False Piety and the Medicare Debate

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SSAs for Medicare, the Ryan-Romney — pardon me, Romney-Ryan — claims are simply absurd. They want credit as the ticket willing to face up to the imperative of entitlement cuts, particularly in Medicare and Medicaid. They support a radical change in the structure of Medicare, to a premium-support, aka voucher, system. And then they have the nerve to criticize Obama, who wants to keep the Medicare system intact, for $716 billion in savings. As The Washington Post’s Wonkblog showed, two-thirds of the Obama reductions come from either curtailing the costly Medicare Advantage program, which has subsidized private insurers, or cuts in hospital reimbursements.
Source: realclearpolitics.com

Video: ObamaCare Guts Medicare Advantage

Rep. Issa Subpoenas HHS Records On Medicare Advantage Program

CQ HealthBeat: HHS Inspector General Raps CMS On Medicare ID Theft Protection Federal Medicare officials reported 14 breaches of medical information in two years affecting nearly 14,000 beneficiaries, but they failed to notify those affected in a timely way and often did not give them much information about the violation, the Office of Inspector General for the Department of Health and Human Services said in a new report. In response to worries about medical identity theft, the government has set up a database with the Medicare ID numbers of 284,000 beneficiaries and 5,000 providers that have been involved in medical identity theft in the past or are regarded as vulnerable. But Medicare contractors have problems using the database, and few remedies are available for those whose numbers have been compromised, the OIG report said (Norman, 10/22).
Source: kaiserhealthnews.org

The impact of Obamacare cuts on Medicare Advantage Plans

The PPACA, as amended, also introduces MA bonuses and rebate levels that are tied to the plans’ quality ratings. Beginning in 2012, benchmarks will be increased for plans that receive a 4-star or higher rating on a 5-star quality rating system. The bonuses will be 1.5 percent in 2012, 3.0 percent in 2013, and 5.0 percent in 2014 and later. An additional county bonus, which is equal to the plan bonus, will be provided on behalf of beneficiaries residing in specified counties. The percentage of the “benchmark minus bid” savings provided as a rebate, which historically has been 75 percent, will also be tied to a plan’s quality rating. In 2014, when the provision is fully phased in, the rebate share will be 50 percent for plans with a quality rating of less than 3.5 stars; 65 percent for a quality rating of 3.5 to 4.49; and 70 percent for a quality rating of 4.5 or greater.
Source: quinnscommentary.com

ICYMI: Health Affairs Article: Medicare Advantage Provides Higher

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

Turning 65: Finding a Medicare Advantage Plan

This is the fifth in a series of posts that examine the process of signing up for Medicare, navigating its rules, choosing supplemental coverage and planning for health care in a program with a very uncertain future. Here are the first, second and third posts and fourth posts in this series. Ah, those Medicare Advantage (MA) plans!’  The government can’t seem to decide if it loves or hates them.’  On the one hand, when I tried to learn about my options, there was much more MA plan information available from the government than for traditional Medigap policies. ‘ So it seemed like I was being encouraged to select an MA plan. ‘ ‘ ‘ On the other hand, Congress with a big nudge from the president, whacked reimbursements to MA plans, cutting out the overpayments they’d been receiving for years.’  It was costing the government far more to fund the benefits to seniors who picked them than it cost to provide the traditional program.’  Lower payments, experts believe, could cause some MA plans to disappear. While government is betwixt and between on MA plans, I am not.’  I know I would not feel comfortable in a restricted provider network, which is the crux of most of these MA plan arrangements.’ ‘  But I approached the selection process with an open mind, taking a careful look at what’s available and evaluating the advice for selecting one.’  As with Medigap policies and the prescription drug plans that go with them, there were too many choices and too many data points for the average senior to comprehend, let alone make the ‘right’ decision that the marketplace model says will appear, like magic. I understand why seniors fall for misleading or deceptive sales pitches.’  We need a helping hand but all too often whoever is extending it doesn’t have our best interests at heart.’  I had heard lots of these pitches before’the kind where a seller invites seniors to a local restaurant, then glosses over the negatives and highlights insurance deals for a very low or no monthly premium with drug coverage, gym memberships, and vision and dental care thrown in to boot.’  Appealing, no? Now it was time for me to cut through the hype. First, I started my review with the sales brochures I received for MA plans.’ ‘  The giant in this universe, UnitedHealthcare/AARP, sent its brochure in an enticing envelope.’  A big red banner screamed ‘$0 premium Medicare health plans’ ‘enough to make me rip it open.’  The insurer’s Medicare Advantage Guide said that although costs vary by plan, all of United’s MA plans have annual limits on out-of-pocket expenses ‘so you can budget for health care expenses and limit your out-of-pocket costs each year.”  That didn’t mean much since I don’t know what illnesses might befall me.’  Marketing jargon, really, but apparently it works. Another sales piece in the mailing gave concrete info about United-AARP’s MedicareComplete Plan 1 (an HMO) with its out-of-pocket limit of $5,900.’  And the other United-AARP offerings?’  For those I had to turn to the government’s Medicare & You handbook where I ran smack into the bizarre world of MA plans.’  It turned out there were also two PPO plans offered through United-AARP.’  Since PPOs are less restrictive than HMOs, I wouldn’t lose my Medicare benefits by going out of network as I would with an HMO. I learned that there were also three other AARP’  HMO choices’the MedicareComplete Essential HMO with an out-of-pocket limit of $5,900; the MedicareComplete Plan 2 which carried an out-of-pocket limit of $4,200; and the MedicareComplete Mosaic with its limit of $2,900.’ ‘  It’s not uncommon for one insurance company to offer several different Medicare plans with fanciful names, which further confuses consumers. All had no monthly premiums, but they paid different amounts for what’s called durable medical equipment, like oxygen, and for critical treatments like chemotherapy drugs.’ ‘  I also discovered that the United-AARP MedicareComplete Essential HMO did not cover drugs, which would force me into shopping for a drug plan, another headache I didn’t need. The United-AARP MedicareComplete Mosaic seemed ideal with its low out-of-pocket maximum, low copayments for doctor visits, and low coinsurance for the expensive stuff like chemo drugs and medical equipment.’  But based on the sales brochure they mailed to me, which were all about Plan 1, it was not the plan United-AARP was encouraging me to buy.’ ‘  With Plan 1, I would be on the hook for more out-of-pocket expenses’meaning that the carrier would pay less and profit more.’  No wonder they were pushing it.’  A second United-AARP mailing also pushed Plan 1. However, both brochures did disclose a significant variable to look at when choosing an MA plan’the copayments for inpatient hospital stays.’  I knew these copays are often hidden in the fine print, and consumers frequently don’t learn of them until they land in the hospital.’  They are clearly a negative for MA plans.’  FYI:’  Medigap policies pay the copayments for hospital stays, which give them an edge in this department.’ ‘  The copay for Plan 1 was fairly hefty’$175 each day up to $1,400 per stay.’  These could add up for a sick person who had multiple admissions. Emblem Health also sent some Medicare insurance mailers, mostly trying to get me to access their website with my own personal password, which was good for a limited time only.’  They were looking for sales prospects, and I didn’t want to become one, especially since I wasn’t interested in watching some NBA hall of famer on a how-to video telling me how easy it is to choose Emblem’s Medicare options.’  But acting like an average senior who had heard of Emblem Health might, I thought I better take a look at the Emblem plans for New York City. It turns out Emblem offers three HMOs and four PPOs.’  The penalty for being able to go out of network in a PPO is steep. They came with high out-of-pocket maximums’$2,500 for going out of network and $6,700 for staying in network, or a’  $10,000 combined maximum.’  Even though two had no monthly premiums, and two had premiums of less than $100, I didn’t go further with Emblem. While sales people push MA plans with low or no monthly premiums, the premium is not the only thing to consider.’  It’s the mix of policy elements that ultimately determine whether a plan is a good or bad deal.’  And then of course, there’s the unknown of your future health status to consider.’  You need to know how the combination of premiums, in- and out-of-network hospital copays, out-of-pocket limits, drug copays, coinsurance for chemotherapy drugs, and copays for doctor visits interact to determine what a plan will really cost.’  The trade-off for a no-premium plan may be hidden’and high’hospital copays, very high out-of-pocket limits, or the obligation to pay 20 percent of chemotherapy bills.’  It boils down to a game of ‘name your poison.’ I also looked for MA plan information on the Medicare.gov website but did not find it helpful.’  Both the handbook and website gave star ratings for MA plans but they seemed to measure different things, further confusing shoppers who might want to use them.’  The government handbook gave the United-AARP CompleteMosaic plan one star for Member Satisfaction.’  That might be important to know.’  At the same time the government website gave the same plan an overall rating of three stars.’  This certainly raised some questions for me about the usefulness of these stars as a shopping tool. Having done lots of homework, it was time to select a plan to cover Medicare’s gaps.’  Was I going to try one of those Medicare Advantage PPO plans that seemed to offer flexibility and let me keep the doctors that I like?
Source: preparedpatientforum.org

Using Medicare Advantage to Gain Political Advantage

It is almost certainly true that quality suffers when reimbursement rates are reduced. It is also appears to be true that competition amongst private providers in Medicare Advantage is leading to efficiencies that aren’t present in traditional Medicare, which we should probably take as a lesson. It is also often the case that when the government pays more for something, it spends more, and when it pays less for something, it spends less. But what all this really reveals is the folly of trying to control health spending through government-designed payment schemes. 
Source: reason.com

Obamacare’s to cut $200 billion from Medicare Advantage to fund Medicaid.

“The quality and variety of the selections you will find on EducationViews.org is second-to-none on the internet today. Since 1997 we have been providing this service at no cost to education professionals, the public in general and policy makers. Hope you enjoy the articles and commentary. Please forward us to your friends and associates. EducationViews.org is maybe the most effective way to transforming educators. The daily email offers a direct and easy way for busy teachers to grow philosophically. I was skeptical, but once you open the email and decide to read a story, you are hooked and it becomes a daily ritual to check out what’s happening. Educating teachers as to what is really going on in the schools opens up a new worldview and vision of thinking most have not been exposed to. The end result, better informed teachers who have a more effective understanding of the principles that make academic achievement a reality. Great job. The more email addresses of educators you get on your list, the bigger the impact and the more kids you will positively influence.
Source: educationviews.org

Issa plans subpoena of Advantage pilot documents

The House Oversight and Government Reform Committee will subpoena documents from HHS relating to the department’s $8 billion Medicare Advantage pilot program after the department failed to produce documents requested nearly five months ago to the committee’s satisfaction. The move to a compulsory order followed repeated requests for HHS to voluntarily produce documents detailing its internal deliberations on a pilot program launched in 2010 that provides bonus payments to most Medicare Advantage plans, according to a letter dated Friday (PDF) from Rep. Darrell Issa (R-Calif.), the panel’s chairman. The program, an amended and much more expensive version of a pilot authorized by the Patient Protection and Affordable Care Act, drew scrutiny from the oversight panel after the nonpartisan Government Accountability Office found this year that the pilot lacked a legal basis and recommended HHS shut it down. Issa wrote HHS Secretary Kathleen Sebelius on Oct. 19 that the subpoena was needed after 1,300 pages of documents the department sent the day before “were of no assistance to the committee’s investigation.”
Source: modernhealthcare.com

Medicare Advantage in PPACA: Undermining Seniors’ Coverage Options

Seniors Forced Back into Poorly Performing Traditional Medicare. Large reductions in MA will force a mass migration back into the traditional FFS program, which is the source of many problems observed in American health care. Medicare FFS provides strong incentives for fragmented care that is poorly coordinated across institutions and provider settings. The result is an emphasis on volume instead of quality care for patients. Moreover, downsizing the role of MA plans will make it more difficult to pursue the kinds of structural changes that are needed to ensure that Medicare can be financially sustained over the long term.
Source: heritage.org

Understanding Medicare "Cuts"

Medicare Advantage is a 15-year failed experiment in privatization. Running Medicare through private insurance companies was supposed to save money through the magic of the marketplace; in reality, private insurers, with their extra overhead, have never been able to compete on a level playing field with conventional Medicare. But Congress refused to take no for an answer, and kept the program alive by paying the insurers substantially more than the costs per patient of regular Medicare. All the ACA does is end this overpayment.
Source: nytimes.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

VIVA MEDICARE Plus Earns Highest Quality Rating Score in Alabama for Second Year in a Row

Posted by:  :  Category: Medicare

VIVA MEDICARE Plus has earned the highest overall star rating in the state for the second year in a row, company officials announced today. Alabamas highest ranked Medicare Advantage plan also has experienced the largest membership growth in its service area, according to Medicares enrollment numbers from October 2010 to October 2011, available on http://www.cms.gov.
Source: jobsdomain.us

Video: studio10: viva medicare cafe – know your options about medicare

VivaMedicareMember.com Viva Medicare Plus :: Trinity Medcare

Get Medicare Supplement Quotes in for these Alabama cities and more. Birmingham Montgomery Mobile Huntsville Tuscaloosa Dothan Decatur Auburn Gadsden Russellville Lanett Clanton Atmore Hamilton Roanoke Brewton Selma Demopolis Monroeville Jasper Troy Sylacauga Enterprise Athens Scottsboro Cullman Anniston Talladega Tuskegee Jackson Greenville Gulf Shores Foley Andalusia Eufaula Bay Minette Albertville Pell City Childersburg Oneonta Elba Haleyville Fayette Marion Thomasville Evergreen Daphne Chickasaw Opp Madison Prattville Valley Opelika Arab Guntersville Prichard Bessemer Florence Hoover Ozark Alexander City Fort Payne Homewood and Fairfield Al.
Source: trinitymedcare.com

Top Medicare Part D Plan Costs Spike in 2013

Posted by:  :  Category: Medicare

Horace D. Grant by jajacks62The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.
Source: webmd.com

Video: Dark Souls Super Duper Expert Playthrough w/ SSoHPKC Part 70 – Kiln of the First Flame

Part D Savings Continues, Especially For Cost

The donut hole is the gap in prescription drug coverage offer by a PDP that was part of he original Part D program, put in place to reduce the cost of the legislation that was enacted in 2003 that included Part D. Under the original benefit, as Part D beneficiaries accrued drug expenses, they first had to satisfy a deductible, then 75 percent of their drug costs were covered up to a certain dollar amount. Then, the donut hole kicked in, a coverage gap where the beneficiary was responsible for 100 percent of drug costs. When total out-of-pocket spending reached a specific maximum, the PDP then provided 100 percent coverage for any additional drug costs.
Source: wolterskluwerlb.com

Medicare Drug Premiums to Go Up in 2013

The seven plans announced with double-digit premium increases were: the Humana Walmart-Preferred Rx Plan (23 percent); First Health Part D Premier (18 percent); First Health Part D Value Plus (17 percent); Cigna Medicare Rx Plan One (15 percent); Express Scripts Medicare-Value (13 percent); the HealthSpring Prescription Drug Plan (12 percent); and Humana Enhanced (11 percent). Another two plans in the top 10 also had single-digit increases. They were the SilverScript Basic (8 percent) and WellCare Classic (3 percent).
Source: firstseniorfinancialgroup.com

Saco Residents eligible for Medicare may qualify for Silver Sneakers Plan

Posted by:  :  Category: Medicare

New Online Rx System Makes UM Student 'Top Entrepreneur' Finalist by University of Maryland Press ReleasesI am a mom of three teenage boys. Our family has struggled with multiple chronic health issues for many years. It was for this reason that I became interested in Xocai healthy chocolate. Our entire family eats healthy chocolate every day as a supplement and I am currently losing weight with the Xocai X-protein meal shake. I have struggled with Fibromyalgia for over 10 years. If you are struggling with your health, you owe it to yourself to check this out. This is the best way I have found to incorporate significant antioxidants into our diet. Feel free to email me if you have any questions. I look forward to hearing from you!
Source: healthchocoholic.com

Video: Medicare Part 1: Eligibility and Enrollment

I Was Eligible For Medicare In December, What Do I Do?

When you are newly eligible for Medicare, you have the 3 months preceding your birthday, the month of your birthday and the 3 months following your birthday to enroll onto a Medicare supplement and stand-alone drug plan or a Medicare Advantage (HMO) plan that includes drug coverage.   So in his case, as long as he made his decision/selection prior to 3/31/13, he would be able to obtain health and drug coverage as a guaranteed issue.
Source: personalmedicareadvisor.com

health care solutions, Medicare FAQ, Questions about Medicare

As an alternative to Part A and B, beneficiaries can select a Part C plan, which is also referred to as a Medicare Advantage plan. Private companies contract with the federal government to offer these plans, which pay for everything covered by Original Medicare and often provide additional services.  Such as dental, hearing, vision benefits and maybe even a gym membership. Beneficiaries usually pay a monthly premium and some other fees, such as copayments and deductibles.
Source: ahealthiermichigan.org

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

What is Medicare Part A, What Does It Cover, Who Is Eligible

: Medicare Part A covers certain skilled nursing care services needed daily in a skilled nursing facility for up to 100 days. In order to have the nursing facility covered, your doctor must decide that you need daily skilled care given by, or under the direct supervision of, skilled nursing or rehabilitation staff. It is important to note that this is in-home care only. For patients who go to a nursing facility 5 or 6 days a week for rehabilitation services only, the care is considered daily care.
Source: bradeninsurance.com

New Mexico Medicare Eligibility Requirements

Most New Mexico residents 65 or older are eligible to receive Medicare health benefits and are generally automatically enrolled.  If you are entitled to receive Social Security benefits because of age or you are disabled and have been receiving benefits for 24 months or longer, you are eligible to receive Medicare even if you are younger than 65. Part A benefits are free for most people, while Part B costs monthly. For those who are not qualified to receive Medicare, it can be purchase during the appropriate time period.
Source: newmexicomedicarehealth.com

When Will YOU Be Eligible For Medicare?

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Source: epilepsytalk.com

What Determines Eligibility for Medicare?

Part A and Part B are a component of Medicare, where individuals who are eligible, receive Part A without any costs, and Part B eligibility for Medicare, is based on premium payments, during an open enrollment period. Part A covers Medicare insurance for hospitalization and Part B is a premium paid medical insurance. Additional eligibility for Medicare plans, include Part C, which allows individuals to be Medicare approved, to sign up with private insurance companies for additional medical benefits. These Medicare Advantage Plans include coverage in medical plans like an HMO and a PPO, while remaining a Medicare enrollee.
Source: seniorcorps.org

Raising the Medicare Eligibility Age: A Costly and Dangerous Proposal 

[1] Congressional Budget Office: Raising the Ages of Eligibility for Medicare and Social Security, January 2012. Available at http://www.cbo.gov/publication/42683. [2]Center for Budget and Policy Priorities: Raising Medicare’s Eligibility Age would Increase Overall Health Spending and Shift Costs to Seniors, States, and Employers, August 2011.  Available at http://www.cbpp.org/cms/?fa=view&id=3564. [3] Henry J. Aaron, Ph. D, The Brookings Institution for AARP Public Policy Institute, Perspectives: Reforming Medicare: Option-Raise the Medicare Eligibility Age, available at http://www.aarp.org/content/dam/aarp/research/public_policy_institute/health/option-raise-the-medicare-eligibility-age-AARP-ppi-health.pdf. [4] Center for American Progress, The Senior Protection Plan, available at http://www.americanprogress.org/wp-content/uploads/2012/11/SeniorProtectionPlan.pdf. [5] Kaiser Family Foundation: Raising the Age of Medicare Eligibility: A Fresh Look Following the Implementation of Health Reform, July 2011, available at http://www.kff.org/medicare/8169.cfm. [6] Ibid. [7] Kaiser Family Foundation, Health Reform Subsidy Calculator, available at http://healthreform.kff.org/subsidycalculator.axpx [8] Ibid. [9] United States National Vital Statistics System. Available at http://www.cdc.gov/nchs/nvss.htm. [10] Health Affairs, Raising the Medicare Eligibility Age: Effects on The Young Elderly, July/August 2003, available at http://content.healthaffairs.org/content/22/4/198.full. [11] Medicare Rights Center, Paying More for Less: Raising the Eligibility Age, available at http://www.medicarerights.org/pdf/Paying-More-For-Less-Raising-Medicare-Age.pdf. [12] ABC News/WashingtonPost Poll, Langer Research Associates, November 2012, available at http://abcnews.go.com/blogs/politics/2012/11/among-cliff-avoidance-options-most-favor-targeting-the-wealthy/. [13] Center for Medicare Advocacy, Deficit Reduction and Medicare: Saving Money without Harming Beneficiaries, available at http://www.medicareadvocacy.org/2012/11/15/deficit-reduction-and-medicare-save-money-without-harming-beneficiaries/ [14] MRC. [15] Center for Medicare Advocacy, Investing in Our Future: Strengthening Medicare in 2012 and Beyond, available at http://www.medicareadvocacy.org/2012/02/09/investing-in-our-future-strengthening-medicare-for-2012-and-beyond/.
Source: medicareadvocacy.org

Brad DeLong : Aaron Carroll: Raising the Medicare Eligibility Age Is Really, Really, Really, Really Bad Policy

Washington would see $24 billion in Medicare savings. But it also would see a rise of about $9 billion in Medicaid spending and another $9 billion in subsidy spending, which would reduce the overall savings to about $5.7 billion. But all those 65- and 66-year-olds need insurance. Those who get it through their jobs would cost employers another $4.5 billion. Others would go to the exchanges. But, ironically, removing these people from the Medicare risk pool and adding them to the exchanges makes both groups less healthy, so everyone’s premiums would go up. This would cost all Americans another $2.5 billion. States have to cover a portion of the new Medicaid spending. That’s $700 million. Finally, there are the out-of-pocket costs to seniors, which may rise by $3.7 billion.
Source: typepad.com

Viewpoints: Health Law’s ‘Sticker Shock;’ Changing Medicare Eligibility Age Is Not A Simple Solution

San Jose Mercury News: Pancreatic Cancer Finally Gets Federal Attention Pancreatic cancer is a devastating and unforgiving disease. My husband, Patrick Swayze, was diagnosed with this terrible cancer in January of 2008. … Of the top five cancer killers, pancreatic cancer is the only one with a five-year survival rate in the single digits — just 6 percent. Patrick fought valiantly before passing away almost 22 months later. While pancreatic cancer may have taken him in the end, it never beat him. And for me, just because he’s gone doesn’t mean this fight is over. Due in part to the lack of federal resources, scientific advances against this disease, whose statistics are shocking, have been minimal at best. No early-detection tools exist, and few effective treatment options are available. Further, despite its being one of the most deadly cancers, there has been no national plan to address pancreatic cancer (Lisa Niemi Swayze, 1/11).
Source: kaiserhealthnews.org

Daily Kos: Are Democrats abandoning raising the Medicare eligibility age?

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Source: dailykos.com

Difference between Medicare and Medicaid

Eligibility for Medicaid:  May differ by state.  People with disabilities are eligible in every state.  Too much space would be needed here to get into all of the details of eligibility so I reccommend you use the Medicaid eligibility tool.  Here is the link:  http://finder.healthcare.gov/
Source: medicarehealthplans.com

Pharma Pricing Top Target for Medicare Cutbacks

We have some fundamental problems that create this situation: our patent expiry life is not long enough to cover costs of regulatory requirements, research, and development. We should address this and make it worthwhile to companies to continue to research and develop or suffer the societal consequences of shutting down this wonderful machine. We should also understand that insurance companies (including Medicare) have a difficult time covering the underwriting implications of these products. I believe that a collaborative partnership between the companies, the plans, and the members could address some of these concerns.
Source: pharmexec.com

Buying Supplemental Health Insurance

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSIf 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

Video: Free Medicare & Medigap Advantage Plan Quotes In California

What is Medicare Supplemental Insurance Open Enrollment, And Why Is It Important For Me?

During open enrollment, your right to purchase a Medicare supplement policy is guaranteed, no matter your health condition or past medical history. Insurers cannot refuse to offer you a policy. You also cannot be asked to pay a higher premium because of insurance risks you may bring to the table. For example, a smoker will pay the same premiums as a non-smoker. There is no medical screening for applicants during the open enrollment.
Source: kurafire.net

Medicare and Medicare Supplemental Insurance

Medicare supplemental insurance is the easiest way to bridge the coverage gaps in traditional Medicare coverage.  The Medicare supplement plans will cover varying numbers and combinations of the nine gaps.  The most popular and expensive of the plans is plan F because it covers the all of the gaps, while plan A tends to be the least expensive because it only covers the minimum of four gaps.  Each plan has its merits but knowing which one to get can only be based off of your individual needs and budget. You can get a free quote of medicare supplement rates here.
Source: tablib.org

Daily Kos: Kaiser report details Medicare options

Medicare cost sharing is relatively high and, unlike most private health insurance policies, Medicare does not place an annual limit on the costs that people with Medicare pay out of their own pockets. Many Medicare beneficiaries have supplemental coverage to help pay for these costs, but with half of beneficiaries having an annual income of $22,500 or less in 2012, out-of-pocket spending represents a considerable financial burden for many people with Medicare.Cost sharing and premiums for Part B and Part D have consumed a larger share of average Social Security benefits over time, rising from 7 percent of the average monthly benefit in 1980 to 26  percent in 2010 (Exhibit I.3). Medicare beneficiaries spend roughly 15 percent of their household budgets on health expenses, including premiums, three times the share that younger households spend on health care costs. Finally, Medicare does not cover costly services that seniors and people with disabilities are likely to need, most notably, long-term services and supports and dental services. Putting the burden of saving Medicare on the beneficiaries, already paying a significant portion of their incomes on health care, isn’t a solution for saving this program, for keeping it’s promise to America’s seniors and disabled. That basic premise should be the starting point for reforms.
Source: dailykos.com

Covering the Health Care Gaps with Medicare Supplemental Insurance

The Medicare Supplemental Insurance is labeled with letters A through L, so you may have Medicare Part B or Medicare Part L, depending on your policy. Each letter stands for a different policy that covers different things. In addition to choosing the correct type of supplemental insurance, you need to sign up at the right time. It is recommended that you chose Medigap insurance when you first join Medicare. It is also recommended that you understand how your policy costs will work – your premiums will be influenced by your age, geography and your community. Therefore, each insurance company may have a very different quote for each part of this supplemental insurance.
Source: medicaremedics.com

Anthem Blue Cross Medicare Supplement Plan F

Also California offers another special enrollment period that is guaranteed issue called the “California Birthday Rule”. The California Birthday rule is great for seniors who already have a Supplement Plan because it allows them to switch to a like or lesser plan guaranteed issue every year on the day of their birth and thirty days after.
Source: healthbrokerdave.com

La Jolla Health Insurance Plans

www.lajollahealthinsuranceplans.com La Jolla Health Insurance Plans specializes in senior Medicare supplements, low-cost small group health insurance, individual and family health insurance, small business health insurance plans, vision insurance, and dental insurance for La Jolla, and all of North San Diego County CA. We offer online comparisons and free quotes, with friendly, outstanding service, plus full support to help guide you through the health insurance maze. Video Rating: 0 / 5
Source: bestinsurancesandiego.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 Supplemental Insurance

We also offer a Plan F High Deductible Medicare Supplement Insurance plan* that is designed to save you money if you stay healthy and keeps the cost of insurance affordable. There is a one-time deduction that must be met each year with this plan. With a Medicare Supplement Insurance plan from Pekin Life Insurance Company you will also have access to discounts on eye exams, eyeglasses, contact lenses, LASIK correction surgery, hearing aids, hearing exams, and more at NO CHARGE.
Source: pekininsurance.com

Former Medicare administrators identify different priorities for reform

Posted by:  :  Category: Medicare

Stop the Machine 2011 by Saint IscariotBruce Vladeck, the top Medicare administrator under President Bill Clinton, said market-based purchasing should be pursued more vigorously. President George H.W. Bush appointee Gail Wilensky advocated for a premium support model involving competitive bidding and payments adjusted for beneficiary income and health status. Their remarks came just hours before CMS announced the second round of its competitive bidding program for Durable Medical Equipment and supplies.
Source: mcknights.com

Video: Progress Illinois: No cuts to Medicaid, Medicare and Social Security press conference

New law allows Medicare 5 years to recoup overpayments

The AOA and its AOAExcel™ subsidiary offer a range of resources to assist optometrists in properly reporting services and filing claims, including “Codes for Optometry” (the only coding manual developed specifically for optometry), the AOA Coding Today website (https://aoacodingtoday. com), free online coding webinars, and the Ask the Coding Experts service that allows AOA member optometrists to request personalized advice on coding issues by email (Askthecodingexperts@aoa.org).
Source: newsfromaoa.org

U.S. expects big Medicare savings from competitive bid program

Wednesday’s announcement illustrates the savings that traditional fee-for-service Medicare could achieve at a time when analysts, policymakers and lawmakers are considering ways to reduce spending as part of deficit reduction. Some have recommended broad use of the competitive bidding process for a host of private operators that do business with Medicare, including private insurers.
Source: medcitynews.com

Tackle Medicare concerns, learn about death

Richard Jaffe: Birmingham Attorney & Author Thursday, Feb. 7 at 6:30 p.m. in the large auditorium Join library staff as they welcome nationally acclaimed Birmingham attorney Richard Jaffe, author of “Quest For Justice: Defending the Damned.” Jaffe is a renowned attorney who has successfully represented innocent people accused of murder and wrongfully sentenced to serve time on death-row as lifelong inmates. In “Defending the Damned,”Jaffe spotlights sensational murder cases in conjunction with his own representation of the Olympic and Birmingham bomber, Eric Rudolph. A book signing will follow Jaffe’s talk.
Source: al.com

Hospital groups denounce Medicare cuts

From admission and discharge to billing and record keeping, today’s hospitals use technology along every point of the care continuum. But challenges remain, especially when so many clinicians and staff access patient records across multiple points, and often on different equipment. This webinar will examine how UC Irvine and other providers are simultaneously using multiple technologies to boost physician access while ensuring data security. Register now!
Source: fiercehealthfinance.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

Report: Medicare scheme involves stolen identities

Dozens of so-called medical providers in Ohio have registered with the Centers for Medicare and Medicaid Services by using nothing more than a mailbox as their address, even though investigators know it’s part of a common scheme used to steal from the government, the Dayton Daily News reported (http://bit.ly/Ve6NXz).
Source: goerie.com

CMS Announces New Medicare DME Pricing, Aims For Expansion

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

Cops: Fugitive behind $1 million Medicare fraud nabbed in Canada

I personally know of 9 cases here in just one small area of Michigan that total almost 2 million, one defendant sentenced to 10 years and others have fled the country. Does anyone else thinks it time to stop screaming about cuts, and see what it would actually cost if it was administered correctly. Here its mostly Pakistani, Indian, and African doctors that operate for about three to five years before being indighted and then flee before trial. (these are just what I have seen and not a judgement on other well meaning doctors) My mother, for example, has retired from two jobs and has health care coverage for the rest of her life. She is the kind of person that looks at the bill, even if it is not hers. She had a little bit of a health scare and had to go to the hospital. When it was all said and done she found 5 different times that a service was double billed, billed without it being performed, or billed incorrectly. Most of those losses would have been to medicare, because private insurance denies first and pays second.
Source: nbcnews.com

Top Medicare Part D Plan Costs Spike in 2013

Posted by:  :  Category: Medicare

DC Voting Rights by dbkingThe opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.
Source: webmd.com

Video: 2012 Medicare Part D Drug Coverage Updates

Kaiser: Medicare Reform Ideas

American Medical Association cancer CBO consumer driven health care diabetes doctors drugs electronic medical records email emergency room EMR ER exercise FDA genetics Health Care Access Health Care Costs health care quality health insurance health IT health policy Health Reform Health Savings Accounts heart disease hospital HSA insurance life expectancy Massachusetts Medicaid Medicare medicare advantage NHS ObamaCare obesity pay for performance public option SCHIP seniors socialized health care Social Security stimulus tax unemployment Uninsured
Source: ncpa.org

Research Roundup: Does Higher Rx Drug Spending Lower Medicare Costs?

Health Affairs: Regions With Higher Medicare Part D Spending Show Better Drug Adherence, But Not Lower Medicare Costs For Two Diseases – Researchers aimed to find a relationship between geographic variation in Medicare Part D spending and medication-taking behavior among patients with diabetes or heart failure. “If systematic regional differences do exist, then policy makers can use this information to better target interventions designed to improve the quality and efficiency of Medicare service delivery,” they write. After analyzing 2006 and 2007 data, they concluded: “We found that beneficiaries residing in areas characterized by higher adjusted drug spending had significantly more ‘therapy days’—days with recommended medications on hand—than did beneficiaries in lower-spending areas. However, we did not find that this factor translated into short-term savings in Medicare treatment costs for these two diseases (Stuart, Shoemaker, Dai and Davidoff, 1/2013).
Source: kaiserhealthnews.org

Simple Guide to Medicare Part D

Understanding healthcare coverage doesn’t have to be complicated, neither should it be. Yet since the Medicare Part D prescription drug program went into effect in 2006, many people have found themselves grappling with complicated policy literature and health plan loopholes. If you are interested in applying for Medicare Part D or simply want to find out more about it, here are answers to five of the most frequently asked Medicare Part D questions.
Source: findlocal-insurance.com

Medicare Part D has been a health care success

The numbers clearly underscore the merits of Medicare Part D: Participants currently have more than 30 choices of prescription drug plans and pay an average premium of only $30 per plan. With this combination of affordability and choice, it isn’t surprising that seniors are overwhelmingly pleased with their coverage. In fact, a recent survey found that 90 percent of seniors are satisfied with Medicare Part D.
Source: dallasnews.com

Real Entitlement Reform: 4 Steps to Cut Billions from the Budget Without Hurting the Safety Net

During our last Fiscal Showdown/Cliff/Curb/Whatever in December, the compromise was to let the tax rates for those making $400,000 or more to revert to Clinton levels. In truth, all of those in the top 2 percent making $250,000 and above can more than afford to revert back too, and by exempting them we lost out on $100 billion over 10 years in badly needed revenue. If the conversation is going to be between cuts for the 98 percent and a marginal, 1990’s level increase on the 2 percent, we should all agree what the priority is.  Limiting tax breaks for the richest 2 percent of taxpayers could raise $500 billion in revenue.  So could a surtax on income over $1 million.
Source: workingamerica.org

Getting information on the Social Security website

Posted by:  :  Category: Medicare

Economically --- Challenged & illiterate .. CIA website forced offline (11th February 2012) ...item 2.. Anonymous turns its attention to the U.S. Senate over controversial bill -- upgrade your lifestyle (December 8, 2011) ... by marsmet526To find out about your personal eligibility for benefits based on your work history, you can go to Socialsecurity.gov/mystatement The Statement provides you with a personalized estimate of future Social Security benefits — retirement, disability, and survivors. It also provides your earnings record for your lifetime, allowing you to check to make sure your earnings are posted correctly.
Source: wordpress.com

Video: Social Security Gearing Up for Civil Unrest

Myths about social security

Social Secu­rity is more than a retire­ment pro­gram. It pro­vides ben­e­fits to retirees, sur­vivors, and peo­ple with dis­abil­i­ties who can no longer work. In fact, almost seven mil­lion dis­abled work­ers and nearly two mil­lion of their depen­dents get Social Secu­rity dis­abil­ity ben­e­fits. Six and a half mil­lion depen­dents of deceased work­ers (includ­ing two mil­lion chil­dren) get Social Secu­rity sur­vivors ben­e­fits. Social Secu­rity is more than just retirement.
Source: thebellevuegazette.com

Bipolar disorder and Social Security Disability

The Social Security Administration (SSA) recognizes bipolar disorder. People who have been diagnosed with the condition are eligible for Social Security Disability (SSD) benefits. However, to apply for SSD benefits, you must get documentation from doctors and psychiatrists. Coordinating this can be a major challenge. That’s why it is important to get help with your claim.
Source: binderandbinder.com

“Keeping the Social in Social Security” by John Edward

9/11 Afghanistan Allen Ginsberg Andre Dubus III baseball Boarding House Park Bob Dylan Boston Cambodia Charles Cowley Chris Doherty Civil War creative economy Egypt Eileen Donoghue Haverhill Iraq Jack Neary Jane Brox John Lennon Kerouac Lawrence Leymah Gbowee Lowell Lowell Cemetery Lowell Folk Festival Lowell National Historical Park Lowell Public Art Collection Merrimack Repertory Theatre Merrimack valley Micky Ward Middlesex Community College Nancye Tuttle Nobel Peace Prize On the Road Paul Tsongas President Barack Obama Red Sox Richard Marion South Common The Beatles The Fighter Tom Sexton Tony Sampas Umass Lowell
Source: richardhowe.com

Obama: Giving Away Social Security

Ever since he appointed the Bowles-Simpson Commission, Obama has been far too inclined to the premise that Social Security will need to be cut back as part of some grand bargain to cut the deficit. In the budget negotiations of 2011 (which will trigger the sequester mechanism if Congress fails to agree on massive cuts), Obama offered House Speaker Boehner Social Security cuts in exchange for tax increases; the president was saved from himself only by Republicans’ refusal to consider tax increases on even the wealthiest Americans.
Source: prospect.org

Baby Boomers have options regarding Social Security

Jennifer L. Whitehead, Public Affairs Specialist, Dallas Region said, “An individual can work and receive retirement benefits, but if he or she is under full retirement age, an annual earnings test does apply. For 2013 the annual earnings test amount is $15,120 yearly ($1,260 monthly). For every $2 in earning above the earnings test, $1 will be deducted from retirement benefits. The amount increases the year that the individual reaches full retirement age, and once he or she reaches full retirement age there is no more earnings test.”
Source: city-sentinel.com

Veterans and Social Security Disability benefit qualifications

One thing that’s important to mention is that the benefits available through the Social Security Administration are different than those available from the Department of Veterans Affairs and each requires its own application. In order to be eligible for federal and state veteran’s disability benefits, you must have been honorably discharged from active military service. If you were not honorably discharged, regardless of the reason, you will not be eligible for compensation.
Source: johntnicholson.com

Get the Facts on Medicare and Social Security

Prior to Election Day, AARP volunteers delivered more than 200,000 petitions along with a report entitled “Americans Have Their Say about Medicare and Social Security” to both the Democratic and Republican National Committees.  The petitions now call on President Obama to give Americans straight talk about what he would do to put Medicare and Social Security on stable ground for the future. 
Source: aarp.org

2013 Medicare Changes for Clinical Social Workers

Posted by:  :  Category: Medicare

Cassandra Q. Butts by Center for American Progress• SUSTAINABLE GROWTH RATE: Under the 1997 Balanced Budget Act of 1997’s Sustainable Growth Rate (SGR) methodology, clinical social workers and other Medicare providers can expect a 26.5 percent reduction in fees beginning January 2013. The SGR is an annual growth rate that applies to practitioners’ services paid by Medicare. The use of the SGR is intended to control growth in Medicare expenditures for practitioner services. For the past decade, Congress has averted this reduction for Medicare providers. NASW  encourages its members to contact their Congressmen and request Congress to override the required SGR reduction. Additional information about the SGR for 2013 is available online at: www.cms.gov/Medicare/Medicare-Fee-for-Service-payment/SustainableGRatesConFact/Downloads/sgr2013p.pdf
Source: nasw-wa.org

Video: Confronting New Medicare Payment Realities – How 2013 Reimbursement Changes Will Impact Pathologists

How Medicare Changes Affect Your Physical Therapy Treatment

Recently, Medicare has implemented changes that impacts physical therapy benefits for all enrollees. Under the “new” Medicare, both outpatient therapies received at a hospital and outpatient physical therapy in a freestanding clinic has financial caps. This combined amount is $3,700, resulting in$1,840 for outpatient services at a hospital services and $1,860 for outpatient services at a freestanding clinic. When patients can no longer receive physical therapy at the hospital due to the new inpatient limitations, the patient is free to seek additional care from a freestanding clinic. We will do our best to keep all of the Medicare patients up to date of any other changes in 2013.
Source: mizutapt.com

Jimmy Buffett Medicare and Healthcare

This attitude for considering such wide latitude of ideas illustrates the sea-change shift that has occurred within the government bureaucracy that has traditionally sought to evaluate “new ideas” primarily by comparing differences in existing care delivery models across the spectrum of the US healthcare system. However, CMS’ Innovation Center does not have full autonomy for conducting Medicare demonstration projects since it is required to focus on new models for paying healthcare providers, e.g., doctors and hospitals.  Because of this limitation (and related anti-kickback laws) the Innovation Center cannot do demonstrations that alter benefit structures, or empower ACOs to create new financial incentives for patients by changing co-payments or other cost sharing requirements. In contrast, private payers are implementing financial incentives to prompt patients to use certain providers, select primary care physicians to help guide them through complex care situations, or adhere to medical therapies for chronic conditions, etc. Perhaps in the future, (either directly or as part of the latitude for accountable healthcare systems), Medicare will be able to test modifications of beneficiaries’ cost-sharing to expand how patients are engaged for improving the quality of care and sharing cost savings.
Source: healthpolcom.com

Coloradans Seek Balanced Approach to Medicare, Social Security Changes

Raju Jairam, 64, of Fort Collins, also is opposed to immediate, major changes. He pointed to the suggestion of boosting the full retirement age for Social Security to 70 from the current 67 for those born in 1960 or later.
Source: aarp.org

Not Happy with Your Medicare Advantage Plan? Change it!

The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.
Source: webmd.com

Older Americans Have Been Highly Resistant to Medicare Changes

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

Medicare changes: What you need to know this year

How YOU CAN save money To help you navigate the Medicare maze, here are some tips from Gail Jensen, an economics professor at Wayne State University and a researcher at its Institute of Gerontology: – Shop around, even if you’re happy with your current plan. You might be able to save money out-of-pocket while preserving your benefits. – Remember that with Medicare Advantage, there is no need to buy Medigap insurance. Your medications are most likely covered, too — though not always — so there may be no reason to pay for a Medicare Part D drug plan, either. – If you like your current doctor, make a call to the office to make sure he or she still accepts your plan after the new year. Or, if you’re leaving an employer-sponsored plan and want to remain with that doctor, find out what Medicare plans he or she accepts. – Likewise, if you’re new to Medicare but like your current insurance, call your insurer. It might have a Medicare version of your current coverage. That can keep you from switching doctors, changing drug coverage or even switching your pharmacy. – If you’re looking for Part D coverage, focus on the medications that you know you need rather than stressing about medications you might never need. Remember that health care reform is forcing discounts on drugs that fall into the previous coverage gap known as the doughnut hole. – Remember that the drug plan that is best for you may not be the best plan for your spouse. Most likely, medication and health needs are different, and your most affordable options will differ. – When you’re ready to dive in and compare policies, have a list of medications ready. You’ll need them to compare your options. – Don’t be afraid to enlist the help of your grown children, a trusted friend or trained counselors.
Source: goerie.com

Medicare Changes for Seniors in Ohio

Governor John Kasich of Ohio announced a medicare medicaid transformation plan with cost saving measures to consolidation of care for  Seniors on Medicare. Kaisch and the State of Ohio had their plan approved the the Centers for Medicare and Medicaid. What the plan  does is coordinate care for Seniors qualify for medicare that are on Medicaid meet low income guidelines.
Source: wordpress.com

Daily Kos: Kaiser report details Medicare options

Posted by:  :  Category: Medicare

Undecided?  Still?? by Patrick FellerMedicare cost sharing is relatively high and, unlike most private health insurance policies, Medicare does not place an annual limit on the costs that people with Medicare pay out of their own pockets. Many Medicare beneficiaries have supplemental coverage to help pay for these costs, but with half of beneficiaries having an annual income of $22,500 or less in 2012, out-of-pocket spending represents a considerable financial burden for many people with Medicare.Cost sharing and premiums for Part B and Part D have consumed a larger share of average Social Security benefits over time, rising from 7 percent of the average monthly benefit in 1980 to 26  percent in 2010 (Exhibit I.3). Medicare beneficiaries spend roughly 15 percent of their household budgets on health expenses, including premiums, three times the share that younger households spend on health care costs. Finally, Medicare does not cover costly services that seniors and people with disabilities are likely to need, most notably, long-term services and supports and dental services. Putting the burden of saving Medicare on the beneficiaries, already paying a significant portion of their incomes on health care, isn’t a solution for saving this program, for keeping it’s promise to America’s seniors and disabled. That basic premise should be the starting point for reforms.
Source: dailykos.com

Video: Medicare Locals Video

To reform Medicare, first expose its moral bankruptcy

Is it proper for the government to force people into such a scheme? Is it right to make the medical expenses of some the unchosen obligation of others? Is Medicare compatible with the founding principle of America — that each individual has a right to live for the sake of his own happiness and not have the fruits of his productivity confiscated for others?
Source: patientpowernow.org

Medicare rewards 1,557 hospitals, penalizes 1,427 in first quality of care analysis

The program is one of several Medicare is launching to make hospitals and doctors accountable for quality and more careful stewards of public money. In October, Medicare also began reducing payments to 2,217 hospitals because too many of their patients ended up back in their care within a month. Medicare already gives bonuses to the private Medicare Advantage insurance plans that score well on quality metrics. In 2015, the health law calls for the government to begin a quality payment program for physician groups of 100 professionals or more, and that is to be expanded to all doctors by 2017.
Source: medcitynews.com

Blog: How Medicare Works with Other Insurance

Medicaid and TRICARE (the healthcare program for U.S.armed service members, retirees, and their families) never pay first for services that are covered by Medicare. They only pay after Medicare, employer plans, and/or Medicare Supplement Insurance (Medigap) have paid.
Source: patch.com

Strathspey Crown and the first Medicare

If Robert Grant is successful – a good bet, judging by his track record – 1 day his new venture, private equity firm Strathspey Crown, will be known as a leader in the nascent field of "lifestyle medicine."
Source: massdevice.com

Darling Downs South West Queensland Medicare Local: Immunisation update

The availability of evidenced based immunisation information resources, such as the Australian Academy of Science publication The Science of Immunisation: Questions and Answers, provide GPs with a valuable tool for informing patients about the safety and efficacy of immunisation. If you would like a copy please email your request to media@ama.com.au. Alternatively, you can also access the publication electronically via the link provided in the AMA GP Desktop Practice Toolkit. 
Source: blogspot.com

CMS Announces First “Qualified Entities” To Receive Medicare Data under Affordable Care Act Program

As part of the Patient Protection and Affordable Care Act, Congress created a new program making certain Medicare data available to “qualified entities” for the “the evaluation of the performance of providers of services and suppliers.”  On December 7, 2011, CMS published a final rule implementing the data use program, which it refers to as the Qualified Entity Program (QEP).  In the final rule, CMS elaborates on the requirements for an entity to be “qualified” as well how the data may be used by qualified entities.  Last week, CMS announced the first three qualified entities that are eligible to receive data under the QEP.  They are the Health Improvement Collaborative of Greater Cincinnati, the Kansas City Quality Improvement Consortium, and the Oregon Health Care Quality Corporation. 
Source: hlregulation.com