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Posted by:  :  Category: Medicare

Bubbles? Take something like 'Not I! ...item 1.. Wakulla Republicans Protest Against Taxes in the County (September 06, 2011) ... by marsmet552Medical billing BCBS NORTHEASTERN basicare COMM PA PO BOX 890062 CAMP HILL, PA 17089 800-829-8599 BCBS OF ALABAMA PO BOX 2294 BIRMINGHAM, AL 35201 800-517-6425 BCBS OF ALABAMA PO BOX 2298 BIRMINGHAM, AL 35201 800-517-6425 BCBS OF ALABAMA PO BOX 2294 BIRMINGHAM, AL 35201 877-779-6565 BCBS OF ARIZONA PO BOX 1200 PHOENIX, AZ 85001 800-232-2345 BCBS OF ARKANSAS PO BOX 2181 LITTLE ROCK, AR 72203 800-225-1891 BCBS OF ARKANSAS PO BOX 2181 LITTLE ROCK, AR 72203 800-827-4810 BCBS OF CENTRAL NY PO BOX 4782 SYRACUSE, NY 13221 800-920-8889 BCBS OF DE BLUE CHOICE PO BOX 8830 WILMINGTON, DE 19899 800-552-5356 BCBS OF FLORIDA PO BOX 1798 JAX, FL 32231 904-791-6111 basicare BCBS OF GEORGIA PO BOX 9907 COLUMBUS, GA 31908 800-441-2273 BCBS OF HAWAII PO BOX 44500 HONOLULU, HI 96804 808-948-6330 BCBS OF ILLINOIS PO BOX 1220 CHICAGO, IL 60690 800-635-9355 BCBS OF KANSAS basicare 1133 SW TOPEKA BLVD TOPEKA, KS 66629 800-432-3990 BCBS OF KANSAS 1133 SW TOPEKA BLVD TOPEKA,KS 66629 800-432-3990 BCBS OF KANSAS CITY PO BOX 419169 KANSAS CITY, MO 64141 800-892-6048 BCBS OF LOUISIANA P O BOX 98029 BATON ROUGE, LA 70898 800-258-3495 BCBS OF MASSACHUSETTS PO BOX 9196 NO QUINCY, MA 02171 800-227-7759 BCBS OF MASSACHUSETTS 100 NEWPORT AVE NO QUINCY, MA 02171 800-872-5298 BCBS OF MICHIGAN PO BOX 2888 DETROIT, MI 48231 800-637-2227 BCBS OF MICHIGAN PO BOX 2888 DETROIT, MI 48231 800-249-5103 BCBS OF MINNESOTA PO BOX 64338 ST PAUL, MN 55164 800-859-2126 BCBS OF MISSISSIPPI basicare PO BOX 1043 JACKSON, MS 39215 800-257-5825 BCBS OF MISSOURI 1831 CHESTNUT ST LOUIS, MO 63103 800-892-6048 BCBS OF MONTANA PO BOX 5004 GREAT FALLS, MT 59403 800-447-7828 BCBS OF NEBRASKA
Source: blogspot.com

Video: Medical Billing Tips – Coding for Medicare Flu Shots

OLReporter: Medicare, Fraud: Providers Most Commonly Caught

In October 2012, the General Accountability Office (GAO ) reported to Congress on its study of the most common sources of fraudulent activities (both criminal and civil) among Medicare program participants.  According to the GAO, medical facilities such as medical centers, clinics, and practices, and durable medical equipment suppliers were the most frequent subjects of criminal fraud cases in 2010.  More than a quarter of the criminal prosecutions involved health centers; durable medical suppliers made up another 16%.  These groups were the subjects in 20% and 18% of the civil actions, respectively.  A very small percentage of fraud cases were brought against individual Medicare recipients. Common health care fraud schemes include providers or suppliers (1) billing for services or supplies not provided or not medically necessary, (2) purposely billing for a higher level of service than that provided, (3) misreporting data to increase payments, (4) paying kickbacks to providers for referring beneficiaries for specific services or to certain entities, or (5) stealing providers’ or beneficiaries’ identities. 
Source: blogspot.com

Optomotrist Busted for Medicaid Fraud 

badgercare plus Better Business Bureau charity scams credit card fraud credit card scams election fraud false claims act fraud fraud alert newsletter Frauds healthcare reform identity theft job scams medicaid fraud Medicare medicare fraud medicare overbilling medicare part D medicare reform medicare reimbursement mortgage fraud phishing scams podcasts prevent medicare fraud scams storm chasers storm scams telephone scams Training voter fraud wisconsin bbb wisconsin check fraud wisconsin child care fraud wisconsin election fraud wisconsin fraud wisconsin head start fraud wisconsin medicaid fraud wisconsin mortgage fraud wisconsin scam wisconsin scams wisconsin smp wisconsin smp training wisconsin unemployment benefits wisconsin unemployment fraud wisconsin voter fraud
Source: wisconsinsmp.org

Federal Government Claims Nursing Homes Overbilled Medicare

A recent study by the inspector general’s office of the Department of Health and Human Services concluded that hundreds of nursing homes billed about a quarter of claims incorrectly in 2009. The report is part of a years-long initiative by the Department of Health and Human Services to rein in costs at the 15,000 nursing homes that provide skilled nursing. Most of those claims were “upcoded,” which means Medicare was billed for services that were more extensive than what was provided or needed. Many of the claims were for intensive physical speech or occupational therapy.
Source: cambridgecap.com

The Grumpy Economist: Billing codes

A while ago, an acquaintance saw her dermatologist for an annual check. She said, “oh, by the way, take a look at the place on my foot where we removed a wart a while ago.” The doctor looked at her foot, said everything is fine, then finished the exam. Checking the bill, there was a $400 extra charge for the wart examination! This nice audio story from NPRs “third coast festival”  tells the story of billing codes. Answer: As insurers and medicare/medicaid reduce payment for services, doctors respond by writing up every billing code they legally can. There are whole conferences devoted to billing code maximization. It’s a lovely unintended-consequences story. Good luck with that “cost control.” The piece quotes the Institute of Medicine that there are 2.2 people doing billing for every doctor, at a $360 billion dollar cost. I couldn’t find the source of these numbers. If any of you can, post a comment. Of course, being NPR, the program leaves the impression that all this will be fixed in our brave new world of the ACA. But it wasn’t even that heavy handed on the point. Perhaps experience is gaining on hope.
Source: blogspot.com

Deforming Medicare into a Competitive Bidding System (part 1)

Posted by:  :  Category: Medicare

FEHBP requires that all plans cover the same medical services. In spite of this, some plans offer more dental and vision coverage than others. However, the primary “choice” is whether to pay now or pay later. Those who choose plans with lower premiums (taken out of biweekly or monthly pay-checks) face higher deductibles and co-payments when they actually need medical care. Often this results in higher overall cost to those who choose what looks like a less-expensive plan. Seeing physicians “out of network” costs more in a “basic”plan than in a “standard” or “high option” plan. We know from many studies that higher co-payments lead low- and even middle-income people to postpone needed medical care. Since FEHBP premiums are independent of the employee’s income, lower-wage workers are likely to choose a “basic” plan and thus face the barrier of higher costs when they have to seek care. And many, of course, will not be able to afford to pay for any plan.
Source: correntewire.com

Video: Medicare Competitive Bidding Fiasco

Competitive Bidding Will Break Medicare? It’s one of the few things that actually might help fix it

Close the “donut hole”. The infamous precipice where seniors’ Medicare Part D does not offer coverage for prescription drugs – from $2,700 to $6,154 – is closed over time under the Affordable Care Act (ACA). Populist appeal aside, this is problematic – the donut hole is one of the important cost saving measures under Medicare Part D, and has helped it remain 30 percent below cost since its inception. It forces seniors to shop around for the best value in drugs, and to use generics instead of brand name drugs. The evidence that closing the donut hole should be a policy priority is also not very convincing. As John Goodman, a health economist and author of Priceless, points out, only six percent of seniors actually reach the donut hole. The cost of coverage for those who do? An extra $32 a month
Source: medicalprogresstoday.com

Medicare’s DME Competitive Bidding Not Built to Last

Bidders have the ability to swoop into a market, bid low, then back out of the process thereby setting a low bar for pricing that CMS will then implement with suppliers that do stay in the process. It sets the stage for monopolies as bigger providers come in and can afford to bid low because of the volume that they will ultimately do. Any short-run cost savings will be more than offset by long-run increases as successful bidders gain market power say critics.
Source: about.com

Paul Ryan and the Problem With Competitive Bidding

Private corporations all rely on competitive bidding, and it just hasn’t done much to hold down costs. That’s because the real source of America’s high medical costs is the fact that we simply pay more than other countries for everything we get: more for doctors, more for procedures, more for hospital stays, more for drugs, and — yes — more for insurance. If you really want to hold down costs, you have to hold down costs at the source, and Paul Ryan’s Medicare plan has no mechanisms for doing this. It relies solely on competitive bidding, and there’s very little chance that this alone can keep Medicare costs from outpacing his "fallback" growth cap. It’s a near certainty that his growth cap will be the real mechanism for reining in costs.
Source: motherjones.com

Containing costs for Medicare via Competitive Bidding

  Health & Social Technologist, Strategist, Chief Instigator and Co-Founder HealthCamp Foundation. Check out http://healthca.mp – Get involved in your future Health Care now. Socially Empowering Health Care Engagement.
Source: posterous.com

Medicare's Competitive Bidding Confusion Confines Woman to Her Bed

The results of the program are a shortage of providers, which is causing delays in the services that seniors and disabled Medicare beneficiaries need to remain independent and living in their own homes. In addition, the pricing that won the bidding process is for the lowest quality equipment, leaving no opportunity to access new techology that can improve lives.
Source: legacyoxygen.com

CMS Announces Timeline for Medicare DMEPOS Competitive Bidding Round 1 Recompete : Health Industry Washington Watch

On August 16, 2012, CMS announced the detailed timeline for the Round 1 Recompete of the Medicare DMEPOS competitive bidding program, which applies to nine geographic areas where competitive bidding currently is in effect. As we previously reported, although CMS is calling this a “recompete,” the agency is actually making significant changes to the products included in Round 1, including subjecting new products to bidding for the first time (i.e., products that were not in the original Round 1 competitive bidding process), and expanding the range of products included in a single product category (which is significant because a contract supplier must furnish all products within a product category, either directly or through a qualified subcontract, in the competitive bidding area). The following is the timeline for registering and bidding (note that dates are subject to change):  
Source: healthindustrywashingtonwatch.com

Employer rules for withholding the new 0.9% Medicare tax

Posted by:  :  Category: Medicare

OBAMAS DEATH PANEL------ GUESS WHAT FOLKS IT'S ALIVE AND WELL---"CRAZY PALIN" NOT SO CRAZY NOW by SS&SSBeginning in 2013, an additional 0.9% Medicare tax is imposed on individuals who receive wages over $200,000 ($250,000 in the case of a joint return, or $125,000 in the case of a married taxpayer filing separately). When added to the current 1.45% employee portion of the Medicare tax, a high-income taxpayer’s wages will be subject to a 2.35% Medicare tax on wages above the threshold. There is no employer match for the additional Medicare tax – the employer’s Medicare tax rate on wages paid to employees will continue to be 1.45%.
Source: pwc.com

Video: Examining Abuses of Medicaid Eligibility Rules

Obama Administration To Relax Medicare Benefit Rules

Modern Healthcare: Class-Action Settlement Would Widen Medicare Chronic-Care Benefits A federal judge in Vermont may approve a proposed legal settlement intended to guarantee Medicare benefits for people with chronic health conditions who need nursing and therapy services at home or in skilled-nursing and outpatient facilities. The settlement would resolve (PDF) a national class-action lawsuit that alleges HHS, Medicare contractors and administrative review boards across the country have rolled out a “clandestine” policy to limit Medicare coverage for nursing and therapy services even though official CMS rules say those benefits should be covered (Carlson, 10/23).
Source: kaiserhealthnews.org

Altering Medicare, Social Security rules won’t trim deficit

First of all, you need to understand that while life expectancy at birth has gone up a lot, that’s not relevant to this issue; what matters is life expectancy for those at or near retirement age. When, to take one example, Alan Simpson – the co-chairman of President Barack Obama’s deficit commission – declared that Social Security was “never intended as a retirement program” because life expectancy when it was founded was only 63, he was displaying his ignorance. Even in 1940, Americans who made it to age 65 generally had many years left.
Source: theolympian.com

Settlement Eases Rules for Some Medicare Patients

Neither the Medicare law nor regulations require beneficiaries to show a likelihood of improvement. But some provisions of the Medicare manual and guidelines used by Medicare contractors establish more restrictive standards, which suggest coverage should be denied or terminated if a patient reaches a plateau or is not improving or is stable. In most cases, the contractors’ decisions denying coverage become the final decisions of the federal government.
Source: usbia.org

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

NY Times: Settlement Eases Rules for Some Medicare Patients Glass Jacobson

We are sharing today an article written by Robert Pear for the New York Times a few weeks back about a proposed settlement of a class-action lawsuit that the Obama administration would uphold, allowing significant change in Medicare coverage rules.  Now that the President has been re-elected, we can be sure that these changes will take place. See what the changes entail:
Source: glassjacobson.com

Medicare Advantage Insurance

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 marsmet524Seniors on Medicare Advantage or considering enrolling beware! The Affordable Health Care Act, commonly referred to as Obamacare, is taking 8 billion dollars from Medicare Advantage. These cuts were to take effect October 15th of this year, but have been postponed until after the election. Most seniors are unaware of this information, and they are not being properly informed so as to make the best decisions regarding their health coverage.  
Source: capeinthesand.com

Video: Medicare Advantage vs. Medicare Supplement Insurance

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

ICYMI: Health Affairs Article: Medicare Advantage Provides Higher

A recent article in the latest edition of Health Affairs provides further evidence that Medicare Advantage plans are delivering higher-quality care to seniors and people with disabilities than the fee-for-service (FFS) part of Medicare.  Data from the article show that Medicare Advantage beneficiaries utilize some health care services, such as the emergency department and ambulatory surgery or procedures, at a rate 20-30 percent lower than those in FFS Medicare.  This data suggests that Medicare Advantage enrollees “might use fewer services and be experiencing more appropriate use of services than enrollees in traditional Medicare.”
Source: ahipcoverage.com

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

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

Signing Up for Medicare Benefits, Act Now!

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

Research Roundup: Medicare Advantage Plan Beneficiaries May Get More Appropriate Services; CHIP Participation Grows

Urban Institute/Robert Wood Johnson Foundation: Medicaid/CHIP Participation Among Children And Parents – “Despite the economic downturn, most states have maintained or expanded Medicaid and CHIP for children, by expanding eligibility to higher income and immigrant children, undertaking enrollment and retention simplifications, and implementing new policy options,” the authors wrote about coverage rates between 2008 and 2010. The rate of eligible children participating in Medicaid or CHIP grew to 86 percent nationwide and the number of eligible children who were not insured fell by 500,000 in that time, the study found. Participation rates for eligible parents were lower, however. The authors conclude that the 2009 law designed to improve participation of children in the program “may have contributed to increased take-up for Medicaid/CHIP among children, but that additional efforts will be needed, particularly among parents, to achieve high levels of Medicaid enrollment under the Affordable Care Act ACA” (Kenney et al., 12/3).
Source: kaiserhealthnews.org

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

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

Daily Kos: Republican Senate Bill Raises Medicare and SS ages

Posted by:  :  Category: Medicare

Newsweek Magazine (February 16, 2009) ... Lenders Add Bigger Fannie, Freddie Fee – Thanks to Payroll Tax Cut (January 15, 2012) ...item 2.. Dupuy: GOP trying to sell pyrmaid scheme to voters (September 3, 2012) ... by marsmet526First, Social Security: as you know, it does not contribute to the debt or the deficit. Raising the cap on FICA taxes and getting rid of the carried interest loophole, making it earned income (which it is) and therefore subject to FICA, would solve any long term problems. Do you live in the real world? Companies love to get rid of older workers and substitute younger workers who make less money. Older workers have a much harder time finding jobs; therefore, you would have a  cohort without jobs, without SS and without Medicare. Lovely way to honor our elders. In addition, for the companies who keep their older workers to the new SS age, that means jobs which are not available for younger workers. So either way, you have more unemployed people with no benefits.
Source: dailykos.com

Video: Medicare Online

Tallahassee retirees and students rally to defend Medicare from ‘fiscal cliff’ budget cuts

Republican lawmakers, like Southerland, have pushed for deep cuts to programs that support workers and retirees, like Medicare and Medicaid. President Barack Obama and the Democratic Senate have proposed a compromise that includes meager tax hikes for the richest 2%, coupled with cuts to Social Security and Medicare in the form of increasing the eligibility age.
Source: fightbacknews.org

Saving Medicare Through Premium Support

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

2013 Medicare Guidelines Course

Are you bulletproof? This course will cover all aspects of Medicare requirements as well as the latest changes for 2013. From audits and billing procedures to documentation requirements, Dr. Fucinari, a certified Insurance Consultant and Medical Compliance Specialist, will clear the muddy waters of Medicare. Are you handling Medicare appropriately? This comprehensive course is designed for doctors, staff and billing personnel.
Source: askmario.com

Daily Kos: Open thread for night owls: Raising Medicare eligibility age would hurt minorities most

un-Constitutional, since illness and injury are not age-dependent. Separating populations by age and income is little more than a sop to segregationist sentiments — sentiments which, in turn, merely satisfy an ideological commitment to hierarchy as a fundamental principle of society. Ranking humans in order to give some more or less authority over others is not natural. If humans are equal, admittedly an ideological commitment, but one that is enshrined in our organizing document, then hierarchy is in basic conflict. Insisting on it merely serves to undermine our democracy. Of course, we have a long history of not living up to our aspirations. But, that’s what moving forward is about. If we are going to make progress, then irrelevant distinctions have to be removed. Medicare should be an option for all, especially now that all income earners are paying into it. Money, btw, is a social utility. People who use it incur some obligations for our communal certification that their IOUs are good. If some people get along with handshakes, more power to them. We won’t expect them to pay in.
Source: dailykos.com

In fiscal bargaining, buzz over ‘means testing’ grows louder

First off I hope I am here when the day comes there are no more rich to tax so I can watch all the losers wonder who is going to pay their bills. Secondly I am on Medicare and one easy way to start fixing it is to stop paying for all the crap that has nothing to do with health such as Viagra, power scooters, endless amounts of dr. visits. The drug companies are lobbying democrats and republicans to get everything possible covered and every provider of equipment rips the system off. Look at what medicare pays for a wheel chair, crutches, and an endless list. If the people on medicare had to pay any of that amount they would be screaming like hell. The seniors do not care what it costs because their kids will pay for it. The seniors who insist on smoking and drinking themselves to death should be allowed to die. Why in the hell are we paying to keep them alive. Go into a casino and look who is playing the slots with smoke so thick you can cut it with a knife. Seniors on walkers, scooters, etc. Guess who is paying for that. Before you climb all over the rich, look at who is abusing the system. Also if you do not want the wealthy to have medicare then do not tax them for it and I am sure they will be happy to have their own insurance. Most of you losers do not want to pay for anything but want everything.
Source: nbcnews.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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

NFCC Financial Education Blog

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

Increasing Medicare Age Increases American Health Care Spending

Lots of those 65 and 66-year-olds will need Medicaid. That will cost the federal government about $8.9 billion. Lots of those seniors will go to the exchanges for insurance. That will cost the federal government about $9.4 billion in subsidies. Oh, that Medicaid will cost states too, about $700 million. The 65 and 66 year olds getting insurance from their employers will cost them about $4.5 billion (they’re expensive). As I’ve reported before, Medicare premiums will go up ($1.8 billion), and exchange premiums will go up ($700 million). And, there will be increased out-of-pocket spending by the 65 and 66-year-olds themselves for premiums, deductibles, co-pays, etc. Add it all up. To save the federal government $24.1 billion, we need to spend $29.8 billion.
Source: keystonepolitics.com

Medicare Terminology To Know

Medicare summary notice (MSN) deals directly with the beneficiary or the person covered  under Medicare. The MSN replaced the Explanation of Medicare Benefits form in 2001.[1] This is an easy to read document sent to the Medicare holder every month that allows them to see their Part A and Part B claims. The MSN also holds the deductible status. Basically it is an information sheet. Often when a patient receives the MSN they think it is a bill. It is important to understand that this is not a bill but rather an explanation of what has transpired the previous month under their Medicare coverage.
Source: codingcertification.org

Ask The Experts: Retirement

Q. I am following up a July 13 opinion about the allowable charges that FEHB plans can consider when a federal retiree incurs charges from a health care provider. The opinion states that FEHB must apply Medicare allowable rates in determining their plan’s benefits, and does not consider the “actual charge” from the provider. However, my reading of the Federal Register vol. 61, No. 189 (9/27/1996) is that the providers themselves cannot charge the retiree more than the Medicare allowable limits. Therefore, under the law as I understand it, it is illegal for the provider’s “actual charge” to exceed these limits. Is that correct? And if my provider submits a bill that exceeds these limits, am I legally obligated to pay the difference between the “actual charge” and the FEHB determination of the Medicare limit?
Source: federaltimes.com

Saving Medicare Through Premium Support

Posted by:  :  Category: Medicare

Newsweek Magazine (February 16, 2009) ... Lenders Add Bigger Fannie, Freddie Fee – Thanks to Payroll Tax Cut (January 15, 2012) ...item 2.. Dupuy: GOP trying to sell pyrmaid scheme to voters (September 3, 2012) ... by marsmet526Comments 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

Video: Cassidy Discusses Medicare Premium Support Reform Proposal

Using FSA funds for Medicare premiums

Yes, you can pay your Medicare Part B or Part D premiums using funds from your Flexible Spending Account (FSA).   Yours is an unusual situation.  Most people who have an FSA would not need Medicare Part B and Part D, since the employer plan covers hospital services and prescription drugs. Nevertheless, it is an allowable expense.  See IRS Publication 502 for a complete list of expenses that an FSA can pay.
Source: bangordailynews.com

Medicare premiums to increase in January

As for Medicare Part D prescription drug coverage, premiums vary among plans. But the Affordable Care Act requires Part D beneficiaries whose modified adjusted gross income exceeds $85,000 ($170,000 for married couples) to pay a monthly adjustment amount. They will pay the regular plan premium on their Part D plan and pay an income-related adjustment.
Source: utu.org

Let’s hope the 2014 Medicare premium rumor is dead

Of course this was nothing but a rumor (probably intended to undermine Obamacare) from the start. There is nothing in the Affordable Care Act in any way related to the Medicare premium and the rate of increase in health care costs needed to reach $247 by 2014 was impossible.
Source: quinnscommentary.com

SSA Announces COLA, Hike in Medicare Premiums

Many are concerned that their Social Security will not be sufficient to support them let alone finance the type of retirement that they would like to enjoy.  Social Security payments are minimal, with the average monthly benefit being less than $1240 as of this writing.  Someone who retired this year having paid the maximum amount into the program over 35 years would receive $2513 per month.  Even this maximum benefit is relatively modest when you consider the cost-of-living.
Source: wealth-counselors.com

Daily Kos: Open thread for night owls: Raising Medicare eligibility age would hurt minorities most

un-Constitutional, since illness and injury are not age-dependent. Separating populations by age and income is little more than a sop to segregationist sentiments — sentiments which, in turn, merely satisfy an ideological commitment to hierarchy as a fundamental principle of society. Ranking humans in order to give some more or less authority over others is not natural. If humans are equal, admittedly an ideological commitment, but one that is enshrined in our organizing document, then hierarchy is in basic conflict. Insisting on it merely serves to undermine our democracy. Of course, we have a long history of not living up to our aspirations. But, that’s what moving forward is about. If we are going to make progress, then irrelevant distinctions have to be removed. Medicare should be an option for all, especially now that all income earners are paying into it. Money, btw, is a social utility. People who use it incur some obligations for our communal certification that their IOUs are good. If some people get along with handshakes, more power to them. We won’t expect them to pay in.
Source: dailykos.com

Medicare premium increase for 2013 lower than expected

401(k) age discrimination aging aging in place annuities Career caregiving COBRA debt economy encore career entrepreneurs financial advisers Hard Times Guide Health health care healthcare health insurance housing IRA Jobs LGBT lifelong learning long-term care longevity Medicare pensions planning portfolio Q&A real estate retirement retirement income retirement jobs Reuters reverse mortgages RMDs Roth IRA saving second careers Social Security start-up taxes volunteering women
Source: retirementrevised.com

Medicare Advantage 2013 Spotlight: Plan Availability and Premiums

This data spotlight report examines trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2013, premium levels and other plan features. It finds almost all plans offered this year will be available again in 2013, despite concerns that reductions in payments to plans under the Affordable Care Act would result in widespread pullouts from Medicare Advantage plans. If all beneficiaries choose to remain in their current plans, monthly premiums would increase about 10 percent, or $4, on average. The analysis also examines the types of plans available (HMOs, PPOs, etc.), changes in out-of-pocket limits, and the availability of special needs plans.
Source: kff.org

Medicare Premium Changes Announced for 2013

Earlier this year CMS 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. However, the good news is that the increase 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: hcafnews.com

Aging & Law in West Virginia: Medicare Premiums and Deductibles 2013

Part A generally pays inpatient hospital, skilled nursing facility, and some home health. Most beneficiaries do not pay a premium for Part A since they have at least 40 quarters of Medicare-covered employment. Part B generally pays a portion of the cost of physician services, outpatient hospital services, certain home health services, durable medical equipment, and other items. Here below are the premiums, deductibles, and copays for Medicare Parts A and B for 2013:
Source: blogspot.com

An Unexpected Result From Roth Conversion

In case you hadn’t already noticed, this blog doesn’t have much to do with ducks – or any waterfowl for that matter. No, what we’re doing here is talking about all things financial; getting your financial house in order. Here in the Midwest, “getting your ducks in a row” implies organization, which is one of the outcomes of having a better understanding of your financial life. I hope you find the answers you’re looking for among the articles here, and perhaps a smile. If you can’t locate your answer, drop me an email or give me a call – we’ll see what we can find for you. And if you’ve come here to learn about queuing waterfowl, I apologize for the confusion. You may want to discuss your question with Lester, my loyal watchduck and self-proclaimed “advisor’s advisor”.
Source: financialducksinarow.com

Good News for SSDI Recipients with Medicare Premium Penalty

Most people who are receiving SSDI cannot wait to sign up for Medicare because it is comprehensive, affordable health coverage which does not deny coverage due to pre-existing health conditions.  However, if your employer provided coverage which went past your Initial Enrollment Period (IEP) or if your COBRA coverage was affordable and lasted past your IEP, you might not have signed up for Medicare at the appropriate time.   Then when you tried to sign up, you found out that you had to wait until the General or Open Enrollment Periods which might have left you with a gap in coverage and a penalty.
Source: retirementeducationplus.com

Raising the Medicare Age Is a Uniquely Terrible Idea

Medicare currently is significantly more cost effective than private insurance. Raising the Medicare retirement age would mean shifting many older people from a more cost effective government program to a less efficient private insurance system. This would not just force those near retirement to pay the full cost of their insurance, but since private insurance is a worse bargain these seniors would need to pay even more to get the same level of coverage Medicare would have provided.
Source: firedoglake.com

Put it on your fall checklist: Medicare Open Enrollment

Posted by:  :  Category: Medicare

Stocking the FINRA info tables by Newton Free LibraryIf your parents want to go online and sort through the details, they can get an early start, and you can help them navigate the process if needed. We’ve already made sure that the Medicare Plan Finder is fully updated with all new 2013 cost and benefit information for health and drug plans and is ready right now. All your parents need to do is start by entering the drugs and checking on the doctors and pharmacies they want to use. A few more steps will get them a personalized list of their plan choices and help them compare.
Source: medicare.gov

Video: ObamaCare Guts Medicare Advantage

Elderly Pharmaceutical Insurance Coverage Funding Restored in New York

After cutting the EPIC budget by about $12 million to help erase a $10 billion state budget shortfall, the legislature earlier this year restored EPIC funding for Jan. 1 to March 31. What will happen when the 2013-14 fiscal year begins April 1 depends on Gov. Andrew Cuomo (D) and the state legislature.
Source: aarp.org

New York Physical Therapy Association: Medicare info

Good Afternoon CMS Issues Cap Letter to Part A Beneficiaries; APTA Updates Patient FAQs The Home Health Section alerted APTA this week that the Centers for Medicare and Medicaid Services (CMS) began issuing its therapy cap letter to Medicare beneficiaries who are receiving home health under Part A, resulting in patients cancelling appointments. To address these beneficiaries’ concerns, APTA has updated its patient FAQs to explicitly state that the cap does not apply to patients who receive skilled therapy at home under the Medicare home health benefit Part A, those who receive services under Part A in skilled nursing facilities, or those under a Part A inpatient hospital stay.  In good health Matthew Hyland President NYPTA
Source: blogspot.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 Extends Enrollment Period For Those Affected By Sandy

The Centers for Medicare & Medicaid Services “understands that many Medicare beneficiaries have been affected by this disaster and wants to ensure that all beneficiaries are able to compare their options and make enrollment choices for 2013,” Arrah Tabe-Bedward, acting director for the Medicare Enrollment and Appeals Group, wrote in a Nov. 7 letter to health insurance companies and State Health Insurance Assistance Programs.
Source: kaiserhealthnews.org

Liberal Dems Line Up Against Raising Medicare’s Eligibility Age

The Hill: Dems Line Up Behind Pelosi Against Changing Medicare Eligibility Age House Democrats are lining up behind Minority Leader Nancy Pelosi (D-Calif.) against raising Medicare’s eligibility age as part of a year-end tax-and-spending package. Pelosi rejected raising Medicare’s eligibility age in an op-ed published Tuesday in USA Today, then doubled down on that position Wednesday. “We want what happens to be fair,” she said in an interview on CBS’s “This Morning” program. “And one of the things that we object to is raising the Medicare age” (Lillis, 12/12).
Source: kaiserhealthnews.org

Maplewoodian: MEDICARE OPTION INFO

Medicare Options for You  The Medicare open enrollment period ends on December 7. Do you have questions about plans and products? Are you aware that New Jersey offers State Pharmaceutical Assistance Plans to those who qualify? Join us for an educational seminar given by Senior Health Care Consultants from ADP/Statewide Insurance Agencies, Inc.  Be prepared to make the right decision concerning your healthcare!  Sponsored by the Maplewood Senior Club and Maplewood Library.  Free and open to the public.  Wednesday, November 28  10:30 am at Main Library 
Source: blogspot.com

Medicare Fact Sheets for Professionals: Medicare Information

“I want to compliment your organization on the quality of the fact sheets and informational materials on your website. I think they are among the most accurate and clearly written materials on Medicare (and Medi-Cal) available anywhere.”
Source: cahealthadvocates.org

Understanding Medicare Supplement Plans

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSScope of Coverages. Every one of the Medigap plans includes a hospital benefit to cover coinsurance payments for standard Medicare Part A benefits, and a preventative medical care benefit that covers certain preventative services not covered by Medicare, as well as 100% of the coinsurance for Part B preventative services after the deductible is paid. The plans include some combination of the following benefits: coverage for Medicare Part B coinsurance obligations; blood during hospital stays; the hospital deductible amount; coverage of nursing facility coinsurance obligations; coverage for Medicare Part B deductibles; coverage for Part B excess charges; partial coverage for foreign travel emergency expenses; coverage for certain at-home recovery costs; and coverage for coinsurance obligations for hospice care.
Source: insuranceadvice.com

Video: Compare Medicare Supplement Plans | Supplemental Medicare Insurance

What is the Cadillac Medicare Advantage plan

A plan’s network of providers: People often think Medicare Advantage plans are only offered as part of healthcare management organizations (HMOs), but many are also preferred provider organizations (PPOs). With HMOs and PPOs, insurance companies typically have a list doctors, specialists and hospitals that are preferred so when you go to those providers, you presumably pay a lower price for care. Either that, or the insurer covers more of your out of pocket costs, or both. Your costs typically differ if you get “in network” care versus “out of network” care. You’re more likely to think of a plan that includes your doctors, specialists and hospitals at a lower price to be a Cadillac plan.
Source: ehealthinsurance.com

Anthem Blue Cross Blue Shield Medicare Supplement Plans Are Affordable…

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

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

Pro’s and Con’s of Justing Having Medicare

Needless to say, money is tight these days and with the prospects of ever increasing health care cost and all of our plans to live to 100. Many people who are turning age 65 go into the decision of whether or not to get a Medicare supplement since this implies additional cost. This is really a two parter and we’ll analyze both in order of importance. First, let’s dig into the question of whether it makes sense to just go with traditional Medicare by itself. What does having only Medicare mean both from a cost point of view and a benefit point of view. Let’s look at the cost first. You shouldn’t need to pay for Part A coverage which is the hospital part of traditional Medicare. You will probably have to pay for Part B however which is the physician costs associated with Medicare. This cost is tied to how much income you make so you’ll need to check on your exact cost. The Part B coverage is also optional. You can choose not to elect it right away but you will likely face a penalty if you choose not to elect Part B once eligible (unless on group coverage). Part B is generally inexpensive enough to get (according to income level) so we’ll assume we mean having both Part A and Part B when describing “Medicare only” coverage. We’ll estimate the cost of Part B at $100/month. Not this doesn’t give us medication coverage but we’ll keep it simple (albeit missing) as our definition of traditional Medicare. So what kind of coverage does that afford you? Basically, for the cost areas that Medicare covers, you can expect to pay the deductibles (Part A runs around $1000 and Part B runs around $160 in 2011). Once you meet these deductibles, you will pay 20% of the remaining charges indefinitely. Right away, we see where the risk is to having no Medicare supplement insurance. How do we compare with and without? First, what is the cost of a standard Medicare supplement insurance? Let’s go with a 65 year old in California as an example. Medicare supplement plan rates don’t tend to vary excessively from State to State although age can affect it quite a bit. Let’s go with $130/monthly for an F plan as an example of Medigap cost. That’s about $1500/annually in supplement cost so this is the amount we want to really look at so that we can compare apples and apples with the deductibles mentioned above. In a year with bigger bills (assuming some hospital care), the cost of Medicare supplemental insurance almost equals the Part A deductible and Part B in their entirety. The point of insurance though isn’t about covering the small bills…it’s about covering the big bills. That’s the 20% co-insurance that Medicare doesn’t cover. If you have a good year health wise (let’s say no health issues at all to be extreme), you are out of pocket $1500 (cost of Medicare supplement plan). That’s the best case to not going with a Supplement. What’s the downside? Well, there’s the issue. It’s unknown. You will have to pay the 20% co-insurance with no cap. If you have a $100K medical espense, you’re on the hook for $20K. $100K sounds like a lot but in today’s medical cost world, it isn’t. A heart stint can run $50K-$100K and any health care treatment that finds you in a facility based setting (i.e. hospital) will get up there pretty quickly. That’s really the reason to get a Medicare supplement insurance. You don’t want save pennies and risk dollars especially since a person is more likely to have big bills as they get older. The second part of the question is a Medicare supplement plan (our example at $1500 annually) versus advantage plan which may have low or no cost. We addressed the comparison of Medigap versus Advantage in a whole separate article since we’re not comparing apples and oranges. Hopefully, we showed where the risk/reward lies between Medigap and just having traditional Medicare. Dennis Jarvis is a licensed insurance agent concentrating on medicare supplement insurance.

Medicare Supplement Plans

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSMedicare coverage has become restricted. Those who are just beginning, or have already reached their Golden years, are more susceptible illness.  To benefit from sickness benefits with ample coverage, a Medicare Supplement is a must. To find the right Medicare Supplement plan for you, medicarequotefinder.com is the way to go.  Search for the Medicare supplement that will complement your already existing Medicare coverage. Sometimes Medicare Supplements can be difficult to understand.  There are many different plans with many different types of coverage, and occasionally you get lost when all you want is to find the Medicare Supplement that you know will work best for you. Medicarequotefinder.com doesn’t want you to feel lost in the maze of Supplement plans. They make it easy to maneuver through their site to find what you need.
Source: medicarequotefinderblog.com

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

What is the Cadillac Medicare Advantage plan

A plan’s network of providers: People often think Medicare Advantage plans are only offered as part of healthcare management organizations (HMOs), but many are also preferred provider organizations (PPOs). With HMOs and PPOs, insurance companies typically have a list doctors, specialists and hospitals that are preferred so when you go to those providers, you presumably pay a lower price for care. Either that, or the insurer covers more of your out of pocket costs, or both. Your costs typically differ if you get “in network” care versus “out of network” care. You’re more likely to think of a plan that includes your doctors, specialists and hospitals at a lower price to be a Cadillac plan.
Source: ehealthinsurance.com

Understanding Medicare Supplement Plans

Scope of Coverages. Every one of the Medigap plans includes a hospital benefit to cover coinsurance payments for standard Medicare Part A benefits, and a preventative medical care benefit that covers certain preventative services not covered by Medicare, as well as 100% of the coinsurance for Part B preventative services after the deductible is paid. The plans include some combination of the following benefits: coverage for Medicare Part B coinsurance obligations; blood during hospital stays; the hospital deductible amount; coverage of nursing facility coinsurance obligations; coverage for Medicare Part B deductibles; coverage for Part B excess charges; partial coverage for foreign travel emergency expenses; coverage for certain at-home recovery costs; and coverage for coinsurance obligations for hospice care.
Source: insuranceadvice.com

Anthem Blue Cross Blue Shield Medicare Supplement Plans Are Affordable…

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

Pro’s and Con’s of Justing Having Medicare

Needless to say, money is tight these days and with the prospects of ever increasing health care cost and all of our plans to live to 100. Many people who are turning age 65 go into the decision of whether or not to get a Medicare supplement since this implies additional cost. This is really a two parter and we’ll analyze both in order of importance. First, let’s dig into the question of whether it makes sense to just go with traditional Medicare by itself. What does having only Medicare mean both from a cost point of view and a benefit point of view. Let’s look at the cost first. You shouldn’t need to pay for Part A coverage which is the hospital part of traditional Medicare. You will probably have to pay for Part B however which is the physician costs associated with Medicare. This cost is tied to how much income you make so you’ll need to check on your exact cost. The Part B coverage is also optional. You can choose not to elect it right away but you will likely face a penalty if you choose not to elect Part B once eligible (unless on group coverage). Part B is generally inexpensive enough to get (according to income level) so we’ll assume we mean having both Part A and Part B when describing “Medicare only” coverage. We’ll estimate the cost of Part B at $100/month. Not this doesn’t give us medication coverage but we’ll keep it simple (albeit missing) as our definition of traditional Medicare. So what kind of coverage does that afford you? Basically, for the cost areas that Medicare covers, you can expect to pay the deductibles (Part A runs around $1000 and Part B runs around $160 in 2011). Once you meet these deductibles, you will pay 20% of the remaining charges indefinitely. Right away, we see where the risk is to having no Medicare supplement insurance. How do we compare with and without? First, what is the cost of a standard Medicare supplement insurance? Let’s go with a 65 year old in California as an example. Medicare supplement plan rates don’t tend to vary excessively from State to State although age can affect it quite a bit. Let’s go with $130/monthly for an F plan as an example of Medigap cost. That’s about $1500/annually in supplement cost so this is the amount we want to really look at so that we can compare apples and apples with the deductibles mentioned above. In a year with bigger bills (assuming some hospital care), the cost of Medicare supplemental insurance almost equals the Part A deductible and Part B in their entirety. The point of insurance though isn’t about covering the small bills…it’s about covering the big bills. That’s the 20% co-insurance that Medicare doesn’t cover. If you have a good year health wise (let’s say no health issues at all to be extreme), you are out of pocket $1500 (cost of Medicare supplement plan). That’s the best case to not going with a Supplement. What’s the downside? Well, there’s the issue. It’s unknown. You will have to pay the 20% co-insurance with no cap. If you have a $100K medical espense, you’re on the hook for $20K. $100K sounds like a lot but in today’s medical cost world, it isn’t. A heart stint can run $50K-$100K and any health care treatment that finds you in a facility based setting (i.e. hospital) will get up there pretty quickly. That’s really the reason to get a Medicare supplement insurance. You don’t want save pennies and risk dollars especially since a person is more likely to have big bills as they get older. The second part of the question is a Medicare supplement plan (our example at $1500 annually) versus advantage plan which may have low or no cost. We addressed the comparison of Medigap versus Advantage in a whole separate article since we’re not comparing apples and oranges. Hopefully, we showed where the risk/reward lies between Medigap and just having traditional Medicare. Dennis Jarvis is a licensed insurance agent concentrating on medicare supplement insurance.

Medigap: Sacramento, Placer Medicare Supplement Rates

Posted by:  :  Category: Medicare

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

Video: Medicare Supplemental Insurance Plan Benefit Comparison California

Pro’s and Con’s of Justing Having Medicare

Needless to say, money is tight these days and with the prospects of ever increasing health care cost and all of our plans to live to 100. Many people who are turning age 65 go into the decision of whether or not to get a Medicare supplement since this implies additional cost. This is really a two parter and we’ll analyze both in order of importance. First, let’s dig into the question of whether it makes sense to just go with traditional Medicare by itself. What does having only Medicare mean both from a cost point of view and a benefit point of view. Let’s look at the cost first. You shouldn’t need to pay for Part A coverage which is the hospital part of traditional Medicare. You will probably have to pay for Part B however which is the physician costs associated with Medicare. This cost is tied to how much income you make so you’ll need to check on your exact cost. The Part B coverage is also optional. You can choose not to elect it right away but you will likely face a penalty if you choose not to elect Part B once eligible (unless on group coverage). Part B is generally inexpensive enough to get (according to income level) so we’ll assume we mean having both Part A and Part B when describing “Medicare only” coverage. We’ll estimate the cost of Part B at $100/month. Not this doesn’t give us medication coverage but we’ll keep it simple (albeit missing) as our definition of traditional Medicare. So what kind of coverage does that afford you? Basically, for the cost areas that Medicare covers, you can expect to pay the deductibles (Part A runs around $1000 and Part B runs around $160 in 2011). Once you meet these deductibles, you will pay 20% of the remaining charges indefinitely. Right away, we see where the risk is to having no Medicare supplement insurance. How do we compare with and without? First, what is the cost of a standard Medicare supplement insurance? Let’s go with a 65 year old in California as an example. Medicare supplement plan rates don’t tend to vary excessively from State to State although age can affect it quite a bit. Let’s go with $130/monthly for an F plan as an example of Medigap cost. That’s about $1500/annually in supplement cost so this is the amount we want to really look at so that we can compare apples and apples with the deductibles mentioned above. In a year with bigger bills (assuming some hospital care), the cost of Medicare supplemental insurance almost equals the Part A deductible and Part B in their entirety. The point of insurance though isn’t about covering the small bills…it’s about covering the big bills. That’s the 20% co-insurance that Medicare doesn’t cover. If you have a good year health wise (let’s say no health issues at all to be extreme), you are out of pocket $1500 (cost of Medicare supplement plan). That’s the best case to not going with a Supplement. What’s the downside? Well, there’s the issue. It’s unknown. You will have to pay the 20% co-insurance with no cap. If you have a $100K medical espense, you’re on the hook for $20K. $100K sounds like a lot but in today’s medical cost world, it isn’t. A heart stint can run $50K-$100K and any health care treatment that finds you in a facility based setting (i.e. hospital) will get up there pretty quickly. That’s really the reason to get a Medicare supplement insurance. You don’t want save pennies and risk dollars especially since a person is more likely to have big bills as they get older. The second part of the question is a Medicare supplement plan (our example at $1500 annually) versus advantage plan which may have low or no cost. We addressed the comparison of Medigap versus Advantage in a whole separate article since we’re not comparing apples and oranges. Hopefully, we showed where the risk/reward lies between Medigap and just having traditional Medicare. Dennis Jarvis is a licensed insurance agent concentrating on medicare supplement insurance.