Supreme Court Hears Arguments In Hospitals’ Medicare Claims Lawsuit

Posted by:  :  Category: Medicare

In honor of Tax Day by swanksalotPolitico: SCOTUS Asks Tough Questions On Hospitals’ Medicare Claims Lawsuit A majority of Supreme Court justices on Tuesday sounded skeptical of a suit brought by hospitals to reopen Medicare claims as much as 25 years old because of calculations that were found to have underpaid them. The justices heard oral arguments Tuesday in the case of Sebelius v. Auburn Regional Medical Center, a challenge brought by 18 hospitals that are seeking compensation from claims dating to 1987 (Norman, 12/5).
Source: kaiserhealthnews.org

Video: Obama Disputes Romney, Ryan Medicare Claims

Lower Proportion of Medicare Patients Dying in Hospitals

Joan M. Teno, M.D., M.S., of the Warren Alpert Medical School of Brown University, Providence, R.I., and colleagues analyzed Medicare claims data to document places of care and health care transitions for Medicare decedents in the last months of life to assess end-of-life care. The study consisted of a random 20 percent sample of fee-for-service Medicare beneficiaries, 66 years of age and older, who died in 2000 (n = 270,202), 2005 (n = 291,819), or 2009 (n = 286,282). Based on billing data, patients were classified as having a medical diagnosis of cancer, chronic obstructive pulmonary disease, or dementia in the last 180 days of life. The main outcome measures for the study were site of death, place of care, rates of health care transitions, and potentially burdensome transitions (e.g., health care transitions in the last 3 days of life).
Source: newswise.com

Owatonna Medicare Claims Processor Job

Minnesota Medical Office Jobs: Whether you are a recent medical secretary or medical transcriptionist graduate or a skilled professional, Mayo Clinic is a place where you can achieve your goals and discover career and personal fulfillment. We invite you to explore a medical secretary or transcriptionist career with Mayo Clinic in Rochester, Minn. Here you will be a valued member of an outstanding healthcare team, and you will experience the exceptional environment of one of the world’s leading healthcare institutions.
Source: mayo-clinic-jobs.com

U.S. Court of Federal Claims Finds that Extraordinary Delay Can Be a Taking

The Government argued for dismissal of the taking claim because it arose under the Medicare Act, and the Tucker Act does not have jurisdiction over Medicare reimbursement claims. But the CFC held otherwise, noting that the plaintiff exhausted its administrative remedies under the Medicare Act and “received full redress  — restoration of its billing rights — but not in time to salvage its business.” Thus, the CFC reasoned, plaintiff was not seeking “reimbursement for Medicare services or reinstatement of its Medicare billing privileges as its remedy….” Instead, the redress sought was for “alleged Governmental delay in conducting its revocation hearing”—a taking claim based out of extraordinary delay.
Source: marzulla.com

Weasel Zippers | Archives

The issue, according to the reports, is timing. When Medicare is alerted that someone is incarcerated or undocumented, its contractors help prevent payments from going out the door. But often, Medicare’s databases aren’t up to date, and improper payments go out.
Source: weaselzippers.us

analyze the basic stand alone medicare claims public use files (bsapufs) with r and monetdb

so these files are baldly inferior to the unsquelched, linkable data only available through an expensive formal application process.  any researcher with a budget flush enough to afford a sas license (the only statistical software mentioned in the cms official documentation) can probably also cough up the money to buy the identifiable data through resdac (resdac, btw, rocks). soapbox: cms released free public data sets that could only be analyzed with a software package costing thousands of dollars.  so even though the actual data sets were free, researchers still needed deep pockets to buy sas.  meanwhile, the unsquelched and therefore superior data sets are also available for many thousands of dollars.  researchers with funding would (reasonably) just buy the better data.  researchers without any financial resources – the target audience of free, public data – were left out in the cold.  no wonder these bsapufs haven’t been used much. that ends now.  using r, monetdb, and the personal computer you already own (mine cost $700 in 2009), researchers can, for the first time, seriously analyze these medicare public use files without spending another dime.  woah.  plus hey guess what all you researcher fat-cats with your federal grant streams and your proprietary software licenses: r + monetdb runs one heckuva lot faster than sas.  woah^2.  dump your sas license water wings and learn how to swim.  the scripts below require monetdb.  click here for step-by-step instructions of how to install it on windows and click here for speed tests.  vroom. since the bsapufs comprise 5% of the medicare population, ya generally need to multiply any counts or sums by twenty.  although the individuals represented in these claims are randomly sampled, this data should not be treated like a complex survey sample, meaning that the creation of a survey object is unnecessary.  most bsapufs generalize to either the total or fee-for-service medicare population, but each file is different so give the documentation a hard stare before that eureka moment.  this new github repository contains three scripts: 2008 – download all csv files.R
Source: r-bloggers.com

Inside Ringler Medicare Solutions

Medicare and Medicaid compliance when it comes to legal settlement claims can be complicated. This is an area especially critical to claimants, attorneys and insurers and expertise is needed. In this podcast, Ringler Radio host Larry Cohen joins Tom Blackwell, Vice President and Program Director of Ringler Medicare Solutions, Inc. (RMS), as they take a look at RMS’ long-term development plan, how RMS can help with the administration of workers’ compensation claims, liability claims and in claim settlement strategies and the impact of the Strengthening Medicare and Repaying Taxpayers Act (SMART) on the structured settlement industry.
Source: legaltalknetwork.com

For highest EHR incentive bonuses, submit all 2012 claims by Feb. 28

Effect of airline travel on performance: a review of the literature…. Rapid eastward or westward travel may negatively affect the body in many ways; therefore, strategies should be employed to minimise these effects which may hamper …performance. In this review, the fundamentals of circadian rhythm disruption are examined along with additional effects of […]
Source: newsfromaoa.org

Responding to some of President Obama’s Medicare claims

No you haven’t. The Affordable Care Act (ACA, also known as “ObamaCare”) slowed Medicare spending growth. The Medicare Hospital Insurance Trust Fund includes less than half of Medicare spending. You can argue that you have extended the life of this trust fund by “almost a decade,” but trust fund accounting ignores a more immediate cash flow problem.  Since the HI trust fund contains only IOUs from the government to itself, this accounting ignores the question of where to find the $296 B in cash this year to pay for Medicare spending above that covered by Medicare payroll taxes and premiums.  Medicare has never been a fully self-funded program, and even with the savings enacted in the Affordable Care Act, it is still an enormous pressure on the rest of the budget.
Source: keithhennessey.com

Taking the temperature of the Medicaid expansion debate: Bryan King wants to rid his system of waste

Posted by:  :  Category: Medicare

Uninsured Direct-Care Workers by Geographical Region, 2007-2009 by PHInational.orgThe good news is that once released, we’ll actually have something to debate, instead of unspecified anecdotes of waste (a “gut” feeling, as House Speaker Davy Carter described it). But politically, it almost doesn’t matter whether the audit findings are as fishy as DHS says. The conversation will shift, and Republican lawmakers hoping to block expansion are giddy about poking holes in the existing system rather than talking about expanding. It certainly feels like this was carefully rolled out this week, as Republicans spread rumors about shocking waste uncovered in the report, then tweeted and re-tweeted reports of those rumors, then Carter went out of his way to offer a preemptive defense of Leg. Audit. (Rumors that Carter may run for governor cast another dark cloud on expansion — can’t win a state-wide Republican primary unless you’re anti-Obamacare).
Source: arktimes.com

Video: Strengthening Medicaid is a Good Deal for Arkansas

Arkansas Lowers Medicaid Shortfall Projection to $61M

Democratic Gov. Mike Beebe told lawmakers at the start of this year’s session that the lower spending so far this year meant the state could avoid the nursing home cuts, which would have affected as many as 15,000 seniors in the state. The department said it also no longer planned to eliminate Medicaid’s adult dental program, an insurance program for low-income workers and community-based services for the elderly.
Source: arkansasbusiness.com

Eyes Turn To Arkansas’ Bold Effort To Cut Medicaid Costs, Add Transparency

First, the three entities analyzed historical billing data to determine the state’s highest-volume and most costly medical conditions. Then, they each individually targeted three conditions for which they would track the costs for “episodes of care” — meaning the total charges of treating patients for that specific illness, everything from office visits, to medications and specialty care. The conditions included perinatal care, upper respiratory infections, attention deficit/hyperactivity disorder, hip and knee replacements, and congestive heart failure.
Source: kaiserhealthnews.org

Legislators discuss concealed carry, Medicaid expansion

• Teacher insurance premiums Scott said she hopes the Legislature will address the rising insurance premiums deducted from the paychecks of Arkansas public school employees. She said the deductions are considerably higher than other state employees. But Hendren said a solution is not easy because the individual school districts have the authority to make decision on whether to use money to boost salaries or to pay more on insurance premiums/
Source: thecitywire.com

Arkansas: Medicaid Magnet?

Medicaid is a federally mandated program intended to serve as a safety-net for very low-income Americans in need of necessary medical care.  But Medicaid’s low reimbursement rates have resulted in 40 percent of physicians restricting access to patients in the program.  So Medicaid patients often end up in the emergency room for basic health services. In fact, Medicaid patients use the ERs more than the uninsured.  And there is growing documentation demonstrating that being enrolled in Medicaid is actually worse than having no health coverage at all.
Source: netsolhost.com

Why AR Republicans In No Rush To Approve Medicaid Expansion

Most state officials and hospitals are openly in support of expansion,” Burris sid. “We haven’t talked a lot about the quarter million people that are going to have private insurance of some form or another and the impact that has on providers and hospitals. I think the number needs to be quantified and it needs to be part of the discussion.”
Source: arkansasmatters.com

Arkansas should not take the federal Medicaid deal because the money is not free but we pay for it!!!

The three layers of government in the United States no longer resemble the tidy layer cake that existed in the 19th century. Instead, they are like a jumbled marble cake with responsibilities fragmented across multiple layers. Federal aid has made it difficult for citizens to figure out which level of government is responsible for particular policy outcomes. All three levels of government play big roles in such areas as transportation and education, thus making accountability difficult. Politicians have become skilled at pointing fingers of blame at other levels of government, as was evident in the aftermath of Hurricane Katrina. When every government is responsible for an activity, no government is responsible.
Source: thedailyhatch.org

Disability Rights Center of Arkansas

Among the mostly partisan public discussions of members of the Arkansas General Assembly about the wisdom of expanding Arkansas’ Medicaid program have been those legislators who want Medicaid recipients to “have some skin” in the game. In other words, make them pay for a portion of their services. Notwithstanding the fact that most of the Medicaid recipients DRC serves will receive a maximum of $710 per month in 2013, we see the whole co-pay thing as fraught with peril. We’ve watched as people with mental illness living in residential care facilities (RCFs) have been co-paid to death on their prescription drugs, with the RCF taking a $3 co-pay per prescription out of their paltry $30 per month personal living allowance. On the front end. And despite the fact that the rules in Arkansas for co-pays say if the recipient can’t afford it, they don’t have to pay it. So we are viewing the proposed rule by the Centers for Medicare and Medicaid Services (CMS) for cost sharing by Medicaid recipients with mixed feelings. We can agree that for those who can afford it, co-pays are not necessarily a bad idea. However, the implementation of such a rule seems to be largely left up to Medicaid providers in Arkansas, without consideration of whether the recipient can really afford the co-pay. Discussion of cost sharing (co-pays) begins on page 225 of the 474 page proposed rule. Public comment is due to CMS by 5 p.m. on February 13, 2013.
Source: livejournal.com

Video: Arkansas gearing up for Medicaid Expansion vote

Legislatures from Alabama to Wyoming are preparing to decide whether to participate in the Medicaid Expansion program under the Affordable Health Care Act. In many of those states, three-fourths of the legislatures will have to approve for the program to provide increased health care benefits to those who can’t afford health insurance. Arkansas Gov. Mike Beebe explained his position on the issue at the annual meeting of the Agricultural Council of Arkansas in Little Rock.
Source: deltafarmpress.com

Lower Proportion of Medicare Patients Dying in Hospitals

Posted by:  :  Category: Medicare

Joan M. Teno, M.D., M.S., of the Warren Alpert Medical School of Brown University, Providence, R.I., and colleagues analyzed Medicare claims data to document places of care and health care transitions for Medicare decedents in the last months of life to assess end-of-life care. The study consisted of a random 20 percent sample of fee-for-service Medicare beneficiaries, 66 years of age and older, who died in 2000 (n = 270,202), 2005 (n = 291,819), or 2009 (n = 286,282). Based on billing data, patients were classified as having a medical diagnosis of cancer, chronic obstructive pulmonary disease, or dementia in the last 180 days of life. The main outcome measures for the study were site of death, place of care, rates of health care transitions, and potentially burdensome transitions (e.g., health care transitions in the last 3 days of life).
Source: newswise.com

Video: EHR: Medicare Incentive Program Attestation Webinar for Eligible Professionals

Former Medicare administrators identify different priorities for reform

Bruce 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

U.S. proposes scrapping some obsolete Medicare regulations

The Department of Health and Human Services described the targeted regulations as unnecessary or excessively burdensome and said their proposed elimination would allow greater efficiency without jeopardizing safety for the Medicare program’s elderly and disabled beneficiaries.
Source: medcitynews.com

Aetna Medicare Marketing Materials Now Available

In addition to the web materials, Aetna provides you with three email templates so that you can thank your clients for their business and let them know you sell Aetna Medicare products at the same time, using approved messaging.  To send an email, click one of the links below and then copy/paste the text into a new email message. (You will need to be a registered user of Producer World). Adjust the variable fields highlighted in red (i.e. name, number, etc.) and then send it out to your clients.  Please note that only the variable fields may be changed; all other email content must remain as is.
Source: agentpipeline.com

What Medicare Needs is a Consumer

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

Another ObamaCare Medicare Gimmick

ObamaCare supporters sometimes like to talk about the legislation’s “delivery system reforms,” which are supposed to change the way health care services are organized in ways that make health care less costly and more efficient. The bulk of these delivery system reforms are essentially payment reforms — restructuring the way medical providers are reimbursed in hopes of changing their incentives. But the sheer complexity of the way Medicare pays providers means that these sorts of payment games are not only commonplace, but key drivers of administrative decisions in medical facilities. Medicare’s size also means that its decisions often have ripple effects throughout the medical payment ecosystem.
Source: reason.com

Medicare Biller/Collector with Hospital experience Phoenix Job

TTF places candidates in the PFS field with the following specialties and titles:  Hospital Collector, Commercial, Government, Managed Care, Billing Representative, Medical Biller, AHCCCS, Medicare, Medicaid, , Medical Claims, Follow-Up Rep, Medical Collections Representative, Medical Collector, Medical Reimbursement Specialist, Patient Account Rep, Patient Financial Representative, Reimbursement Representative, Reimbursement Specialist, Claims Processing, Claims Processor.
Source: jobing.com

Obama to set elders against the poor by going after Medicare not Medicaid

A blog (from “web blog”) is a discussion or informational site consisting of discrete entries (“posts”) typically displayed newest first. All Corrente posts are front-paged; there is no up-rate or down-rate process. Corrente posts are almost entirely community moderated. We encourage a clash of ideas, and do not encourage a clash of persons.
Source: correntewire.com

Doctors praise bill to repeal Medicare cost

Posted by:  :  Category: Medicare

White House Medicare Presentation by National Institutes of Health LibraryThe AMA and other healthcare providers strongly oppose the IPAB, which would essentially have the power to make Medicare cuts now reserved for Congress — and thus subject to intense lobbying by groups trying to avoid a cut to their payments.
Source: thehill.com

Video: Cheryl Bradley lectures on Medicare Billing

In brief: Industry holds on, Medicare bill revived

Quantum Rehab has a new company logo. Featuring the slogan “Life Beyond Limits,” the new logo is designed to “match the evolving, cutting edge features and functionality of the Quantum product line,” according to a press release…Members of Ottobock’s marketing, sales and clinical teams have come together to form an upper limb prosthetics team. Ottobock tapped Dave Slipher, a business development manager and sales specialist, to lead the team…Invacare will release its financial results for the fourth quarter of 2012 before the market opens on Friday, Feb. 8, according to a press release. The company will sponsor a conference call for investors and other interested parties on that day at 8:30 a.m. EST to discuss its quarterly performance (1-888-498-8379, ID 89525970)…Invacare has completed the sale of its medical supplies unit, Invacare Supply Group, to AssuraMed. AssuraMed, the parent company of Edgepark Medical Supplies and Independence Medical, purchased ISG for approximately $150.8 million in cash, which is subject to final post-closing adjustments.
Source: hmenews.com

Judge may issue own order for WakeMed settlement over Medicare billing violations

The government said that the order would hold WakeMed publicly accountable for its actions and force the hospital to pay back money to the Federal government. Prosecutors say if WakeMed was taken to court on a criminal charge, it would put the hospital out of business and thousands of workers would be left unemployed.
Source: news14.com

Medicare Foots $120 Million Bill For Ineligible Patient Groups

Bloomberg: Drugmakers Prep For U.S. Rules On Disclosing Payments Drug companies and medical-device makers would be forced to publicly disclose any money paid to doctors under new U.S. regulations designed to make patients aware of conflicts of interest that may affect their health. The final rule, a provision in President Barack Obama’s health law that is more than a year overdue, is set to be released soon, said Brian Cook, a spokesman for the Centers for Medicare and Medicaid Services. Companies would have to publish payments to doctors for research and consulting services (Edney and Wayne, 1/24).
Source: kaiserhealthnews.org

Rangel Introduces NEWT Act To Close Loophole In Medicare Tax

There are two prominent examples of this loophole. In 2010, Gingrich Holdings, Inc and Gingrich Productions paid Newt Gingrich $444,327 in wage income while declaring $2.4 million as profits of the S corporation. This allowed Speaker Gingrich to avoid $69,000 in Medicare taxes. He earned the money by giving speeches and consulting, but the fees were paid to the S-Corporation. In 1995, John Edwards earned $26.9 million from his work as a trial lawyer. He paid himself a salary of $360,000 each year for four years and took the rest as distributions from his S corporation. This saved Senator Edwards an estimated $600,000 in Medicare taxes.  
Source: house.gov

President Signs Committee Bill that Creates Efficiencies in Medicare and Saves Taxpayer Dollars

“Four years ago, one of my constituents suffered severe injuries in a terrible car accident,” said Murphy. “After coming to a settlement with the insurer, 73-year-old Lorraine Babich of Washington County was unable to get a straight answer from the Centers for Medicare and Medicaid Services about the amount of her medical bills, which had to be repaid to the Medicare Trust Fund. As a result of unnecessary bureaucratic hurdles, Lorraine waited years to get the proper settlement due to her. Unfortunately, Lorraine’s heartbreaking story isn’t an isolated case because there are thousands of senior citizens just like her who continue to await settlements, see their Social Security checks garnished, and Medicare coverage denied through no fault of their own. With the SMART Act now signed into law, Lorraine and thousands of other senior citizens will no longer needlessly suffer due to bureaucratic red tape.”
Source: house.gov

HCAN Partners: Tax Corporations, Protect Medicare, Medicaid, ACA

Citizen Action of Illinois held a press conference outside the office of Rep. Rodney Davis (R-13) in Champaign, Illinois to highlight the negative impact of budget cuts and joined the Chicago Federation of Labor at a gathering in Chicago to push back against cuts to Medicare, Medicaid, the Affordable Care Act, and Social Security. Leaders were joined by U.S. Reps. Jan Schakowsky (D-9) and Bill Foster (D-11).
Source: healthcareforamericanow.org

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

Medicare and Medicare Supplemental Insurance

Posted by:  :  Category: Medicare

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

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

Medicare Supplemental Insurance Comparison Website Created by Senior Citizen Announces 25,000th Customer Helped

Medicare Supplemental Insurance Comparison (MSIC) announced today that they have successfully assisted their 25,000th customer. For anyone who has searched for Medicare supplemental insurance they know it can be a challenging process. The advent of the internet has certainly made the process easier, but only until recently clients still had to part with sensitive information such as their name, age and home address. Medicare Supplemental Insurance Comparison was created with the researcher’s privacy in mind, and is one of the first comparison websites of its kind to give insurance quotes while only requiring a zip code. “This is what allowed us to take our website to the next level,” said Steven Pewter, creator of the MSIC. “I’m a senior citizen myself and I wanted to create something that anyone could be comfortable using. The majority of our clients just aren’t OK with giving personal information up front. Our goal was to allow people to search for supplemental insurance anonymously, and I think our success with that has made us so popular.” “Hitting the 25,000th visitor helped is indeed a fine achievement,” said David Bartholomew, director of marketing. “We’ve found that as soon as anything ‘personal’ is requested people immediately click away. They just don’t want that, it feels completely invasive. With our site people can search all the most reputable Medicare supplemental insurance providers in their area and do so 100% anonymously. They can contact the companies on their own terms, and the fact that they get competing price quotes puts them in the place of power during negotiations.” MSIC also recently announced that they have added 250,000 companies to their database, all of them vetted according to reputation and years in business. To learn more, or to get a fast comparison of all the highest rated insurance companies in a specific area, please visit: http://medicaresupplementalinsurancecomparison.net/ About MSIC Medicaresupplementalinsurancecomparison.net (MSIC) was created in September of 2012 to help shoppers get the best rates for Medicare supplemental insurance. The website utilizes the absolute latest in price quote technology, and has already received rave reviews from the industry.
Source: sbwire.com

Adding Medicare Supplemental Insurance to Your Primary Medicare Coverage

Health insurance can be a confusing mess if you don’t have someone who can help you sort through eligibility, policy differences and red tape. While you certainly don’t have to have an insurance agent and can sign up for insurance on your own, it can be very helpful to have someone break it down for you into easy terms. This can be especially true for Medicare Supplemental Insurance plans, simply because there are twelve different Medigap plans, and even those are different from state to state. Medicare simply doesn’t always cover all of your healthcare needs, however, and you may need additional coverage.
Source: medicaremedics.com

How Do I Decide On Supplemental Insurance For Medicare?

Look ahead at what medical expenses you expect to incur in the next year. Look back at what medical expenses you had to pay last year that wasn’t covered by Medicare. Now obtain a benefit summary booklet from the supplemental insurance company and study the coverage and compare to what you expect to need. Every year in October Medicare sends out a new coverage booklet and in the back will be identified the supplemental insurance plans that cover your geographical area. Call the one or two plans that seem to fit your criteria and ask for a benefit booklet to be sent to you. These books compare the coverage of the companies to the Medicare benefit plan. You can easily see how you can benefit.
Source: seniorcorps.org

California Birthday Rule Medicare Supplement

Because of the “equal or lesser value” restriction in the California Birthday Rule for Medicare Supplements, it is often best for new enrollees to choose the highest level plan they can afford. You can always keep this plan for a year, and then downgrade later to save money if needed. However, if your health is adversely affected and you find you are using your supplemental insurance more and more, you’ll be glad you have access to the higher coverage plan.
Source: healthbrokerdave.com

How To Know If You Need Medicare Supplemental Insurance

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

Buying Supplemental Health Insurance

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

Looking Into Different Aspects Of Medicare Supplemental Insurance

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

Part V: Medicare Supplemental Insurance

You can only obtain Medicare supplemental insurance, or Medigap, if you enroll in Traditional Medicare. While Medigap covers the out of pocket costs that arise under Medicare Parts A and B, it does not usually pay for any costs under Part C, Part D or private health insurance plans. Many private insurers offer Medicare supplemental insurance, and coverage comes in 10 different options: A, B, C, D, F, G, K, L, M and N. Some of these options do provide prescription drug coverage through Part D.
Source: wordpress.com

Colonial Penn Medicare Supplement Insurance

• Long-term hospitalization. Medicare only covers a small portion if any of the cost for those people who need to be hospitalized. Colonial Life Medicare supplement insurance on the other hand, covers all or most of your hospitalization depending on the type of supplemental insurance you purchase. This is a huge benefit to most elderly people who simply do not have the income to pay those large hospital bills.
Source: lifeinsurancequotesnreviews.com

Medicare and Medicare Supplemental Insurance

Posted by:  :  Category: Medicare

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

Video: Protect your Family with Medicare Supplement Insurance

Cancel Medicare Advantage

Because of their flexibility, the ability to move states and the fact that the insurance company cannot change the plan are just a few of the reasons we prefer Medicare Supplement Insurance Plans to MAPD. If you would like to hear more about the reasons a Medicare Supplement can be a better fit for your insurance, please fill out the short form at the top of the page and one of our experts will get you a new medicare supplement quote and help explain how you can save the most off your medicare cost.
Source: medicarecost.net

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

California Birthday Rule Medicare Supplement

Because of the “equal or lesser value” restriction in the California Birthday Rule for Medicare Supplements, it is often best for new enrollees to choose the highest level plan they can afford. You can always keep this plan for a year, and then downgrade later to save money if needed. However, if your health is adversely affected and you find you are using your supplemental insurance more and more, you’ll be glad you have access to the higher coverage plan.
Source: healthbrokerdave.com

What Is A Medicare Supplement

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

Medicare Supplemental Insurance Plans D, F, and G

In addition to what Plan A covers, Medicare Part D provides coverage for coinsurance for skilled nursing facility, Medicare Part A deductible and foreign travel emergency coverage. Over and above Plan A coverage, Medicare Part G provides coverage of skilled nursing facility, Medicare Part A deductible, foreign travel emergency coverage, and Medicare Part B excess cost coverage.
Source: medicaremedics.com

Comparing Medicare Supplemental Insurance Benefits

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

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

Buying Supplemental Health Insurance

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

Things You Should Know about Medicare Supplement Insurance Plans

One of the most hotly contested debates in the country today revolves around Medicare reform. It is certainly no secret that Medicare alone is not sufficient to cover all of our health care needs. Medicare supplemental health insurance is the health insurance taken in addition to the Medicare insurance. Supplemental refers to the add-on nature of the insurance; it supports the Medicare insurance by paying for costs that are not covered by Medicare. These include charges such as deductibles, copayments and coinsurance. Because it helps pay for gaps in the cost and reimbursements of the Medicare insurance, it is also called Medigap insurance. Private health insurers offer supplemental insurance plans; the prices for the plans vary from one insurer to another even for the same plan. Finding out the right plan is important from two aspects: getting the right supplemental insurance plan for your requirements, and getting it at the lowest cost.
Source: greatinsurancedirectory.com

Senior Health Insurance Cover

Posted by:  :  Category: Medicare

Joe the Plumber - To Flush The System ... More scams aim to ensnare Brevard seniors - Their ingenuity is boundless, Archer said. (Jul 2, 2012) ... by marsmet524The senior citizen health insurance is a very important insurance cover for the citizens who wish to be medically covered past their retirement age. This is one insurance cover for people who once they are retired or retrenched are planning to depend on their interests or pension. Many people have had to endure difficult financial crisis as a result of the sudden medical emergencies. Senior citizens are therefore encouraged to take the senior insurance cover to avoid running into the financial crisis.
Source: wordpress.com

Video: Health Insurance Policies for senior citizens in India.wmv

streetvoiceuk2011: Senior Health Insurance

After the age of 55, it is more difficult to get certain types of insurance, whether it be group insurance at your workplace, or health insurance from private sources that will cost more. After the age of 70 it is very difficult to find any private supplemental health insurance. As time goes by the need for supplemental health insurance becomes more important. Senior health insurance is more expensive in some situations because of the risks the insurance company consider could be involved, for example an extended illness of the insured costing many thousands of dollars, which the insurance company would have to pay, therefore such situations are considered and included in the cost of the policy. We all know that as we age our health becomes more of a concern, therefore getting adequate insurance for possible needs also becomes a concern.
Source: blogspot.com

As America ages, senior care options flourish

The average rate for adult day care last year was $70 a day, or about $18,000 annually. Licensing and certification requirements vary by state and county. More than 5,000 centers run programs across the country and can be found through groups like the National Adult Day Services Association. The group recommends visiting potential centers and going through a checklist of options and amenities, including door-to-door transportation and accessibility. For more, visit: http://www.nadsa.org/ consumers/site-visit-checklist/.
Source: spokesman.com

Tips to Find Affordable Health Insurance for Senior Citizens

Protection policies provided by the state government These are the policies offered by non-public organisations. It is a particular coverage, as there are different policies for different age group. The help that is provided to the senior citizens are processed through the federal government. This also enables the government to provide the same class of coverage under the exact policy irrespective of their place where they are living. The state health insurance assistance programme, which is organised by the state government through which you can get the help, provided you qualify and your health issues will be taken care. There are many companies like Medi care, Medi gap, in which you can be profited on condition if you meet their criteria.
Source: financemoz.org

Insurance Commissioners Reject Calls To Limit Seniors’ Medigap Policies

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

Get to know and understand your health insurance plan

Lori Blatzheim is a wife, mother, grandmother, writer, thrift advocate, and retired nurse. She knows that use of Thrift can help people because she has experienced the benefits. Are you a Senior? Do you have a friend or relative who is considering retirement or has already retired? Check out this web site: Retire and Renew:
Source: stretcher.com

Understanding Senior Citizens’ Health Insurance [With Comparison Chart]

the article is a good sum up of the details of health insurance of senior citizens. Especially the tips given to the children to buy insurance for their aging parents and the data table provided is really magnificent. To add to this, I would like mention a name of one more organization to the senior citizens and their children who will be reading this article. The name of the organization is “The Golden Estate”, this team has come up with this ideology of service apartments specially for senior citizens. Currently it’s based in Faridabad but they planto come up with such apartments in various cities of the country very soon. You can have a look at their site http://www.thegoldenestate.com
Source: sohamfp.com

Arizona Senior Health Insurance Solutions

In Arizona, there are a wide array of Senior Health Insurance Plans. The many options available to you include health insurance plans for people that have certain health conditions, health insurance plans for people who like to travel the United States and foreign countries , health insurance plans for those who want to seek out the best treatment from doctors throughout the United States that accept Medicare, and health insurance plans for people with lower incomes that receive extra help.
Source: arizonaseniorhealthinsurancesolutions.com

Health Insurance Broker for Redondo Beach – Dave Vaccaro

There are a couple of significant benefits you would get by using me as your insurance broker. Firstly, I am dedicated to each and every one of my clients, and as such I am always accessible. When you go directly to the larger insurance firms, you can often be left waiting for simple answers to your questions. I will eliminate that problem as I will be dealing with the carriers on your behalf and will get you the answers you need right away.
Source: healthbrokerdave.com

Money Magazine honors senior health care watchdog Bonnie Burns of Scotts Valley

Other Money heroes included Holly Petraeus, assistant director, Consumer Financial Protection Bureau and wife of former CIA director David Petraeus; and Robert Shireman, of California Competes, who as a U.S. Senate staffer pitched the idea of federal direct loans to college students to eliminate middlemen and lower interest rates.
Source: santacruzsentinel.com

Senior Health Insurance & Medicare Luncheon

In addition to providing pertinent information, Elizabeth will answer questions and assist with making choices.  The community is invited, so feel free to bring a friend or two.  Lunch will be provided at the conclusion of the program for a donation.  Questions?  Contact PFC’s Wellness Coordinator, Nancy Elliott-Carter, (484-433-1290).
Source: parkerfordchurch.com

The Washington Health Benefit Exchange: A Key Part of the Post

Washington state will have a vibrant marketplace for individual and small group plans both inside and outside of the exchange. So, just like today, if you want to buy coverage, you can go directly to the insurer or work through a broker or agent. The plans sold inside and outside the exchange must meet the same consumer protections. The primary differences are that the advanced tax credits and cost-sharing support is only available for those plans purchased inside the exchange, and the exchange will make comparing and shopping for insurance more transparent, allowing small businesses, individuals, and families to make apples to apples comparisons.
Source: wsba.org

Daily Kos: Kaiser report details Medicare options

Posted by:  :  Category: Medicare

Raging Grannies: No Private Parts by Grant NeufeldMedicare 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: Rob Cornilles: The Original Tea Party Candidate

What Medicare doesn’t cover

Bankrate wants to hear from you and encourages comments. We ask that you stay on topic, respect other people’s opinions, and avoid profanity, offensive statements, and illegal content. Please keep in mind that we reserve the right to (but are not obligated to) edit or delete your comments. Please avoid posting private or confidential information, and also keep in mind that anything you post may be disclosed, published, transmitted or reused.
Source: bankrate.com

Report: Private Medicare Advantage Plans Make Progress in Combating Chronic Disease

Since its start in 2003, Medicare Advantage has gained popularity because of its high quality, coordinated benefits and patient-centeredness.  Its central role for private health plans makes MA extremely popular with seniors.  The best practices of these plans should be integrated into conventional Medicare.  That’s the only hope if Medicare is to contain its costs without sacrificing quality and care in the process.
Source: hlc.org

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

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

Medicare Spending Not Running Wild Compared to Private Payors, Economist Argues

Contrary to popular belief, Medicare spending is not spiraling out of control, writes Princeton economics professor Uwe E. Reinhardt in a New York Times column. Rather, he says for most of its more than 40-year history Medicare payment rates have grown more slowly than private payors’, with exceptions for the early years after it began to cover prescription drugs last decade and when insurers first introduced cost-saving managed-care plans in the 1990s. Among his arguments in favor of Medicare’s tempered spending growth, Mr. Reinhardt challenges those who claim providers in effect shift the cost of care to higher-reimbursing private insurers as a result of lower reimbursement from Medicare. He disagrees with the cost-shifting hypothesis, claiming instead that providers’ practice of charging private payors more is purely profit-maximization — charging more of those who can pay more, and less of those who are less profitable. More Articles on Medicare Spending:
Source: beckershospitalreview.com

Cravaack, Nolan battle over Medicare

Referring to Medicare’s low administrative costs relative to what private insurers spend on overhead, Nolan said, "It costs roughly 3 or 4 percent to administer Medicare. Private insurance on average runs somewhere between 27 and 30 percent administrative costs. So once you turn Medicare back over to the insurance industry, you know, right out of the chute you are dramatically increasing the administrative costs."
Source: publicradio.org

Health Care Spending Trends: Medicare and Private Health Insurance

Slowing the growth of health care spending continues to be a major domestic policy challenge. In 2010, total U.S. health expenditures reached $2.6 trillion – 18 percent of gross domestic product (GDP). Although health care spending has slowed in recent years, it is projected to grow faster than GDP over the next decade.Medicare, the nation’s largest health insurance program, accounts for one in five health care dollars, and in 2010 accounted for 15.1 percent of the federal budget – a figure that is expected to reach 17.4 percent by 2020.
Source: nasi.org

Health Insurance: Medicare Rebates and Private Health Insurance Cover for Osteopathic Treatment in Australia

If you want to commit an osteopathic treatment in Australia, it is important to know how your treatment will be covered by Medicare, the scheme of the government universal health care or private health insurance funds. Medicare One patient in Australia with a chronic disease (eg, a condition long musculoskeletal system), which is overseen by a family physician, is entitled to Medicare for up to five sessions of osteopathic treatment in a calendar year, such as by an osteopath with the Osteopathy Board of Australia are registered. However, there are certain conditions that can be applied in the order for a patient to be eligible for the rebate. First, the treatment must be an osteopath from a chronic disease management MBS physician services provided to the patient and the patient’s GP Management Plan (GPMP) and the detention orders are recommended. Team (ATC) A reference GP is necessary for a referral form, which is provided by the Australian Department of Health and Ageing, this form must be submitted to the osteopaths the first treatment. After all five sessions have been committed, if further treatment is necessary, a new benchmark GP is required. Second, if more than five sessions of osteopathic treatment is undertaken, the following sessions are not covered by Medicare. Third, the osteopath needed a reference GP written report. Usually at the end of treatment that provide detail the proposed treatment, tests or analyzes and plans for the future management of the patient A patient who has private health insurance, chose not to seek a guarantee that their osteopathic treatment, but to their Medicare claims is also entitled to the cost of five treatments each year civil claim above conditions are provided fulfilled. Private health insurance Osteopaths in Australia as allied health professionals are a patient with osteopathic treatment required by their private health insurance does not start treating doctor’s recommendation. Generally have a private health insurance either a form of collateral or Extras: right of a patient to a specific number of sessions of osteopathy during the calendar year, depending on the amount of coverage, or to pay a contribution towards the cost of osteopathic treatment, to for an agreed amount. However, it is important that patients check with their health insurance, that osteopathic treatment is covered in her special diet, and other expenses that they can be held accountable. It is also important that patients who decided to have not claim the cost of osteopathic treatment on their private health insurance, know, and instead to claim their Medicare rebate can not use their private health insurance for Any shortfalls between Medicare and fees to pay for the processing.
Source: blogspot.com

State Trends: Per Person Costs of Private Insurance Rising Faster Than Medicare

Rising health care costs and stagnant incomes have pushed more families into poverty. As a result of the recession, the percentage of people with ESI dropped from 58.9% to 55.3% from 2008 to 2010. An estimated 9 million adults between 19-64 lost a job with health benefits and became uninsured. As Say Ahhh! readers know, a new alternative poverty measure from the Census Bureau finds that 16% of the population would have been counted as poor, compared to 12.7%, when medical spending is factored in to the calculation.
Source: georgetown.edu

Choice Of Rep. Ryan Puts His Plan To Overhaul Medicare At Center Of Campaign

Posted by:  :  Category: Medicare

Dr Fixit is on the Job / Alternate title The Proctologist by bitzceltThe Wall Street Journal: Democrats, GOP Spar Over Ryan On Shows Republicans and Democrats sparred Sunday over Mitt Romney’s choice of Rep. Paul Ryan (R., Wis.) as his running mate, seizing on his proposals in Congress to highlight differences between the parties over taxes, spending and entitlement programs. Republican Sen. John McCain of Arizona, who lost to President Barack Obama, a Democrat, in the 2008 presidential election, said Mr. Ryan understands that “the most compelling challenges this nation faces obviously are jobs and the economy.” … Other Republicans, however, were more careful to avoid conflating the particulars of Rep. Ryan’s budget proposals with Mr. Romney’s campaign. “Mitt Romney appreciates and admires the work and the ideas that Paul Ryan has done,” Republican National Committee Chairman Reince Priebus said on NBC’s “Meet the Press.” But while celebrating Rep. Ryan’s bold efforts, he noted that the presumptive Republican presidential nominee can offer his own proposals (Entous and Peterson, 8/12).
Source: kaiserhealthnews.org

Video: Stephanie Cutter: Medicare Whiteboard

How Raising The Medicare Age Hurts The Job Market

So instead of calling it increasing the retirement age, why not be truthful and honest, and call it what it is; the age at which coverage begins. Because as it is, the implied message being sent is a senior will simply move from his work health coverage to Medicare. The truth is the a significant number of seniors today are already facing a gap between the time they are being forced out of their jobs and thus losing medical coverage, and years later when they finally can attain Medicare.
Source: wordpress.com

Group Medicare Sales Executive

View All Insurance Sales and Marketing Jobs Jobs by Type Account Representatives / Executives / Managers Brokers Directors / Executives District / Regional Managers Field Sales Associates / Representatives Insurance Agent Jobs Insurance Agent Jobs Property / Casualty Agency Insurance Agent Jobs Life / Annuities Agency Insurance Marketing Insurance Producer Insurance Sales Assistants Marketing Managers
Source: insurancesalesweb.com

Call Congress December 5th to say NO to cuts for Medicare, Medicaid and vital services.

Afghanistan audit budget deficit chained CPI Congress corporation cost-of-living CPI defense entitlements Federal budget Fiscal Cliff grinch images inflation jobs Jobs-Not-Wars Campaign Lame Duck Legislature Letter to Editor local government Medicare military contractor military spending NDAA Obama Pentagon petition president Progressive Caucus promotional handout protest Republican Tax Plan resolution seniors sequester social safety net Social Security Talking Points tax unemployment veterans video war White House
Source: jobs-not-wars.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

Medicare Advantage Works As Long As You’re Healthy, But Boots Off Neediest Patients

8 to 11 year old category 12-15 year old category barack obama barbara revels bunnell city commission don fleming economic development elections 2012 Flagler Beach flagler beach city commission Flagler County Commission flagler county crime flagler county school board flagler county schools flagler county sheriff’s office Flagler Palm Coast High School florida education Florida Legislature gop gov. rick scott health care health care reform ideology janet valentine jim landon jobs jon netts l’infame little miss junior flagler county pageant local government budgets milissa holland Miss Flagler County Pageant miss flagler county scholarship pageant obama administration Palm Coast palm coast city council palm coast crime police state republicans rick scott small government taxes traffic accidents unemployment us economy
Source: flaglerlive.com

Scheduled Medicare cuts will wipe out jobs

The Tripp Umbach model estimates that, during the first year of the sequester, more than 496,000 jobs will be lost. The report found that the job losses will affect many economic sectors beyond healthcare, and will be spread across every state with more than 78,000 jobs lost in California alone by 2021. The report notes that for decades, the healthcare sector has long been an economic mainstay, providing stability and growth even during times of recession. The Bureau of Labor Statistics’ data shows that healthcare created 169,800 jobs in the first half of 2012 and accounted for one out of every five new jobs created this year. Tripp Umbach notes that it designed a customized model based on the national economic impact models developed by MIG IMPLAN, as well as previous impact studies. The Tripp Umbach report and other resources are available at this link.
Source: emaxhealth.com

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

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

Daily Kos: One big way to reduce poverty

it’s DOABLE.  Despite the immense investment our country has in inefficient private medical insurance, the existence of Medicare sets an easy template for extending national health coverage to everyone.  All we would have to do is to systematically REDUCE THE AGE of eligibility.   Say do it by five years at a time, every five years.   It would phase in the shift over 40 years, giving the private insurers plenty of time to switch business plans.  But it would have social benefits from Day 1, as each time the age was reduced, it would reduce overall costs of the program by adding relatively younger, healthier people to the overall Medicare pool, and reduce unemployment by enabling earlier retirements among mature middle class workers whose jobs could then go to younger people now locked out of the job market.  A controlled phase-in of universal Medicare would be a win-win-win on a half dozen different fronts (and the poor, put-upon insurance companies would have plenty of time to plan for alternative lines of business).
Source: dailykos.com

Daily Kos: Kaiser report details Medicare options

Posted by:  :  Category: Medicare

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

Video: Labor: strengthen Medicare, make dental care affordable

Medicaid News: Minn. Effort To Expand Program Praised

California Healthline: Access Denied? Implications Of Medi-Cal Pay Cut In 2014, about 1.5 million adults in California are expected to gain access to Medi-Cal under the Affordable Care Act. However, insurance coverage could be all they get, as some observers say there might not be enough doctors willing to treat them. The fiscal year 2013-2014 budget proposal that Gov. Jerry Brown (D) released this month could be read as contradictory. On one hand, he makes it clear that California will pursue a full expansion of Medi-Cal, offering coverage to individuals with incomes up to 138 percent of the federal poverty level. At the same time, however, the governor’s budget plan also counts on $488.4 million in savings from a 10 percent cut to Medi-Cal reimbursements. Medi-Cal is California’s Medicaid program. State officials maintain that the provider pay cut should not hurt access to care during the expansion, but others fear the reduction could be implemented at the worst possible time (Wayt, 1/30).
Source: kaiserhealthnews.org

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 Myths » Toni Says

Myth #1:  Most baby boomers think Medicare is just like regular health insurance plans…FALSE!!  Only 2 in 5 or 40% of the baby boomers surveyed know that Medicare is totally different than traditional group or individual health insurance.  Medicare has 2 Parts A & B.  Part A has a $1,184 deductible 6 times a year for an in hospital stay.  Part B of Medicare includes doctor’s services such as office visits and doctor performing surgery, outpatient services and surgery, scans, x-rays, chemotherapy and radiation, and the list goes on.  There is a 1 time deductible for Part B of $147.00 once a year with Medicare picking up 80% and you pay 20% of the Medicare approved amount with no co-insurance or stopping.  Not like the typical 80/20 to $5,000 with a stop lost. The 20% just keeps on going!! Toni Says: Medicare is completely different than health insurance. Your out of pocket can be huge if you only have Medicare or the red, white and blue card. Learn what Medicare offers.
Source: tonisays.com

Dental Vacation Packages to Costa Rica

The steep costs of dental treatments in most countries of the West are daunting for people with limited budgets. It makes matters even worse for those who have limited or no dental insurance.The US Centers for Medicare and Medicaid predicted that by 2013 insurance cover would be available for only about 48 per cent of expenses related to dental treatment. A Survey of Dental Care Affordability and Accessibility conducted by Empirica Research in conjunction with Dr. David Neal in 2011 stated that approximately 50% of Americans did not have dental insurance.
Source: dentalimplants-costarica.com

Medicare Eligibility and Senior Health Care

Medicare Advantage popularly known as MA refers to a health insurance program which offers an eligible individual with the US Medicare benefits. MA differs from the previous Medicare model that offered a standard plan offered directly by the United States. In contrast, MA is program that is normally provided by private providers.
Source: eazyretirement.com

medicare fee schedule 2011: The cost of dental prämienverbilligung care can be high

since prophylactic cleaning, fluoride applications and oral x-rays, allowing you to take advantage of them for free. However, there are a lot of dental insurance providers in the market offering a wide variety of products. prämienverbilligung Which one should you choose? prämienverbilligung Before beginning to choose between dental insurance companies, first decide what kind of dental prämienverbilligung coverage insurance you need. The most typical types of dental insurance plans are Preferred Provider Organization prämienverbilligung (PPO) and Health Maintenance Organization (HMO) packages. prämienverbilligung In an Health Maintenance Organization plan, you may be asked to select a practitioner prämienverbilligung belonging to the HMO’s provider network, who provides you with primary dental and refer you to a professional if you need specialized treatment. A PPO plan allows you to visit virtually
Source: blogspot.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

Medicare Dental Plans: Medicare does cover these types of dental services

Dental services that are an integral part of a covered procedure (e.g., reconstruction of the jaw following accidental injury). Extractions done in preparation for radiation treatment for neoplastic diseases involving the jaw.                                                    Oral examinations, but not treatment, preceding kidney transplantation or heart valve replacement, under certain circumstances. Such examination would be covered under Part A if performed by a dentist on the hospital’s staff or under Part B if performed by a physician. This is because the purpose of the examination is not for the care of the teeth or structures directly supporting the teeth. Rather, the examination is for the identification, prior to a complex surgical procedure, of existing medical problems where the increased possibility of infection would not only reduce the chances for successful surgery but would also expose the patient to additional risks in undergoing such surgery. Hospital stays if needed for emergency or complicated dental procedures, even when the dental care itself is not covered. In these cases you should call your Part A contractor for more information. Inpatient hospital services in connection with the provision of such dental services if the individual, because of his underlying medical condition and clinical status or because of the severity of the dental procedure, requires hospitalization in connection with the provision of such services. Surgical procedures for the reconstruction of a ridge as the result of and at the same time as a tumor removal (for other than dental purposes). Dental splints are covered if used in conjunction with the treatment of a covered medical condition (i.e., dislocated upper and/or lower joints). Medicare makes payment for a covered dental procedure no matter where the service is performed. The hospitalization or non-hospitalization of a patient has no direct bearing on the coverage or exclusion of a given dental procedure. Payment may also be made for services and supplies furnished incident to covered dental services. For example, the services and supplies of a dental technician or nurse who is under the direct supervision of the dentist or physician are covered if the services are included in the dentist’s or physician’s bill. Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.
Source: blogspot.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: cfah.org