Medicare Eligibility Age

We must give them a chance — early indicators are positive, though they may be conflated with recession-induced (i.e., temporary) dips in demand.  If they fail to control costs, then it’s back to the drawing board.  But now’s the time to watch and evaluate, not to reduce access to what is a highly efficient, effective form of health coverage for the nation’s seniors.
Source: businessinsider.com

Medicare eligibility age may increase

Advocates for seniors say that increasing the Medicare eligibility age will hurt the elderly. Health insurance for seniors is expensive – more expensive than it is for most other people. Health care costs tend to be higher, because seniors often have chronic medical conditions that need regular care in order to prevent life-threatening problems. Because insurance is so expensive, many seniors wait to get health insurance until they turn 65 and become eligible for Medicare. This means that they potentially forego care they need and consequently, grow sicker.  So increasing the Medicare eligibility age from 65 to 67 means these seniors will go even longer without the health care they need.
Source: epochsl.com

GAO Praises Upgrades to Medicare Eligibility Transaction System

The letter referenced complaints from health care providers and beneficiaries about “unusually long wait times while trying to affirm eligibility.” In addition, they wrote that health care providers have not been able to get support through a secondary telephone line (iHealthBeat, 9/22/11).
Source: ihealthbeat.org

Democrats Resist Significant Changes To Medicare, Other Entitlement Programs

CQ HealthBeat: A House Of Cards In Deficit Talks Talk of finding health care savings in the federal budget inevitably involves making changes to Medicare. But some lawmakers are starting to suggest that President Barack Obama’s signature health care overhaul also imposes costs that must be borne by taxpayers and that could be pared back. In its entirety, the law is expected to reduce the deficit over time, according to the Congressional Budget Office. At the same time, it contains individual provisions that, by themselves, cost money. Some observers, especially Republicans on the lookout for ways to constrain the 2010 law, say negotiators trying to avoid upcoming tax increases and spending cuts — known collectively as the fiscal cliff — should take a hard look at those provisions. The problem is, the two most costly parts of the law — setting up subsidies to help people buy insurance and expanding Medicaid to provide care to more uninsured Americans — are also two of the pillars upon which the law is built. If lawmakers start scraping money away from either, they risk weakening the law (Attias, 11/26).
Source: kaiserhealthnews.org

6 Fixes to America’s Fiscal Crisis

1. Raise the Social Security eligibility age to match increases in longevity. People are living longer, and entitlement programs need to be updated to reflect that fact. According to the Social Security actuaries, continuing to increase the eligibility age to 69 by the year 2034 and allowing it to rise more slowly thereafter to reflect gains in longevity could go a long way toward reducing Social Security’s funding shortfall. While this would not reduce today’s budget deficit, it would strengthen Social Security’s finances and put it on a path toward sticking around in the future.
Source: themainewire.com

Medicare eligibility, payment rates on table in ‘fiscal cliff’ talks

It pronounced options embody simply capping spending expansion rates pegged to sum domestic product, that would outcome in remuneration reductions or some-more out-of-pocket costs to seniors; some-more remuneration rate reductions to hospitals and doctors; lifting a eligibility age dual years to 67; and lifting a reward for Part B coverage.
Source: socialpaygate.com

When Will YOU Be Eligible For Medicare?

Phylis Feiner Johnson has been a professional copywriter for 30 years. She also spent 20 years with epilepsy. She writes from the heart to increase education, awareness and funding for epilepsy research. For further information, contact The Epilepsy Foundation of Eastern Pennsylvania at http://www.efepa.org/ and please make a contribution to become an advocate, too.
Source: epilepsytalk.com

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

Posted by:  :  Category: Medicare

Medicare for All! by juhansoninWhile 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: Top 10 Medicare Insurance Tips

Medicare Supplement Insurance Plans

You just need to fill out a fundamental questionnaire when employing a service to get Medicare Prograde supplement evaluations Supplement Insurance Plans.  Prices from multiple providers will be collected for you so you can evaluation the policy figures and rates from all the insurance providers.  You can choose out those insurance plans that give you exactly what you need to have and that are within your economic attain.
Source: lapappalpomodoro.com

Staten Island Insurance Agency Offers Free Medicare Health

“As an authorized representative of insurers such as Empire Blue Cross/Blue Shield; AARP® Medicare Plans from UnitedHealthcare® (UHC); EmblemHealth®, and Touchtone, we routinely provide clients with a free comparison between all the different plans offered on Staten Island,” DeFranco said. “In addition, our firm has knowledge of which doctors and prescriptions are covered by each of the plans.”
Source: siborrealtors.com

Medicare Hospital Insurance Tax

Beginning in 2013, as part of the health care reform legislation of 2010, an additional 0.9% of HI tax will apply to an individual’s wages, other compensation and self- employment income that exceed a threshold amount based on the taxpayer’s filing status (please see the chart below). There is no employer match for the additional HI tax. It is solely paid by employees but employers are required to withhold and pay it to the Internal Revenue Service. The additional HI tax brings the high-income taxpayers HI taxes to 3.8% (1.45% employee share, 1.45% employer share, plus the new 0.9% additional employee share), the same for self-employment tax (a 2.9% base and  the new 0.9 % additional).
Source: mohlernixon.com

Daily Kos: Claire McCaskill on MTP: Let’s Cut Medicare Benefits

Vatexia, Cartoon Peril, Chi, sceptical observer, HoundDog, dance you monster, chuco35, historys mysteries, Gooserock, divineorder, tardis10, cactusgal, eXtina, Navy Vet Terp, quill, phonegery, maryabein, winsock, wayoutinthestix, koseighty, Shirl In Idaho, prettygirlxoxoxo, stevej, LillithMc, Sunspots, countwebb, Polly Syllabic, ferg, joe from Lowell, maybeeso in michigan, RubDMC, chuckvw, blueoasis, old wobbly, ItsSimpleSimon, Grandma Susie, Egalitare, nupstateny, TAH from SLC, Observerinvancouver, ratcityreprobate, tarheelblue, zerelda, jacey, grrr, gooderservice, MarkInSanFran, artisan, Flying Goat, anodnhajo, hyperstation, ozsea1, Byron from Denver, DMiller, RFK Lives, royce, mumtaznepal, ardyess, jedennis, figbash, boomerchick, Militarytracy, MartyM, Brooke In Seattle, Chaddiwicker, psnyder, Catte Nappe, mrgavel, DBunn, fou, ctsteve, StrayCat, SoCaliana, Alumbrados, exNYinTX, KenBee, slowbutsure, IndieGuy, Sylv, VirginiaBlue, Hillbilly Dem, caliberal2001, dewley notid, CT yanqui, lcs, rmx2630, Eyesbright, Nulwee, jdld, HarpboyAK, kaliope, leeleedee
Source: dailykos.com

Medicare: Save Money on Premiums and Copayments in 2013

More plans offer lower copays at "preferred" pharmacies: In 2013, for example, more than half the 32 Part D plans in California will charge lower copays at preferred pharmacies than at regular network ones — with savings of between $2 and $28 for the same prescription. Sounds like a deal, but be careful: If a plan’s preferred pharmacies aren’t within a convenient distance, you may be better off in another plan.
Source: aarp.org

Adult caregivers and medicare

QUESTION: Why would anyone add, review or possibly change their coverage? Because you want to avoid surprises by checking to see if the current health plan has made any benefit changes for 2013. The  major goal for AEP is to avoid surprises by knowing how benefit changes may affect your loved-ones out of pocket insurance costs.  If you check your loved-ones coverage and know what’s changed for 2013, it’s easier to plan for out of pocket expenses in the upcoming year. During last year’s AEP, switching to the plan with the lowest total out-of-pocket costs could have saved our average customer over $600.
Source: ehealthinsurance.com

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 Part D Open Enrollment Clinics in Lenoir County

Posted by:  :  Category: Medicare

Medicare Part D Press Conference (44) by Korean Resource Center 민족학교Lenoir County Seniors’ Health Insurance Information Program (SHIIP) operating under the NC Department of Insurance and in conjunction with Lenoir County Cooperative Extension will provide two counseling clinics during the week of December 3, 2012. This will be the last week of counseling clinics in Lenoir County for 2012. Medicare Part D Open Enrollment ends on December 7, 2012.
Source: ncsu.edu

Video: Medicare Part D

Changes in Medicare Part D for 2013

Open Enrollment ends Friday, December 7, 2013.  If you have not done so already, please take a few minutes to review your coverage information today. If you find your plan is not meeting your expectations, call me to set up an appointment to find a plan that offers better coverage. Call 440-255-5700.
Source: mutskoinsurance.com

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

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

Medicare Part D Premiums Holding Steady

Thanks to the marvels of medical science, our parents are living longer than ever before. Adults over age 80 are the fastest growing segment of the population; most will spend years dependent on others for the most basic needs. That burden falls to their baby boomer children. In The New Old Age, Paula Span and other contributors explore this unprecedented intergenerational challenge. You can reach the editors at newoldage@nytimes.com.
Source: nytimes.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

Seniors Pay Too Much for Medicare Part D

Insurance companies offering Part D drug insurance are required to mail information about the coming years  premium costs and drug coverage to current members well in advance of the December deadline.  These hefty documents arrive just ahead of the busiest time of year and, after reading the cover letter stating they will be automatically signed up if they do nothing, many do just that: nothing.  Unlike other types of insurance, Medicare Part D drug coverage changes every year because new drugs, manufacturing costs, regulations and effectiveness findings come out literally every day.  As a result, insurance companies must change their formularies, the list of the drugs they cover and the cost, at least every year.
Source: californiahealthplans.com

Why Medicare Part D Works [VIDEO]

The Catalyst provides news and commentary on access to life-saving treatments, America’s biopharma industry and researchers’ progress in developing new medicines. The Catalyst is edited by Kaelan Hollon, communications director at PhRMA. Contributors include PhRMA staff and leaders from the industry.
Source: phrma.org

Decoding Part D Marketing And Other News

Medpage Today: Medicare Fraud Efforts Queried Lawmakers are exploring ways to fight Medicare fraud and abuse as part of the effort to trim the federal budget and they’re looking to the private sector for suggestions. For instance, investigators at the health insurer WellPoint recently contracted with a company to mine data on practice patterns and spot spikes in payment or identify emerging areas of fraud potential, Alanna Lavelle, Wellpoint’s director of special investigations, told members of the House Energy and Commerce Health Subcommittee on Wednesday. The most egregious billers are flagged and investigated for potential waste, fraud, and abuse, Lavelle said (Pittman, 11/29).
Source: kaiserhealthnews.org

Medicare Part D: A First Look at Part D Plan Offerings in 2013

NOTE: Originally released in October 2012, this data spotlight was updated in November 2012 to reflect revised data from the Centers for Medicare and Medicaid Services. 
Source: kff.org

Commentary: The case for Medicare Part D

One certain reason enrollees are satisfied is that 2012 premiums are lower on average than 2011 premiums. In 2011, the Centers for Medicare and Medicaid Services (CMS) found that the Medicare Part D program saved enrollees $2.1 billion in 2011 because of the Gap Discount program, which requires drug manufacturers to provide discounts on brand-name and generic drugs to seniors in the gap or “donut hole.” About 3.6 million enrollees nationwide benefitted from these discounts, at an average of $604 each.
Source: northwestopinions.com

Daily Kos: Claire McCaskill on MTP: Let’s Cut Medicare Benefits

Vatexia, Cartoon Peril, Chi, sceptical observer, HoundDog, dance you monster, chuco35, historys mysteries, Gooserock, divineorder, tardis10, cactusgal, eXtina, Navy Vet Terp, quill, phonegery, maryabein, winsock, wayoutinthestix, koseighty, Shirl In Idaho, prettygirlxoxoxo, stevej, LillithMc, Sunspots, countwebb, Polly Syllabic, ferg, joe from Lowell, maybeeso in michigan, RubDMC, chuckvw, blueoasis, old wobbly, ItsSimpleSimon, Grandma Susie, Egalitare, nupstateny, TAH from SLC, Observerinvancouver, ratcityreprobate, tarheelblue, zerelda, jacey, grrr, gooderservice, MarkInSanFran, artisan, Flying Goat, anodnhajo, hyperstation, ozsea1, Byron from Denver, DMiller, RFK Lives, royce, mumtaznepal, ardyess, jedennis, figbash, boomerchick, Militarytracy, MartyM, Brooke In Seattle, Chaddiwicker, psnyder, Catte Nappe, mrgavel, DBunn, fou, ctsteve, StrayCat, SoCaliana, Alumbrados, exNYinTX, KenBee, slowbutsure, IndieGuy, Sylv, VirginiaBlue, Hillbilly Dem, caliberal2001, dewley notid, CT yanqui, lcs, rmx2630, Eyesbright, Nulwee, jdld, HarpboyAK, kaliope, leeleedee
Source: dailykos.com

Tips for Navigating the Medicare Part D Plan Selection Process

There are many factors to consider when reevaluating your prescription plan during open enrollment period. Each year, annual out-of-pocket expenses, premiums, deductibles and prescription co-payments can change, while the costs and drugs covered under Medicare Part D may vary according to plan and region. If your prescriptions have changed, you’re traveling more frequently or have moved, it’s important to reevaluate your current prescription plan. Opting for the right plan can help save you money and benefit your overall health. These may not necessarily be the first things that come to mind when you’re thinking about the open enrollment process, so talk to your pharmacist because we can help make the process a lot less confusing.
Source: agingabundantly.com