Medicare Plan Finder for Health, Prescription Drug and Medigap plans

Posted by:  :  Category: Medicare

READ THE HEALTHCARE BILL NOW... by roberthuffstutterBetween January 1–February 14, if you’re in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare. If you switch to Original Medicare during this period, you will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.
Source: medicare.gov

Video: Medicare Options – Making Sense of Them All!

Medicare Beneficiary Options

Seniors approaching Medicare eligibility are often confronted with choices and timelines that may be confusing.  If you are six months away from celebrating your 65th birthday and would like to discuss your Medicare options (i.e. Original Medicare, Medicare Advantage Part C, Medicare Part D and Supplements), call me.
Source: patch.com

Jehlen: Review Your Medicare Options, Save Money

The full implementation of Obamacare over the next couple of years makes reevaluating your Medicare options even more important.  You will notice many positive changes and reviewing options will maximize your savings.  Most notably, Obamacare will close the Medicare Part D “donut hole.”  Currently, if your yearly prescription drug costs exceed a certain amount ($2,930 in 2012), but your out-of-pocket costs have not reached the point where you qualify for “catastrophic coverage” ($4,700 in 2012), you fall into the donut hole.  Starting in 2012, seniors got a 50% discount on brand-name prescription drugs and 14% discount on generic prescriptions.  These discounts will increase incrementally until 2020, when 75% of prescription drug costs for people in the donut hole will be covered by Medicare.
Source: patch.com

Help with the Medicare options

The MedicareStore is holding an informational open house 9 a.m. to 5 p.m. Friday. An audiologist from hi Healthinnovations and a representative from SilverSneakers fitness program will be on hand, and there will be a SilverSneakerod demonstration at 1 p.m. The store is open 9 a.m. to 5 p.m. Mondays through Fridays, and is in the Golf Acres Shopping Center at 1412 N. Hancock Ave. For more information, call 357-1281.
Source: gazette.com

The Future of Medicare: 15 Proposals You Should Know About

Here are summaries of 15 options being talked about in Washington. Each summary is accompanied by two opinions that AARP commissioned from experts whose views typically represent different sides of the issues.
Source: aarp.org

Navigating Your Medicare Options

Alaska Andrew Schorr Awards BCBSA Blood pressure Corporate Citizenship Cost containment Coverage basics Customer service Diabetes Doctors Federal healthcare reform Fitness tips Food Health screenings Health tips Healthy Eating Holidays Home Visit Program ID theft Immunizations Lean process improvement Medicaid Medical Home Medical Loss Ratio Medication Safety Nursing Nutrition Pharmacy Playmakers Premera Cares Premera Employees Premera in the Community Premera members Preventive Providence Health & Services Recipes Saving money Seahawks Social media State Insurance Exchange Step Out Walk United Way Wellness Women’s health
Source: premeranews.com

Medicare Silver Bullets: What’s The Best Way To Control Costs?

If I could make only one change, it would be a massive reform of Medicare’s payment policies. Right now, Medicare payment policies drive overuse, waste, inappropriate and sometimes harmful use of services. There should be a number of changes, such as paying in ways that encourage the use of team-based care, telephone, group and e-visits, more flexibility to allow nurses and other health professionals to operate at “the top of their licenses” with physician oversight and in the most quality and cost-effective ways. The more we can bundle payments to reward improved health (not just health care), and allow providers to self-organize to deliver the greatest benefits for patients and value or payers, the better off we will all be. The most successful providers tend to be integrated delivery systems. Although we will never have enough such systems around the whole country, we can develop and support as many of these as possible and also have payment models that foster virtual integrated delivery systems and reward the best performers, that is, the ones that provide the safest care in the most efficient manner.
Source: kaiserhealthnews.org

Medicare Open Enrollment: find comfort in convenience

Like most people, I take comfort in the things I’m familiar with. I choose to shop at the supermarket around the corner because I know exactly where to find the things I’m looking for. Sure, I might be able to save a little more money by shopping at a different store on the other side of town, but I choose to stick with what I’m most comfortable. We all like to get a good deal, but convenience is a big part of the value.
Source: medicare.gov

Newsroom – 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

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

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Source: reportingonhealth.org

Liberalism: Does the fiscal

But Mr Chait goes on to make a different point: while it looks as though entitlement programmes are nearly impossible to cut, just about everything else the government does is much more vulnerable. Everything from food inspections to foreign aid to environmental regulation to legal defence for the indigent to scientific research to the national parks to education to road, rail and air infrastructure to…pretty much everything. These programmes are diverse and often have small constituencies. There is, basically, a lot of stuff that the government does. And when you ask the public, you find that they want the government to do these things. But public attention is a very limited commodity; it’s impossible to actually marshal public attention to each of the individual programmes that get cut when “government” gets cut. What’s happened over the past 30 years, and in an accelerated tempo over the past two years, is that everything the government does apart from wars and transferring money to old and poor people has gotten creamed. The savings are trivial in comparison with the overall long-term debt picture, which is almost entirely a function of Medicare and Medicaid spending. But the cuts have effectively curtailed the vision of liberals who want government to do things like invest in basic scientific research, improve infrastructure, kick-start green technology and support education. In that sense, it’s true, the ability of Republicans to block Democrats from expanding the tax base has been a conservative victory.
Source: economist.com

Be aware of all your Medicare options

Cost and coverage.  Some Medicare Advantage Plans (Medicare Part D) cover much of your overall health care costs and some even have exceptional medication programs to suit your needs.       If you are happy with your current Medicare coverage, make sure that the benefits for 2013 are what you need and can afford.  Ask your doctor what health plans they like and how satisfied are their enrollees.
Source: oc-breeze.com

Medicare And Home Health Care: A Quick Overview

Addi­tion­ally, Medicare cri­te­ria for receiv­ing home health care are very strin­gent; many peo­ple who may want to use a Medicare-approved home health com­pany will not actu­ally receive cov­er­age. In fact, Medicare pays only about half of all health care costs to seniors. Medicare fre­quently denies pay­ment due to not meet­ing cri­te­ria, so it is impor­tant to know if you meet these cri­te­ria prior to lim­it­ing your­self to only Medicare-approved home health companies.
Source: nurseswithheart.com

CMS Names 106 New Medicare ACOs

Posted by:  :  Category: Medicare

day 6 365 days Hipstamatic by drivebybiscuits1CMS has named 106 new accountable care organizations that will participate in the Medicare Shared Savings Program, effective Jan. 1. With the addition of the 106 new organizations, as many as 4 million Medicare beneficiaries will be covered by a CMS ACO. According to CMS, the savings achieved by its ACOs could be up to $940 million in four years. The new group of ACOs includes 15 Advance Payment Model ACOs, which are physician-based or rural organizations that will benefit from greater access to capital. The application period for organizations wanting to participate in the MSSP in 2014 will begin this summer. The 106 new ACOs named to the MSSP are listed here, with their service areas: 1.    A.M. Beajow, MD Internal Medicine Associates ACO, P.C. (Nevada) 2.    AAMC Collaborative Care Network (Maryland) 3.    Accountable Care Clinical Services, PC (California, Connecticut, Iowa, Massachusetts, Pennsylvania) 4.    Accountable Care Coalition of Central Georgia (Georgia) 5.    Accountable Care Coalition of DeKalb (Georgia) 6.    Accountable Care Coalition of Georgia (Georgia) 7.    Accountable Care Coalition of Greater Athens Georgia II (Georgia) 8.    Accountable Care Coalition of Greater Augusta & Statesboro (Georgia, South Carolina) 9.    Accountable Care Coalition of New Mexico (New Mexico) 10.    Accountable Care Coalition of North Central Florida (Florida) 11.    Accountable Care Coalition of North Texas (Texas) 12.    Accountable Care Coalition of Southern Georgia (Georgia) 13.    Accountable Care Coalition of Western Georgia (Alabama, Georgia) 14.    Accountable Care Organization of New England (Connecticut, Massachusetts) 15.    ACO of Puerto Rico (Puerto Rico) 16.    Advocare Walgreens Well Network (New Jersey) 17.    Affiliated Physicians IPA (California) 18.    Akira Health (California) 19.    Alegent Health Partners (Nebraska) 20.    Alexian Brothers Accountable Care Organization (Illinois) 21.    Amarillo Legacy Medical ACO (Texas) 22.    American Health Alliance (Florida) 23.    American Health Network of Ohio (Ohio) 24.    APCN-ACO (California) 25.    Arizona Care Network (Arizona) 26.    Atlanticare Health Solutions (New Jersey) 27.    AVETA Accountable Care (Puerto Rico) 28.    BAROMA Health Partners (Florida) 29.    Billings Clinic (Montana, Wyoming) 30.    Bon Secours Good Helpcare (Kentucky, New York, Ohio, South Carolina, Virginia) 31.    Cambridge Health Alliance (Massachusetts) 32.    Cape Cod Health Network ACO (Massachusetts) 33.    Cedars-Sinai Accountable Care (California) 34.    Central Florida Physicians Trust (Florida) 35.    Central Jersey ACO (New Jersey) 36.    Christie Clinic Physician Services (Illinois) 37.    Collaborative Care of Florida (Florida) 38.    Collaborative Health ACO (Massachusetts) 39.    Colorado Accountable Care (Colorado) 40.    Community Health Network (Minnesota) 41.    Diagnostic Clinic Walgreens Well Network (Florida) 42.    Doctors Connected (Virginia) 43.    Essential Care Partners II (Texas) 44.    Fort Smith Physicians Alliance ACO (Arkansas, Oklahoma) 45.    Franciscan Northwest Physicians Health Network (Washington) 46.    Franciscan Union ACO (Illinois, Indiana) 47.    GPIPA ACO (Arizona, New Mexico) 48.    Hartford HealthCare Affordable Care Organization (Connecticut) 49.    HHC ACO (New York) 50.    HNMC Hospital/Physician ACO (New Jersey) 51.    Independent Physicians’ ACO of Chicago (Illinois) 52.    Indiana Care Organization (Indiana) 53.    Indiana Lakes ACO (Indiana) 54.    Integral Healthcare (Florida) 55.    Integrated ACO (Texas) 56.    KCMPA (Kansas, Missouri) 57.    KentuckyOne Health Partners (Indiana, Kentucky) 58.    Keystone Accountable Care Organization (New York, Pennsylvania) 59.    Lahey Clinical Performance Accountable Care Organization (Massachusetts, New Hampshire) 60.    Lower Shore ACO (Delaware, Maryland, Virginia) 61.    Marshfield Clinic (Wisconsin) 62.    Maryland Collaborative Care (Maryland, Washington, D.C.) 63.    MCM Accountable Care Organization (Florida) 64.    Medicare Value Partners (Illinois) 65.    Mercy ACO (Arkansas, Missouri) 66.    Meridian Accountable Care Organization (New Jersey) 67.    Meritage ACO (California) 68.    Morehouse Choice ACO-ES (Georgia) 69.    National ACO (California) 70.    Nature Coast ACO (Florida) 71.    NOMS ACO (Ohio) 72.    Northeast Florida Accountable Care (Florida) 73.    Northern Maryland Collaborative Care (Maryland) 74.    Northwest Ohio ACO (Michigan, Ohio) 75.    Ochsner Accountable Care Network (Louisiana, Mississippi) 76.    OneCare Vermont Accountable Care Organization (New Hampshire, Vermont) 77.    Owensboro ACO (Indiana, Kentucky) 78.    Paradigm ACO (Florida) 79.    Partners in Care (Michigan) 80.    Physician Organization of Michigan ACO (Michigan) 81.    Physicians Collaborative Trust ACO (Florida) 82.    Physicians HealthCare Collaborative (North Carolina) 83.    Pioneer Valley Accountable Care (Connecticut, Massachusetts) 84.    Primary Care Alliance (Florida) 85.    Primary Partners ACIP (Florida) 86.    ProCare Med (Florida) 87.    ProHealth Physicians ACO (Connecticut) 88.    Qualable Medical Professional (Tennessee, Virginia) 89.    Rio Grande Valley Health Alliance (Texas) 90.    Saint Francis HealthCare Partners ACO (Connecticut) 91.    San Diego Independent ACO (California) 92.    Scott & White Healthcare Walgreens Well Network (Texas) 93.    SERPA-ACO (Nebraska) 94.    South Florida ACO (Florida) 95.    Southcoast Accountable Care Organization (Massachusetts, Rhode Island) 96.    Southern Maryland Collaborative Care (Maryland, Washington, D.C.) 97.    St. Luke’s Clinic Coordinated Care (Idaho, Oregon) 98.    Summit Health-Virtua (New Jersey) 99.    The Premier Health Care Network (Georgia, New Hampshire) 100.    UCLA Faculty Practice Group 101.    UW Health ACO (Wisconsin) 102.    Virginia Collaborative Care (Virginia) 103.    Wellmont Integrated Network (Tennessee, Virginia) 104.    Winchester Community ACO (Massachusetts, New Hampshire) 105.    Yavapai Accountable Care (Arizona) 106.    Yuma Accountable Care Organization (Arizona)
Source: beckershospitalreview.com

Video: Georgia Health Insurance Medicare

Medicare Secondary Payer Bill Summary

CMS is required to maintain a secure web portal with access to claims and reimbursement information. The web portal must meet the following requirements: • Payments for care made by CMS must be loaded into the portal within 15 days of the payment being made. • The portal must provide supplier or provider names, diagnosis codes, dates of service and conditional payment amounts. • The portal must accurately identify that a claim or payment is related to a potential settlement, judgment or award. • The portal must provide a method for receipt of secure electronic communications from the beneficiary, counsel, or the applicable plan. • Information transmitted from the portal must include an official time and date of transmission. • The portal must allow parties to download a statement of reimbursement amounts. The Reimbursement Process The SMART Act requires parties to notify CMS of when they reasonably anticipate settling a claim (any time beginning 120 days before the settlement date). CMS then has 65 days to ensure the portal is up to date with all of the appropriate claims data. CMS can have an additional 30 days on top of the 65 days to update the portal if necessary. At the expiration of the 65 and potentially the 30 day periods, the parties may download a final conditional payment amount from the website. The final conditional payment amount is reliable as long as the claim settles within 3 days of the download.
Source: wordpress.com

Medicare agrees to pick up the tab for obesity counseling — Health — Bangor Daily News — BDN Maine

Unfortunately, those best prepared to provide obesity counseling will not be able to bill directly to do so. CMS has limited who is able to bill for those services to primary care physicians and practitioners, including nurse practitioners, clinical nurse specialists and physician assistants. Those with expertise in the field, such as registered dietitians, are not eligible to bill directly. Medicare will cover services from “auxiliary” providers only if the service is provided in a physician’s office suite and the physician is immediately available to provide assistance and direction.
Source: bangordailynews.com

Devil is in the details of a new Medicare plan to buy medical supplies

Cramton, together with economist Brett Katzman and mathematician Sean F. Ellermeyer of Kennesaw State University in Georgia, analyzed Medicare’s system to see whether it would set the same price as other systems. They computed what’s called the “Bayesian Nash equilibrium,” which is a bidding strategy for all participants in which no one could earn more money by changing their own bid, assuming that everyone else’s bids stay the same. Over time, bidders would be expected to converge toward the Bayesian Nash equilibrium strategy.
Source: sciencenews.org

Kaiser Permanente Georgia Offers Seniors Tips for Selecting a Medicare Plan

 Kaiser Permanente is Georgia’s largest not-for-profit health plan. Its mission is to provide high quality, affordable health care services to improve the health of its members and the communities it serves. Kaiser Permanente serves more than 235,000 members in a 28-county service area including metro Atlanta with care focused on their total health and guided by their personal physicians, specialists, and team of heath care providers. Expert and caring medical teams are supported by industry-leading technology and tools for health promotion, disease prevention, state-of-the art delivery, and world-class chronic disease management. Nationally, Kaiser Permanente is recognized as one of America’s leading health care providers, serving mort than 9 million members in nine states and the District of Columbia. For more information, visit www.kp.org.
Source: patch.com

A Different View about Obama’s Medicare “Actual Facts”

The Affordable Care Act assumes deep reductions in payments to doctors, hospitals, nursing homes, and Medicare Advantage program, totaling $716 billion over ten years. By paying providers less, the trust fund may last a bit longer, but it means seniors will have a harder and harder time finding a doctor to see them as they drop out of the program or stop taking new Medicare patients. The law may not explicitly cut benefits, but it certainly will impact access to care. What good is a Medicare card if you can’t find a doctor? That is precisely the problem that patients on Medicaid — the program for lower-income Americans — face today, forcing them to go to hospital emergency rooms for even routine care. Do seniors want that?
Source: georgiapolicy.org

Expand Medicaid to Reduce Uninsured in Georgia

AARP Georgia’s top legislative priority this year is getting many of those people — and hundreds of thousands of others in the same boat — covered under Medicaid, the federal-state health insurance program for the poor.
Source: aarp.org

Georgia Cancer Specialists Settles with Feds over Medicare Billing

The civil settlement resolves the United States’ investigation into Georgia Cancer Specialists’ practices relating to billing for evaluation and management (E&M) services on the same day as a related procedure. Generally, providers are not permitted to bill both E&M services and a related procedure on the same day under the Medicare program’s regulations. In specific circumstances, providers can avoid this prohibition by submitting their claims marked with modifier -25, which tells Medicare to pay both the procedure and the E&M service. Here, the U.S. Attorney’s Office alleged that Georgia Cancer Specialists applied modifier -25 to claims that did not qualify for its use, leading to overpayments by Medicare.    
Source: patch.com

Georgia voters oppose Romney

Georgians are sour on the direction of both the country and the state. Self-identified independent voters are especially skeptical of our national and state progress. Only 24 percent of independents believe Georgia is headed in the right direction while 66 percent say things have gotten off on the wrong track.  Their views on the country mirror these numbers with only 21 percent saying the country is headed in the right direction and 77 percent believing things have gotten off on the wrong track.
Source: bettergeorgia.com

Man pleads guilty to Medicare fraud in Georgia

Individuals convicted of Medicare fraud in Georgia face serious penalties, making it important for those accused of such offenses to seek qualified legal representation immediately. The man in this case is currently in prison in a different state for a guilty plea in another health care fraud case, but faces a fine of up to $250,000 and up to five years of jail time once he is released if he is convicted in Georgia. Because he is not an American citizen and was living in the United States on an expired Visa at the time of the alleged fraud, he will likely face deportation as well. Those proceedings would not occur until he has completed any applicable prison sentences.
Source: atlantacriminaldefenseblog.net

Oregon’s new Medigap Policy “Birthday Rule”

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSIn the past, beneficiaries typically stayed with the company that they signed up with during their initial enrollment period. Switching Medigap policies required medical underwriting, and Some Medigap policies have a waiting period for coverage of pre-existing conditions if you wanted to switch companies because of a price increase in your policy.
Source: cedaradvisors.com

Video: Choosing a Medicare Supplement Policy in 2011

AFLAC Medicare Supplement Plans Now Released in Indiana

Please Note: Commission schedules for Indiana have changed from the original schedules.  Under the new commission schedules all premium is commissionable at the same commission level. There is no reduction in comp for G.I. business. There is no non-commissionable premium in Indiana. The Part B Deductible portion of the premiums is fully commissionable. The only exception is that the commission rate is applied to the original premium. No commission is payable on future rate increase premium.  No commission is payable on the policy fee.
Source: ihealthbrokers.com

What Is A Medicare Supplement

There are ten different Medicare supplement plans.  Each one is given a different letter.  The letters skip a few here and there because plans that were once available have been retired and the labeled the new plans with the next letter in the alphabet so as not to create confusion for people who were grandfathered in on the old plans.  The plans themselves cover a varying number of combinations of the nine different coverage gaps that were left by the coverage you get with Medicare Part A and Medicare part B.  The Gaps include: the deductible, coinsurance, first three pints of blood and hospice care from Medicare Part A, The deductible and coinsurance for Medicare Part B, skilled nursing facility care, and expenses for foreign travel emergencies. Which plan you select dictates how many or what combination of these coverage gaps are covered.  Plan A covers only four of the gaps while Plan F covers all nine.
Source: seanbrock.com

What is a Medicare Supplement Plan?

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Source: croweandassociates.com

Best Health Care Plans at Affordable Prices

If you are buying one of these plans to get run in conjunction with a medical professional that you would through the entire process of applying for the insurance. So guys, what are you waiting for? Just visit a closeness doctor receive Medicare benefits. Also check to see if your plan offers Medicare Part D prescription drugs involves. Not included with your plan is part D coverage, you will need to purchase a separate policy.
Source: viewfour.com

Buying Supplemental Health Insurance

If you elect to work past the age of 65 and have an employer-sponsored health insurance plan, you will not need a Medigap policy. In this situation, you may still want to enroll in Medicare Part A (it’s free). Once you enroll in Part B, your Open Enrollment period begins, so you will want to hold off enrolling in Part B. Remember, if you do not purchase a Medigap policy during Open Enrollment, you may later be denied coverage or find yourself paying much higher premiums for identical coverage. It is probably best to wait until your employer coverage ends before enrolling in Medicare Part B.
Source: skepticwiki.org

Best Medicare Supplement Insurance

You simply want to give basic details into a form when employing a website to obtain Greatest Medicare Supplement Insurance coverage.  You will see various insurance coverage policies from varying providers Prograde supplements and you will be capable to critique the costs and policy figures from each and every provider.  You will have the ability to choose out the policies that are meet your demands and that you can spend comfortably.
Source: pakchom.net

What Medigap Insurance Has That Medicare Advantage Doesn’t

Compare this to Medicare Advantage plans. Plans are not standardized and vary from company to company. The same named plan may even include different benefits depending on the County where it is offered. Because of the moving parts, shopping for and comparing Medicare Advantage plans is much more difficult and can result in less certainty that you have actually chosen the best plan for your circumstances.
Source: medicareprofs.com

Dave Fluker’s California Health Insurance Blog: Anthem Blue Cross Raising Medicare Supplement Rates in 2013

David Fluker Insurance Services – Gilroy, California Serving California Residents Since 1995 For specific Health Insurance information, please visit my site at the link below www.davefluker.com Email Me CA Insurance License # 0B58920
Source: blogspot.com

What are AARP Medicare Supplement Plans?

aarp medicare supplement AARP Medicare supplement plans are offered in different categories, in the same way that the main Medicare insurance plan is comprised of. There are twelve types of Medicare supplement plans from Plan A to Plan N, which exhibit different coverage, premium rates, and benefits. These categories differ in the cases, locations, and conditions of the coverage to be exacted for the recipient in order to cut down costs on the particular service to be covered.
Source: webmasterstalks.com

Daily Kos: Raising the Age on Medicare???

Posted by:  :  Category: Medicare

looking out for the little guy by TheeErinit occurred to me today that the president might be less willing to compromise on this now than he was in 2011. For one thing, he has a stronger hand now. Second, I realized that July 2011 was before the Supreme Court ruling that states could reject the Medicaid expansion, and before so many GOP governors opted out of the exchanges. So it is very possible that President Obama and Democrats on the Hill are less open to raising the age now that it is apparent that the ACA would not provide an alternative outlet of coverage for everyone ages 65-67.
Source: dailykos.com

Video: Romney Campaign: ‘WILL Raise Age for Medicare’

Jon Chait’s Miserable Endorsement of Raising the Medicare Eligibility Age

What’s more, raising the Medicare retirement age would help strengthen the fight to preserve the Affordable Care Act […] The political basis for the right’s opposition to universal health insurance has always been that the uninsured are politically disorganized and weak. But a side effect of raising the Medicare retirement age would be that a large cohort of 65- and 66-year-olds would suddenly find themselves needing the Affordable Care Act to buy their health insurance. Which is to say, Republicans attacking the Affordable Care Act would no longer be attacking the usual band of very poor or desperate people they can afford to ignore but a significant chunk of middle-class voters who have grown accustomed to the assumption that they will be able to afford health care. Strengthening the political coalition for universal coverage seems like a helpful side benefit — possibly even one conservatives come to regret, and liberals, to feel relief they accepted.
Source: firedoglake.com

Change of Subject: Raising eligibility age for Medicare would be a costly ‘reform’

The Kaiser Family Foundation has found that lifting the eligibility age from 65 to 67 would reduce federal spending by about $5.7 billion in its first year of full implementation. But that would be offset by $11.4 billion in spending by other parties. That includes $3.7 billion in higher costs for 65- and 66 year-olds, $4.5 billion from employers through company-sponsored insurance, $0.7 billion from state governments, and $2.5 billion in higher average prices for third parties once younger seniors are shifted out of the Medicare risk-pool and into the general population.
Source: chicagotribune.com

Daily Kos: Ed Rendell: Obama “must deliver” on raising Medicare eligibility age & chained CPI

just the continuous claims I hear over and over again.  I can’t really give you an answer about why he does the things he does because I’m not sure either but even when he shows willingness to give Republicans what they want they still bitch and yell “No”.  In fact when I talk to people who are misinformed and yell, “both sides do it!  Obama is always fighting with Republicans” I always point out what he tries to do to get the other side on board.  After I explain that they go, “Oh, ok.  Some of those things he shouldn’t have agreed to but you’re right, he at least is trying to be the adult in the room and it is the Republicans who are the problem.”  I also hear this answer from moderate Republicans or moderates in general “I wish Bill Clinton was President again because he got shit done with the congress he had” but then I usually come back with, “That would be nice except that these Republicans are not the Republicans from the 90s and a lot of those racist tea baggers who represent racist voters would rather eat shit and die than be caught working with the black guy.”  They then respond, “Yeah, I guess you’re right.”
Source: dailykos.com

Sanders opposes effort to raise age for Medicare

Rodolphe “Skip” Vallee, chairman of R.L. Vallee Inc., a third company named by Sanders, said in an email, “We are competitive in every market we are in. ” He also complained that Sanders had interfered in the siting review process for discount retailer Costco’s plan to open a cut-rate gas station in Colchester. That project has been under review for five years, Sanders said, calling that “a very long time for a decision.”
Source: lifehealthpro.com

HCA Senior VP: Government Needs to Increase Medicare Age

As Congress members and President Barack Obama continue to grapple with the so-called “fiscal cliff” of spending cuts and tax hikes, one executive at Nashville, Tenn.-based Hospital Corporation of America believes increasing the eligibility age of Medicare must be considered and enacted instead of cutting payments to hospitals, according to a Nashville Public Radio report. HCA Senior Vice President Vic Campbell spoke at an investor conference in New York earlier this week and fielded a question from a person who asked if the Medicare eligibility age should be elevated from 65 to 70.
Source: beckershospitalreview.com

Daily Kos: Durbin on Medicare age hike: ‘Not on the table from the White House’

Given that Republicans refuse to put anything specific on the table, that means it’s not on the table at all, and if it ever did get on the table, Republicans would have to be the ones to put it there. But Republicans are trying this weird negotiating strategy of not only demanding cuts in programs like Social Security, Medicare, and Medicaid, but they are also demanding that Democrats identify the cuts and therefore take responsibility for them. If Democrats were to do that, Republicans would obviously turn right around and attack Democrats for proposing the cuts that Republicans demanded.
Source: dailykos.com

Raising Medicare's Eligibility Age: A Complex Proposition

The Alliance for Health Reform and the Kaiser Family Foundation present a briefing to discuss the complexities of raising the age for Medicare eligibility. Speakers address questions on how this proposed change may affect beneficiaries, employers, and the workforce, as well as the cost and coverage implications for those approaching the current age of eligibility or enrolled in Medicare today.
Source: kff.org

Progressives to Obama: Don’t even think about raising the Medicare eligibility age

“Raising the age of eligibility, the legal retirement age, sounds like a good idea if what you do for a living is talk and write, mostly while sitting in comfortable chairs in climate-controlled buildings,” Nichols observed. “But if what you do for a living is pick up and move heavy things, or spend eight to ten hours a day on your feet without interruption bringing food and clearing tables, or waiting on retail customers, or doing one physical thing over and over on an assembly line, then being required to do that for two or five or 10 more years before you can join Medicare is fairly cruel.”
Source: msnbc.com

Should Medicare’s Eligibility Age Be Raised?

Yes of course it should be raised as part of entitlement reform, along with the eligibility age for Social Security. To not do so would be foolish, given demographic trends, and lead to the unsustainable growth of the welfare state. The poor will still have the Medicaid safety net until they reach 67.
Source: wsj.com

Durbin: White House Won't Increase Medicare Age

WASHINGTON (AP) — One of President Barack Obama’s top Senate allies says he’s been assured by the White House that the president won’t yield to GOP demands to increase the eligibility age for Medicare.
Source: realclearpolitics.com

Viewpoints: Pelosi Says Higher Medicare Age ‘Doesn’t Work;’ Marketplace’s Clout Could Lower Seniors’ Drug Costs

Baltimore Sun: The Other, More Dangerous, Cliffs The “fiscal cliff” isn’t nearly the biggest cliff we face — if we’re talking about dangerous precipices looming on the horizon. Here are three: The child poverty cliff. A staggering number of our children are impoverished. Between 2007 and 2011, the percentage of American school-age children living in poor households grew from 17 percent to 21 percent. Last year, according to the Agriculture Department, nearly 1 in 4 young children lived in a family that had difficulty affording sufficient food at some point in the year. Yet federal programs to help children and lower-income families — such as food stamps, federal aid for poor school districts, Pell grants, child health care, subsidized lunches, child nutrition, prenatal and postnatal care, Head Start and Medicaid — are being targeted for cuts by deficit hawks who insist we can no longer afford them (Robert Reich, 12/12).
Source: kaiserhealthnews.org

Seniors have until Friday to change Medicare drug plan

Posted by:  :  Category: Medicare

Harry Reid, Health Care narrow by Truthout.orgNorth Carolina Health News is an independent, not-for-profit, statewide news organization dedicated to covering health care in North Carolina employing the highest journalistic standards of fairness, accuracy and extensive research. NCHN seeks to become the premiere source for health reporting in North Carolina. Visit NCHN at northcarolinahealthnews.org.
Source: carolinapublicpress.org

Video: MEDICARE SUPPLEMENTAL INSURANCE

Mental health pro pleads guilty to Medicare fraud

A man who opened two suspect mental health centers in the Miami area is facing fraud charges and allegations that he robbed the Medicare system of millions of dollars. The man, age 50, had also planned on opening a psychotherapy clinic in Tennessee, and he had already established several other facilities in North Carolina. The man and his associates have been charged with taking at least $60 million from the government program. He faces 30 years to life in prison in connection with the alleged crimes.
Source: ncfederalcriminaldefenseblog.com

NC Healthcare service costs soar, Hospitals buy out doctors, Medicare rules let hospitals charge more than independent doctors, Indigent care cost shifting

Why would Muslim oil billionaires finance and develop controlling relationships with black college students? Well, like anyone else, they would do it for self-interest. And what would their self-interest be? We all know the top two answers to that question: 1. a Palestinian state and 2. the advancement of Islam in America. The idea then was to advance blacks who would facilitate these two goals to positions of power in the Federal government, preferably, of course, the Presidency. And why would the Arabs target blacks in particular for this job? Well, for the same reason the early communists chose them as their vanguard for revolution (which literally means “change”) in America. Allow me to quote Trotsky, in 1939: “The American Negroes, for centuries the most oppressed section of American society and the most discriminated against, are potentially the most revolutionary element of the population. They are designated by their historical past to be, under adequate leadership, the very vanguard of the proletarian revolution.” Substitute the word “Islam” for the words “the proletarian revolution,” and you most clearly get the picture, as Islam is a revolutionary movement just like communism is. (Trivia: it is from this very quote that Van Jones takes his name. Van is short for vanguard. He was born “Anthony”). In addition, long before 1979, blacks had become the vanguard of the spread of Islam in America, especially in prisons.
Source: wordpress.com

NC Medicaid Primary Care Docs: 18% fee increase January 1

amendment one Art Pope budget charter schools civil rights consumer protection corporations corruption Crucial Conversation death penalty Duke Energy economy Education Election energy environment federal budget fracking global warming Health health care higher education immigration jobless jobs Legislature LGBT rights Marriage amendment Marriage discrimination amendment medicaid mental health Phil Berger poverty Prosperity Watch public education Racial Justice Act Reproductive rights republicans right-wing state budget taxes Thom Tillis Unemployment Voter Suppression Wake County schools
Source: ncpolicywatch.org

Senior Care in Gastonia, NC: 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: affordablehomecarenc.com

ONLY ON 3 UPDATE: Injured man on Medicare is able to stay in hospital to await surgery

Tom, I know portions have kicked in, like the part that removed the lifetime cap on benefits. This alone saved us from financial ruin when my wife came down with cancer. I am sure more provisions will be forthcoming. What gets me is all these people have moaned and groaned for years about having to foot the medical bills for those who choose not to carry insurance. Obama did something about it and they are still whining. Probably most of those who are complaining the most are the ones that will have to slack off on their Marlboros, cheap beer, tattoos and piercings and use that money to buy insurance.
Source: wwaytv3.com

Medicare Part D Open Enrollment Clinics

Lenoir County Seniors’ Health Insurance Information Program (SHIIP) operating under the NC Department of Insurance and in conjunction with Lenoir County Cooperative Extension will provide three counseling clinics during the week of November 26-29.
Source: ncsu.edu

Medicare Nursing Home Ranking System Under Scrutiny in North Carolina

While not every injury case meets our criteria, we offer free initial confidential injury case consultation, so call us toll free at (800) 752-0042. If you cannot get through due to high call volume, please leave a voicemail so we can return your call.
Source: hsinjurylaw.com

Medicare Supplemental Insurance

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSMillers First lays off 12, continues restructuringAlton TelegraphPersonal auto, homeowners, personal umbrella liability and dwelling fire property and casualty coverage are issued for Millers policyholders in Illinois, Missouri, Wisconsin, and Iowa." Formerly called Millers Mutual Insurance Association, the company …and more » […]
Source: unitel.cc

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

Best Medicare Supplement Insurance

You simply want to give basic details into a form when employing a website to obtain Greatest Medicare Supplement Insurance coverage.  You will see various insurance coverage policies from varying providers Prograde supplements and you will be capable to critique the costs and policy figures from each and every provider.  You will have the ability to choose out the policies that are meet your demands and that you can spend comfortably.
Source: pakchom.net

15% Medicare Supplement Rate Increase is Outrageous!!! » Toni Says

Cindy, one Medicare rule that you should be aware of since you are not happy with your rate increase from your current Medicare Supplement company is…if you had a Medicare Supplement policy before you joined a Medicare Advantage Plan for the first time, and you aren’t happy with the Medicare Advantage Plan, you will have special rights to buy a Medicare Supplement policy if you return back to “Original Medicare” within 12 months of first joining a Medicare Advantage plan.  If you had a Medicare Supplement policy before you joined, you may be able to get the same plan back if the company still sells it.  If it isn’t available, you can buy another Medicare Supplement policy. (Please see page 66 of the
Source: tonisays.com

What Is A Medicare Supplement

There are ten different Medicare supplement plans.  Each one is given a different letter.  The letters skip a few here and there because plans that were once available have been retired and the labeled the new plans with the next letter in the alphabet so as not to create confusion for people who were grandfathered in on the old plans.  The plans themselves cover a varying number of combinations of the nine different coverage gaps that were left by the coverage you get with Medicare Part A and Medicare part B.  The Gaps include: the deductible, coinsurance, first three pints of blood and hospice care from Medicare Part A, The deductible and coinsurance for Medicare Part B, skilled nursing facility care, and expenses for foreign travel emergencies. Which plan you select dictates how many or what combination of these coverage gaps are covered.  Plan A covers only four of the gaps while Plan F covers all nine.
Source: seanbrock.com

AFLAC Medicare Supplement Insurance Plans Now Available for Sale in 27 States

All states except NY and FL are now available for recruiting. The final states recently added are WI, MN and MA. If you plan to recruit in these states make sure you are appointed. If you are not currently set up for any of these states and would like to be, please forward the State License you would like to be set up in and we will get you set up as quickly as possible.
Source: ihealthbrokers.com

Medicare Supplement Insurance › Medicare Supplement Insurance

So I decided to check into different types of Medicare insurance and how much they cost. I found that many insurance companies that offer regular insurance also offer the supplement plans. I also read testimonials from people who had Medicare supplement plans. Some people found them to help and others said they don’t help enough. After finding a plan that fit my budget I found that it did help cover some costs but there was still some left over that I still had to cover. I feel that some months when I have more bills the insurance is a lifesaver and other months when I don’t I feel as if I’m putting out more money than is necessary. I still have mixes emotions about the supplement plans and being that I have only invested in them for the past 3 years I will continue to purchase Medicare supplement insurance. The best advice I can give is to research the different plans, they are very similar but there is always the fine print that needs to be read and understood.
Source: savestvictors.org

Looking Into Different Aspects Of Medicare Supplemental Insurance

One issue that is near and dear to our hearts when considering health insurance is prescription drug coverage.  It is notable to understand that any Medicare Supplemental Policy you currently purchase will not come with prescription drug coverage.  This is something that needs to be purchased through separately and is referred to as Medicare Part D prescription drug coverage.
Source: seniorhealthdirect.com

Medicare Supplemental Insurance Website Server Starts Data Center Fire, Authorities Say

A blaze which started at a Denver data center on Wednesday night has been contained with no one hurt, authorities say. The fire was reportedly started by an overheated server utilized by local Medicare Supplemental Insurance comparison website: http://medicaresupplementalinsurancecomparison.net. The fire started roughly two hours after the website’s initial launch. As the server heated up from the initial rush of traffic the CPU cooling system malfunctioned causing a chain reaction that led to the fire starting. The fire rapidly consumed a corner of the first floor in the data center. “This isn’t the first time a website’s launch has caused a server to overheat,” says Marcus Stevenson, director of operations at FSPServerDirect. “Overheating servers are common with websites that underestimate the demand they’ll receive at any given time. Though a fire would not have started if the system had not malfunctioned in the way that it did.” The fire reportedly caused significant damage to the host building but none of the neighboring structures were affected. Experts say the most expensive loss will likely come from the damaged server racks- Each one costing up to $10,000. The Medicare website owners would not comment, but according to a company spokesman the website is back up and running and was only down for 3 hours. “Admittedly we underestimated the sheer demand for this type of website,” says a company spokesperson. “We received 18 thousand visits in our first 2 hours online, most of which came from people searching for Medicare supplemental insurance through Google. As we entered our second hour after launch our site was suddenly kicked offline. Only the next morning were we told that our website might have caused the fire, but since hosting is an outside service we were not held accountable. The data center admitted to us that their own negligence was a major contributor to the fire. Needless to say we have upgraded to a brand new server and had it checked over thoroughly. We will now be able to handle as much traffic as we can get.” Experts say the demand for the site was so high because it’s one of the first websites of its kind to provide side by side comparisons of Medicare supplemental insurance companies by only entering a zip code. “This is rare for these types of sites,” says a company spokesman. “Most sites like this require personal info before they provide quotes, and the non-invasiveness of our site has definitely contributed to its popularity.” To learn more about the fire, or to get free side by side comparisons of the most reputable Medicare supplemental insurance providers in an area, please visit: http://medicaresupplementalinsurancecomparison.net/ About medicaresupplementalinsurancecomparison.net Medicaresupplementalinsurancecomparison.net was created in December of 2012 to help shoppers get the best rates for Medicare supplemental insurance. The website utilizes the absolute latest in price quote technology, and has already received rave reviews from the industry.
Source: sbwire.com

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

Healthcare Systems: Are You in Need of Medicare Supplement Insurance?

Of course, one of the most important things to think about when you are looking for a supplement plan is the rates. You don’t want to spend a lot of money but you need a good policy. So you need to look not only at the policy’s coverage but also at the Medicare supplement rates offered by various carriers for that plan. When you find the plans that will cover the things your basic Medicare does not, you need to compare the rates. Medicare supplement rates can vary widely depending on how much the plan covers. If you want a supplement plan that covers many things then you will likely have to pay a higher premium for that plan. If you’re on a Medicare plan such as a supplement, it means that you don’t have enough money to pay for all of your medical bills by yourself or you are tired of Medicare not covering what you need, such as deductibles and coinsurance not covered by Medicare. You will need to make sure that you find a plan that will cover all or at least most of those things. Then you need to make sure that you don’t end up paying a ton of money for this supplement plan. There are plans out there that can get you exactly what you need. All it takes is a little searching, and perhaps some help from your local health insurance agent who works with Medicare plans on a regular basis.
Source: blogspot.com

How To Know If You Need Medicare Supplemental Insurance

If you require a lot of medical attention, getting the most coverage you can afford makes sense. Whether you have cancer, chronic illnesses, a major health condition, or regular visits to hospitals and specialists, supplemental insurance will help ensure that everything you need is covered and affordable. Getting Medicare supplemental insurance is also a good idea if your regular Medicare policy does not cover something specific that you need, such as a prescription medication, a certain type of service, or additional medical care that you need. Talk to your doctors and healthcare providers about your current health and the steps you will need to take in order to stay healthy. This will give you a good idea of what you need, and whether Medicare will cover it. If not, seek out a supplemental insurance plan.
Source: dzida.org

Comparing Medicare Supplemental Insurance Benefits

These plans, called “Medigap” plans, each have different medical care coverage. Variable benefits of coverage to be considered are: • Coinsurance plus coverage that last 365 days after medicare benefits end (Medicare Part A) • Coinsurance/Copayment for medicare part B. • Pints of blood (transfusions, first three pints) • Hospice care copayments or coinsurance • Coinsurance for Skilled Nursing Facilities • Part A medicare deductible • Part B medicare deductible • Part B excess charges • Emergencies during foreign travel • Preventative care coinsurance, per Medicare Part B If any of these are important for you to have covered, comparing medicare supplemental plans that include benefits is the only way to ensure they are included.
Source: seniorcorps.org

Exclusive Medicare supplement leads are a vital investment in the growth of your agency

America is graying, a fact that is mentioned frequently in media reports about the health care system and health reform. It’s a fact that there is a big wave of seniors about to become eligible for Medicare, and once that happens, they will need Medicare supplements. As a busy and experienced insurance agent that deals with seniors on a regular basis, you know first-hand that the growth of your business depends on a constant supply of Medicare supplement leads. You want quality leads, fresh to your inbox daily or weekly, whichever suits your timetable.
Source: benepath.net

Linda Joy Adams: Tom Blackwell to Lead Ringler Medicare Solutions

Posted by:  :  Category: Medicare

Healthcare solution >> more doctors by / // /An informal news letter of all kinds of news and comments on the news. Specific intent is to ‘track’ mergers and acquisitions at the highest levels in our world and the impact these have on individual rights. This blog was started to aid me keep track for my personal benefit. It evolved into a shared content with anyone interested.
Source: blogspot.com

Video: Congressman Huelskamp questions Chief Actuary of Medicaid/Medicare, part 2

Daily Kos: Tiptoeing into solutions: Dieter Helm’s The Carbon Crunch

There are three parts to his book.  The first deals with the topic of “why should we worry about climate change,” and is a discussion, familiar to many readers here, about the nature of human-caused climate change in this era.  It’s a discussion, in short, of “greenhouse gas emissions.”  The issue of “who is to blame” is of interest, for the most part because Helm would like to suggest some sort of equalization as regards who is to be regarded as entitled to burn the Earth’s carbon reserves.  “The fact that emissions are lower per head in developing countries,” he argues, “is relevant to apportioning carbon targets.” (61)  In the end, Helm recommends the idea of “carbon pricing,” which has become a sort of code for an additional tax on fossil fuels.  “The trick is to get that price established,” he argues.  “The challenge is not to get the price exactly right, but to make progress away from a situation where carbon is not priced at all and therefore is exactly wrong.”  (71)  The phrasing here appears to me to be inexact.  Carbon is already “priced” — everyone is paying for energy production already when they participate in consumer life, buying goods and services.  Helm’s real concern appears to be that they aren’t paying enough, and if they were paying more that would be “something which goes in the right direction” (71).  
Source: dailykos.com

Medicare Pay Cut Averted…again

Doctors can breathe a sigh of relief as a Medicare pay cut of nearly 30 percent is narrowly averted — at least temporarily.  On New Year’s Day, Congress approved a “fiscal cliff” bill that includes a one-year delay of the scheduled Medicare pay cut — to the tune of 26.5 percent — due to the flawed sustainable growth rate (SGR) formula.
Source: wordpress.com

Protect Social Security and Medicare During Budget Debates

Americans have been paying into Social Security for more than 75 years and collecting these earned benefits when they retire. Currently, Social Security has enough money in its coffers to pay 100 percent of the promised benefits for the next 20 years. After that, there are sufficient funds to cover 75 percent of promised benefits. However, with gradual and modest adjustments, we can ensure that future generations will receive the benefits they’ve worked for.
Source: aarp.org

Decrease Increasing Medicare Costs with Healthnet Medicare Arizona

Posted by:  :  Category: Medicare

Healthnet medicare arizona also helps you cover your medications. The more medication that you are on, the more money you will need to pay for these medications. The cost of medications keeps increasing, and since you need them, each month you will have a fixed cost for your medications. The only way to change a fixed cost is to change find a new provider for the medications or by enrolling into a new health plan that will help you reduce your monthly payments. By enrolling in healthnet medicare Arizona, you can save money on these medications and thus increase your discretionary income for each month. For example, if you make $3,000 a month and $400 of it goes to medications, then you enroll in healthnet medicare arizona, and your medication cost is decreased to $20 a month, you would increase your monthly discretionary income by $380. So, that is $380 that you can use on anything else you want instead of the medications that you need to live a healthy life.
Source: millionboatfloat.org

Video: Health Net Medicare Part D Insurance – Compare to 180+ Comp

Marin•Sonoma IPA inks Medicare contract with Health Net for Sonoma County Seniors

Great. Seniors get their coverage so that they don’t have to experience the inconvenience of leaving town. (Even though their property taxes are exempt from the huge costs to keep "their" local hospital in business.) The non-insured also get to keep their "free" local care; paid for by the rest of us. The only ones to be forced to leave town for their health care are working families, who must use Kaiser or other out-of-town options because the local out-of-pocket costs are too high. So those that are paying for this huge privilege of localized medical care in this town are the least likely to be able to use it. Something stinks about this picture.
Source: patch.com

Medicare imposes marketing and enrollment suspensions on HealthNet, Arcadian and Universal American (Today’s Options).

Arcadian had their webinar today as well. On the call the moderator did not and would not discuss the other companies. It was very refreshing for me to see that respect for the competitors. One of the things we did discuss was the sanctions, while marketing practices were a component, a large part of the sanctions revolved around Rx administration. The Rx vendor is not specifically mentioned nor will I name them. I am however disappointed that no specific action is to be taken when this vendor is responsible for issues with ALL the companies receiving sanctions. All of the companies/MAPD Plans are working hard with the CMS to correct the issues and will be back to marketing in 4 to 6 months. My feelings go out to all of the beneficiaries that will miss out on these plans. In some markets, the sanctioned plans are the most intelligent option.
Source: wordpress.com

Health Net expects earnings per share 2013
Best Insurance StocksBest Insurance Stocks

Best Insurance Stocks – Health Net Inc expects earnings per share 2013, Analysts expect eps 2013, Health Net stock forecast 2012, Health Net revenue prediction 2013 : Health Net Inc. has issued an initial 2013 earnings forecast that comes with room for growth according to analysts who cover the health insurer. The Woodland Hills, Calif., company said Tuesday after markets closed that it expects earnings per share next year to range from $2 to $2.10, with revenue of between $10.7 billion and $11.2 billion.
Source: blogspot.com

Health Net Terminates Agreements with Six Tenet Healthcare Hospitals

• AB 1846 (Gordon) establishes a regulatory licensing framework for consumer owned and operated plans (CO-OPs), which are designed to foster the creation of consumer-driven, nonprofit health insurance organizations. • AB 1761 (Perez) prohibits people or entities from representing, constituting, or otherwise providing services on behalf of the California Health Benefit Exchange without having a valid agreement with the Exchange. • AB 999 (Yamada) modifies the process for LTC rate development to protect consumers from excessive premium rate volatility. It is considered one of the strongest LTC consumer protection measures in the nation. • AB 2138 (Blumenfield) provides increased funding for district attorneys to investigate and prosecute health and disability insurance fraud in collaboration with CDI enforcement personnel. • SB 1216 (Lowenthal) and SB 1448 (Calderon) ensure that CDI has the regulatory authority to protect consumers in response to changes brought by the globalization of the insurance business and insurer use of reinsurance. • SB 1216 provides a framework for when a California-based insurer cedes business to a non-U.S. based reinsurer. Commissioner Dave Jones notes that the recession brought to light the need for regulators to have more authority to evaluate the risks that a non-insurance entity poses on an insurer in a holding company system. • SB 1448 updates California’s Insurance Holding Company System Regulatory Act so the financial status of an insurer in a holding company system can be assessed. • AB 2303 (Assembly Committee on Insurance) gives the insurance commissioner the authority to take over an insurer that the U.S. Treasury Secretary determines is insolvent or in danger of becoming insolvent. • SB 1170 (Leno) expands restrictions on misleading advertising tactics directed at seniors and senior veterans. It would enhance the notification requirements for an agent or broker to meet with a senior in their home to sell an insurance product. • SB 1184 (Corbett) is designed to stop unscrupulous insurance agents and brokers who charge a fee to help senior veterans qualify for veterans’ aid programs when these services are readily available for free for those who qualify. Insurance agents and brokers cannot be involved in obtaining senior veterans’ benefits with the sole purpose of financial gain. • AB 1747 (Feuer) requires a life insurer to send a pending lapse notice to the policyholder within 30 days of nonpayment. The policyholder must be able to name one or more people to receive a copy of the pending lapse notice or termination of a policy for nonpayment of premium. People can easily lose the critical protection of life insurance if just one premium is accidentally missed, even if they have been paying premiums on time for many years, notes Commisioner Dave Jones.
Source: calbrokermag.com

Arizona Health Net Medicare HMO Customers Fraudulently Transferred to United Health’s AARP Medicare HMO as of 12.07.2011

I was told by another person from Health Net that this appears to have been the work of one sales person. I said I wanted the person’s name and other information because I plan on suing them. He said that he would give me that information after the investigation was over. I’m not going to hold my breath. In reality I doubt they can point to one person as the supervisor I last talked with told me the applications were filed online. A sales person would only be responsible if they’d personally signed people up for AARP. Did one salesperson submit hundreds (or more) fraudulent applications online? Did one salesperson process all of the fraudulent online applications? Neither scenario seems likely. Or were they submitted by phone or mail as others first told me?
Source: wordpress.com

Health Net sanction means one less low

Los Angeles-based Health Net Inc. to stop enrolling people into its Medicare Advantage and prescription-drug plans. That’s a blow because Health Net is the second-largest Medicare Advantage provider in Oregon. It offered one of the few plans with no additional premium, experts say. The agency said it took action because Health Net has “continually subjected its enrollees to impermissible hurdles in their attempts to obtain needed, and in some cases, life sustaining, prescription medications.” Medicare officials say they would monitor Health Net until it corrected the problems. Health Net emphasized in a statement that the suspension does not effect its existing Medicare enrollees. 
Source: oregonlive.com

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

Posted by:  :  Category: Medicare

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

Video: Medicare Plans from Blue Cross and Blue Shield of Minnesota and Blue Plus

Blue Cross, Blue Care Network expand service areas, add plan options

If you enjoy the content on the Crain’s Detroit Business Web site and want to see more, try 8 issues of our print edition risk-free. If you wish to continue, you will receive 44 more issues (for a total of 52 in all), including the annual Book of Lists for just $59. That’s over 55% off the cover price. If you decide Crain’s is not for you, just write “Cancel” on the invoice, return it and owe nothing. The 8 issues are yours to keep with no further obligation to us. Sign up below.
Source: crainsdetroit.com

Blue Cross Blue Shield of Michigan Offers New Medicare Plans

HMO’s (health maintenance Organizations) let you select a primary care physician from the BCBS provider network and this PCP manages your overall care. He or she will refer you to a specialist or to a selected hospital for care should you need additional services beyond his scope of practice. Referring yourself to an outside provider will cause a forfeit of benefits and out-of-pocket costs. The four BCBSM HMO products, formerly known as Options 1, 2, and 3, will now be known as BCN Advantage Elements, Classic , and Prestige. The Blues Care Network will also continue to offer the BCN Advantage Basic Plan.
Source: emaxhealth.com

Flash of Genius: Medical Matters: URGENT: WPS J8 MAC Medicare change starts at 2:00 Thursday 7/12/2012

. WPS officially starts payor id 08202 on Monday July 16, however they have announced “Dark Days” of Friday July 13 through Tuesday July 17. A dark day is a business day during the cut-over period when the Medicare claims processing system is not available for normal business operations. System dark days may occur between the time the outgoing claims administration contractor ends its regular claims processing activities and the incoming claims administrative contractor begins its first day of normal business operations. Genius is not certain what would happen if you sent Medicare claims with the new payor id between 2:01pm Thursday through 12:00am Monday.It is possible that BCBSM or WPS might hold them until they finish their dark days and process them normally, but we do not have any confirmation from BCBSM or WPS that this actually will happen. Therefore Genius recommends you do all of your Medicare billing before 2pm on Thursday July 12.Then do no Medicare billing until July 16 or later.On July 16 go to your Insurance Code Files and change payor id 00953 to 08202. Don’t change anything else and don’t change it before July 16. Click here for step-by-step instructions for changing the payor id in THOMAS. After you have changed your payor id on July 16 or later you should be able to resume sending your Medicare claims.
Source: blogspot.com

More on Proposed Cuts to Medicare Advantage: Seniors Would Save Far More Than They Lose

“It turns out that the additional benefits and flexibility created by recent increases in MA payment rates simply weren’t worth very much to seniors,” Frakt writes. “Consumer surplus loss associated with cuts in payments to MA plans will be only 14 cents per dollar saved. . . the truth is that under Obama’s plan a small fraction of Medicare beneficiaries will lose their MA benefits and/or face higher costs. However, the potential savings are enormous and research shows that the benefit cuts needed to achieve them will not be terribly missed.”
Source: healthbeatblog.com

Change in specialty designation for physicians

Primary specialty will come from the CAQH UPD application Beginning July 1, 2012, the BCBSM online provider search will display both primary and secondary specialties, if applicable. The specialty listed will be taken from the CAQH UPD application, regardless of board certification status, provided credentialing requirements are met.
Source: mi-osteopathic.org

How Does Blue Cross Medicare Crossover Work?

Blue Cross offers the following program choices: Blue Cross Plus, Blue Cross PPO, High Option Supplement to Medicare and Core. Blue Cross Medicare Crossover is an option for all Blue Cross programs. The Blue Cross Medicare Crossover system allows Medicare to directly provide Blue Cross access to a person’s explanation of benefits (EOB), so that neither the individual nor the provider needs to file a separate claim with the insurance carrier after sending a claim to Medicare. The Blue Cross Medicare Crossover system simplifies the procedure. Under the new Blue Cross Medicare Crossover system, most claims are automatically sent to Blue Cross.
Source: seniorcorps.org

Medicare Targets Health Plans With Low Ratings

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

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

How will 2011 Medicare Rates Affect your ASC Business?

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Bubbles? Take something like 'Not I! ...item 1.. Wakulla Republicans Protest Against Taxes in the County (September 06, 2011) ... by marsmet552Dan is the Founder and President of Clearwater Florida based Liberty Search Associates a full service executive and management search and recruiting firm. He is a 20 year veteran of the human resource management and recruiting industry. His experience involves sourcing and hiring thousands of people while working for three global corporations. In 2002, Dan was specializing in health care recruitment while working as an executive recruiter for the world’s largest management recruiting firm. By 2003, he gained further healthcare experience while working directly for a Healthcare System as a market recruiter for a division of 15 acute care hospitals in West Central Florida. Here he had the opportunity to recruit all levels of nursing and other healthcare leaders. Dan started Liberty Search Associates in 2004 and recruits highly talented people that are motivated and self-directed. They are proven health care professionals with ability and aspirations for career growth and unique opportunities. Dan works with client hospitals and surgery centers nationwide to bring them the very best talent for key leadership positions. Dan and his wife Donna live near Clearwater, Florida. They have a son, Matthew, who is attending middle school.
Source: libertysearch.com

Video: 2011- 4/19 MEDICARE PATIENTS HAVE SHORTER HOSPITAL STAY AFTER HIP REPLACEMENT BUT

18 Recent Medicare, Medicaid Issues

Here are 18 issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent. 1. The Medicare Payment Advisory Commission approved a final recommendation, saying hospital inpatient and outpatient Medicare payments should be increased by 1 percent in fiscal year 2014 despite the fiscal cliff agreement. MedPAC recommended that CMS eliminate any update for ambulatory surgery centers. 2. Accelerating a three-year trend, spending per Medicare beneficiary rose just 0.4 percent in fiscal year 2012, far slower than the 3.4 percent increase in gross domestic product per capita. 3. CMS named 106 new accountable care organizations that will participate in the Medicare Shared Savings Program, effective Jan. 1. 4. California Gov. Jerry Brown (D) released his 2013-14 budget, and he indicated that the state, as expected, will expand its Medicaid program under the Patient Protection and Affordable Care Act. 5. CMS estimated that total Medicare and Medicaid electronic health record payments since the incentive program began in January 2011 surpassed $10.3 billion at the end of 2012. 6. State lawmakers are gearing up for policy discussions this year for fiscal year 2014 budgets, and a survey found one of the biggest topics to impact those talks will be Medicaid. 7. Following a recent report that Medicare Advantage plans were overpaid an estimated $598 million in 2007, the HHS Office of Inspector General released a report that found the private company charged with scouring certain Medicare claims for possible fraud focuses only a small portion of its efforts on the Medicare Advantage program. 8. New Mexico Gov. Susana Martinez (R) agreed to expand Medicaid to more low-income residents with additional federal money available through the healthcare law. 9. Hospitals in the Fort Wayne, Ind., region, on average, performed the best on CMS’ Value-Based Purchasing Program, which went into effect this year, and Washington, D.C., hospitals collectively scored the worst, according to a regional analysis by Kaiser Health News. 10. The U.S. District Court for the District of Columbia ordered HHS to re-evaluate Medicare disproportionate share hospital payments for more than 100 hospitals and pay interest on any additional amounts owed after recalculation. 11. Oliver Fein, MD, a general internist at NewYork-Presbyterian Hospital in New York City and a professor of clinical medicine and public health at Weill Cornell Medical College, shared his thoughts on where Medicare stands today. 12. CMS said Maine can cut about 15,000 low-income residents from its Medicaid program, but the federal government protected another 21,000 from rollbacks sought by Gov. Paul LePage (R). 13. Florida Gov. Rick Scott (R) said he does not want to expand Medicaid in Florida under the healthcare reform law because it is too expensive, but an investigation by Health News Florida found that Gov. Scott’s Medicaid figures were wrong and based on a flawed report — but he continued to use the figures despite warnings about the inaccuracies. 14. Beginning in July, the agency that administers Florida’s managed care Medicaid program announced it plans to implement diagnosis-related group payments for hospital stays. 15. CMS announced the availability of $32 million in grants for public entities and private community organizations with approved proposals to identify and enroll children eligible for Medicaid and the Children’s Health Insurance Program. 16. In his state of the state address, Idaho Gov. C. L. “Butch” Otter (R) announced he would not expand his state’s Medicaid program to more people using additional money that would be made available under the federal healthcare reform law, making him the 10th Republican governor to do so. 17. National healthcare expenditures grew 3.9 percent in 2011, similar to growth rates in 2009 and 2010, meaning healthcare spending continues to grow at historically slow levels. However, CMS noted a few areas where national healthcare expenditures grew rapidly from 2010 to 2011, including Medicare spending. 18. The Supreme Court deferred to a previous federal appeals court ruling that Social Security recipients cannot reject Medicare coverage.
Source: beckershospitalreview.com

Hospitals’ Readmissions Rates Not Budging

Medicare calculates readmission rates over three years. The most recent rates are based on readmissions spanning July 2008 through the end of June 2011. The Medicare data published Thursday on its Hospital Compare website showed that 19.7 percent of heart attack patients were readmitted within 30 days of discharge, a drop of only 0.1 percentage point from the previous year’s figures, which were based on the years 2007 through 2010. The data show that 24.7 percent of heart failure patients were readmitted, also a 0.1 point decrease. Pneumonia readmissions actually increased by 0.1 percentage points, to 18.5 percent of all Medicare pneumonia patients.
Source: kaiserhealthnews.org

Growth of national health expenditures, 2011

In 2011 US health care spending grew 3.9 percent to reach $2.7 trillion, marking the third consecutive year of relatively slow growth. Growth in national health spending closely tracked growth in nominal gross domestic product (GDP) in 2010 and 2011, and health spending as a share of GDP remained stable from 2009 through 2011, at 17.9 percent. Even as growth in spending at the national level has remained stable, personal health care spending growth accelerated in 2011 (from 3.7 percent to 4.1 percent), in part because of faster growth in spending for prescription drugs and physician and clinical services. There were also divergent trends in spending growth in 2011 depending on the payment source: Medicaid spending growth slowed, while growth in Medicare, private health insurance, and out-of-pocket spending accelerated. Overall, there was relatively slow growth in incomes, jobs, and GDP in 2011, which raises questions about whether US health care spending will rebound over the next few years as it typically has after past economic downturns.
Source: pnhp.org

Medicare Reimbursement For Skilled Nursing Facilities Remains High For 2012 Despite Reductions In Overpayments  

The GAO reported as early as 2002 that SNFs had shifted their assessment practices to assign residents to the rehabilitation RUG-III categories that gave them the most favorable reimbursement rates, often without actually providing residents with the number of minutes of therapy they required in order to be placed in those categories.[29]  In addition, the GAO reported that two years after the prospective payment system was implemented, "The patients categorized into the two most common (high and medium) rehabilitation payment group categories typically received 30 minutes less therapy during their first week of care, a 22 percent decline."  Id. 3.  While reimbursement to SNFs increased, rehabilitation services for residents actually decreased.
Source: medicareadvocacy.org

10 Statistics on Average Percent of Medicare Rates for Best Payors

1. 9 percent reported their best payor reimbursed less than Medicare. 2. 8 percent reported their best payor reimbursed 100 percent of Medicare. 3. 8 percent reported their best payor reimbursed 100 percent to 105 percent of Medicare. 4. 10 percent reported their best payor reimbursed 106 percent to 110 percent of Medicare. 5. 20 percent reported their best payor reimbursed more than 110 percent of Medicare. 6. 38 percent of anesthesiologists reported their best payor reimbursed more than 110 percent of Medicare. 7. 38 percent of orthopedists reported their best payor reimbursed more than 110 percent of Medicare. 8. 36 percent of plastic surgeons reported their best payor reimbursed more than 110 percent of Medicare. 9. 33 percent of gastroenterologists reported their best payor reimbursed more than 110 percent of Medicare. 10. 32 percent of general surgeons reported their best payor reimbursed more than 110 percent of Medicare. More Articles on Payors: 18 Statistics on Best Regional Payors 11 Statistics on Most Payor Coverage Denials 8 Ways ASCs Can Prepare for ICD-10
Source: beckersspine.com

2013 Medicare pay hike for ODs back on track under Washington’s last

While the immediate Medicare pay crisis has been averted for now, the one-year SGR fix and the two-month sequester delay signal the start of a new effort to prevent future Medicare pay cuts and finally fix Medicare’s broken SGR payment formula. A growing concern, the two-month delay in sequester cuts directly aligns with the date on which the nation is expected to reach its borrowing limit, providing yet another opportunity to potentially target Medicare payments to doctors of optometry.
Source: newsfromaoa.org

Medicare Is More Efficient Than Private Insurance

The CBO explicitly stated that its data on relative cost growth should not be used to make the argument that Goodman and Saving make, writing that the relatively low growth rate of all health care expenditures other than Medicare and Medicaid “should not be interpreted as meaning that Medicare or Medicaid is less able to control spending than private insurers.” Goodman and Saving mistakenly suggest that the growth rate of private insurance is the same as the growth rate of all health care expenditures other than Medicare and Medicaid; however, as CBO points out, the growth rate of all health care expenditures other than Medicare and Medicaid includes not just spending by private insurers, but also government programs and out-of-pocket costs paid by the uninsured.
Source: healthaffairs.org

Prime Hospital Abruptly Stops Billing Medicare for Rare Ailment

About six months after it took control of the Shasta Regional Medical Center in Redding in late 2008, Prime began billing Medicare for treating senior citizens it diagnosed with kwashiorkor, a dangerous nutritional disorder usually seen among children during famines in developing countries. At its height, the hospital’s billing for the malady surged to nearly 70 times the state average.
Source: kqed.org