Summit Medigap: What Is Medicare Supplement Plan F?

Posted by:  :  Category: Medicare

The basic and original coverages provided by Medicare are Part A (hospitalization) and Part B (doctor visits and required medical equipment). Currently, there are at least 11 supplement plans referred to as Medigap policies that fill any coverage gaps involved with Parts A and B. One of these is Plan F. It’s important to know that not every company offers all 11 supplement plans. However, if they do offer at least 2 of them, they are required to offer Plans C and F. Plan F premiums typically cost between $65 and $295 per month. The premium will vary depending on the insurance carrier and the state you live in. Coverage Provided By Plan F The coverage required of Medigap coverage plans is mandated and regulated by the Centers for Medicaid and Medicare. Plan F also has a “high deductible” plan because it will not pay for any type of services covered by Medicare until the plan beneficiary has paid an out-of-pocket minimum of $2,000. Once that deductible has been met, Plan F will cover 100% of the co-insurances, co-pays, and deductibles of Parts A and B including hospice care co-insurance as well as preventative services. If you get the regular Plan F you will have no deductibles or coinsurance. When speaking to an insurance professional it’s important to make sure which Plan F you are being quoted. Comparisons There are only two supplements that covers any deductible expense of Part B, one of which is Medicare supplement Plan F. Additionally, this is the only supplementary plan that covers excess Part B charges. These charges typically accrue if doctors can legally charge more than what Medicare considers as reasonable service charges. Other supplement plans will usually pay for expenses that Medicare classifies as allowable. Finally, the excess amount that is allowable according to Medicare is covered by F. Is Plan F Right For You? Medicare supplement Plan F is viewed as one of the most popular plans because it covers 100% of the gaps encountered with Plans A and B meaning that it provides the highest amount of coverage of any of the Medigap insurance plans. For many individuals, the plan may seem a bit confusing initially. However, if you answer a few questions, it will not only explain the plan more thoroughly, you will be able to decide whether or not it is right for you. Basically, if you are someone who is willing to pay for 100% coverage, then this plan is tailored to meet your personal needs. With Medicare supplement Plan F, your only expenses will be your monthly premiums. For more information regarding this supplement plan, you can visit the official Medicare website or speak to a licensed insurance professional.
Source: blogspot.com

Video: Medicare Supplemental Insurance Comparison

Medigap: Sacramento, Placer Medicare Supplement Rates

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

Medicare Supplement Plans Medicare Supplements Comparisons

Effective January 1, 2013: Individuals who own a Medicare supplement policy in the State of Oregon may change Medicare supplement plans once per year for a period of 60 days beginning 30 days before and ending 30 days after the individual’s birthday. The new policy must be guaranteed issue which means there are no health questions. This will allow traditionally uninsurable applicants to obtain the exact same coverage elsewhere for less premium.
Source: searchmyquote.com

San Francisco Medicare Supplement Plans and Rates

Finding the right Medicare Rx plans is another research project for you.  Every year during the annual open enrollment period from October 15th through December 7th, all Medicare Part D Rx members can and should compare their current Drug plan to what is going to be available the following year.  All plans change a little each year.   Deductibles may change, drugs may be taken off of the formulary list, premiums can go up or down.  But, the biggest factor is how the plan pays for your medication list.  For help deciding which plan works best for your med list, feel free to call anytime.
Source: wordpress.com

Compare Medicare Supplement Insurance Plans

This is the basic plan. Its coverage includes: Medicare Part A coinsurance, Medigap coverage for hospital benefits, Medicare B coinsurance, Medicare B copayments, first three pints of blood, Part A hospice care coinsurance or copayments, and Medicare preventive care Part B insurance. By law, all Medicare Supplement insurance carries must offer this plan.
Source: ihealthcoalition.org

Business Owners Learn the Hard Way about High Income Penalties with Medicare

PRLog (Press Release) – Jan. 24, 2013 – Most business owners try to cut expenses so that their organizations can increase the bottom line and efficiency.   Manager meetings and board meetings will soley exist at times just to figure out ways to cut costs.  Several years ago there was a method dealing with health insurance that helped businesses save money; however, due to Medicare changes this option could end up costing you more if you are not careful.   We are talking about business owners 65+ leaving the group health plan.  Having a sixty-five year old off the group health plan and having their coverage provided by Medicare and a Medicare Supplement (which equals better coverage) should mean everyone walks away happy.  This was the case several years ago, but now it takes a little more evaluation to see if it is best for all parties involved.   Medicare has implemented a high income penalty, that changed the way business owners should analyze their health insurance once they become eligible for Medicare.  This penalty starts with incomes as low as $85,000 for individuals and $170,000 for couples.  The cost of this penalty or tax whichever you would like to call it, starts at roughly $50 and goes up to roughly $285 per month/per individual. So let’s take a basic example of a husband and wife both 65.  They own a business and are in the highest income tax bracket. • Group Health Insurance – $700 per month for the couple (Medical and Drug) • Medicare Part A – Free, • Medicare Part B – $335.70 per month individually (includes high income penalty) • Medicare Part D – $100 per month individually (includes high income penalty) • Medicare Supplement – $100 per month (rates available at www.medicareinsurancefinders.com) Total Monthly Cost of Medicare Option Per Person = $565.70 COUPLE COST COMPARISON – MEDICARE vs. GROUP HEALTH Group Health – $700   vs. Medicare Option – $1,131.40 Business owners should consider their options carefully before making any decisions to get on Medicare.  Realize that their are enrollment periods with Medicare and they can be very strict.  Medicare Insurance Finders and MWG Senior Services have advisors that can help analyze your Medicare options.
Source: prlog.org

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

Between 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

FTD/Dementia Support Blog: FTD and Medicare

Posted by:  :  Category: Medicare

Now that I was off the 17 pills a day after being misdiagnosed for six years my head was slowly clearing from being kept in a medically induced fog. It took me close to a year to recover to my FTD self. My behavior, language and 6 year history was like a checklist for a poster boy FTD patient.  I was having many new difficulties which was discovered by my friend David and Dr. Blatt to have been side effects of the only drug I was on, Aricept. Dr. Blatt had contacted Dr. Ted Huey, a well known FTD specialist at Columbia. Dr. Huey confirmed that many FTD patients were having difficulty with Aricept, a drug made for Alzheimer’s patients. Aricept is now on the “medications to avoid” list by UCSF. Dr. Blatt suggested that I start seeing Dr. Huey or one of the FTD specialists at Columbia. The only problem was my insurance didn’t cover Columbia or any of the doctors in it.
Source: blogspot.com

Video: Fidelis Care Training and Opportunity!

Medtronic Settles Sprint Fidelis Family of Defibrillation Leads Lawsuits

Under the terms of the agreement, Medtronic has agreed, subject to certain conditions, to settle U.S. lawsuits and claims pending as of October 15, 2010 for a total payment of $268 million.  The payment includes an amount for attorneys’ fees and administrative expenses.  The parties will file joint requests to terminate the Multi-District Litigation (MDL) and Minnesota state court proceedings related to the Sprint Fidelis leads and to dismiss the plaintiffs’ appeals pending before the U.S. Court of Appeals for the Eighth Circuit and the Minnesota Court of Appeals. The parties will also request dismissal of other Fidelis-related cases throughout the country. Medtronic can cancel the agreement if certain conditions are not met, and the agreement can be terminated by either party if the MDL proceedings are not terminated.
Source: gustafsongluek.com

Fidelis adds urological surgeons to network

Fidelis Care, the New York State Catholic Health Plan, has added Capital Region Urological Surgeons PLLC to its provider network.   Capital Region Urological Surgeons, with 13 physicians and 2 nurse practitioners, has been providing urologic care in the Capital Region for nearly 30 years. The group’s specialties include urologic oncology, prostate disorders, kidney stone therapy, infertility, urinary incontinence and female urology. Offices are located in Albany and Saratoga Springs.
Source: timesunion.com

What is your stance on the Patient Protection and Affordable Care Act?

One week after the Supreme Court’s 5-4 ruling, one public opinion poll reported that 54% of American voters wanted the law repealed. MDLinx surveyed U.S. primary care physicians after the court ruling and found 64% of the physicians do not believe the Affordable Care Act will be able to achieve 100% effectiveness of health care coverage for Americans. The MDLinx survey revealed that 45.7% of primary care physicians are skeptical of the decision, whereas only 22% think the act will result in an extremely positive impact for their practices. However, KevinMD’s physician blogger Kevin Pho, M.D., stated that the court decision is one everyone should be happy with. Physicians can expect lower Medicare and Medicaid reimbursements. KevinMD also states the benefits of for patients, not only uninsured but also those most vulnerable in the U.S. He suggests that the benefits will be tangible for more than just progressive Americans.
Source: fidelismp.com

Enable Your Cookies to Continue

It varies by browser, but you can usually change your cookie settings by going to the browser “Options” or “Settings” menu and finding the “Privacy” settings. Or, just search your browser’s “Help” menu for “enable cookies”.
Source: usaa.com

Medtronic Sprint Fidelis: Four Have Died During Extractions

Two years after Medtronic stopped selling the vilified Sprint Fidelis lead, there is a growing concern as to its continued viability—and while Medtronic and the medical community in general recommend not replacing working leads unless they fail, some doctors are doing just that. The problem lay with the tricky surgery necessary to extract a lead, a procedure that is fraught with risk. A heart lead will often be overgrown, or entwined with tissue. Thus, removing a heart lead—regardless of whether it is a working lead, or one that has proved to fail—is an exact and dangerous procedure that can’t be done by just anybody. In other words, the successful removal of a heart lead will be accomplished by a surgeon with a great deal of experience doing just that. Sometimes, surgeons with those qualifications are hard to come by. Medtronic had a hit on its hands when the Sprint Fidelis lead was first introduced onto the market in 2004. Thinner than its competitors, surgeons found it easier to thread to the heart and it wasn’t long before a quarter of a million people around the world were walking around with Sprint Fidelis leads. In the US, that figure is around 150,000. But then came the failures. The Sprint Fidelis lead was found to be prone to cracking, which affects the communication pathway to the heart. In the case of a defibrillator, this breach has resulted in a failing heart not getting the proper electronic prompting it needs to get it going again. Worse, there have been cases where such a breach in the wire has resulted in the defibrillator getting an incorrect signal, and thinking that the heart was failing, delivered a life-sustaining electrical pulse to what was in reality a properly-functioning heart. Some patients have died. Others have had their health compromised after a pacemaker, connected to a Sprint Fidelis lead, was incapable of helping the heart maintain a correct rhythm. Medtronic has said that the failure rate is about 5 percent, 45 months into the life of a lead. And even though many patients are finding that their leads are, indeed functioning properly, many patients who cannot live with the prospect of the lead potentially failing are opting to have them replaced proactively. “I think we are just seeing the tip of the iceberg,” said Dr. Charles J. Love, a cardiologist at Ohio State University Medical Center in Columbus, who specializes in cable extractions, in comments published in the New York Times. However, as more and more patients opt for the risky procedure, the death toll may rise given the inherent risk to the heart and / or arteries when an extraction is attempted. Already, four patients have died during extraction procedures, and industry watchers fear that those numbers will rise as more patients seek extractions from a medical community that has limited expertise in the risky extraction process. The risk is such that many surgeons, when replacing a heart lead, will often leave the old lead in place—threading the new lead alongside. There are diverging opinions and positions as to what to do when a pacemaker, or defibrillator itself needs to be updated once the batteries wear out, usually after five years. Some surgeons will reconnect to the existing Sprint Fidelis lead if it is still functioning. Others, including Dr. Love in Ohio State, are routinely replacing the Sprint Fidelis leads when pacemakers or defibrillators are in need of updating in younger, more active patients. Typically, those patients are age 60 years of age or lower. The reason? Greater physical activity places more stress on a cable, which raises the likelihood of fracture. Critics of the Sprint Fidelis lead cite that very fact as to why, in part, the lead should never have been approved in the first place. As the baby boomers age, the country is seeing a more active senior. Using a thinner lead in concert with an active individual—heart problems aside—just doesn’t seem to make a lot of sense.
Source: lawyersandsettlements.com

Occupational Medicine Job in Occupational Medicine position in Metro LA, CA, California with CompHealth Inc :: Physicians Employment

CompHealth offers thousands of physician jobs nationwide–permanent placement and locum tenens. Make the career choice that is right for you with no cost, no risk and no obligation. Call 800.782.9029 Fax 800.328.3091 or visit www.comphealth.com
Source: physemp.com

Manhattan’s Family Health & Wellness Guide (NY Metro Parents Magazine)

Chelsea Piers is a 28-acre sports village located on three historic Hudson River piers, offering Manhattan’s best sports programming for children ages 12 mos. to 17 years. Children enjoy state-of-the-art facilities, including a gymnastics center, rock-climbing wall, indoor soccer fields, basketball courts, batting cages, two indoor ice rinks, high-tech golf driving range, 40-lane bowling center, and Little Athlete Exploration Center. For gymnastics, basketball, soccer, baseball, rock climbing, and other sports programs, call 212-336-6500. For ice skating or hockey programs, call 212-336-6100. For junior golf programs, call 212-336-6400. For bowling, call 212-835-BOWL (2695).
Source: nymetroparents.com

9 Recent Medicare, Medicaid Issues

Posted by:  :  Category: Medicare

No doctor shopping here, buddy by Newtown grafittiHere are nine issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent. 1. Protecting Medicare and implementing online health insurance marketplaces were among Americans’ top priorities in a recent poll conducted by the Kaiser Family Foundation, Robert Woods Johnson Foundation and Harvard School of Public Health. 2. Medicare Recovery Auditors, also known as recovery audit contractors, set a new record for most overpayments collected in a quarter, as they recouped $744.8 million from hospitals and other providers in the first quarter of the federal government’s 2013 fiscal year. 3. A bill temporarily halting the nation’s $16.4 billion debt ceiling through mid-May passed the House 285-144, but automatic cuts to Medicare and other programs are still scheduled to take effect March 1. 4. Maryland found it may lose more than $1 billion in Medicare payments by losing its eligibility for a waiver that grants it full reimbursement from CMS, rather than the discounted rates all 49 other states receive unless the state can suppress its healthcare cost growth. 5. A Kaiser Family Foundation report showed many states have increased Medicaid access and eligibility over the past year, though a few have added restrictions to eligibility. 6. The U.S. Supreme Court issued a unanimous opinion that reversed and remanded a circuit court ruling that hospitals could appeal decisions by the Provider Reimbursement Review Board that are up to 25 years old. A group of 18 hospitals challenged their Medicare disproportionate share adjustments for 1987 through 1994. 7. A study found the number of all-cause 30-day rehospitalizations and all-cause hospitalizations decreased more in communities where quality improvement initiatives were led by Medicare Quality Improvement Organizations than in communities without these initiatives. 8. Hospital executives are on board with Arizona Gov. Jan Brewer’s plan to impose a provider fee to expand the state’s Medicaid program. 9. President Barack Obama gave airtime to the need to reform healthcare entitlements in his second inaugural address Monday, but he defended their existence and pushed back on calls to make drastic cuts to the Medicare and Medicaid programs.
Source: beckershospitalreview.com

Video: Heartland Could be Removed from Medicare list of Providers Saturday

National Provider Call on FY 2014 Medicare DSH Changes

On January 8, 2013, CMS hosted a National Provider Call to discuss the changes to Medicare disproportionate share hospital (DSH) payments under section 3133 of the Affordable Care Act.  Beginning in FY 2014, Medicare DSH payments will be cut to 25% of the amount expected to have been paid under the preexisting methodology.  The remaining 75% will be reduced by a factor based on the percent change since 2013 in the under-65 uninsured population.  What money remains will form the available “pool” for an additional payment to be redistributed according to each hospital’s proportion of the estimated, aggregate amount of uncompensated care.  Thus, the two main unknowns driving the reduction and redistribution of Medicare DSH payments are how CMS will measure (1) the change in the uninsured population; and (2) each hospital’s share of uncompensated care.  During the call, a number of issues were raised by listeners with respect to each of these factors.  Providers will have to wait for the FY 2014 Hospital IPPS Proposed Rule for answers.  Stakeholders are invited to submit formal comments on the implementation of section 3133 via email to Section3133DSH@cms.hhs.gov by January 15th for consideration in the Proposed Rule.
Source: jdsupra.com

Health Care Authority Prepares Website to Answer Medicaid Providers’ Questions About Rate Increases

FOR MORE INFORMATION ON HEALTH CARE REFORM OR BACKGROUND: The Medicaid Expansion 2014 website: www.hca.wa.gov/hcr/me The Health Benefits Exchange website: www.hca.wa.gov/hcr/exchange The Provider Rates Change website: www.hca.wa.gov/acarates Provider questions about the rate increase can be emailed to prvrates@hca.wa.gov Jim Stevenson, Communications, HCA 360-725-1915 jim.stevenson@hca.wa.gov
Source: wa.gov

More Doctors, Hospitals Partner to Coordinate Care for People with Medicare: Providers Form 106 New Accountable Care Organizations

The group announced today also includes 15 Advance Payment Model ACOs, physician-based or rural providers who would benefit from greater access to capital to invest in staff, electronic health record systems, or other infrastructure required to improve care coordination. Medicare will recoup advance payments over time through future shared savings. In addition to these ACOs, last year CMS launched the Pioneer ACO program for large provider groups able to take greater financial responsibility for the costs and care of their patients over time. In total, Medicare’s ACO partners will serve more than 4 million beneficiaries nationwide.
Source: shoreupdate.com

California HIE grants target rural providers, analytics tools

CHeQ is also seeing to allocate $300,000 for up to two Innovation in Data Analytics awards that will provide funding to health information organizations and providers to implement data analytics tools to better manage shared patient populations served by three or more unaffiliated health care provider organizations or systems. These electronic tools should support health maintenance and disease prevention services and chronic disease management, and they should align with emerging care delivery and value-based payment models such as Patient-Centered Medical Homes and Accountable Care Organizations. CHeQ is especially interested in projects that focus on high-impact conditions and/or medically underserved populations.
Source: healthcare-informatics.com

ODs have one month to earn dual bonuses under new Medicare EHR

Health care practitioners who qualified for bonuses through the Medicare Electronic Health Records (EHR) Incentive program during 2012 may also qualify for 2012 payment bonuses under the Physician Quality Reporting System (PQRS), if they enroll in the new Medicare PQRS-EHR Incentive Pilot Program by Feb. 28, 2013, according to the U.S. Centers for Medicare & Medicaid Services (CMS).
Source: newsfromaoa.org

Congressional Accord Preserves Medicare Doctor Pay

Politico Pro: Health Care Cuts Send Ripple Through The Industry The potential fiscal cliff deal … squeezes health savings from a variety of places. But spreading the pain around didn’t prevent complaints from rippling through the industry and Congress. Hospitals are protesting the loudest, since about half of the agreement’s $30 billion in health care cuts would fall on their backs — and most of that $30 billion would go to preventing doctor Medicare pay cuts from kicking in under SGR this month. But insurers and pharmacies are irked as well, since some of the savings would come from trimming payments to Medicare Advantage plans and reimbursements for diabetes tests (Cunningham, 1/1).
Source: kaiserhealthnews.org

RAC Alert: How to Bill Medicare for Hospice Patients When You Are Not the Hospice Provider of File

When hospice coverage is elected, the beneficiary waives all rights to Medicare Part B payments for services that are related to the treatment and management of his/her terminal illness during any period his/her hospice benefit election is in force, except for professional services of an attending physician, which may include a nurse practitioner. If the attending physician, who may be a nurse practitioner, is an employee of the designated hospice, he or she may
Source: managemypractice.com

CMS angling to ease providers’ burdens from Medicare Administrative Contractors

CMS has called for provider contact information so the agency can survey a random sample of long-term care operators. This will help the agency determine just how satisfied providers are with the recently instituted Medicare Administrative Contractors (MACs). The Social Security Act names provider satisfaction as a MAC performance standard.
Source: mcknights.com

campusCATALYST now accepting applications for Spring Program

Posted by:  :  Category: Medicare

What's In My Bag... by Amy DiannacampusCATALYST engages top college undergraduates from all academic majors, backgrounds, and career aspirations. Participant selection is highly competitive with rigorous application requirements and complimentary academic coursework to promote high-performing and knowledgeable teams. campusCATALYST selects members who exemplify leadership, teamwork, and dedication to strengthening our communities.
Source: campuscatalyst.org

Video: Los Angeles: Medicare Fraud Summit Beneficiary/Consumer Panel

Uwe E. Reinhardt: Comparing the Quality of Care in Medicare Options

Both traditional Medicare and Medicare Advantage plans are monitored annually through surveys of patients, using the Consumer Assessment of Health Care Providers and Systems, known in the trade as Cahps. The findings from this survey make it possible to compare traditional Medicare with Medicare Advantage plans on quality. As Medpac reports in Table 12-8 of Chapter 12 of the March 2012 report, the commission found little difference in the relatively few quality-performance scores of the traditional Medicare and Medicare Advantage plans.
Source: nytimes.com

Why Grandma Owes More on Her Credit Cards Than You Do

The reality is, credit card debt for nearly all age groups declined between 2008, when we did our last study on credit debt, and 2012. That’s because the financial crisis and housing crash caused lenders of all kinds to offer less credit; $211.1 billion in credit card debt was written off as uncollectable; and households hit by the recession made renewed efforts to live frugally and pay down their bills. But we found that credit card debt levels among older Americans declined less than they did for young people. In fact, Americans age 75 and older are the only group in our survey for which credit card debt actually increased over this time period. Why?
Source: policyshop.net

Medicare: Definition from Answers.com

Program enacted in 1965 under Title XVIII of the Social Security Amendments of 1965 to provide medical benefits to those 65 and older. The program has four parts in 2007: 1. Part A, Hospital Insurance, contributes to the payment of inpatient hospital, skilled nursing expenses, hospice, and other ancillary expenses. The deductible is $992 for 60 or less days in a benefit period. For days 61–90, the deductible is $248 per day, and for more than 90 days, the deductible is $496 per day up to the lifetime maximum days. No premium is paid if the beneficiary has at least 40 quarters of Medicare covered employment. 2. Part B, Medical Insurance, provides coverage for medical services that Part Adoes not cover for a premium and subject to a deductible ($93.50 per month standard premium and a deductible of $131 per benefit payment in 2007). Coverage includes ambulance services, ambulatory surgery center, blood, bone mass measurement, cardiovascular screenings, limited chiropractic services, clinical laboratory services, clinical trials, colorectal cancer screenings, diabetes screenings, diabetic supplies, doctor services, durable medical equipment, emergency room services, limited eyeglasses, flu shots, foot exams and treatment, glaucoma tests, hearing and balance exam, Hepatitis B shots, home health services, kidney dialysis services and supplies, mammograms, medical nutrition therapy services, outpatient mental health care, occupational therapy, outpatient hospital services, outpatient medical and surgical services and supplies, pap test and pelvic exam, one-time physical exam within the first six months, physical therapy, pneumococcal shot, practitioner services, limited prescriptions (injectable drugs), prostate cancer screenings, prosthetic/orthotic items, second surgical opinions, smoking cessation, speech-language pathology services, surgical dressings, telemedicine, tests (X-rays, MRIs, CT scans, EKGs, and other diagnostic tests), transplant services, and urgently needed care (nonmedical emergency illness or injury). The initial enrollment period for Medicare Part B begins three months before age 65 and continues for the next seven months. If enrollment is not effected in this time period, there is a waiting time until the general enrollment period from January 1 through March 31 every year. Coverage then begins the following July 1. 3. Part C, Medicare Advantage, provides for individuals with Part A and Part B coverage to receive all of their health care coverage through a single health care provider. See also medicare plus choice (medicare part c). 4. Part D, Prescription Drug Insurance, contributes to the payment of medication/prescription expenses as prescribed by a physician. Coverage added for drugs by joining a Medicare Prescription Drug Plan through private insurance companies. A separate monthly premium (varies by plan) is required. Each plan must cover at least two drugs in all of the classes of drugs that are the most commonly prescribed. For those people covered under Medicare A, coinsurance or copayment is required and a yearly deductible may be in force. Retired workers qualified to receive Social Security benefits, and their dependents, also qualify for the hospital insurance portion. The program is paid for by payroll taxes on employees and covered workers. Parts B, C, and D insurance provides additional coverage on a voluntary basis for physician services. The Prescription Drug Plans are optional and can be added by paying an additional premium. Those enrolled in the program pay a monthly premium. Coverage is also available to persons younger than 65 who are disabled and have received Social Security disability benefits for 24 consecutive months.
Source: answers.com

Smart card plan proposed to combat Medicare fraud

Introduced by Senators Mark Kirk (R-Ill.) and Ron Wyden (D-Ore.) and Representatives Jim Gerlach (R-Pa.) and Earl Blumenauer (D-Ore.), the legislation would require the issuance to all Medicare beneficiaries of an upgraded, secure identity card–stripped of its current Social Security number identifier–that is similar to the Department of Defense’s Common Access card. This “smart card” would have a computer chip embedded in it with identifying information about the patient and the patient’s provider.
Source: fiercehealthit.com

How To Learn More About Medicare

The reason I say this is because the internet is a great place to learn just about anything. In order to be an educated insurance owner, you need to learn about Medicare as soon as humanly possible. Am I saying that you need to know everything, everything about Medicare, no, but you should know as much as you can about the Medicare policy that you own. Another thing that you can do to learn more about Medicare is to call the number on the back of your Medicare card. A lot of people don’t understand what this phone number is really for and that is actually why Medicare put the number on the card. For example, lets say you need to go to see a medical specialist but don’t know if your Medicare policy covers it. All you have to do is quickly call the number on the back of the Medicare card and you will be able to figure out that answer in no time at all. When learning about Medicare it would be a good idea to write down everything that you learn so that you don’t have to come back and try to figure all of this stuff out again. The problem with not knowing much about the Medicare policy that you have is that you might not utilize it on something that you really should have. For example, if you had a Medicare part b policy you would be covered if you had to purchase a Wheelchair or something similar to that. I understand that you might not want to take notes on what you just learned but it would be highly beneficial to you now and in the long run.
Source: sensitivehealth.com

Aging News Alert: Enrollment in Medicare Advantage Plans Affected by ‘Star Ratings’

Posted by:  :  Category: Medicare

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

Video: Medicare Advantage Enrollment 2012

Higher quality rating for Medicare Advantage plan linked with increased likelihood of enrollment

“To inform enrollment decisions and spur improvement in the Medicare Advantage marketplace, the U.S. Centers for Medicare & Medicaid Services (CMS) provides star ratings reflecting Medicare Advantage plan quality. A combined Part C and D overall rating was created in 2011 for Medicare Advantage and prescription drug (MAPD) plans,” according to background information in the article. The star ratings incorporate data from several sources. “In 2011, MAPD star ratings ranged from 2.5 to 5 stars. Only 3 MAPD contracts received 5 stars; some were unrated because they were too new or small,” the authors write. “While star ratings clearly matter to insurers, it is unclear whether they matter to beneficiaries.”
Source: sciencecodex.com

Medicare Part C, Medicare Advantage Plans, What Does It Cover, Who Is Eligible

Before you enroll in a Medicare Part C plan you will have to enroll in Medicare Parts A and B. Generally, individuals are automatically enrolled in both if they are already receiving Social Security. Otherwise you will need to contact your local Social Security office to enroll. Once you are enrolled in Parts A and B you can select a Medicare Advantage Plan. For most people, this can all be done at the same time, when they turn 65 years of age. There is a seven month window to enroll which starts three months before your birthday month and ends three months after.
Source: bradeninsurance.com

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

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

HHS: Medicare Advantage enrollment is up, premiums down

Medicare Advantage plans cover skilled nursing facility stays following acute episodes and other post-acute care. MA also includes special needs plans for chronically ill and disabled individuals such as dual eligibles. Republicans raised concerns over an MA demonstration project in June that gave quality bonuses to plans with more stars.
Source: mcknights.com

Medicare Advantage enrollment projected to grow 11 percent in 2013

Health and Human Services Secretary Kathleen Sebelius said the latest data shows that the reform law’s curbs on premium rate increases and other regulations on private insurers has made Medicare Advantage more accessible to the nearly 50 million senior citizens and disabled Americans who are Medicare beneficiaries.
Source: medcitynews.com

ICYMI: New York Times Economix Blog Highlights Higher Quality Care Medicare Advantage Plans Provide

3rd Party Studies ACOs Admin Costs affordability Age Rating Cadillac Tax cbo Cost-Shift Employers Essential Benefits Exchanges GRP Health Insurance Tax Health Plan Innovations Health Plan Satisfaction House hearings House legislation HSAs KI MA McCarran-Ferguson Medical Prices Medical Tests medicare medigap MedMal MLR Morning Headlines MT Patient Safety premiums Profits Provider Consolidation PWC Quality Rate Review Readmissions Reform RZ Senate hearings Senate legislation Small Business The Link Vilification Waste Fraud and Abuse
Source: ahipcoverage.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

Between 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

Resource Center for Religious Institutes: Medicare Open Enrollment Period Closes Tomorrow!

Note that you can join a health or drug plan under Medicare when you first get Medicare (initial enrollment periods for Part C & D), such as when you turn age 65. Each year, you have a chance to make changes to your Medicare Advantage or Medicare prescription drug coverage for the following year. There are 2 separate enrollment periods each year. According to the Medicare website:
Source: blogspot.com

Medicare Open Enrollment: More is better

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

Medicare Advantage Open Enrollment Ends December 7

The annual open enrollment opportunity to enroll or to change Medicare Advantage HMO plans for the 2013 plan year ends on December 7, 2012. CMS, Medicare administrator, has provided the mailing address of all Medicare participants to the various Medicare Advantage insurance companies to flood our mailboxes with advertisements for their various plans. Should you decide to change plans, make certain that your current doctors are covered by the new plan and that any maintenance drugs you are currently taking are covered by that plan. Remember that you are only making a commitment for the 2013 calendar year, as open enrollment for the following year usually occurs from October 15 to December 7 of each year.
Source: calrta.org

Reader Response: Medicare Options and Quality of Care

Medicare beneficiaries self-select into traditional Medicare or Medicare Advantage plans. They may differ systematically in characteristics that could indirectly affect readmission rates. Age and health status are two characteristics that can usually be measured and might be included in the available data set; but there may be others not included. Researchers try as best they can to make statistical adjustments for differences in the characteristics among self-selecting beneficiaries, as the authors of all of the studies cited in my previous post did. But the adequacy of these adjustments depends on the available data. Typically researchers acknowledge such limitation of their studies forthrightly in their reports.
Source: nytimes.com

Are You Set for the New Year With Medicare Enrollment Over

You can switch to a Medicare Advantage plan or prescription drug plan with a higher quality rating. Whether you have traditional Medicare or Medicare Advantage, you can switch to a Medicare Advantage plan that has a five-star quality rating if one of these plans is available in your area. If you have a prescription drug plan, you can switch to one with a five-star rating. You can make the switch at any time during 2013, but you can only do it once.
Source: allsup.com

What is the Difference Between the PDAC and the DME MACs?

Posted by:  :  Category: Medicare

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Source: safestepblog.net

Video: Guess That Code Episode 2

OIG Calls for Cuts in Medicare Rates for Back Orthoses : Health Industry Washington Watch

The OIG is calling on CMS to lower Medicare payment for certain back orthosis products, either by subjecting these products to the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program or by making an inherent reasonableness adjustment. This recommendation stems from the OIG’s findings that Medicare payment amounts far exceeded supplier acquisition costs for lumbar-sacral orthoses billed under L0631. Specifically, between July 2010 and June 2011, the average Medicare-allowed amount for L0631 was $919, compared to the average supplier acquisition cost of $191, resulting in Medicare paying an estimated $37 million more than supplier costs. Moreover, while the code descriptor for L0631 references fitting and adjustment services, the OIG found that for 33% of claims the supplier did not report providing such services, and only 7% of suppliers reported providing any additional services other than general instructions. CMS agreed that Medicare payments for back orthoses billed under HCPCS code L0631 “should be adjusted to more closely reflect the supplier’s acquisition costs for the device and the level of service provided when furnishing the device.” CMS indicated that it would be pursing competitive bidding rather than an inherent reasonableness adjustment, noting that it is working to finalize its classification of HCPCS codes that may be considered to be “off-the-shelf” orthotics and subject to DMEPOS competitive bidding (the preliminary classification list included HCPCS code L0631). 
Source: healthindustrywashingtonwatch.com

Medicaid & Medicare 2019: Healthcare Common Procedure Coding System (HCPCS) Level II Coding Procedures

Each year, in the United States, health care insurers process over 5 billion claims for payment. For Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner, standardized coding systems are essential. The HCPCS Level II Code Set is one of the standard code sets used for this purpose. The HCPCS is divided into two principal subsystems, referred to as level I and level II of the HCPCS. Level I of the HCPCS is comprised of CPT (Current Procedural Terminology), a numeric coding system maintained by the American Medical Association (AMA). The CPT is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. These health care professionals use the CPT to identify services and procedures for which they bill public or private health insurance programs. Decisions regarding the addition, deletion, or revision of CPT codes are made by the AMA. The CPT codes are republished and updated annually by the AMA. Level I of the HCPCS, the CPT codes, does not include codes needed to separately report medical items or services that are regularly billed by suppliers other than physicians. Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician’s office. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the level II HCPCS codes were established for submitting claims for these items. The development and use of level II of the HCPCS began in the 1980’s. Level II codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits, while CPT codes are identified using 5 numeric digits.
Source: blogspot.com

Medicare: 2013′s New PCI Codes Prompt a Key CCI Policy Manual Change

stdClass Object ( [term_id] => 207 [name] => Hot Coding Topics [slug] => hot-coding-topics [term_group] => 0 [term_order] => 0 [term_taxonomy_id] => 207 [taxonomy] => category [description] => The latest news [parent] => 0 [count] => 835 [cat_ID] => 207 [category_count] => 835 [category_description] => The latest news [cat_name] => Hot Coding Topics [category_nicename] => hot-coding-topics [category_parent] => 0 ) [1] => stdClass Object ( [term_id] => 312 [name] => ICD-10 [slug] => icd-10 [term_group] => 0 [term_order] => 0 [term_taxonomy_id] => 4475 [taxonomy] => category [description] => All About ICD-10 [parent] => 0 [count] => 38 [cat_ID] => 312 [category_count] => 38 [category_description] => All About ICD-10 [cat_name] => ICD-10 [category_nicename] => icd-10 [category_parent] => 0 ) [3] => stdClass Object ( [term_id] => 349 [name] => Provider News [slug] => provider-news [term_group] => 0 [term_order] => 2 [term_taxonomy_id] => 104 [taxonomy] => category [description] => Insurers, CMS, etc [parent] => 0 [count] => 276 [cat_ID] => 349 [category_count] => 276 [category_description] => Insurers, CMS, etc [cat_name] => Provider News [category_nicename] => provider-news [category_parent] => 0 ) [4] => stdClass Object ( [term_id] => 102 [name] => Coding Challenge [slug] => coding-challenge [term_group] => 0 [term_order] => 3 [term_taxonomy_id] => 102 [taxonomy] => category [description] => Test Your Skills [parent] => 0 [count] => 232 [cat_ID] => 102 [category_count] => 232 [category_description] => Test Your Skills [cat_name] => Coding Challenge [category_nicename] => coding-challenge [category_parent] => 0 ) [5] => stdClass Object ( [term_id] => 350 [name] => Toolkit [slug] => toolkit [term_group] => 0 [term_order] => 4 [term_taxonomy_id] => 110 [taxonomy] => category [description] => Coding & Billing Tools [parent] => 0 [count] => 133 [cat_ID] => 350 [category_count] => 133 [category_description] => Coding & Billing Tools [cat_name] => Toolkit [category_nicename] => toolkit [category_parent] => 0 ) ) –>
Source: inhealthcare.com

Billing Medicare Claims with HCPCS Codes

The Healthcare Common Procedure Coding System or HCPCS (pronounced as ‘hicks picks’) is a medical billing coding system that includes a standard of codes used for processing and billing Medicare claims. Specific codes are used to identify procedures and services administered to patients. Icon Medical Billing use the HIPAA regulated HCPCS codes for healthcare information transactions and billing Medicare claims. Continue reading.
Source: iconmedicalbilling.com

Coding Ahead: 2013 New HCPCS Code for External Ventricular Assist Devices or Any Ventricular Assist Device (VAD) For Which Payment Was Not Made Under Medicare Part A

Payment on a fee schedule basis is required for prosthetic devices by the Social Security Act, Section 1834(h). The following codes are being added to the December 2012 HCPCS code set and are, effective for services on or after April 1, 2013: Q0507 – Miscellaneous Supply Or Accessory For Use With An External Ventricular Assist Device Q0509 – Miscellaneous Supply Or Accessory For Use With Any Implanted Ventricular Assist Device For Which Payment Was Not Made Under Medicare Part A Effective April 1, 2013, claims for replacement of accessories and supplies for VADs implanted in patients who were not eligible for coverage under Medicare Part A or had other insurance that paid for the device and hospital stay at the time that the device was implanted, but are now eligible for coverage of the replacement supplies and accessories under Medicare Part B, should be submitted using HCPCS code Q0509. Such claims will be manually reviewed. In rare instances, it may be appropriate to pay for replacement of supplies and accessories for external VADs used by patients who are discharged from the hospital. In addition, in some rare instances, it may be necessary for a patient to have an emergency backup controller for an external VAD. Coverage of these items is at the discretion of your Medicare contractor. Claims for replacement of supplies and accessories used with an external VAD that are furnished by suppliers should be billed to the local carriers. Claims for replacement of supplies and accessories used with an external VAD that are furnished by hospitals and other providers should be billed to the FIs or A/B MACs. Effective April 1, 2013, these items should be billed using code Q0507 so that the claims can be manually reviewed. In order to clarify the descriptor of miscellaneous VAD accessory and supply code Q0505, the following new code is being added December 2012 to the HCPCS Quarterly Update with an effective date of April 1, 2013: Q0508 – Miscellaneous Supply or Accessory For Use With An Implanted Ventricular Assist Device Code Q0508 clarifies that the miscellaneous supplies and accessories billed under this code are for use with implanted VADs. Code Q0508 replaces code Q0505 that is discontinued March 31, 2013. Please note that when determined to be medically necessary, dressings used with VADs are covered under the prosthetic device benefit as a supply necessary for the effective use of the VAD/prosthetic device. Claims for dressings necessary for the effective use of a VAD should be billed using the appropriate miscellaneous VAD supply code, depending upon whether the patient was eligible for coverage under Medicare Part A at the time that the VAD was implanted. The claims processing jurisdiction for dressings used with VADs is identical to that of other VAD replacement supplies and accessories and does not fall under DME MAC jurisdiction. Reference:
Source: codingahead.com

GU cheap HCPCS 2008: Medicare’s Best Price

If you put up claims to Medicare, you consider the need to have essentially the most up-to-date checklist of HCPCS Level II codes. This important useful resource important points Medicare s National Level II codes for DME, medicine and different clinical provides and the mandated adjustments for 2008. Do no longer accept much less compensation than you deserve.
Source: myfreenew.com

^UNDERPAD,POLYMER,Normal,23X36,10/10S*** HCPCS CODE REIMBURSEMENT IS STATE Certain. THIS Item IS NOT COVERED By way of MEDICARE BUT Could BE REIMBURSABLE By way of MEDICAID. THE Client WILL Require TO CHECK WITH THEIR Regional MEDICAID Workplace TO VERIFY THE AP

Get rid of waste with Medline Protection Plus disposable underpads with polymer. These odor-lowering pads lock-in fluids, practically eliminating the require to stack pads to prevent leaks. Polymer underpads available in deluxe or typical weight. Polymer underpad with wings tucks into the sides of the mattress. Also offered are airstream breathable underpads or underpads with wings. Medline Protection Plus Disposable Underpads with Polymer Holds Fluids 10 Bag / Case 100 Every / Case
Source: pokhong-medical.com

HCPCS 2005 Coder's Choice: Health Care Procedure Coding System, National Level II & Medicare Code…

HCPCS 2003 Coder’s Choice, Millennium Edition, Health Care Procedure Coding System, National Level II,. HCPCS 2005 Coder’s Choice: Health Care Procedure Coding System, National Level II & Medicare. 2005 ICD-9-CM Coder’s Choice. Hcpcs Codes on Disk – ShopWiki HCPCS 2005 Medicare Level II Codes.. hcpcs – ShopWiki HCPCS 2007 Coder’s Choice.. ICD-9-CM 2004, Deluxe Edition, Millennium Edition, International. Health Care Procedure Coding System, National Level II,. HCPCS Level II 2013. HCPCS 2005 Coder’s Choice: Health Care Procedure Coding System,. HCPCS 2005 Coder’s Choice: Health Care Procedure Coding System, National Level II & Medicare Codes. HCPCS is the Healthcare Common Procedure Coding System, and contains Medicare’s National Level II codes. HCPCS 2003 Coder’s Choice, Millennium Edition, Health Care Procedure Coding System, National Level II,. Medical Billing and Coding Books Coder’s Choice ICD-9-CM 2012 Hospital Edition.. medical terminology and procedures, different health insurance. Practice Management Information – books from this publisher (ISBNs
Source: diigo.com

My Medical Bill Advocate: Medicare HCPCS Codes

Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician’s office. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the level II HCPCS codes were established for submitting claims for these items. 
Source: blogspot.com

Cigna Announces New Medicare Supplement Product

Posted by:  :  Category: Medicare

BLOOMFIELD, Conn., January 16, 2013 – On February 4, 2013, Cigna will begin sales of its new Medicare Supplement Plans insured by American Retirement Life Insurance Company. The program will be marketed and administered through Cigna’s Supplemental Benefits division in Austin, Texas. The new Medigap plans have been filed for approval with the states and are already approved in AL, IA, NM, OK & SD. Medicare Supplement plans help America’s seniors cover some of their health care costs, including deductibles and coinsurance payments, not covered by Medicare Part A or Part B.
Source: prsync.com

Video: CIGNA Medicare Supplement Plan Launch

Cigna expands supplemental business

This acquisition grows Cigna’s reach in both the individual and Medicare Supplement markets, both which position the company well for thriving in a post-PPACA world. The deal also enhances Cigna’s distribution network of agents and brokers and extends global direct-to-consumer retail channel, Cigna says.
Source: benefitspro.com

American Financial (AFG) Closes Sale Of Medicare Supplement And Critical Illness Businesses

AFG’s balance supplemental insurance operations consist solely of its run-off long-term care business, which has a book value of approximately $170 million, and which will continue to be based in Austin, Texas. AFG’s Austin-based life and annuity operations will transition to its home office in Cincinnati, Ohio before the end of the year.
Source: istockanalyst.com

Cigna Completes Acquistion of Great American Supplemental Benefits Group

The organization formerly known as GASB will now be called Cigna Supplemental Benefits and will continue to operate out of its current location in Austin, Texas. Cigna Supplemental Benefits will focus on developing and introducing high quality Medicare Supplement and Individual Supplemental products focused on the customer. In alignment with our strategy, we expect this partnership to offer quick entry into new markets, a highly scalable platform and strong product base on which to build. We intend to take that success to a new level by drawing on Great American Supplemental Benefits Group’s core competencies, integrating them across our business and expanding them into diversified products and integrated services.
Source: ihealthbrokers.com

Aetna to buy Genworth’s Medicare Supplement business

In an important move in the Medicare Supplement market, Aetna has announced today that they have entered into an agreement with Genworth Financial to acquire Genworth’s Medicare Supplement block of business.  According Aetna’s CEO and President, Mark T. Bertolini, “By acquiring this business, Aetna will significantly expand its footprint in the Medicare Supplement business”.  
Source: wordpress.com

Mutual of Omaha Announces Changes to Medicare Supplement Plan N Underwriting

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

CIGNA To Withdraw From Medicare Private FFS Market

CIGNA will continue to market Medicare supplement products, Arizona Medicare Advantage health maintenance organization coverage, and Medicare and non-Medicare group plans aimed at employer retiree and pre-retiree benefits programs, the company says.
Source: lifehealthpro.com

My Experience Applying for Medicare Online

Posted by:  :  Category: Medicare

Once submitted you are advised: “Thank you! Your data has been received and we are working to process your request. You will be able to check the status of your action online in 5 business days. To check the status, go to http://www.socialsecurity.gov. You will need to enter your Confirmation Number to get status information, so please put this number in a safe location. We hope you found our internet application convenient to use and easy to understand.” Well, we three found the online application process both convenient and easy. I applaud Social Security for an excellent implementation and the person-to-person customer service I received when I had a question.
Source: medicarebenefits.com

Video: Patty and Richard say, “Apply online for Medicare” (20 seconds) – Social Security

The Medicare age is still 65

At the web­site, you’ll find more than just the online Medicare appli­ca­tion. You’ll also find infor­ma­tion about Medicare, and have the oppor­tu­nity to watch some short videos about apply­ing for Medicare online. One is a fam­ily reunion for the cast of The Patty Duke Show. In another, Patty Duke and George Takei go boldly where you should be going — online. Why go online to apply for Medicare? Because it’s fast, easy, and secure. You don’t need an appoint­ment and you can avoid wait­ing in traf­fic or in line. As long as you have ten min­utes to spare, you have time to com­plete and sub­mit your online Medicare application.
Source: thepennews.com

You Can Apply For Medicare Online

The nice thing about applying online is that you do not need to wait for an appointment.  You can fill out your application when you are ready from your own home.  As you are filling out your application, you may save it at any time during the application process and finish it when you are ready, so you do not have to worry about possible interruptions.  The web site is very secure, so your information is protected.  Once you complete the application, you will receive a receipt and an application number so that you can log in anytime to check your application status.
Source: mexicoonmymind.com

My Experience Applying for Medicare Online

Part D (Prescription Drug Plan) Offers special assistance to beneficiaries with limited income, and a choice of prescription drug plans (PDP) to anyone enrolled in Part A and Part B. Medicare prescription drug plans (PDPs) cover only outpatient drugs for people in original Medicare who have no other drug coverage. You can not enroll both in a Prescription Drug Plan and in a Medicare Advantage plan. When you enroll in a Medicare Advantage plan, you will automatically lose your current PDP coverage, even if the Medicare Advantage plan does not cover drugs. Every year Medicare has an enrollment period from November 15 through December 31 when it is possible to change prescription drug providers. Medicare imposes penalties if you want to enroll in a prescription drug plan and you were not previously enrolled in a creditable drug plan. The long list of Part D providers, and the many options for monthly fees, types of coverage, and deductibles make it very difficult to choose. It is important to think carefully before making a selection because the wrong choice can cost you hundreds of dollars more in out-of-pocket expenses. Medicare has an interactive Prescription Drug Plan Finder in its Prescription Drug Coverage web page. Source: scientificpsychic.com
Source: medicarehelpco.com

Ask The Experts: Retirement

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

Application of Medicare Contribution Tax of 3.8% to Certain U.S. Persons Owning Stock in A Controlled Foreign Corporation or Passive Foreign Investment Company : Federal Taxation Developments Blog

As mentioned, a U.S. shareholder of a CFC is required to include certain amounts in income, i.e., Subpart F income to the extent of earnings and profits, under Section 951(a). The Preamble to the Section 1411 proposed regulations states that constructive or pass through income includible under Section 951 will generally not be treated as dividends in computing NII as dividend income unless expressly provided for in the Code. Still NII treatment will result to the extent the Subpart F income is derived from a trade or business to which the tax applies as provided in Section 1411(c)(1)(A)(ii)(trading trading in financial instruments or commodities) and Prop. Treas. Reg. § 1.1411-4(a)(1)(ii)). As to PFICs, a U.S. person is required to income in income amounts described under Section 193 if the taxpayer makes a QEF election under Section 1295.. Section 1293 inclusions also are not treated as dividends unless expressly provided for in the Code, and, therefore, also are not taken into account for purposes of calculating net investment income (unless the amount is derived from a trade or business to which the tax applies as provided in Section 1411(c)(1)(A)(ii) and Prop. Treas. Reg. §1.1411-4(a)(1)(ii)).  This difference in timing for reporting income for chapter 1 (regular income tax) and chapter 2A (Section 1411), as well as other overlapping provisions, will require a taxpayer to compute separate stock basis for chapter 1 and chapter 2A, subject to making an election under Prop. Reg. §1.1411-10(g) which seems to only be available after 2013 although the Preamble to the regulations when read with the proposed regulations is not entirely clear on this point, i.e., whether such election can be made for a taxable year beginning in 2013.
Source: foxrothschild.com

Social Security and You: Signing up for Medicare

However, WEP does not affect benefits paid to your wife as a widow in the event of your death. For example, a worker and spouse both claim their benefits at full retirement age. Because the worker receives a pension based on work not covered by Social Security, the benefit amount under the WEP benefit formula is $700. Based on the WEP benefit amount, the spouse’s benefit is $350 (one-half of the worker’s WEP benefit amount). When the worker dies, the WEP reduction is removed. The surviving spouse’s benefit is refigured using the regular benefit formula.
Source: mysanantonio.com

UCLA Health System Selected As Medicare Shared Savings Program Accountable Care Organization

“UCLA Health System is one of only a few academic medical centers to participate in this program,” said Dr. Samuel A. Skootsky, chief medical officer of the UCLA Faculty Practice and Medical Group. “This Medicare Shared Savings Plan challenges hospitals and doctors, together with their patients, to re-evaluate and redesign patient care to be more patient-centered and efficient—across all care settings, including at home.”
Source: bhcourier.com

Discover Phillips County Economic Development

HELP WANTED:  Phillips County is seeking an experienced, licensed Registered Nurse, Bachelor’s Degree preferred, but not mandatory, to fill the position of Administrator for the County Health Department and Medicare certified Home Health Agency.  Phillips County offers an excellent benefit program.  Applications are available from the Phillips County Clerk or the Health Department. Send completed application and resume to the Phillips County Commissioners, 301 State Street, Ste A, Phillipsburg, KS  67661. Applications will be taken until the position is filled.  Phillip County is an equal opportunity employer.
Source: discoverpced.com

UCLA Health System chosen as a Medicare Shared Savings Program accountable care organization / UCLA Newsroom

The UCLA Health System, which comprises the UCLA Hospital System and the UCLA Medical Group and its affiliates, has provided a high quality of health care and the most advanced treatment options to the people of Los Angeles and the world for more than half a century. Ronald Reagan UCLA Medical Center, the Resnick Neuropsychiatric Hospital at UCLA, Mattel Children’s Hospital UCLA, and UCLA Medical Center, Santa Monica (which includes the Los Angeles Orthopaedic Hospital) deliver hospital care that is unparalleled in California. Ronald Reagan UCLA Medical Center is consistently ranked one of the top five hospitals in the nation and the best in the western United States by U.S. News & World Report. UCLA physicians and hospitals continue to be world leaders in the full range of care, from maintaining the health of families to the diagnosis and treatment of complex illnesses.
Source: ucla.edu

How will pay for performance ultimately impact the quality of care?

Posted by:  :  Category: Medicare

No doctor shopping here, buddy by Newtown grafittiWhile the CMS program does not yet directly impact the individual practicing physician, they will be included in a similar program, starting in 2015 for the largest group practices, and in 2017 for all practicing physicians in the United States. At that time, physicians’ Medicare reimbursement is going to be directly tied to how well they meet treatment benchmarks, how much it costs them to do so, and how patients perceive the care they received (again, through post-treatment satisfaction surveys). The list of benchmarks is extensive, and includes everything from how often you prescribe steroids for chronic lung disease (when appropriate), to how often you obtain blood samples in diabetics, to the number of times your patients went to the emergency room.  Each physician will receive a report from CMS, which breaks down their performance, and highlights where they stand in comparison to their peers. Those that provide the cheapest care, while meeting the highest pre-set standards, will be reimbursed the most. Sounds simple right?
Source: kevinmd.com

Video: Canadian Wait List Insurance

Reader Response: Medicare Options and Quality of Care

Medicare beneficiaries self-select into traditional Medicare or Medicare Advantage plans. They may differ systematically in characteristics that could indirectly affect readmission rates. Age and health status are two characteristics that can usually be measured and might be included in the available data set; but there may be others not included. Researchers try as best they can to make statistical adjustments for differences in the characteristics among self-selecting beneficiaries, as the authors of all of the studies cited in my previous post did. But the adequacy of these adjustments depends on the available data. Typically researchers acknowledge such limitation of their studies forthrightly in their reports.
Source: nytimes.com

LSU doctors and Peoples Health look to improve treatment of chronic diseases

Solomon said the physician-owned plan is working to put in place teams of medical professionals to assist physicians across south Louisiana in helping patients tackle their health problems. Solomon said that means, for example, making available a social worker that physicians can call to go to a patient’s home if that person can’t go to the doctor’s office. Teams will also include nurse practitioners, nurses and dieticians.
Source: nola.com

UCLA Health System Selected As Medicare Shared Savings Program Accountable Care Organization

“UCLA Health System is one of only a few academic medical centers to participate in this program,” said Dr. Samuel A. Skootsky, chief medical officer of the UCLA Faculty Practice and Medical Group. “This Medicare Shared Savings Plan challenges hospitals and doctors, together with their patients, to re-evaluate and redesign patient care to be more patient-centered and efficient—across all care settings, including at home.”
Source: bhcourier.com

When does Medicare require the referring doctor’s name on electronically filed claims?

Effective January 1, 1992, a physician or supplier that bills Medicare for a service or item must show the name and UPIN (or NPI) of the ordering/referring physician on the claim form, if that service or item was the result of an order or referral from a physician. If the ordering physician is also the performing physician, the physician must enter his/her name and assigned UPIN as the ordering physician. If the ordering/referring physician is not assigned a UPIN, the biller may use a surrogate UPIN, e.g., until an application for a UPIN is processed and a UPIN assigned. (See §14.9.2.)
Source: askthebdcdoctor.com

UCLA Health System chosen as a Medicare Shared Savings Program accountable care organization / UCLA Newsroom

The UCLA Health System, which comprises the UCLA Hospital System and the UCLA Medical Group and its affiliates, has provided a high quality of health care and the most advanced treatment options to the people of Los Angeles and the world for more than half a century. Ronald Reagan UCLA Medical Center, the Resnick Neuropsychiatric Hospital at UCLA, Mattel Children’s Hospital UCLA, and UCLA Medical Center, Santa Monica (which includes the Los Angeles Orthopaedic Hospital) deliver hospital care that is unparalleled in California. Ronald Reagan UCLA Medical Center is consistently ranked one of the top five hospitals in the nation and the best in the western United States by U.S. News & World Report. UCLA physicians and hospitals continue to be world leaders in the full range of care, from maintaining the health of families to the diagnosis and treatment of complex illnesses.
Source: ucla.edu

Medicare to Punish Most Doctors for Not Practicing Medicine the Way It Thinks They Should

Do the math: 280 million people will have health coverage. Maybe 110 million of them will have low-paying government coverage that pays only about half what private insurers pay physicians. Only about a third of a physician’s billings represent profit. This suggests physicians are expected to treat Medicare and Medicaid patients for less than doctors’ average cost per patient. Depending on the practice, doctors may even be losing money at the margin on some patients. The certainly will find Medicare patients with their complex needs to be not worth the effort.
Source: ncpa.org

2013 Brings More Benefits and Free Screenings

Another major benefit for Medicare beneficiaries is the recent settlement of a class action lawsuit regarding Medicare’s coverage requirements for skilled nursing and rehabilitation services. This benefit is covered under Medicare Part A. Prior to this settlement, coverage would only last while a patient’s condition was showing improvement. If a patient was not improving but remaining stable in their health condition, they would be denied coverage.
Source: lifelongwellnessadvocates.com

Uwe E. Reinhardt: The Complexities of Comparing Medicare Choices

Posted by:  :  Category: Medicare

Undecided?  Still?? by Patrick FellerEach 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

Video: Deadly Medicare Choices – Loliondo Part 2

Obama’s Inaugural Speech, Medicare View Trigger Reaction, Analysis

The Medicare NewsGroup: Fact/Fiction: Raising The Medicare Eligibility Age Would Save The Program Money Deficit hawks have long argued that raising the Medicare eligibility age is a good way to reduce entitlement spending. It has routinely been part of Republican, and sometimes bipartisan, proposals to reform the program. Rep. Paul Ryan’s (R-Wis.) fiscal year 2013 budget proposal would raise the eligibility age from 65 to 67 years by two months a year starting in 2022, until it reaches 67 in 2033; and the bipartisan Burr-Coburn deficit reduction plan would gradually raise the age to 67 by 2027. The Facts: This is fact. The federal government would spend less on the Medicare program because costs primarily would be shifted to individuals, employers and state government programs. They would, collectively, pay more for health care services than Medicare would pay to cover the same group of people (Sojerdsma, 1/22).
Source: kaiserhealthnews.org

A Season For Medicare Choices

• Get help if you need it. The Medicare.gov website lists all the plans in your area. You can call 1-800-MEDICARE for general information and to enroll in a plan. You can also get a referral for your local State Health Insurance Assistance Program (SHIP). Every state has one, and they provide free counseling and advice to everyone with Medicare.
Source: smmirror.com

Need Help with Medicare Choices? SHIP Advice to the Rescue

The programs are called SHIP programs (State Health Insurance Programs.)