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

Posted by:  :  Category: Medicare

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

Video: Learn About Medigap Plans

Insurance Commissioners Reject Calls To Limit Seniors’ Medigap Policies

Medigap policies are popular with seniors because Medicare does not cap out-of-pocket expenses. The policies are not cheap — the average premium nationwide was $178 a month in 2010 — but they protect subscribers from unexpected high medical bills, which is important to people on fixed incomes. The C and F Medigap plans cover nearly all of the out-of-pocket costs that beneficiaries would usually pay.  Two thirds of people who buy Medigap plans have incomes below $40,000 a year — about the same income levels for all Medicare beneficiaries.
Source: kaiserhealthnews.org

Putting a Donut Hole Back in Medicare: Proposals to Increase Medigap Costs Put Vulnerable Beneficiaries at Risk 

[1] See Medicare Supplement Insurance First Dollar Coverage and Cost Shares Discussion Paper, National Association of Insurance Commissioners (NAIC), Senior Issues Task Force, Medigap PPCA Subgroup, (October 2011), available at: http://www.naic.org/documents/committees_b_senior_issues_111101_medigap_first_dollar_coverage_discussion_paper.pdf.  Also see, e.g., Leadership Council on Aging (LCAO) issue brief “Reforming Medigap Plans by Shifting Costs onto Beneficiaries: A Flawed Approach to Achieving Medicare Savings” (December 2012), available at: http://www.lcao.org/docs/LCAO-Medigap-Issue-Brief-12-12.pdf [2] Medigap Reform: Setting the Context, Kaiser Family Foundation, (September 2011), available at http://www.kff.org/medicare/8235.cfm. [3]Medigap Reform: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs, Kaiser Family Foundation, (July 2007), available at http://www.kff.org/medicare/8208.cfm. [4] See, e.g., previous Weekly Alerts, including finding drug savings in Medicare (November 2011) http://www.medicareadvocacy.org/2012/11/15/deficit-reduction-and-medicare-save-money-without-harming-beneficiaries/ ; Prescription Drug Rebates (July 2011) http://www.medicareadvocacy.org/2011/07/21/debunking-medicare-myths-drug-rebates-for-dual-eligibles/ ; and additional options for achieving Medicare savings (June 2011) http://www.medicareadvocacy.org/2011/06/09/so-what-would-you-do-real-solutions-for-medicare-solvency-and-reducing-the-deficit/.
Source: medicareadvocacy.org

When Can I Get Out of My Medicare Advantage Plan?

First and foremost, you should apply for the supplement plan with either a February 1 or March 1 effective date. Approval on a Medigap policy can take 2-3 weeks to complete underwriting. So it is important to do this well in advance of when you want the plan to start. For example, if you want to make the changeover effective 2/1/13, apply early in January for the supplement (or even during the last couple weeks of December). Once your Medigap plan is approved, you can proceed with returning to Medicare with a Part D plan. The easiest way to do this is to call Medicare (1-800-MEDICARE) and select a Part D plan, while at the same time disenrolling from your Medicare Advantage plan. You cannot have both a Part D plan and a Medicare Advantage plan, so this changeover can be done within the same phone call. Make the changeover effective either 2/1/13 (if doing it in January) or 3/1/13 (if doing it between 2/1 and 2/14).
Source: medicare-supplement.us

Medigap: Providing Financial Security and Peace of Mind for Medicare Beneficiaries

Proponents of limiting first-dollar coverage in Medigap often cite the findings from a 1970’s RAND experiment to make the case zero cost-sharing leads to higher health care spending.  AHIP commissioned a white paper to examine the relevance of this study to current Medicare beneficiaries. The white paper found that the RAND study “was set in a reimbursement environment far different from today’s Medicare,” and noted that “a higher proportion of Medicare beneficiaries are low income (and low wealth), and so the impact of higher cost-sharing may be magnified for this population.” The authors conclude that “an across-the-board ban on first-dollar coverage Medigap plans is an overly blunt tool for lowering healthcare expenditures and invites adverse, unintended consequences.”
Source: ahipcoverage.com

Medigap Plans and the Affordable Health Care Act

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

NAIC Senior Issues Task Force rejects cost sharing under Medigap plans

The statute requires the NAIC to base nominal cost sharing revisions on “peer-reviewed journals or current examples of integrated delivery systems”. However, the Subgroup discovered that there is a limited amount of relevant peer-reviewed material on this topic. None of the studies provided a basis for the design of nominal cost sharing that would encourage the use of appropriate physicians’ services. Many of the studies caution that added cost sharing would result in delayed treatments that could increase Medicare program costs later (e.g., increased expenditures for emergency room visits and hospitalizations) and result in adverse health outcomes for vulnerable populations (i.e., elderly, chronically ill and low-income).
Source: pnhp.org

Obama’s Medicare Plan: Seniors Will Pay More

Obama’s latest budgetary scheme for cost-shifting to seniors is just another indication that the Administration and its allies on Capitol Hill are running out of options. They have already cut the Medicare provider payments to achieve a 10-year “savings” estimated at $716 billion, but most of those “savings” will finance Obamacare. In a letter to Senator Jeff Sessions (R–AL), ranking member of the Senate Finance Committee, the CBO writes, “Unified budget accounting shows that the majority of the HI trust fund savings under PPACA would be used to pay for other spending and therefore would not enhance the ability of the government to pay for future Medicare benefits.”
Source: amac.us

Consumer reps: Medigap is not the bad guy

In the current draft of the NAIC cover letter, drafters state that, “We strongly disagree with the assertion that Medigap is the driver of unnecessary medical care by Medicare beneficiaries. Medigap insurance pays benefits only after Medicare has determined that the services are medically necessary and has paid benefits. Medigap cannot alter Medicare’s determination and the assertion that first-dollar coverage causes overuse of Medicare services fails to recognize that Medigap coverage is secondary and that only Medicare determines the necessity and appropriateness of medical care utilization and services.”
Source: lifehealthpro.com

State insurance commissioners: No way should we charge seniors more for Medigap policies

“None of the studies provided a basis for the design of nominal cost sharing that would encourage the use of appropriate physicians’ services,” the letter says. “Many of the studies caution that added cost sharing would result in delayed treatments that could increase Medicare program costs later (e.g., increased expenditures for emergency room visits and hospitalizations) and result in adverse health outcomes for vulnerable populations (i.e., elderly, chronically ill and low-income).”
Source: medcitynews.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

A Short Overview About Medigap Plans F Assisting Address Expenses Which Are Deductible For Every Single Person

To start with let us initial see what does medigap implies? Medigap plans are a sort of a reward insurance coverage or in superior conditions an added insurance coverage which you commonly buy from the private company that will be getting care of the well being treatment fees that are definitely not coated by the unique medicare. These don’t look after the long term remedies but only includes a basic types like an eye or vision check-up, nursing,dental care and couple of much more.The medigap ideas may also be called the medicare nutritional supplement plans.The medicare complement plan B gives you the fundamental benefits which involves the hospitalization as well as the healthcare expenditures.So,the Medicare Supplement Plans F essentially gives you total protection which comprise of the excess medical costs.Receiving into particulars of what medicare supplement plan F covers let us start with medicare benefits which again includes hospitalisation,medical expenditures and blood. Then arrives the 2nd part which it addresses and that is specialised nursing,deduction from the expenses in hospitalisation,then will come the deduction of outpatient costs for hospitalisation and healthcare bills plus the perfect element concerning this strategy is the fact that it addresses the abroad journey healthcare bills also. Isn’t that outstanding? From each of the medigap plans the medicare supplement plan F could be the most beneficial as it has an alternative for high deduction.These higher deductible procedures have reduced rates as in contrast but in situation an individual gets to be ill or unwell you may find yourself investing larger out of your pockets.This plan could wind up costing exceptionally higher yearly. To avail any medigap plans positive aspects an individual ought to first be enrolled in plan A and the plan B.To know even more about these insurance coverage medical plans you can easily normally seek advice from a medicare insurance supplier.You can easily discuss your specifications with them who are able to recommend you which strategy may get along with your each day amazing as well as a healthful life. Medigap plans or even the plan go over 18% medical beneficiaries.The medicare supplement plan F might be availed based on the area you keep.So its time to suit your needs all to acquire to operate.Obtain out the private agencies which produce the medigap plans and procedures . Speak for your healthcare insurance supplier and avail one of the best strategy you can actually for oneself and your members of the family.
Source: posterous.com

AARP Medigap Rates 2013 Connecticut

AARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 Anthem Anthem High F plan Anthem Medicare Anthem Medigap Anthem Supplement Coverage Gap Donut Hole Drug Help High Deductible F supplement LIS Connecticut Medicare Medicare Advantage Medicare Complete Medicare Complete connecticut Medicare Connecticut Medicare for Dummies Medicare Guide Medicare Introduction Medicare part B Medicare part D Medicare prescription drug plans Medicare Rx Medicare Saving program Medicare Supplement Medicare Supplement Connecticut Medigap Medigap rates 2013 Medigap rates NY 2013 MSP Connecticut Part D Part D Drug help Rx Help Rx help connecticut united healthcare United Healthcare AARP United Medicare complete 2013
Source: croweandassociates.com

Can Medicare and Dental Insurance Be Used Together?

Posted by:  :  Category: Medicare

The basic rule is that Medicare does not cover any dental services unless such services are needed or are the result of non-dental services and procedures that Medicare does cover. For example, if a dental procedure requires hospitalization, Medicare will pay its normal coverage for hospitalization and doctors fees, but not the fee from the dentist for the procedure performed. No follow up, out patient expenses will be covered, but some prescription medicines may be covered. Another example of a dental service that might be covered is when it is necessary to pull a tooth to prevent the spread of infection.
Source: seniorcorps.org

Video: Health Insurance Information : About Medicare Dental Benefits

Medicare Dental Plans: Medicare Dental Benefits

Where are my Medicare dental benefits? If you person asked this query, you are not uncomparable. Galore group who possess transmute Medicare-eligible jazz either been popeyed or silent supported to discover, that for the most concern, Medicare dental benefits are nearly non-existent. In fact, there are rattling few circumstances when Medicare will address dental procedures. Medicare is not plenary welfare news and there are various gaps that are the arena of the Medicare donee. There is a dominion allowable for hospitalization and 20% co-insurance required for outpatient procedures. The Medicare governing also includes a statutory dental banishment. This expulsion states that: “where such expenses are for services in instrumentation with the mend, management, fill, separation, or equal of set or structures direct activity set, object that defrayal may be prefabricated low conception A in the sufferer of patient hospital services in memory with the fund of much dental services if the organism, because of his underlying medical premise and clinical status or because of the harshness of the dental activity, requires hospitalisation in shape with the supplying of specified services.” In 1980 the banishment was revised to appropriate Medicare dental benefits for patient infirmary services when the dental process itself prefab hospitalization needful. Medicare testament also pay for dental services that are split of a strewn expense. This could countenance age of the jaw due to an injury. Medicare dental benefits are also lendable for the extraction of set correlative to radiation direction and in both cases instrument pay for an examination communicating (but not communication) prior to kidney transplants or disposition regulator surgery. Medigap testament not supply – an Vantage thought may Purchasing a Medigap insurance contract give not get you dental amount. Medigap policies do not allow dental benefits and only the gaps from a barnacled procedure give be professional. By definition, a Medigap contract module alter the gaps of Medicare clothed claims, not request added benefits. The exclusive possibleness to find dental benefits beyond what’s included in Medicare, is to inscribe in a Medicare Welfare direction that includes dental benefits. Not all Medicare Advantage plans include dental benefits and many that do, only worship discounts for doomed procedures. An Vantage counseling is not a Medicare matter, but kinda another way to incur your Medicare benefits. One good of an Advantage mean is the knowledge to comprehend benefits that are beyond what Medicare provides. Before you enter in a Medicare plus plan you should see the differences between a Medigap insurance and an Asset program. Not all Benefit plans are created equate. Whatever testament include the player benefits that you are hunting for and others module not. Many faculty bid exclusive discounts on dental services, patch added give permit dental contract as break of the program. Alikeness Medicare Plus plans online to regulate which plans allow the moral Medicare dental benefits for you.
Source: blogspot.com

The Disability Information and Resource Centre

Medicare benefits will not be paid for any dental services under the Medicare Chronic Disease Dental Scheme after December 1st 2012. Patients without a GP care plan in place before September 8th 2012 will not be able to access the Medicare Chronic Disease Dental Scheme before it closes on December 1st 2012.
Source: org.au

Medicare Open Enrollment: More is better

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

zulemabaier140: Medicare Dental and vision Benefits

Community or Government Dental and foresight Care – I have seen ads for dental clinics, ad even mobile dental care vans, at local community centers. Many church or community sponsored centers will have facts on reduced fee clinics for seniors, disabled people, or others with low income. The federal government, state, or county may also run reduced fee clinics in some areas. Your local health and human resources offices should have information. There is help out there for older people, but it can take some digging to find it.
Source: blogspot.com

Tricare Help – Can wife, over 65 but ineligible for Medicare, be put on Tricare Prime?

What you need to do is contact your local Social Security Administration office and make them aware that your wife is not eligible for Medicare Part A under either her own work history or yours. As such, she should be eligible to receive a “Notice of Disapproved Claim” from the SSA. Once you have that in hand, take it to your nearest military installation ID Card/DEERS office. DEERS is the Defense Enrollment Eligibility Reporting System, the Defense Department’s eligibility portal for Tricare. The SSA’s “Notice of Disapproved Claim” should be sufficient to allow your wife to retain eligibility for Tricare Prime, Standard and Extra even though she is already past her 65th birthday, once you update your wife’s DEERs registration file and get a new ID card for her.
Source: militarytimes.com

Ohio Health Policy Review: States across the county slashing Medicaid dental benefits

Without the ability to decrease Medicaid eligilbility in recent years, states have instead began reducing optional benefits for adults as a way to face financial shortfalls. And the benefit most likely to be cut is dental coverage (Source: "Sharp Cuts in Dental Coverage for Adults on Medicaid," New York Times, Aug. 28, 2012).
Source: healthpolicyreview.org

Oral cancer patient fights Medicare for coverage 

alcohol cancer CDC Cervarix cervical cancer cetuximab chemotherapy chewing tobacco cigarettes cisplatin DNA early detection erbitux FDA Food and Drug Administration Gardasil head and neck cancer HPV HPV-16 human papilloma virus human papillomavirus lung cancer mouth cancer National Cancer Institute nicotine oral cancer oral cancer foundation oral sex oropharyngeal cancer radiation radiation therapy radiotherapy smokeless tobacco smokers smoking snus squamous cell carcinoma surgery survival The Oral Cancer Foundation throat cancer tobacco vaccination vaccine xerostomia
Source: oralcancernews.org

Are You Set for the New Year With Medicare Enrollment Over

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2.. Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481You can switch to a Medicare Advantage plan or prescription drug plan with a higher quality rating. Whether you have traditional Medicare or Medicare Advantage, you can switch to a Medicare Advantage plan that has a five-star quality rating if one of these plans is available in your area. If you have a prescription drug plan, you can switch to one with a five-star rating. You can make the switch at any time during 2013, but you can only do it once.
Source: allsup.com

Video: Medicare Enrollment | Medicare Sign Up | Apply for Medicare

More Time to Enroll in Medicare If You Live in Storm Areas

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

Office of Statewide Benefits provides information on Medicare Parts A, B enrollment

Failure to enroll and maintain enrollment in Medicare Parts A and B upon eligibility may result in the subscriber being held financially responsible for the cost of all claims incurred, including prescription costs. Retirees and spouses enrolled in Medicare Parts A and B must provide a copy of their Medicare Identification Card to be enrolled in the state of Delaware Special Medicfill plan.
Source: udel.edu

I’m an MS Activist: REMINDER: MEDICARE OPEN ENROLLMENT ENDS DEC. 7TH

If you are a Medicare beneficiary who was impacted by Hurricane Sandy, the Centers for Medicare and Medicaid Services (CMS) is making accommodations to ensure that all Medicare beneficiaries can enroll in the health and drug plans that are best for them.
Source: blogspot.com

VPR News: As Deadline Approaches, Welch Urges Seniors To Enroll For Medicare

The year saw some disappointments in the development of drugs to treat Alzheimer’s. But the setbacks were offset by progress in other areas. The upshot from this year’s mixed results, some scientists say, is that treatment for Alzheimer’s needs to start long before forgetfulness and muddled thinking are apparent.
Source: vpr.net

Medicare open enrollment: Did I mess up by not taking Part B when I retired from my federal government job?

Q. I retired from a federal government agency and did not enroll in Medicare Part B when I became eligible. Instead I continued my coverage through the Federal Employees Health Benefit Program. I understand that if I ever want to enroll in Part B in the future there will be a 10 percent penalty for every year that I delayed. Did I make a mistake? A. Last week brought a spate of queries from federal retirees who are in the enviable situation of having multiple health coverage options. But with options comes complexity.
Source: consumerreports.org

Annual Enrollment for Medicare Advantage (Part C) & Part D: October 15 – December 7 

Even beneficiaries who were satisfied with their 2012 plans need to review their plan options for 2013.  Part D and MA plans may have made changes to their coverage, provider networks and other plan features.[3] Plan information for 2013 will be available on the Medicare Plan Finder at www.medicare.gov.[4]  For the computer-savvy, the Medicare Plan Finder is an excellent plan comparison tool, allowing users to enter all their drugs and drug dosages, compare up to three plans at a time, save their drug information for later use, and actually enroll in a plan on-line.  This is the best – if not only – way to truly compare the many plans available to choose from.  People who cannot use the Plan Finder themselves may contact 1-800-Medicare, or their State Health Insurance Assistance Program (SHIP), for assistance with evaluating, selecting, and enrolling in a Part D plan.
Source: medicareadvocacy.org

Medicare revalidation, DMEPOS fee still prompt questions among ODs

“Medicare covers post-op eyeglasses for cataract patients only if the glasses are provided by a DMEPOS supplier who is enrolled in Medicare,” Dr. Jordan said. “If the optometrist is not enrolled in Medicare for DMEPOS, then the glasses are not covered. Neither the doctor nor the patient can obtain reimbursement for the glasses from Medicare if the supplier is not enrolled. If a Medicare beneficiary wants to pay out-of-pocket for eyeglasses from a supplier who is not enrolled in Medicare, she or he may do so, but the doctor should be sure to explain to the patient that the glasses would be covered if they were obtained from another supplier who is enrolled in Medicare. In addition, the doctor should be certain to have an ABN form signed by the patient acknowledging that although she/he could have these glasses covered elsewhere she/he agrees to pay the doctor out-of-pocket and that he or she cannot get reimbursement from Medicare.”
Source: newsfromaoa.org

Modern Aging: Understanding Medicare’s annual enrollment

As in previous years, Medicare beneficiaries have the option of making no change during the AEP, and they automatically will be re-enrolled in their existing plan for another year, along with any changes that their current Medicare plan may have made for 2013. To inform members how their plans are changing, Medicare plan carriers are required to send each member an Annual Notice of Change letter.
Source: timesdispatch.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

Seniors overwhelmed by Medicare open enrollment marketing

On both options, one should already have a Medicare Part A, which is the hospital coverage and Part B, which is the medical or doctor’s coverage. Both Part A and Part B may be acquired by. those 65 or older (including those under 65) as long as they’re entitled on the basis of their Social Security benefits. For those who do not have Medicare Part A, they may purchase it from the Social Security Administration and Part B also has a required premium to be paid. Part C on the other hand, is the supplement coverage for long-term care and Part D is the prescription drug plan.
Source: balita.com

Blue Shield Medicare in San Jose, CA

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSThis brings me to my next point of the mysterious bill you get in the mail from Medicare.  One of our current clients just signed up for a Blue Shield Medicare Supplement plan.  The plan is about $97/mo which is great!  However, she got a bill in the mail from “Medicare” asking her to pay over $500.  What?!  We were just as confused.  I called up Blue Shield last week to check and see if everything had gone correctly and she was enrolled for exactly the $97/mo and no penalties had been given.  Nope—just fine on the Blue Shield side.   I called and emailed said client back and let her know not to worry about her Medicare Supp plan, but we’d like to review that bill she received in the mail from “Medicare.”
Source: brauerinsurance.com

Video: Is Freedom Blue PPO a Medicare Supplement?

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

Blue Care Network expands Medicare Advantage service area, Blue Cross and Blue Care Network add plan options

In addition, BCN Advantage members will now be able to “buy up” to more comprehensive dental and vision benefits for a modest additional premium. Members will receive partial coverage on restorative services such as fillings, root canals, crowns and crown repairs. They’ll also get an allowance for frames and lenses to improve their vision health.
Source: hcwreview.com

Blue Medicare Advantage: Blue Cross Blue Shield of Illinois

In addition to your Part B premium, there are small copayments to receive care.  With copayments as low as $7 for Medicare covered primary care doctor’s office visits, $45 for Medicare covered specialist visits and $3  for generic prescription drugs, it’s easy to get the care you need when you need it. An Advantage plan includes all of your Part A and Part B Medicare benefits, prescription drug coverage and emergency care if needed for an additional $65 copayment. Coverage is convenient and hassle free, and with an extensive provider network, there are always quality doctors nearby, ready to help from a wide range of specialties.
Source: ssiinsure.com

Medicare Open Enrollment: Independence Blue Cross

Do you have all of your questions answered about Medicare?  Before Open Enrollment ends on December 7, come learn about one of the plan options in the Medicare Program: Independence Blue Cross. Tina Garrity of Senior Advisors Group will give a presentation on Blue Cross Medicare Advantage and Medicare Supplemental Plans. She will highlight the plan benefits and changes for 2013. Through Senior Advisors, Ms. Garrity represents over 20 companies such as: Aetna, AARP, Mutual of Omaha, Central States Indemnity, Humana, Independence Blue Cross Medicare Advantage and Medicare Supplemental Plans  and many more.  While her presentation will focus on Independence Blue Cross, she can answer questions about the difference between plans and about program participant’s Medicare Advantage plan, Supplemental (Medigap) plan, or their Part D Stand Alone Prescription Drug plan. This program is free and open to the public.  Registration is not required, but highly recommended. This program will be repeated on Tuesday,  November 27 at 7:00 pm
Source: patch.com

Are you ready for 2013? 4 questions to ask yourself

Don’t forget, if you have Medicare Part B and are in Original Medicare, you’ll have to meet your deductible before your Medicare coverage pays for services and supplies. Next year, the Medicare Part B deductible will be $147. Make sure to plan your health care budget to account for the increased cost of doctor visits for the time that it will take to cover your deductible.
Source: medicare.gov

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

FW: Silver Cross Physicians Join New Blue Medicare Advantage (HMO) Plan

Learn how to protect yourself from some of the expenses Medicare doesn’t cover. Attend a free Our All-in-One Package: Medicare Advantage Prescription Drug (MAPD) program in the Silver Cross Hospital Conference Center, Pavilion A, 1890 Silver Cross Blvd., New Lenox.  One-hour sessions will be held on Oct. 26 and Nov. 1, 16 and 28 at 10 a.m. and 1 p.m.  Each seminar features an informative presentation followed by a question and answer session with a BCBSIL Product Specialist.  A sales person will present information and applications. Free valet parking and shuttle service will be available.  Refreshments will be served.  Register to attend by calling BCBSIL at 1-877-632-5920, TTY/TDD 711, 8 a.m. – 8 p.m., local time, 7 days a week.  For accommodation of persons with special needs at a sales meeting, call 1-877-632-5920, TTY/TDD 711. Friends and family members welcome.
Source: patch.com

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

Blue Cross Blue Shield of North Dakota sponsoring free Medicare workshops for seniors

The workshops will be held in Grand Forks on Oct. 15, Bismarck on Oct. 17, Fargo on Oct. 18 and Minot on Oct. 23. The workshops are free and open to all North Dakotans who are eligible or soon to be eligible for Medicare. Seniors are encouraged to register for one of the free workshops online at www.medicareworkshopsnd.com or by calling 1-888-235-3905. The first 25 to register for one of the workshops will receive a free pedometer.
Source: bcbsnd.com

Avoiding The ‘Fiscal Cliff’ Likely Means Changes In Medicare

Posted by:  :  Category: Medicare

Rogue Magazine (October 1964)  Volume 9 Number 5 - Water Balloons ...item 1.. routinely use devious devices -- wears us down like rabid trial lawyers until we give in (August 15, 2011 / 15 Av 5771) ... by marsmet542REDUCE PAYMENTS TO PROVIDERS: Hospitals, physicians and other health care providers – many who are now facing payment cuts either in the 2010 health care law or from the upcoming “sequestration” reductions (or both) – may take another hit in a deficit deal. Among the options sometimes mentioned are limiting the amount of “bad debt” that hospitals and other providers can write off their taxes,  reducing federal funding for medical education and requiring more prior authorization for some medical services, such as imaging, to help reduce unnecessary care. Lawmakers looking for political cover from angry providers could cite the many deficit-reduction proposals that have advanced provider cuts: Obama’s 2011 deficit reduction proposal, the Simpson-Bowles plan and the Medicare Payment Advisory Commission, or MedPAC, which advises Congress on Medicare payment policy.
Source: kaiserhealthnews.org

Video: Improving Medicare in 2011

Older Americans Have Been Highly Resistant to Medicare Changes

The income gap among Republicans and Republican leaners is about as large as the difference between GOP supporters of the Tea Party and non-supporters. Among Republicans and Republican leaners who agree with the Tea Party, 57% view deficit reduction as more important than preserving Social Security and Medicare benefits as they are. Among Republicans and leaners who do not agree with the Tea Party, just 36% say that reducing the deficit is more important than maintaining benefits.
Source: people-press.org

CNN Poll: Majority Opposes Medicare Changes

A clear majority of Americans opposes the Republicans’ plan to change Medicare, according to a new CNN/Opinion Research Corporation poll, with seniors particularly opposed to any changes to the program. Just 35 percent of Americans favor the GOP plan, according to the poll, while 58 percent oppose it. Only 32 percent of seniors aged 65-and-over favor the plan, while 64 percent were in opposition. Among those under the age of 50, only 36 percent support the plan. Independents also side heavily against the Republicans’ proposal; only 34 percent favor the GOP proposal. As last week’s special election in New York showed, the Medicare provisions are beginning to define the GOP budget. Some Republican Senate candidates were hesitant to embrace Rep. Paul Ryan’s, R-Wis., proposal in House votes last week, and other GOP candidates facing competitive primaries are being pressured to go on record with statements of support or opposition.
Source: nationaljournal.com

Medicare Changes Worry Seniors

“What we’re talking about here is a premium structure that makes sense,” said Robert Bixby, executive director of the nonpartisan Concord Coalition, which advocates reducing the deficit. “Politicians have been afraid to charge full fare because of public reaction. But that time is coming to an end.”
Source: wcbi.com

Eligible For Medicare? Learn New Changes And Benefits for 2011

Audio Included in Post. Runs 17 Minutes. Audio ©2010 WTLC/Radio One. Crystal Thomas, Regional Director of the Department of Health and Human Services recently talked with Amos and Afternoons with Amos about the Open Enrollment period for Medicare.  In the interview Thomas talks about positive changes in medicare as part of the new Health Care Law.  Listen to the interview above.  And click beflow to go diretly to the Medicare Web Site.
Source: praiseindy.com

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

Mutual of Omaha Announces Changes to Medicare Supplement Plan N Underwriting

Mutual of Omaha has announced underwriting changes to their Plan N Medicare Supplements.  This will affect all Mutual of Omaha companies including United World and United of Omaha.  Exceptions will include New York, where health questions may not be asked (per state regulations) and in open enrollment or other guarantee issue situations where health questions normally do not apply.
Source: wordpress.com

New Medicare Benefits and Changes for 2011

Once your total drug costs reach $4,550 (see the Ms. Medicare column "Paying Less for Drugs in the Doughnut Hole" for details about how this is calculated), you are eligible for "catastrophic coverage" and your prescription costs drop to a lower copay for the remainder of the year. Last year, when there were no doughnut-hole discounts, $250 rebate checks were sent to all affected Part D subscribers. Because of the discounts now in place, there will be no rebate checks for 2011 expenses. Another 2011 change for Part D subscribers is that if you have a high annual income (more than $85,000 for individuals and $170,000 for couples) and pay higher-income premiums for Part B, you’ll also pay a higher premium for Part D drug coverage.
Source: aarp.org

Obama’s Medicare Plan: Seniors Will Pay More

Obama’s latest budgetary scheme for cost-shifting to seniors is just another indication that the Administration and its allies on Capitol Hill are running out of options. They have already cut the Medicare provider payments to achieve a 10-year “savings” estimated at $716 billion, but most of those “savings” will finance Obamacare. In a letter to Senator Jeff Sessions (R–AL), ranking member of the Senate Finance Committee, the CBO writes, “Unified budget accounting shows that the majority of the HI trust fund savings under PPACA would be used to pay for other spending and therefore would not enhance the ability of the government to pay for future Medicare benefits.”
Source: amac.us

Obama Puts Social Security and Medicare Cuts on the Table

The debt-ceiling debate adds more than a little urgency to the negotiations. The debt ceiling expires on August 2, and as Felix Salmon writes, “No responsible legislator would risk letting it pass. Beyond that date is uncharted territory: Here Be Dragons stuff.” The Treasury Department is trying to figure out how they might slay some of those dragons (and, by the way, prevent “financial meltdown”) if the deadline arrives without a deal. They’ve looked into whether the government could delay or prioritize payments, and, intriguingly, whether the New York Fed could broker a deal on the Treasury’s behalf to raise its borrowing cap in global markets.
Source: nymag.com

Ryan Takes to Pennsylvania to Push Medicare Message

Posted by:  :  Category: Medicare

1stMC Vauxhall Astra RRV Kit by EssexTechMr. Ryan was extrapolating from a 2010 report from Medicare’s Office of the Actuary. It analyzed the potential impact of lower premium supports paid to private companies that issue Medicare Advantage plans, popular alternatives to traditional Medicare with extra benefits such as gym memberships. To slow the growth of Medicare spending, the Affordable Care Act reduces support for the private plans, which Democrats consider inefficient. Beneficiaries would still be covered under traditional Medicare.
Source: nytimes.com

Video: State Takeover of Harrisburg, Medicare/Medicaid Funding [Pennsylvania Newsmakers]

Medicare Takes Center Stage In Close Pennsylvania Races

The campaign jockeying over Medicare comes at a time when the program represents a huge fiscal challenge to both parties. With almost 50 million beneficiaries — and growing at the rate of 10,000 baby boomers every day — the entitlement program is one of the fastest-growing portions of the federal budget. Both parties acknowledge the need to curb its growth; both have also used the issue for political gain, casting themselves as the program’s protectors against what they portray as rivals’ threats.
Source: kaiserhealthnews.org

Growing bill for charity care makes margins smaller for Western Pennsylvania hospitals

“It’s clear employers are pushing more costs onto employees and those costs are increasingly harder to pay in the economic environment we are in,” Loch said. “Let’s be realistic: If people have a choice between paying for food on the table and paying a medical bill, they are going to pick food, hands down. Health care is way down on the list of what people consider to be a priority payment.”
Source: medcitynews.com

Pa. Home Health Care Providers Worried About Medicare Cuts

AAHomecare AARP AARP Public Policy Institute Alliance for Home Health Quality and Innovation Almost Family Amedisys Amedisys Inc. American Association for Homecare American Association for Long Term Care Insurance Apria Healthcare Group Avalere Health Brookdale Senior Living Care.com Center for Medicare Advocacy Centers for Medicare & Medicaid Services CMS Employee Benefit Research Institute Ensign Group featured First Care Home Health Care Gentiva Gentiva Health Services Gentiva Health Services Inc. HHS Home Health Depot Home Health International Houston Compassionate Care Humana IntegraCare Intel-GE Care Innovations Jordan Health Services Kindred Healthcare MDLIVE MedPAC Microsoft NAHC National Association for Home Care & Hospice Nationwide New York Times Northwestern Medicine Paraprofessional Healthcare Institute Partnership for Quality Home Healthcare PHI VA Wall Street Journal
Source: homehealthcarenews.com

Medicare to End Practice of Requiring Patients to Show Progress to Receive Nursing Coverage

For decades, home health agencies and nursing homes that contract with Medicare have routinely terminated the Medicare coverage of a beneficiary who has stopped improving, even though nothing in the Medicare statute or its regulations says improvement is required for continued skilled care. Advocates charged that Medicare contractors have instead used a “covert rule of thumb” known as the “Improvement Standard” to illegally deny coverage to such patients. Once beneficiaries failed to show progress, contractors claimed they could deliver only custodial care, which Medicare does not cover.
Source: pennsylvaniatrustsandestates.com

Senior Care in Sharon, PA: Open Enrollment for Medicare –Now through Dec 7, 2012

Would a small increase in premiums result in a large reduction in health care costs you pay? Check, for example, what coverage is available for prescription drugs you take? Medicare representatives can create a report containing the costs and benefits of various insurance products if you supply them with a list of your drug prescriptions. Ask questions about participating doctors and clinics. Some Medicare Advantage plans limit which physicians a patient can visit.
Source: cgphomecarehermitage.com

Corbett’s Insurance Exchange Decision Leaves Medicaid Fate Unknown

Corbett’s too busy cutting education, human services, and drilling for gas to worry about health care for Pennsylvanians. If he turns away the Medicare money many unemployed and low wage Pa. workers will have no health care..The people who are the poorest of the poor are getting free health care as usual. The Medicare expansion under Obamacare was set up to help low wage earners and those recently laid off from jobs..To not get these funds when your only donation will be 10% of the cost is unconscionable..
Source: patch.com

Health care union members accuse Pa. chamber of “Scrooging” the middle class

SEIU Healthcare Pennsylvania members and leaders rally outside the Pennsylvania Chamber of Business and Industry in Harrisburg to demand the chamber stop lobbying efforts supporting the extension of tax cuts to the wealthiest two percent of Americans and restructuring of programs such as Medicaid, Medicare and Social Security. Danell Fuller, a nursing home worker from Philadelphia, takes part in the rally. 12/13/2012 DAN GLEITER, The Patriot-News
Source: pennlive.com

The Consequences of Missing Medicare Signup

Posted by:  :  Category: Medicare

Healthcare in America: Who's Paying Who? And Who's Getting What? (g1a2d0014c1) by watchingfrogsboilPaying for the gaps in Medicare Part A and B coverage out-of-pocket can be financially devastating for a prolonged or serious illness or injury. Supplemental insurance is very important to control this risk. One choice is to enroll in both a Medigap policy plus a drug plan, known as Medicare Part D. Another choice is to sign up for a Medicare Advantage Plan, also known as Medicare Part C. Neither enrollment is automatic. You will have to choose these plans from private insurers. Again, the “Medicare and You” handbook is very good at outlining the types of coverage plan choices. Once you decide on the type of plan(s) you want, choosing your policies from the array of available private insurers can be overwhelming. A good insurance broker can be very helpful at this point.
Source: ga-cpa.com

Video: Medicare Enrollment | Medicare Sign Up | Apply for Medicare

Medicare Part B Enrollment When Working Beyond 65

By law, people who continue to work beyond age 65 still must be offered the same health insurance benefits (for themselves and their dependents) as younger people working for the same employer. So your employer cannot require you to take Medicare when you turn 65 or offer you a different kind of insurance — for example, by paying the premiums for Medicare supplemental insurance or a Medicare Advantage plan — as an inducement to enroll in Medicare and drop your employer plan. However, this law (known as ERISA) applies only to employers with 20 or more workers.  So if you work for a smaller business or organization, you may be required to enroll in Part B at age 65. Do I need to do anything about Part B at age 65 if I continue to be insured at work? It depends on whether you’re already receiving Social Security retirement benefits.  If you are, Social Security will automatically enroll you in Part A and Part B just before your 65th birthday.  The letter sent to you with your Medicare card explains your right to opt out of Part B if you have employer insurance.  To opt out, follow the instructions included in that letter within the specified deadline.
Source: aarp.org

What Medicare Needs is a Consumer

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

How Does Medicare Affect TRICARE?

Effective October 2009, TRICARE beneficiaries who are awarded retroactive benefits based on disability or permanent kidney failure do not have to pay for Part B for those months in the past in order to keep TRICARE. You should, however, contact the Department of Defense to find out whether you would now need to enroll in Medicare Part B in order to keep your TRICARE.
Source: specialneedsplanning.net

A Tricky Medicare Enrollment Season

All of them must navigate a system that is changing rapidly, in part because of requirements imposed by the new health care law. “It’s a complicated year for Medicare beneficiaries,” said Judith Stein, executive director of the Center for Medicare Advocacy, a nonprofit group that helps Medicare beneficiaries.
Source: nytimes.com

Part D Formulary Is Key To Choosing The Right Plan

Posted by:  :  Category: Medicare

My dad had to move from Ky to GA so my sister and I could take care of him. Humana (his Part D) just terminted him for the month of Dec because he moved out of his service area. They mailed us a letter on 11/25/10(Thanksgiving) and it stated as of 11/30/10 he would no longer have Part D coverage. I spent almost all day last Friday talking to Humana and got no where. They did deduct his payment from his SS??? Any suggestions? Is there a plan that would cover him in GA and KY should he decide to move back and stay with my other sister???
Source: affordablemedicareplan.com

Video: Healthcare Solutions DME Formulary

British National Formulary (BNF) now available online

Add new tag audiovisual equipment blackboard blogs Building work databases discover drop ins ebooks ejournals exams feedback frequently asked questions Glasgow University Library internet access journals Knowledge Base Library library widget NewsFilm online Open Access passwords PCs in Saltire Centre PINs placement podcasts quiet study zones RefWorks research serials solutions Surveys theft top tips twitter web pages your views youthwire
Source: caledonianblogs.net

Sanctions Blocking Medicare Sales Lifted

Aetna Inc. has admitted interest in acquisitions that would increase the presence of Medicare. Recently, the company announced the purchase of Genworth Financial Inc., which is a Medicare supplement company, for just under $300 million. Unaffected by the restrictive sanctions, Medicare supplement plans were bought by individuals that held coverage under traditional Medicare. Medicare supplement plans offer beneficiaries with protection against paying any out-of-pocket expenses that may not be covered by Medicare. According to Aetna Inc., the Genworth unit featured almost 150,000 members.
Source: medhealthinsurance.com

Aetna Faces Medicare Sanctions

Wall Street Journal: The problems pointed out by the Centers for Medicare and Medicaid Services involve “compliance problems related to drug-plan requirements.” According to the Journal, “Aetna went from an open formulary in 2009 to a closed formulary this year for many of its Medicare plan benefit packages, spokesman Fred Laberge said. In an open formulary, patients can be prescribed most any drug, while a closed formulary restricts the choices of available medications. The issue relates mostly to existing individual-plan members who were prescribed a drug that was on the 2009 formulary but was no longer on the formulary this year, he said. While CMS approved the health insurer’s 2010 formulary, affected members may not have received a one-time, 30-day transition supply of drugs, he said.” The company has said it will cooperate fully with the CMS review and is working to resolve the problems as soon as possible. “The company estimates some 20,000 current members may have been affected by compliance problems related to transition” from an open formulary in 2009 to a closed formulary for “many of its Medicare plan benefits packages” (Wisenberg Brin, 4/9).
Source: kaiserhealthnews.org

A new year brings new Medicare Part D plan options for long

The impact of these notifications is that any LIS beneficiary (a ‘dual’) enrolled in a 2009 LIS plan may need to consider another plan for 2010 year or be willing to pay premiums. Those who were “choosers” in 2009 will again need to choose to enroll in a new plan for 2010 or they will be randomly assigned to a different LIS plan for 2010 by CMS. It’s important to note that SNF LIS beneficiaries can change their LIS Medicare Part D plan monthly, if desired, in order to better align their changing drug regimens with an optimal plan formulary.      
Source: mcknights.com

2010 Medicare Part D Changes

Many people do not bother to wade through all the fine print, but you should.  If you do not, you may regret it for all of 2010.   For 2010 the number of plans offered in Washington State has dropped slightly to 44, and of this number a couple of plans are not open to new enrollees, but are just allowing their existing clients to keep their coverage if they so choose.  The biggest change I have noticed this year is that the number of plans that are offering programs with zero deductibles has dropped sharply, from 27 plans in 2009, to 16 plans in 2010.  Over 60% of the programs will have deductibles ranging from $50 to $310 in 2010.
Source: wordpress.com

What is the Cadillac Medicare Advantage plan

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98A 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

Video: How to Compare Medicare Advantage Plans Side-By-Side on PlanPrescriber

Medicare Advantage Plan Comparisons

Medicare Part D –  Prescription Drug Program, also overseen by the Centers for Medicare and Medicaid. Prescription Drug Plans are sold by private insurers that are contracted by the Federal Government to offer Prescription Drug Coverage to individuals. The plans sold by the private insurer must have the following and must be just as good or better than the model established by the Federal Government.
Source: wordpress.com

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 Advantage HMO Enrolles Use Fewer Outpatient Surgery Benefits

Medicare Advantage HMO plans may be offering more efficient care than Medicare Part A and Part B plans, according to a study published in the journal Health Affairs. According to the study, MA HMO enrollees receive fewer hip and knee replacements and use fewer benefits for outpatient surgeries and procedures, inpatient stays and emergency department visits. Based on a national comparison of data from MA HMO and traditional Medicare plans from 2003 to 2009, the researchers found that utilization rates in some areas — like ER and ambulatory surgery — were around 20 percent lower in MA HMO plans. MA HMO enrollees also received about 10 percent fewer hip and knee replacements and initially had lower rates of ambulatory visits and hospitalizations. Related Articles on Coding, Billing and Collections: Billing Company Executive to Be Charged With $41M in Tax Evasion Fraud 5 ICD 10 Regulation Myths
Source: beckersasc.com

Annual Enrollment for Medicare Advantage (Part C) & Part D: October 15 – December 7 

Even beneficiaries who were satisfied with their 2012 plans need to review their plan options for 2013.  Part D and MA plans may have made changes to their coverage, provider networks and other plan features.[3] Plan information for 2013 will be available on the Medicare Plan Finder at www.medicare.gov.[4]  For the computer-savvy, the Medicare Plan Finder is an excellent plan comparison tool, allowing users to enter all their drugs and drug dosages, compare up to three plans at a time, save their drug information for later use, and actually enroll in a plan on-line.  This is the best – if not only – way to truly compare the many plans available to choose from.  People who cannot use the Plan Finder themselves may contact 1-800-Medicare, or their State Health Insurance Assistance Program (SHIP), for assistance with evaluating, selecting, and enrolling in a Part D plan.
Source: medicareadvocacy.org

Moneycation: Medicare Part D: Plans and price comparison

You are likely to find several plans offered to you from several private insurance companies that seem to meet your needs. By using Medicare.gov’s Medicare Plan Finder before you make a change, you will be able to see which plans provide coverage for your state and town. You will see which are likely to have a low cost when the monthly premium, deductible and copayments are all considered. By contacting the various company’s websites or agents you can learn what is required of you in regards to using their network. Following these steps should make it easier for you to select the right prescription drug plan for you needs.
Source: blogspot.com

Deductibility of Medicare premiums as Self Employed Health Insurance Deduction

Posted by:  :  Category: Medicare

CROPS----GUESS WHO WANTS TO CONTROL THEM? WELL OF COURSE THE SAME PEOPLE WHO WANT TO CONTROL US by SS&SSBackground Prior to 2010, self-employed individuals were not allowed to take an above the line self-employed health insurance deduction under Section 162(l) for Medicare premiums. Health insurance is only considered deductible under the statute if it is established by your trade or business.  The purpose of the health insurance deduction is to equalize the treatment of owners of corporations who are allowed to exclude health care benefits as a fringe benefit and self employed individuals who cannot. Since Medicare is established by the Federal government the IRS did not consider Medicare premiums deductible as self employed health insurance. Recently the IRS reversed their opinion on the matter referencing Notice 2008-1. Notice 2008-1 states that as long as the self employed individual’s business ultimately pays for the health insurance and follows certain reporting requirements, the health insurance premium payments are deductible as above the line for the self employed individual. The Office of Chief Counsel IRS Memorandum extended Notice 2008-1 to apply to self employed individuals who pay Medicare premiums. Now all Medicare premium parts-A, B, C and D-paid by the self-employed individual for themselves, their spouse and dependents are deductible as self employed health insurance. The premium payments need not be paid directly by the self-employed individual. For example, the S corporation of a more-than-2% shareholder can make the payments directly and the self-employed individual is entitled to the deduction. 
Source: marcumllp.com

Video: SHIIP Medicare Premiums.flv

2010 Roth Conversion Might Spell Higher Medicare Premiums

This year, the IRS will generally provide tax returns from the year 2010 for the SSA to review the modified adjusted gross income. As you might recall, 2010 was the big year for converting traditional individual retirement accounts (IRAs) into Roth IRAs. If you participated in this conversion tactic, you might have seen an increase in your Medicare premium this year. If you spread your conversion income with the deal provided by the IRS over the tax years of 2011 and 2012, you might see an increase in your premium in 2013 and 2014. However, keep in mind these increases are only temporary. Once your income returns to its previous level, your Medicare premiums will be readjusted. For a closer look into what your Medicare premiums might be, click on the Medicare booklet.
Source: richmondbrothers.com

Study Finds Premium Support Plan Could Raise Medicare Premiums In Many Parts of Country

The study modeled the impact of a generic version of premium support, under which beneficiaries would receive a defined subsidy, or voucher, to buy health insurance in a competitive market instead of getting a guaranteed set of benefits, as Medicare has traditionally provided. That payment would be tied to the second-lowest-cost plan offered in an area or traditional Medicare, whichever is lower. This kind of a change is a central part of the House Republican budget written by Rep. Paul Ryan of Wisconsin, now the GOP’s vice-presidential candidate, and it has also been embraced by GOP presidential nominee Mitt Romney. Even a few Democrats have flirted with such a plan as a way to leverage market efficiency to rein in the spiraling cost of Medicare.
Source: aarp.org

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

Transforming Medicare into a Premium Support System: Implications for Beneficiary Premiums

The analysis does not attempt to model any specific proposal, but is generally based on an approach included in House Budget Chairman Paul Ryan’s fiscal year 2013 budget plan, the proposal Chairman Ryan co-sponsored with Senator Ron Wyden of Oregon, and; in the plan put forward by former Senator Pete Domenici and Dr. Alice Rivlin. In the first two proposals, people who are at least 55 years old, including current beneficiaries, would be exempt from the new system. Republican presidential nominee Gov. Mitt Romney has supported a premium-support system along these lines.
Source: kff.org

Remember Your 2010 Conversion to a ROTH IRA?? That Conversion May Hurt For 2013 Medicare B

It may have made good sense to Convert your TIRA to a ROTH IRA in 2010, you could spread the income tax bite over 2 years, 2011 and 2012. So you made your first income tax payment earlier this year when you filed your2011 tax return, and now you are preparing to pay the last half of that tax bill when you file your 1040 for 2012. But you have already received a big surprise, your Medicare B premium for 2013 DOUBLED from what the premium was in recent years. Since 2004, Medicare Premiums have been partly determined based on income. Those in the higher income brackets get to pay more for their Medicare B premiums. The modified adjusted gross income (magi) from your tax return will impact your Medicare B premium 2 years later. So from your 2011 tax return your modified adjusted gross income may impact your Medicare B premium starting in January 2013. The good news is that this increase cost for Medicare B is on a year by year basis. When the taxpayer’s modified adjusted gross income exceeds $170,000 (married filing jointly) the Medicare B premium will be increased. There is a graduated scale that will increase their Medicare B costs. Let’s suppose this married couple typically has an AGI of $70,000. Their Medicare premium has been less than $100 per month for each of member of the couple. In 2010 they converted TIRA funds to a ROTH IRA in the amount of $400,000. Half of this income was reported on their 2011 tax return increasing their AGI to $280,000. This increase would set their Medicare premium for 2013 at $209.80 for each of them. When they file their 2012 tax return reporting the second half of the 2010 ROTH Conversion, and have a similar AGI their 2014 Medicare B premium will be increased due to the taxpayer’s AGI. The Medicare B premium will be set in late 2013. The good news is if their 2013 is back below the threshold, the Medicare B premium will return to the amount payable by most Medicare beneficiaries. Here is the 2013 Medicare B premium table for MFJ tax payers with higher AGI: Modified AGI is: More than: But not over:………………………2013 Part B Premium $170,000…….. $214,000………………………….. $146.90 $214,000…….. $320,000………………………….. $209.80 $320,000…….. $428,000………………………….. $272.70 $428,000…….. No Limit……………………………. $335.70 You can learn more about Medicare B premiums and deductibles here: http://www.medicare.gov/your-medicar…at-glance.html
Source: christianpf.com

Blue Cross Blue Shield of Michigan broadens Medicare options with new Medicare Advantage PPO product

October 1 is the first day BCBSM and Medicare Advantage carriers across the nation can market their Medicare Advantage products for 2010. Beneficiaries in BCBSM Medicare Advantage products will receive letters in the next 10 days about the new product line-up. "Blue Cross remains fully committed to providing products to Medicare beneficiaries and will continue to have the broadest array of Medicare Advantage products in the state," said Mark Owen, BCBSM vice president for federal and individual business. "It’s important for Medicare beneficiaries to know that there is no immediate change to their coverage. They have until the end of the year to make their selection for 2010." In addition to the three BCBSM products for 2010, seniors also can select from three Medicare Advantage products offered by Blue Care Network, the BCBSM-affiliated HMO. "We will be working with insurance agents and other groups across the state to reach out to Medicare beneficiaries to help them navigate these product and premium changes," said Owen. Seniors who meet low income guidelines can receive subsidies from the state and/or federal government to pay for all or part of their premiums. Medicare Advantage premiums vary by product and region. The new PPO product is expected to provide beneficiaries with value for their premium. For example, the BCBSM Medicare Plus Blue PPO, which includes Part D prescription drug coverage, will cost between $61 and $141 a month (premiums vary by geographic region), while traditional BCBSM Medicare Supplemental (Medigap) Plan C plans cost $183 when combined with a stand-alone Part D BCBSM prescription drug program. Medicare Advantage plans offer Medicare benefits through private health insurance plans and most include Part D prescription drug coverage. When you purchase a Medicare Advantage plan, you do not need to also purchase a Medigap policy. Medicare Advantage plans are regulated solely by the federal government, while Medigap plans are regulated by the state. The announced product changes are only for Medicare beneficiaries who directly purchase their Medicare Advantage products, not for beneficiaries enrolled in a group plan. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Source: bcbsm.com

Medicare Premiums 2011 to 2012: What Has Changed?

Medicare premiums 2011 have gone through many different changes. Cost of living adjustments in 2009 and 2010 caused a freeze in medicare premiums 2011, which are now being raised to adjust for heightened living costs. In 2011, beneficiaries making below a certain amount will not be charged medicare premiums, because the state typically pays for these. Eligibility requirements vary by state, but they are still based on income.
Source: seniorcorps.org

Study: Premium support plan could raise seniors’ costs in many cities

Modern Healthcare: Premium-Support Model Would Have Been Costlier For Most Medicare Beneficiaries: Study About 59% of Medicare beneficiaries would have paid higher Medicare premiums in 2010 under a premium-support system if they had remained in their same plan and if such a model had been implemented, a new Kaiser Family Foundation study (PDF) concludes. In their nearly 50-page analysis, authors Gretchen Jacobson, Tricia Neuman and Anthony Damico examined the premium-support approach that connects federal payments to the second-lowest cost plan offered in an area, or traditional Medicare—whichever is lower. The study acknowledged that while this model was included in House Budget Committee Chairman Paul Ryan’s (R-Wis.) fiscal 2013 budget and embraced by former Massachusetts Gov. Mitt Romney, it “should not be interpreted as an analysis of any particular proposal, including the Romney-Ryan proposal” because that analysis would require more policy details, and it would also require certain assumptions about future shifts in factors such as demographics, spending and enrollment (Zigmond, 10/15).
Source: medcitynews.com