Voice For Medicare, Medicaid Retiring

Posted by:  :  Category: Medicare

HELP ME HELP MYSELF! by eyewashdesign: A. GoldenIn a statement Friday, President Barack Obama hailed Rockefeller’s service. “From his time in the state legislature to the Governor’s office to the Senate floor, Jay has built an impressive legacy, one that can be found in the children who have better schools, the miners who have safer working conditions, the seniors who have retired with greater dignity, and the new industries that he helped bring to West Virginia,” Obama said. “A long-time champion of health care reform, Jay was also instrumental in the fight to make sure that nobody in America has to go broke because they get sick.”
Source: kaiserhealthnews.org

Video: You Can Help Fight Medicare Fraud

House Passes Legislation Designed To Help Curb Medicare Identity Theft

Johnson — who chairs the subcommittee on Social Security– said, “This common-sense bill is a vital step in protecting our nation’s seniors from identity theft.” He added, “I hope the Senate will act immediately to pass this legislation” (Viebeck, “Healthwatch,” The Hill, 12/21/12).
Source: ihealthbeat.org

Center for Medicare and Medicaid Innovation to launch ‘medical neighborhood’

Edward Marx is senior vice president and CIO for Texas Health Resources, a 24-hospital system based in Dallas-Fort Worth. He earned his B.S. in psychology and an M.S. in consumer sciences (business) from Colorado State University. He also served 15 years in the Army Reserve, first as a Combat Medic, then as a Combat Engineer Officer. Marx is a member of CHIME and the Society of Information Management (SIM), and is a HIMSS fellow. He also has served as the president of the Ohio and Tennessee chapters of HIMSS and chair of the membership services committee.
Source: fiercehealthit.com

Medicare Preventive Services: What’s free, what’s not!

Medicare also offers several other preventive services that require some out-of-pocket cost-sharing. With these tests, you’ll have to pay 20 percent of the cost of the service (Medicare picks up the other 80 percent), after you’ve met your $147 Part B yearly deductible. The services that fall under this category include digital rectal exams for prostate cancer, glaucoma tests, and diabetes self-management training services.
Source: hampshirereview.com

Medicare: Help enrolling or switching plans

Visit Medicare.gov. Its Plan Finder allows you to compare a wide range of costs across multiple drug and Medicare Advantage plans available in your county. It also has ratings on each plan’s performance and quality. Most important, it allows you to enter prescription drug names to gauge whether they’re covered and at what cost under a variety of plans.
Source: oregonlive.com

Medicare Open Enrollment Help Available

Medicare part D and Medicare advantage plans will have changes announced and policyholders will have to decide to re-enroll, change their plan, or drop enrollment completely. Crossroads of Pella can provide some help with understanding the changes and re-enrolling. Contact Crossroads of Pella to get in touch with a Senior Health Insurance Information Program volunteer at 641-628-1212. Medicare enrollment begins on October 15th.
Source: kniakrls.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

Not Happy with Your Medicare Advantage Plan? Change it!

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

Help Improve Your Access to Wheelchairs and Medical Equipment

In different regions of the country Medicare has adopted a program called the “bidding program.” It is what it sounds like. Medicare requires medical equipment companies to bid at a low price to have the opportunity to be offered a contract to provide Medicare business for a specific area, regardless of your choice of provider. That could mean, because they receive such a low price for the products and service they provide, they may only be able to carry the cheapest products (not as durable or comfortable) and may reduce their service. For example, consumers have voiced their concerns stating their equipment supplier is now too far from their home; the provider they have been using is now out of business, or the device they need is not available anymore.
Source: usersfirst.org

Reform Law Helped Slow Growth in Medicare Spending, HHS Finds

Study authors Richard Kronick and Rosa Po, with the HHS Office of the Assistant Secretary for Planning and Evaluation, noted that per capita spending is estimated to grow “at or below the rate of GDP per capita [and that] the number of Medicare beneficiaries is projected to increase by approximately 3% annually.” They added, “As a result, aggregate Medicare spending will account for a growing share of GDP over the next decade.”
Source: californiahealthline.org

What Are the Medicare Lein Laws for Personal Injury Settlements?

Your Personal Injury Attorney will report to the Coordination of Benefits Contractor (COBC) with information such as the Medicare number, injury, date of injury/loss, and other pertinent information.  Later, they must submit consent forms and proof of representation to the Medicare Secondary Payer Recovery Contractor (MSPRC).  Then you and your attorney can address any unrelated payments and dispute those payments. Finally, a settlement should be immediately reported to Medicare’s MSPRC.
Source: sandiegolegaloffice.com

Medicare Surtax Regulations Are Out

to help employers implement the additional .9% Medicare surtax for wages, self-employment income and other compensation. Effective January 1, 2013, employers must begin withholding this additional .9% Medicare tax for employees with wages in excess of $200,000. For a joint return on which neither spouse earns more than $200,000 but, when combined, results in earnings of more than $250,000, the tax is due but the employer will not be responsible for the added withholdings.
Source: wscpa.org

Navigating the Health Care System: Resources to Help You Stay Healthy in the New Year

Medicare Loosens the Purse Strings

Posted by:  :  Category: Medicare

Record shop Ithaca, NY by exaktaThanks 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

Video: New York: Medicare Fraud Summit Remarks (DOJ)

Daily Report: Medicare Is Faulted on Shift to Electronic Records

The report says Medicare, which is charged with managing the incentive program that encourages the adoption of electronic records, has failed to put in place adequate safeguards to ensure that information being provided by hospitals and doctors about their electronic records systems is accurate. To qualify for the incentive payments, doctors and hospitals must demonstrate that the systems lead to better patient care, meeting a so-called meaningful use standard by, for example, checking for harmful drug interactions.
Source: nytimes.com

Grappling With Details of Medicare Proposals

Still, it’s clear the proposed changes would shift costs from the federal government to retirees. An early version of a Republican plan would have more than doubled out-of-pocket health expenses for older adults, to $12,500 in 2022, the Congressional Budget Office estimated. “All scenarios will require seniors to pay more,” said Robert Moffit, senior fellow at the Heritage Foundation, a conservative research organization in Washington. To think otherwise, he said, “is a fantasy.”
Source: nytimes.com

Do Republicans Want to Cut Medicare?

The Republican positioning on Medicare has set the tone for the current budget impasse. Obama is asking for $1.6 trillion in higher tax revenue. Republicans are demanding more spending cuts, but they won’t say how much they want, let alone what specifically they will cut. The current party thinking on Medicare, sanctified by Romney and Ryan, has defined itself as matching or even outspending Obama on Medicare for anybody aged 55 and up. That would lock out any budget savings at all for the next decade, and make any savings roll in extremely slowly afterward.
Source: nymag.com

Navigating Medicare's Open Enrollment Period

Medicare beneficiaries who are happy with their plans do not need to do anything, if they don’t want to change. But it is still a good idea to check options, Ms. Metcalf advises, to make sure a version of Medicare is the best one in terms of cost and coverage. If, for instance, you have the original version of Medicare and pay extra for prescription drug coverage (so-called Part D coverage), you may want to make sure important medications you need are still covered under your plan, to avoid having to pay more for them.
Source: nytimes.com

The Official Medicare Set Aside Blog And Information Resource: New York Plaintiffs Once Again Attempt to Avoid Medicare Part C Reimbursements and Fail

, plaintiff Rebecca Meek-Horton filed suit on behalf of herself and all similarly situated Medicare beneficiaries enrolled in Medicare Advantage plans who settled New York personal injury or wrongful death insurance claims. The New York law passed in 2009 to encourage insurance settlements presumes that any such recovery does not include any compensation for medical expenses except where there is a statutory right of reimbursement; therefore, the plaintiffs felt they have no obligation to reimburse the MAO. The MAO plans disagreed and assert a statutory recovery right expressly exempted by the state law. The Court ultimately found the plaintiffs’ arguments were defeated by the plain language of the the governing statute. 42 USC 1395w-26(b)(3) expressly preempts all but a limited number of state licensing and solvency laws and the New York law in question does not fall into those categories. Furthermore, 42 CFR 422.108(f) also expressly states that “the rules established under this section supersede any State laws, regulations, contract requirements, or other standards that would otherwise apply to MA plans.” Because the plaintiffs exclusively plead their claims under the New York state law, claiming they were not seeking benefits or reimbursement for benefits so the Medicare Act did not apply, the U.S. District Court for the Southern District of N.Y. found the federal preemption sufficient to dismiss the action for failing to state a claim upon which relief could be granted.
Source: medicaresetasideblog.com

Former N.Y. clinic owner pleads guilty in $71 million Medicare fraud

Irina Shelikhova, a Ukranian national and former Brooklyn, and Staten Island, resident, pleaded guilty to one count of conspiracy to commit money laundering. Shelikhova owned a Brooklyn clinic that operated under three corporate names: Bay Medical Care PC, SVS Wellcare Medical PLLC and SZS Medical Care PLLC (Bay Medical Clinic). Owners and employees of Bay Medical paid cash kickbacks to Medicare beneficiaries and used their names to bill Medicare for more than $71 million in unnecessary, or never provided, services, authorities said.
Source: ifawebnews.com

Brooklyn, N.Y., Clinic Employee Pleads Guilty in Connection with $71 Million Medicare Fraud Scheme

Khandrius was an employee of a clinic in Brooklyn that operated under three corporate names: Bay Medical Care PC, SVS Wellcare Medical PLLC and SZS Medical Care PLLC (Bay Medical clinic).  According to court documents, owners, operators and employees of the Bay Medical clinic paid cash kickbacks to Medicare beneficiaries and used the beneficiaries’ names to bill Medicare for more than $71 million in services that were medically unnecessary or never provided.  The defendants billed Medicare for a wide variety of fraudulent medical services and procedures, including physician office visits, physical therapy and diagnostic tests.
Source: geyergorey.com

In Swing States, Obama Leads on Handling of Medicare

Mr. Romney and Mr. Ryan have called for curbing the growing costs of Medicare by making major changes to the program. Their plan would change Medicare for people who are now under 55 so that when they are eligible for coverage they would no longer receive a government-guaranteed, fee-for-service health plan but rather a fixed amount of money each year that they would use to purchase private health insurance or buy into a version of the existing Medicare program. But they have not provided enough details of their plan to assess how much it might increase out-of-pocket costs for future beneficiaries. Mr. Obama has pledged to preserve Medicare in its current form, but has spoken less about its rising costs.
Source: nytimes.com

Stories I’d like to see : CJR

I would further add one cannot compare buying a cane at Walmart to getting a cane covered by Medicare. Walmart does not require you to have a doctors order with all relevant information, have medical notes/history that show: “o The patient has a mobility limitation that significantly impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADL) in the home; AND o The patient is able to safely use the cane or crutch; AND o The functional mobility deficit can be sufficiently resolved by use of a cane or crutch”, have to check eligibility to verify patient can get a cane, might have to deal with multiple insurances and verify coverage, show proof of delivery and training on use of unit, and finally submit a claim to Medicare who pays 80% within 21 days and get the balance from all other payor sources after that. Moreover Walmart gets the money upfront while DME companies might have to revolve credit while waiting to get paid. So its not a fair comparison. I would say then the system needs to change to have a transaction like Walmart for simple items like canes, walker, and the disposable supplies. The reality is that the high cost of a cane is related to the administrative requirements for proof of medical necessity placed on the DME company. One would think the doctor should have already informed Medicare of such a need through their own billing eliminating the excess paperwork allowing competitive prices. I say patient sees doctor, doctor bills Medicare saying they have and need x,y,z, patient gets some sum whether recurring or one-time based on doctors requests, and allow the patient to price shop (let market forces work). If the patient needs more due to need or cost of an item, there is a method to authorize for a larger stipend by the physician. Its my ecommerce way of how light equipment and supplies should be.
Source: cjr.org

Brooklyn, N.Y., Physician and Clinic President Pleads Guilty to Medicare Fraud Scheme

According to court documents, Ho Yon Kim, 86, of Flushing, N.Y., was the president of URI Medical Service PC and Sarang Medical PC, both doing business in Flushing, and purportedly providing physical therapy and electric stimulation treatment. He was also a rendering physician at both clinics. Kim pleaded guilty in Brooklyn federal court before U.S. Magistrate Judge Marilyn D. Go to a superseding information charging him with conspiracy to commit health care fraud.
Source: jameshoyer.com

REPORT: NY House GOP Protecting Tiny Minority from Taxes While Aiming Cuts at Social Security & Medicare

“Many members of Congress are sitting on the fence as the fiscal cliff debate rages on. As our report clearly illustrates, the needs of the many outweigh the needs of the few,” said Ron Deutsch, Executive Director of New Yorkers for Fiscal Fairness.  “It’s time for members to jump off the fence and support asking the favored few to contribute just a little more so we can ensure that our seniors and the most vulnerable members of our society get the services our shared social contract has promised them.  Poll after poll shows that the public completely supports rescinding the Bush tax cuts for people making over $250,000 and protecting Social Security and Medicare.  It’s time to listen to the public, not wealthy contributors.”
Source: strongforall.org

NY Times: Medicare Flexes Financial Muscle to Prevent Hospital Readmissions

Diversity. It’s a buzzword that’s heralded everywhere, from college campuses to neighborhoods and the business world, and senior living companies may want to take heed: research overwhelmingly points to the value and importance of a gender-diverse corporate board. Bringing together a variety of backgrounds, perspectives, work styles, and interests are highly beneficial when it comes… Read More »
Source: seniorhousingnews.com

Owner of Brooklyn Clinic Pleads Guilty in Connection with $71 Million Medicare Fraud Scheme

Shelikhova was an owner and manager of a clinic in Brooklyn that operated under three corporate names: Bay Medical Care PC, SVS Wellcare Medical PLLC, and SZS Medical Care PLLC (Bay Medical Clinic). According to court documents, owners, operators, and employees of Bay Medical paid cash kickbacks to Medicare beneficiaries and used the beneficiaries’ names to bill Medicare for more than $71 million in medical services and procedures that were medically unnecessary or never provided, including physician office visits, physical therapy, and diagnostic tests.
Source: brooklynews.com

NY Medical Society Calls for Resolution of Deep Medicare Cuts

These cuts are driven by a flawed formula called the Sustainable Growth Rate (SGR) which penalizes physicians by lowering their payments when growth in the use of medical care exceeds the Gross Domestic Product. This is done despite the fact that service use is driven by factors outside physician control such as patient health needs, emerging technology and public policy changes. When factoring in cuts to the Medicare conversion factor in 2002 along with some very minor increases in the conversion factor since then, Medicare payments are, on average, level with what they were 10 years ago. In fact, many physicians have experienced significant cuts. Yet, at the same time, liability insurance costs and other overhead costs for physicians have risen rapidly in New York while reimbursement from health insurers has been constrained.
Source: readmedia.com

Making the Election About Race

The result is a campaign run at two levels. On the trail, Paul Ryan argues that “we’re going to make this about ideas. We’re going to make this about a positive vision for the future.” On television and the Internet, however, the Romney campaign is clearly determined “to make this about” race, in the tradition of the notorious 1988 Republican Willie Horton ad, which described the rape of a white woman by a convicted African-American murderer released on furlough from a Massachusetts prison during the gubernatorial administration of Michael Dukakis and Jesse Helms’s equally infamous “White Hands” commercial, which depicted a white job applicant who “needed that job” but was rejected because “they had to give it to a minority.”
Source: nytimes.com

Ask The Experts: Retirement

Posted by:  :  Category: Medicare

ROBERT L. HUFFSTUTTER'S HEALTHCARE PLAN FOR AMERICA by roberthuffstutterI’ve also provided for a spousal annuity for him should I pass. My human resources office advised that if he does sign up, because I just retired, any penalty, etc., will be waived. I’ve been researching to try and understand the pros and cons of him signing up for Part B, which will cost us an additional monthly premium. We  already pay hefty monthly premiums for the FEHB coverage.
Source: federaltimes.com

Video: Guide to Medicare Part A and Part B

The ABCs (and D) of Medicare

Medicare helps pay for health care, but it does not cover all medical expenses. Medicare is divided into four parts: Part A, generally called hospital insurance, covers services associated with inpatient hospital care (including an overnight stay in a hospital, skilled nursing facility, or psychiatric hospital). Part A also covers hospice care, home health care and medications received while in the hospital. Part B covers your doctor bills and other outpatient services. Some of the bills covered include medical equipment, lab tests and rehab. Doctor’s services are paid by Part B whether received in the hospital or in the doctor’s office. While Part A covers medicines received while in the hospital, medicines administered in a doctor’s office are covered by Part B. Other services covered under Part B include ambulance service, preventive care and annual wellness visits. Part C is a different creature altogether. Instead of covering specific benefits, Part C offers you a different way to receive your Medicare benefits. Basically, Part C is an insurance package that covers Part A, Part B and sometimes even Part D benefits. Part C is often referred to as Medicare Advantage. Part D covers prescription drugs, including insulin supplies and some vaccines. The only way to get prescription coverage is to enroll in a Part D drug plan or to join a Medicare Advantage plan that includes prescription coverage. Services not covered by Medicare: Medicare covers services that it deems "medically necessary". Not included in this definition are vision, hearing and dental care. Also, nursing home care and medical services received outside the United States are not covered. Example of how Medicare coverage works: Assume you break your hip and go into the hospital for four days for treatment. Medicare Part B covers the cost of taking an ambulance to the hospital. Medicare Part A covers your expenses while in the hospital, such as your room, meals, and nursing care. Part A also covers the cost of the emergency room and medications received while you are in the hospital. Medicare Part B pays for your doctor bills, physical therapy and the cost of using a wheelchair. Note that your doctor bills are covered whether you see your doctor while in the hospital or at the doctor’s office.
Source: squidoo.com

Closing The Medicare Part D Program Doughnut Hole: The End Is In Sight!

There’s also some encouraging research confirming what a lot of us intuitively sense: that making prescription drugs more affordable saves money down the road by keeping people healthier. When people with diabetes get their insulin regularly, for example, they’re more likely to stay out of the hospital. Of course this is great for them; no one likes going to the hospital. But it’s good for all of us, because hospital care is expensive, and keeping people healthy and out of the hospital is one of the most obvious ways of bringing health care costs under control. Recently, the Congressional Budget Office – the green eyeshade folks who keep track of the cost of everything the government does – concluded that making prescription drugs in Medicare more affordable does, in fact, save some money later on by reducing things like hospital admissions. As a result, filling in the doughnut hole is going to cost about 40 percent less than was previously forecast. At a time of tight budgets, that’s great news for all of us.
Source: smmirror.com

Medicare Part D: Do You Still Need To Make Changes to Your Prescription Drug Coverage?

Medicare Part D has a standard Medicare Part D drug benefit, but in reality plans and premiums vary widely. Health insurers must offer the standard benefit set out by law or a benefit package that is at least as comprehensive as the standard package. Although there is no standard drug formulary, there are minimal requirements that major classes of drugs necessary to treat common diseases are covered. Plans vary greatly as to the specific drugs covered and the co-pays/coinsurance for individual drugs. For more information on Medicare Part D benefits and the Donut Hole, see our article “Medicare Part D-The Donut Hole and Me”.
Source: myhealthcafe.com

Uwe E. Reinhard: The Complexities of Comparing Medicare Choices

Each private plan would have had to offer a benefit package that covered at least the actuarial equivalent of the benefit package provided by the traditional fee-for-service Medicare. Medicare’s contribution (or “premium support”) to the full premium for any of these choices, including traditional Medicare, would have been equal to the “second-least-expensive approved plan or fee-for-service Medicare” in the beneficiary’s county, whichever was least expensive. That premium support payment would have been adjusted upward for the poor and the sick and downward for the wealthy.
Source: nytimes.com

When Does One Become Eligible for Medicare?

One can become eligible for Medicare under the age of 65 if he or she is disabled or has been receiving Social Security disability payments for over 24 months. In order to enroll in Medicare one needs to go to the local Social Security office. One can ask questions about his or her eligibility, options and penalties in the office or by joining the American Boomer Network and visiting one of the forums there. It is imperative that one has understanding of his or her options, rights and penalties. For example if some people delay enrolling into Medicare after the age of 65 but decide to enroll later, they are subjected to a 10% penalty for every year of the delay.
Source: harmonyway.org

33 Arrested in Florida as Part of Medicare Fraud Sweep

The arrests were a part of a joint effort between the U.S. Department of Justice and the U.S. Department of Health and Human Services. The agencies used new software to detect the alleged fraud. According to Reuters, those who were arrested were mostly small operations who officials believe were trying to fleece the system.
Source: labaradams.com

Make Social Security and Medicare sustainable (and better) through progressive changes, not devastating cuts.

Posted by:  :  Category: Medicare

Love it! Improve it! Medicare for All! by TheeErinEliminate Medicare Advantage.   Medicare Advantage was instituted about 30 years ago as a sop to private for-profit insurance companies, giving seniors an option to pick a private plan over the traditional fee-for-service features of regular Medicare. The Medicare system pays the privately run plans a set “premium” per enrollee for hospital and physician services based on a prediction of how costly the enrollee’s care will be. In 2012, the cost to Medicare averaged $10,123 per person, which is approximately 14% more than the average per person cost for regular Medicare.
Source: pdaillinois.org

Video: Blue Medicare Options Illinois or Medicare Options Illinois

Illinois suspends Medicaid payments to controversial psychiatrist

A joint 2009 investigation by the Tribune and ProPublica, a nonprofit investigative journalism group, revealed Reinstein’s unusually heavy reliance on clozapine, which has been linked to at least three deaths. In 2007 he wrote more prescriptions for clozapine than all the doctors in Texas combined, the investigation found. The Illinois Department of Financial and Professional Regulation mentioned the series in its complaint.
Source: chicagotribune.com

Illinois Medicare Advantage Disenrollment Period

Luckily, if you’re not satisfied with your Illinois Medicare Advantage plan, you have options. Switching back to Original Medicare may make it easier to get the medical care you need by eliminating networks or restricted coverage often associated with Medicare Advantage. If you’re looking for more options that can help you pay for out-of-pocket expenses associated with Medicare, a Medicare Supplement plan may be the right solution. The right Medigap plan can also save you money. A high deductible plan F offers the same great coverage but for reduced monthly payments. That’s convenience and peace of mind that when you need medical attention, you can get it- no questions asked.
Source: ssiinsure.com

Medicare, Medicaid & Social Security Vital To Illinois Economy, New Report Finds

Less contentious an issue has been the willingness of both parties to reduce government spending. The president’s plan would call for $350 billion in cuts to health programs, plus another $250 billion in other spending cuts over the next 10 years. Republicans seek to cut $600 billion from health programs and another $600 billion from other, non-specified programs over the same period.
Source: progressillinois.com

Medicare eligibility age hike off the table, Durbin says

All posts, comments and statements made on IR are those of the authors only. Any disputes must be addressed to the writers, who are solely responsible for their posts, comments and statements. We reserve the right to deny or remove comments. Content may not be used without permission of the author.
Source: typepad.com

Some in Illinois worry budget deal to avoid fiscal cliff could create crisis for them

Even though Moore has trouble getting around, she made sure to get downtown for one of a series of recent protests in front of Illinois Sen. Dick Durbin’s office. A coalition called Make Wall Street Pay Illinois has organized demonstrations in recent weeks to get Durbin’s attention. On Nov. 9, several protesters were arrested in his office and in the lobby of the Dirksen Federal Building. Then on Dec. 6 they built a large shantytown named “Durbinville” in the Federal Plaza. Moore was among the protesters at “Durbinville.” Four days after that, the demonstrators had another march on his office.
Source: chicagonow.com

Lisa Madigan Scores Settlement against Illinois Medicaid Swindler

Madigan announced a settlement with the pharmaceutical company Amgen Inc. over allegations that Amgen illegally promoted six of its drugs to defraud state and federally funded health care programs, including $1.7 million in false claims submitted to the Illinois Medicaid program.
Source: illinoisobserver.net

Protesters urge Hultgren to pull Social Security, Medicare off ‘cliff’ 12

“As a Democrat, I am deeply disappointed and angry that our president has put us on the table as part of the menu. It is just an outrage,” said Mary Shesgreen of Elgin, co-chairwoman of the Jobs With Justice group. “This crisis was manufactured to provide justification for an attack on these programs.”
Source: nijwj.org

farmdocdaily: Farms and the New 2013 Medicare Tax Increases

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

The Annuity Agent Directory

http://www.kellyfinancialservicesinc.com/ With the end of the year rapidly approaching, President Obama and members of Congress are working frantically in an effort to avoid going off what the media has termed the fiscal cliff, when a number of major tax cuts that were instituted by the Bush Administration will expire and several major governmental spending cuts will simultaneously go into effect. Many economists fear that this combination could push the fragile U.S. economy back into a deep recession, and politicians are therefore laying virtually everything out in the tax code in an effort to avert this possibility. However, many taxpayers are unaware that “everything” includes one of their most precious assets: their retirement savings. Financial Advisor Retirement Planner John Kelly in Hickory Hills Illinois says” there are strategies to protect your retirement assets using annuities…that also have upside growth potential and no downside risk.”
Source: annuityagentdirectory.com

Democurmudgeon: Illinois Democrats Medicare Ad Most Effective Way to Defend the Program.

I was in Chicago over the weekend, and came across this ad on one of the local channels for Democratic congressional candidate Brad Schneider. The ad features a clip of President Lyndon Johnson describing the reason why he pushed so hard for Medicare. This ad should have been from the Obama campaign. Incredibly effective, it shows Medicare was created to solve a problem, not spread socialism.
Source: blogspot.com

Medicare card scam pops up in WI

Posted by:  :  Category: Medicare

GIMME SOME OF THAT GOOD 'OLE OBAMA DOUBLESPEAK by SS&SSRemember that representatives with the Medicare program will never call you to verify personal information.  If you receive a call about a replacement Medicare card, hang up immediately.  If you or a family member receives a similar call and turns banking information over to the caller, you should immediately contact your bank and inform them of the situation.  The bank may choose to close the account and issue you a new account number.
Source: dewittmedia.com

Video: Detroit: Medicare Fraud Summit Consumer Panel

Don’t Fall for Medicare Card Phone Scam

You answer the phone, and the unknown caller claims to be with Medicare or another government office. He informs you that your new Medicare card is in the mail, and you will receive it in a few days.  In the meantime, you need to set up your direct deposit so your Medicare funds can be deposited into your bank account. To do this, you just need to tell the caller your banking information. He will take care of the rest.
Source: bbb.org

BC Services Card to replace CareCard

The current CareCard was introduced in 1989 and has not been significantly updated over the last 20 years. The new BC Services Card takes advantage of significant advances in technology since that time, to provide a more convenient and secure piece of identification with enhanced features to protect citizens

How Much Does Medicare Part D Cost?

Posted by:  :  Category: Medicare

HOPE lives. by eyewashdesign: A. GoldenHello, I had ssi in 1997 to 2008 soc. Sec told me i wS working and hD been cut off before working. I never received a dime or med care or apied after i was cut off when i apied again i. 2008, due to denials, i went to court, and reinstated from time applied in 2008. They took money to be paid to them from 1997. From my back pay. I never once teceived one letter saying i wS on part d. I was td all benefits ceased at that time of cut. I paid my kaiser from work, and did without insurance and medical care when no insurance. Even had hospital events and medicare or no soc sec paid. Never even heRd fr
Source: seniorcorps.org

Video: Linda Meckler Medicare Parts ABCD.MP4

Understanding Medicare Part A, Part B, Part C and Part D

But as complicated as all that sounds, there’s a single key choice at the core of all your decision-making: Will you go with the Original Medicare plan, which is run by the federal government and consists of Parts A and B, or a Medicare Advantage plan (also called Part C) that is offered by a private insurer and approved by Medicare? Medicare Part A — Your Hospital Coverage When you apply to Medicare, you are automatically enrolled in the Part A plan. Part A is your hospital insurance plan. It covers nursing care and hospital stays, although not doctors’ fees. Part A also covers some home health services, skilled nursing care after a hospital stay and hospice care. You likely won’t have to pay a monthly premium for Medicare Part A, thanks in part to all the payroll taxes you paid while you were employed. You must, however, pay a yearly deductible before Medicare will cover any hospitalization costs. For 2011, the Part A deductible is $1,132.
Source: aarp.org

2012 Medicare Premiums, Deductibles and Co

Enrollees in Medicare Part D prescription drug plans pay premiums that vary from plan to plan.  Beginning in 2011, Part D enrollees whose incomes exceed the same thresholds that apply to higher income Part B enrollees must also pay a monthly adjustment amount. The regular plan premium will be paid to their Part D plan, and the income-related adjustment will be paid to Medicare.  The amounts by income level are below.
Source: medicareadvocacy.org

Cool Medicare Part A B C D images

Scenario Three: A primary care doctor sees a Medicare patient for an office visit. She thinks her patient has heart failure, starts the initial management. She orders labs and a echocardiogram. The echocardiogram is read by the cardiologist who recommends the patient come and see him. The primary care doctor spent around 15 minutes with patient and gets paid around for the office visit. The patient’s pharmacist later calls and says the medication that was prescribed must be changed due to insurance formulary restrictions. The doctor spends a minute or two reviewing that patients chart before deciding on an alternative medication. The doctor does not receive any additional reimbursement for this service. She was still only paid total. Later, the patient drops off some paperwork for the physician to fill out for the medical insurance. The doctor spends around 10 minutes filling out that paperwork and having his nursing staff fax the complete forms to the insurance company. The doctor does not receive any additional reimbursement for this service. She was still only paid total.
Source: coloradomedicaremedigap.com

Medicare Open Enrollment Ends Dec. 7!

BACKGROUND:  SHINE (Serving the Health Information Needs of Elders) provides free health insurance information, counseling and assistance to Massachusetts residents with Medicare and their caregivers. ABCD’s Events for Open Enrollment are continuing throughout Boston and are a chance for seniors and disabled adults on Medicare to learn about changes in Medicare Drug Plans for the 2012 year. After each presentation, FREE on-site Medicare counseling & assistance will be available!
Source: bostonabcd.org

Best Medicare Supplement Insurance

The Medicare Supplement policies generally do not pay a huge amount of you bill unless you have a mojor health condition with ongoing doctoring and testing. Medicare will pay 80% of the claim once the required deductibles have been meet. Medicare Part A deductible is $1156, which can be charged up to 5 times in one year, this would require a perfect storm, but it can happen. The Medicare Part B deductible is now set at $140 annual.
Source: medicarepartsabcd.com

Please Explain Medicare Part A B C D to Me

Medicare Part A and Part B do not cover all medical costs. There are deductibles and co-insurances required when you have a medical event. The coverage gap is the term used for the amount of out-of-pocket expenses you must pay. Private Medigap insurance came available to help fill the gap. Medigap policies are restricted to filling the coverage gap. Additional coverage for things such as hearing, vision, dental and prescriptions cannot be included with Medigap plans. Private insurance is required for these. So, to get total coverage, you would have to have three insurance plans: Medicare, Medigap and private coverage. That means for every medical episode, you could potentially file three claims.
Source: co.uk

Medicare Health Insurance

Medicare Part C is the “private” portion of Medicare. In Part C, a private insurer has contracted with the government to take over the management of all of your Medicare benefits. You pay premiums directly to this private insurer. Your benefits are then all provided through this private insurer. That is the insurer and pays claims on your behalf. Part C is optional and you still have to pay the Part B premium. The difference is that your benefits are provided by a private insurer and not the government. Both Medicare Advantage and Medicare supplemental insurance covers the gaps left by the original coverage. You do not need both. The difference is that Medicare Advantage pays instead of Medicare, whereas supplements pay AFTER Medicare pays;
Source: infobarrel.com

Daily Kos: Republican U.S. senator: Cut Medicare … or we’ll shut down the government

Posted by:  :  Category: Medicare

Medicare for All by juhansoninRepublicans approve of the American farmer, but they are willing to help him go broke. They stand four-square for the American home–but not for housing. They are strong for labor–but they are stronger for restricting labor’s rights. They favor minimum wage–the smaller the minimum wage the better. They endorse educational opportunity for all–but they won’t spend money for teachers or for schools. They think modern medical care and hospitals are fine–for people who can afford them. They consider electrical power a great blessing–but only when the private power companies get their rake-off. They think American standard of living is a fine thing–so long as it doesn’t spread to all the people. And they admire of Government of the United States so much that they would like to buy it. 65 years later and nothing changed. They just got worse.
Source: dailykos.com

Video: Medicare and Medicaid: What’s it all mean?

7 Recent Medicare, Medicaid Issues

Here are seven issues dealing with Medicare or Medicaid that occurred in the past two weeks. 1. Both the House of Representatives and Senate have passed legislation — the American Taxpayer Relief Act of 2012 — which will temporarily avoid the long-discussed fiscal cliff of tax hikes and spending cuts. Yet again, the sustainable growth rate, which is the formula used to determine Medicare reimbursements to physicians, was temporarily delayed through 2013. However, the SGR fix and other healthcare extensions — which cost $30 billion — were paid for by several provisions that will siphon federal funds away from hospitals and health systems. 2. Colorado Gov. John Hickenlooper (D) announced his state would expand its Medicaid program to an estimated 161,000 more people. 3. CMS announced that 1,557 hospitals will receive higher Medicare payments for quality ratings as part of the Hospital Value-Based Purchasing Program under the Patient Protection and Affordable Care Act. 4. Florida Gov. Rick Scott and other Republicans agreed to require — pending federal approval — the state’s Medicaid recipients to enroll in managed care plans in hopes of keeping healthcare costs down and better coordinating medical services. 5. Since the Supreme Court’s ruling in June that Medicaid expansion is optional, hospitals in some states face dire financial situations, according to an article in the New England Journal of Medicine. 6. After serving in the role for 18 years under multiple presidents and parties, CMS Chief Actuary Rick Foster announced he will retire. 7. Contrary to popular belief, Medicare spending is not spiraling out of control, according to a column by Princeton economics professor Uwe E. Reinhardt.
Source: beckershospitalreview.com

Guest opinion: Allow Medicaid, Medicare to bargain with pharmaceutical companies

In 2011, 12 Fortune 500 drug manufacturers pulled in combined profits of $49.3 billion. One company, Merck, saw its profit explode by more than 600 percent compared to 2010. Meanwhile, the top 10 pharmaceutical companies’ CEOs took in pay of almost $200 million in 2011. That is $20 million per CEO per year, a world away from the earnings of our men and women returning from Iraq and Afghanistan.
Source: spokesman.com

Native American Report: Expect Medicaid, Medicare to Dominate Next Round of Debt, Deficit Talks

For subscribers only-> FREE audio and special report: What the 2012 Elections Mean to Social Services Programs        For subscribers only-> FREE audio and special report: What the 2012 Elections Mean to Social Services Programs        For subscribers only-> FREE audio and special report: What the 2012 Elections Mean to Social Services Programs
Source: cdpublications.com

Medicare, Medicaid, and Other Health Provisions in American Taxpayer Relief Act of 2012 (Updated)

Extension of Family-to-Family Health Information Centers:  This provision continues the Family to Family Health Information Centers (F2F HIC) to assist families of children and youth with special health care needs in making informed choices about health care in order to promote good treatment decisions, cost-effectiveness and improved health outcomes.  The centers are intended to help families navigate the health care system so that their children can get the benefits they need through Medicaid, CHIP, SSI, early intervention services, other government programs, and private insurance.  F2F HICs also train health care providers and policymakers and advocate for a family-centered “medical home” for every child. There is one F2F HIC in every state and the District of Columbia.
Source: piperreport.com

Healthpoint Ltd. Agrees to Settle Medicare and Medicaid False Claims Act Case for up to $48 Million

The Department of Justice announced a settlement it reached with Healthpoint Ltd. and DFB Pharmaceuticals for up to $48 million.  The settlement resolves allegations that Healthpoint submitted false claims to Medicare and Medicaid for Xenaderm, a prescription skin ointment for the treatment of bed sores in nursing home patients.  The companies will pay $28 million now and an additional $20 million if there is a change in ownership of Healthpoint or DFB over the next three years.
Source: wordpress.com

Let’s Fight to Protect Medicare, Medicaid and Social Security!

I want vital services like Medicare, Medicaid and Social Security to be there when we need them. Working people deserve it. After you’ve worked for half of your life, you should have the benefits that you’ve worked hard for. If Republicans in Congress have their way and continue to give tax breaks to the wealthy, working middle class people like me, who will do whatever it takes to support their families, will suffer.
Source: seiu.org

Voice For Medicare, Medicaid Retiring

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 marsmet481In a statement Friday, President Barack Obama hailed Rockefeller’s service. “From his time in the state legislature to the Governor’s office to the Senate floor, Jay has built an impressive legacy, one that can be found in the children who have better schools, the miners who have safer working conditions, the seniors who have retired with greater dignity, and the new industries that he helped bring to West Virginia,” Obama said. “A long-time champion of health care reform, Jay was also instrumental in the fight to make sure that nobody in America has to go broke because they get sick.”
Source: kaiserhealthnews.org

Video: 2010 Medicare Quote Engine Demonstration Video

Illegal Immigrants Give Billions to Medicare, Social Security With No Hope of Benefit

Company Location, Quotation, Person Attributes, Person Location, Person Career, Social Issues, Labor, Federal assistance in the United States, Healthcare reform in the United States, Presidency of Lyndon B. Johnson, United States National Health Care Act, Health, Government, Withholding taxes, Medicare, United States, Social Security, Federal Insurance Contributions Act tax, Payroll, USD, Social Security Administration, Illinois, Ira Mehlman, Sophia, The Medicare NewsGroup, Merry Maids, Gregory Schell, Federation for American Immigration Reform, Trust Fund, Hospital Insurance, Mexico, Gurnee, food, restaurant Jimmy Johns, kitchen manager, federal health insurance program, inpatient services, HI Trust Fund, Medicare HI Trust Fund, Florida, legal advocacy, attorney, Migrant Farmworker Justice Project, Stephen C. Goss, the New York Times, chief actuary, spokesman, American College of Emergency Physicians, health care services
Source: reportingonhealth.org

Daily Kos: White House might use Medicare reform momentum to push further health care reform

No, he has waited for the American people to get smart enough to see your bullshit for what is.  Very much the same tactic he’s used on entitlement cuts.  He lays out the bait, they start telling the truth, it hurts them.   They’ve finally figured that out.  You’ll notice they won’t say a word about WHAT they want cut?  Here’s some entitlements that need cutting:  subsidies and tax cuts for oil and gas companies enjoying record profits; subsidies to factory farms that pollute the water and the soil; tax breaks to companies that outsource jobs; tax breaks to companies that move to your town, provide a few jobs, pay nothing for infrastructure they need; continued payment to defense contractors who miss deadlines and fail to perform; payments to outside contractors who are twice as expensive and half as competent to provide government services.  Short list, there are dozens more.  Obama uses their language, twists it a bit, gets what he wants.  When Progressives miss the big picture and go nuts about his language they reveal an inability to shift to 21st Century politics.  The main complaint I’m reading is he doesn’t talk tough enough.  Hmmmm. Maybe people with conviction and a plan don’t need to engage in macho bullshit?  Maybe Obama gets it that Americans are sick of posturing and just want action?  Why is that so hard to grasp?
Source: dailykos.com

Analysis: Obama may turn Medicare debate into more healthcare reform

Medicare, long considered a program that U.S. politicians would touch at their peril, is acknowledged, along with the national Medicaid program for the poor, to be a major driver of the deficit. The aging population puts Medicare on a collision course with major financial difficulties; the so-called Medicare trust fund is on pace to run out of money in 2024.
Source: medcitynews.com

Obama’s Road to Socialism: Next Destroy Medicare Advantage

The reason that Medicare Advantage is so attractive is that it utilizes market forces that drive efficient outcomes. For example, according to the Medicare Payment Advisory Commission, the Advantage HMOs that serve 15 per cent of all seniors in Medicare cost on average 2 per cent less for the same benefits than the traditional program. The insurer trade group, AHIP, estimates that Advantage beneficiaries in California spend 30 per cent fewer days in hospital than fee for service and 23 per cent fewer days in Nevada. These successes occur because Advantage allows insurers and providers to collaborate, pay for value instead of per unit service, and coordinate care.
Source: charlesrowley.com

Social Security & Medicare Lifetime Benefits

I recently published with Caleb Quakenbush “Social Security and Medicare Taxes and Benefits Over a Lifetime: 2012 Update” which updates previous estimates of the lifetime value of Social Security and Medicare benefits and taxes for typical workers in different generations at various earning levels based on new estimates of the Social Security Actuary. The “lifetime value of taxes” is based upon the value of accumulated taxes, as if those taxes were put into an account that earned a 2 percent real rate of return (that is, 2 percent plus inflation). The “lifetime value of benefits” represents the amount needed in an account (also earning a 2 percent real interest rate) to pay for those benefits. Values assume a 2 percent real discount rate and all amounts are presented in constant 2012 dollars.
Source: thedoctorweighsin.com

3 Tips for Avoiding Pitfalls in Medicare Enrollment

Posted by:  :  Category: Medicare

OOPS I THINK THE SHINE IS OFF THE PEACH ...........IT'S ABOUT TIME by SS&SSIAM is an SEC registered investment adviser with its principal place of business in the State of Texas.  IAM and its representatives are in compliance with the current registration and notice filing requirements imposed upon registered investment advisers by those states in which IAM maintains clients.  IAM may only transact business in those states in which it is noticed filed, or qualifies for an exemption or exclusion from notice filing requirements.  Any subsequent, direct communication by IAM with a prospective client shall be conducted by a representative that is either registered or qualifies for an exemption or exclusion from registration in the state where the prospective client resides.  For information pertaining to the registration status of IAM, please contact IAM or refer to the Investment Adviser Public Disclosure web site (www.adviserinfo.sec.gov).  For additional information about IAM, including fees and services, send for our disclosure brochure as set forth on Form ADV using the contact information herein.
Source: iaminvest.com

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

Not Happy with Your Medicare Advantage Plan? Change it!

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

Medicare open enrollment: Sandy victims get an extension

If you do want to make a change, CMS would still like you to hit the December 7 deadline if you possibly can. But if you can’t because of the big storm, you can enroll as soon as you’re able by calling 1-800-MEDICARE (1-800-633-4227). Your new coverage will start Jan. 1, 2013 if you sign up before the end of December. If it’s later than that, coverage in most cases will start at the beginning of the next month.
Source: consumerreports.org

Ask The Experts: Retirement

I’ve also provided for a spousal annuity for him should I pass. My human resources office advised that if he does sign up, because I just retired, any penalty, etc., will be waived. I’ve been researching to try and understand the pros and cons of him signing up for Part B, which will cost us an additional monthly premium. We  already pay hefty monthly premiums for the FEHB coverage.
Source: federaltimes.com

Voice For Medicare, Medicaid Retiring

In a statement Friday, President Barack Obama hailed Rockefeller’s service. “From his time in the state legislature to the Governor’s office to the Senate floor, Jay has built an impressive legacy, one that can be found in the children who have better schools, the miners who have safer working conditions, the seniors who have retired with greater dignity, and the new industries that he helped bring to West Virginia,” Obama said. “A long-time champion of health care reform, Jay was also instrumental in the fight to make sure that nobody in America has to go broke because they get sick.”
Source: kaiserhealthnews.org

Baby Boomer Confusions About Medicare Soars as Enrollment Date Looms

More than a year after President Obama signed the Patient Protection and Affordable Care Act, many older adults still remain unaware of the most significant changes. The change in the Annual Enrollment Period (AEP) affects all beneficiaries. Previously, the AEP began on November 15, but now it’s a month earlier. It now begins October 15 and ends December 7. During the AEP beneficiaries are able to choose or change their supplemental insurance, including Medigap plans that cover hospitalization deductibles, and Part D plans that cover prescription drugs. Less than 10 percent of the survey respondents identified the correct date and the majority still believe they have until December 31 to file.
Source: hvsfinancial.com

Eight mistakes to avoid during Medicare enrollment

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

Are Hearing Aids Covered By Medicare?

Posted by:  :  Category: Medicare

OBAMACARE WATCH: MORE DARKNESS THAN LIGHT AND OF COURSE TAXES AND PENALTYS by SS&SSMost hearing problems are relatively easy to correct with hearing aids. The problem becomes that a large majority of the people that need the hearing aids are living on a fixed income and are unable to afford the $3,000 to $5,000 out of pocket. If medicare or medicaid would cover the hearing aids then these people would have the means to get them, resulting in a dramatic improvement in their quality of life. It is been proven over and over again that if you have a positive outlook on life and are happy then you are healthier. I wonder how much money would be saved on treatment of physical ailments if the insurance companies were to focus on improving peoples quality of life so that they are upbeat and happy. Providing hearing aids seems like an easy place to start.
Source: empowernetwork.com

Video: Does Medicare Insurance Cover Hearing Aids? : Medicare Insurance Questions

Are hearing aids covered by insurance

Chiropractic care is covered by many health insurance plans, but certainly not all. Chiropractic is one of the most widely used health services today. It has gained iacceptance as a treatment for back and neck pain. Check individual policy. ! Any reply?
Source: insurance911.org

Medicare and Hearing Aids

Hearing loss is very common among aging adults. Your hearing loss may stem from several causes, though the most common is sensorineural. That means that the tiny hairs inside your ears have been damaged and are deteriorating, usually because of aging. You losing your hearing if you notice that straining to hear thing clearly makes you tired, or if you watch the mouths of people around you to understand what they are saying. Other troubling signs of hearing loss include having difficulty hearing people in public places where there is a lot of ambient sound, or if you often find yourself asking people to repeat themselves.
Source: totalmedicare.com

Does Medicare Supplemental Insurance Pay For Hearing Aids?

The Medicare insurance program available to those 65 and older is where the confusion starts. Medicare insurance is not all inclusive on in its own right, and includes several “parts” to which the applicant must decide which is best for them. These parts are listed and identified by letters that represent the coverage offered in each of these parts or plans. Seniors must decide which plan is most appropriate for them by looking at each individual plan to decide if the coverage optional available in that plan is required for their personal health situation. Clients that have reduced hearing capacity should pay special attention to Medicare Part B. The Part B plan clearly states that routine hearing exams and hearing aids are not covered under this plan except for specific diagnostic hearing exams and then if only ordered by your doctor.
Source: seniorcorps.org

Hearing Aids and Medicare

Medicare doesn’t cover the cost of a regular hearing exam, or one that’s conducted during yearly check-ups. However, Medicare does cover a diagnostic hearing exam, which is based on an actual medical need. Consumers can tell roughly what Medicare will or won’t cover by asking this question: “Is this service/product medically necessary?” If your answer is yes, then it’s likely it will be covered by one of the many aspects of Medicare.
Source: boomers-with-elderly-parents.com

Insurance is now paying for hearing aids

Insurance is now paying for hearing aids, at least Blue Cross PPO: Hearing evaluations In Network 100% covered; limited to one exam every 24 months Out of Network 60% of maximum allowance after deductible; maximum allowance is the lesser of providers billed charges or 100% of base Medicare rate excluding Medicare adjustments Hearing aids In Network 80% covered after deductible is met; children to age 19 for treatment of congenital defect only: Check with plan. Out of Network 60% of max allowance after deductible; to age 19; treatment of a congenital defect;max allowance is lesser of provider bille This is a huge help for me.
Source: alldeaf.com

5 Services Medicare Won’t Pay For

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

Why Private Medicare Plans Don't Cost Less

Many contend that the government “overpays” for people enrolled in private plans, since traditional Medicare could have covered these patients for less money. But the reason it would have cost less is partly that the government has done a woeful job in figuring out how much to pay the private plans. The government compensates insurers based on the health of their enrollees at the start of the year. Plans with healthier patients receive less money than those with sicker ones to reflect the likelihood that healthier people will use less care. Healthier patients enroll in Medicare Advantage plans, so in, principle, plans should be reimbursed less by the government for enrolling these patients (the technical term for this process is “risk adjustment”). But for decades, the government has failed to determine who is healthy and who is sick with any precision, with the result that private plans receive larger payments to cover their patients’ costs than necessary. This botched payment system gives insurers an incentive to spend more time selecting the healthiest patients, and less time treating them more efficiently.
Source: nytimes.com