Hot Stuff Supplements: Finding the Best Medicare Supplement Insurance

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSFinding the Best Medicare Supplement Insurance The best Medicare supplement insurance offers several benefits in every plan option including hospitalization, medical expenses, hospice and blood. There are also additional benefits of every plan in Medicare supplement insurance. As mentioned above, before you purchase Medicare supplemental insurance, you need to find the best Medicare supplement policy provider which is reliable and offers the best benefits for you because there is no such thing as important as your health.
Source: blogspot.com

Video: California Medicare Supplement Insurance Plans 1-800-243-8100

Which Medicare Supplemental Insurance Plans Offer The Best Coverage?

Standard Medigap plans must cover basic benefits. Plans A through G cover one set of those benefits, and Plans K, L, M, and N cover another set of basic benefits. This is governed by the federal government. All the plans now cover preventive medical care. Plans A through L offer Medicare Part A hospital benefits, including the extended 365 hospital days. With Medicare Part B, plans A through J are again, all the same for co-insurance payments.
Source: seniorcorps.org

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

Locating The Best Medicare Supplemental Insurance Illinois Can Provide Provides Many Advantages

Furthermore anyone that meets the start out requirements may not be declined access to these optional gap cover policies, whether healthy or not. The added open enrollment stage generally refers to the initial six months commencing date of entering the fund. During this point in time after first joining the fund, the members has the added option of choosing from any of the gap funds on offer and are free to swop over from one plan to the next more than once during this period.
Source: wordpress.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

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

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

Medicare Supplement Insurance › Medicare Supplement Insurance

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

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

Posted by:  :  Category: Medicare

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

Video: Learn About Medigap Plans

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

Medicare open enrollment: What’s the best Medigap policy?

The difficulty for consumers is that the nature of Medigap makes it a lot harder to shop for than Medicare Advantage. Here’s why. Medicare Advantage plans are regulated and overseen on a national level. Medicare routinely collects all kinds of information on them about customer satisfaction and quality of care. In addition, the premium of a specific Medicare Advantage plan is the same for each customer. As a result, it’s possible (as I explained yesterday) to go to Medicare.gov and compare Medicare Advantage plans in detail, including quality ratings and price. It’s also why we can publish rankings of Medicare Advantage HMOs and PPOs through our partnership with the National Committee on Quality Assurance.
Source: consumerreports.org

Oregon’s new Medigap Policy “Birthday Rule”

In the past, beneficiaries typically stayed with the company that they signed up with during their initial enrollment period. Switching Medigap policies required medical underwriting, and Some Medigap policies have a waiting period for coverage of pre-existing conditions if you wanted to switch companies because of a price increase in your policy.
Source: cedaradvisors.com

1. There Are 10 Standard Medigap Policies

You only need one policy. Each policy builds on the previous one. Plan D includes all the coverage options offered by A, B, and C, plus additional options under Plan D. Plan E, provides everything Plan D does, plus additional coverage, and so on. It is illegal for an insurance company to sell you more than one plan.
Source: 30stm.org

Insurance Officials Warn Against Premium Hikes for Medigap Coverage

The group argues that doing so would backfire and cause higher spending because beneficiaries would stop seeking out necessary medical care when they need it. After nearly 18 months of research and discussions into increased cost-sharing proposals, none of the studies provided evidence that would encourage beneficiaries to seek out appropriate physicians’ services, NAIC says.
Source: californiahealthline.org

Finding the Right Medigap Insurance

Although all the Medigap plans are standardized, Medigap rates may vary from one insurer to another. According to a study carried out by Weiss Ratings premium rates for Plan A range from a low of $439 to a high of $5776. This shows that you cannot assume that all insurers offer the same rates. It is best to shop around and compare rates from different insurers. You should also compare the cost of Medigap plans at different ages such as 65 and 70. This will give you a good idea of your annual premiums. In addition, factor out-of-pocket expenses in your Medigap plan costs. This includes expenses for purchasing prescription drugs or processing claims.
Source: seanbrock.com

Is It Mandatory To Buy One Of The New Medigap Policies?

The number one benefit of holding Medigap policies is that you will be covered in all cases if you purchase the right insurance. This means that you will never have to worry about paying expensive medical bills because you hit a category that Medicare does not cover. If that happens and you are holding a Medigap policy, then you know that you will be in the clear. The younger you are, the better the deal you are going to get on the cost of your Medigap policies as well. This is something that you should keep in mind if you are considering getting this kind of insurance.
Source: seniorcorps.org

Medicare & California Seniors: 2013 Part D Plan Changes and Updates

Posted by:  :  Category: Medicare

Basilique Saint-Pierre-et-Saint-Paul d'Andlau by kristobaliteSix of the plans will be benchmark plans, which have premiums below the benchmark amount of $29.88. Beneficiaries eligible for Extra Help who enroll in benchmark plans do not have to pay the premium or deductible. Of these 6 benchmark plans, 4 are continuing benchmark plans from 2012 and 2 are new. One of the renewing plans, SilverScript Basic is a consolidation of 3 Part D plans from 2012: CVS Caremark Value, Health Net Orange Option 1 and Community CCRx Basic. CVS Caremark Value and Health Net Orange Option 1 are both benchmark plans in 2012. Members currently in these plans will be “crosswalked” into SilverScript Basic for 2013. Since these plans are consolidating, not terminating, members in the 3 plans will have neither a Special Election Period to change plans, nor a guaranteed issue right to a Medigap plan. They can, however, change plans during the Annual Election Period (between Oct 15 – Dec 7).
Source: amanteandassociates.com

Video: Mario and Luigi: Plan Z (MLPZ) Episode 1 Part 2 of 2 -Preview 1-

Top Medicare Part D Plan Costs Spike in 2013

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

HealthSpring Part D Review

When you search for a plan on the official Medicare website you will find most plans are assigned a star rating based on past performance. Some plans are listed as too new to evaluate, while others include a warning that for three years in a row the plan has received poor ratings.
Source: partdplanfinder.com

Happy Shopping: More Part D Plans with Premiums Under $20

And the timing of this news is impeccable – open enrollment begins in three weeks (October 15). According to the latest Medicare Today survey, 88 percent of seniors say they are satisfied with their coverage under Part D, but for the other 12 percent, open enrollment is their opportunity to find a better fit. CMS has just launched a major redesign of the Medicare.gov website to make navigation more accessible, especially for mobile use, and a good starting point for exploring plans is their Medicare Plan Finder.
Source: phrma.org

2013 Transition Rights to Medications Under Part D

A Part D sponsor may need to make arrangements      to continue to provide necessary drugs to an enrollee via an extension of      the transition period, on a case-by case basis, to the extent that his or      her exception request or appeal has not been processed by the end of the      minimum transition period.  It is      vital that sponsors give affected enrollees clear guidance regarding how      to proceed after a temporary fill is provided, so that appropriate and      meaningful transition can be effectuated by the end of the transition      period.  Until that transition is actually made, however, either through a switch to an appropriate formulary drug, or a      decision is made regarding an exception request, continuation of drug      coverage is necessary, other than for drugs not covered under Part D.”
Source: nsclc.org

Part D Formulary Medical Review Awarded to Strategic

Strategic’s team of pharmacists and data analysts will work with CMS to monitor drug updates and evaluate Medicare Part D Plan formularies and benefits to ensure the Part D prescription drug program — offered through Medicare Advantage drug plans and stand-alone prescription drug plans — meets CMS formulary guidelines. These guidelines help to ensure that Medicare beneficiaries receive clinically appropriate medications at the lowest possible cost and that Part D plans do not have formularies that discriminate against beneficiaries.
Source: strategichs.com

In Medicare Part D Plans, Low or Zero Copays and Other Features to Encourage the Use of Generic Statins Work, Could Save Billions

The researchers of this study found that a low copayment for generic statins is the strongest factor influencing the use of these drugs, and eliminating the copay altogether has an especially large effect. Other tools that have an effect are higher copays and prior authorization or “step therapy” requirements for popular brand-name statins. In this drug class, where generics can be readily substituted for brand-name drugs for most people, adoption of the policies most effective in encouraging generic use could lead to considerable savings for the plans, Medicare, and enrollees. These researchers estimate that every 10 percent increase in the use of generic, rather than brand-name statins would reduce Medicare costs by about $1 billion annually. Plans could apply the lessons from this analysis and consider a zero copay for use of generic drugs, and Medicare might consider further incentives for plans to use benefit designs that increase such drugs’ use. 
Source: rwjf.org

Florida Medicare Part D Plans

Anyone who require for this medical facility can opt for this service in any case if he or she is with limited source of income. Those who do not earn much have facility of getting extra help for various services that included in medication part D plan. $4,000 is almost amount that you will get as an extra help from these medication plan. Monthly premium and it can also be your prescription payment for which you will get all help. This can act as big saving for those who do not earn much. So make sure that are you clearing criteria of getting that much help.
Source: medicare-supplement-advisor.org

How do I know I have the cheapest Part D plan?

You have plenty of company in confusion, it turns out. Only 5 percent of Medicare beneficiaries buying stand-alone Part D drug plans choose the plan that’s cheapest for them, according to a study published in the October 2012 issue of Health Affairs. The average beneficiary paid $368 more in premiums and drug costs than they would have if they’d chosen the cheapest plan for their specific assortment of prescriptions, and more than a fifth overspent by at least $500 a year.
Source: consumerreports.org

Medicare Part D Plans to Take Active Role in Reducing Prescription Abuse

This drew concern from many physicians and physicians organizations. “Part D sponsors are not in a position to evaluate medication overutilization,” academic pathologist James Madara, CEO and executive vice president of the AMA wrote in a letter to CMS in response to the notice. “The only information they have is the various claims that are submitted for prescription coverage. Sponsors do not know diagnoses and they do not know about any other services the patient is receiving that do not involve Part D coverage.”
Source: physicianspractice.com

Open Enrollment 2013: Medicare Part D Benefits Improve but Premiums an…

Once you’ve found a plan that fits your budget and medication needs, don’t forget about convenience when filling your prescriptions. A pharmacy accepted as “preferred” by a Medicare Part D Plan is a network pharmacy that offers covered drugs to plan members at lower out-of-pocket costs than what the member would pay at a non-preferred network pharmacy. For example, Walmart is a preferred pharmacy on multiple plans including the Humana-Walmart Preferred Rx Plan. People with high blood pressure or who are concerned about heart health also should know that Humana and Walmart just announced that members of the Humana Walmart-Preferred Rx Plan will have access to 10 hypertension drugs for a penny each when filled at one of the 4,400 Walmart or Sam’s Club pharmacy locations. Source: lifeandleisurenj.com
Source: medicarehelpco.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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

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

For states, Washington’s budgetary seduction proves too hard to resist

Posted by:  :  Category: Medicare

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations by Christiana CareThe Medicaid program is the most important of these joint federal-state initiatives. Founded in 1965 to provide medical care for the poor, Medicaid is run by state governments, but the states receive 50 percent to 83 percent of the funding from the federal government. (The size of the federal contribution varies according to states’ wealth.) The bigger the federal contribution, the “cheaper” the Medicaid program from the perspective of a state government. Under the ACA’s Medicaid expansion, participating states will be required to increase eligibility to include all households that earn up to 133 percent of the poverty threshold. In return for accepting this expansion of Medicaid, the federal government will pick up 100 percent of the cost of covering these newly eligible enrollees. Eventually, this federal contribution will decline to 90 percent. But from the perspective of state governments, this expansion will be “free,” or close to it.
Source: reuters.com

Video: Medicare : How to Qualify for Medicare Under 65

Electronic Health Records and Small Nonprofits

Funding is one of the top concerns for nonprofits. The Centers for Medicare & Medicaid Services offer an EHR Incentive Program that provides incentive payments to eligible hospitals and critical access hospitals (CAHs) as they make the digital transition. These payments can range from $44,000 for eligible professionals to more than $2,000,000 for eligible hospitals for Medicare and $63,750 and more than $2,000,000 respectively for Medicaid providers. The Health Information Technology for Economic and Clinical Health also offers transition funding.
Source: idealware.org

The Human Cost of Refusing to Expand Medicaid

By my rough back-of-the-envelope calculation from Kaiser Family Foundation numbers, there are about 4 million of such unlucky duckies in the 10 states that are pretty clearly not going to participate in the Medicaid expansion, a number that could jump to well over 5 million if Rick Scott manages to keep Florida out as well….So what do they care about the injustice of this coverage hole? Not a thing, clearly.
Source: motherjones.com

Tick, Tock: Administration Misses Some Health Law Deadlines

The administration also has delayed giving states guidance on a new coverage option known as the “basic health program,” designed to help low and moderate-income people who don’t qualify for Medicaid.  At least one state –Washington — has already decided to not implement the program in 2014 because it won’t have enough time. Washington, along with Minnesota and New York, are keenly affected by the federal inaction because they already have government subsidized programs to help cover such residents which expire at the end of this year. As a result, tens of thousands of people who now have coverage but who won’t qualify for expanded Medicaid could see their coverage become unaffordable next year.
Source: kaiserhealthnews.org

Fewer to get health insurance under reform law, CBO says

Do you need a physician who actually LISTENS to you and SPENDS TIME with you? I provide therapy and medications, if indicated. I am Shalini Varma MD and practice psychiatry without the intrusion of third party payors. I am a Board Certified Psychiatrist by the American Board of Psychiatry and Neurology and I find confidentiality to be of utmost importance. Why should your insurance company, your job, and multiple in betweeners (coders, billers, front desk staff) know about your illnesses? I answer all my own calls, I make my own appointments and I bill the patient myself. No one gets in the middle of the doctor patient relationship that both my patients and I value highly. I am able to see patients within 2 weeks, and I spend quality time. There is no rush in your appointments with me, and I do not type your note into a computer while I am meeting with you. Your health is extremely important. Please take care of yourself as such. DrVarmaMD.com.
Source: nbcnews.com

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

Do You Qualify for Medicare's Extra Help Program?

Every individual who qualifies represents an important potential benefit to our tribal communities. Social security is responsible for implementing that benefit; we call it “extra help.” Many Medicare beneficiaries won’t have to file for assistance because they’ll automatically get it based on benefits they receive.
Source: indiancountrytodaymedianetwork.com

Medicaid Eligibility in Texas

Following an initial check of the information, all applicants are required to visit a Health and Human Services Commission Benefits office. This visit interviews the applicant to ensure all information is present and correct – forming the final part of the application. Applicants who have specific reasons why they cannot travel to the Health and Human Services Commission Benefits office may be able to complete the review by telephone, or a representative may make a home visit.
Source: tex.org

Prime hospital chain acknowledges it faces two federal investigations

In November, California regulators fined Prime $95,000 for violating state confidentiality laws in the case. Disclosing a patient’s medical records without consent also violates federal law. The chain denies wrongdoing and is confident it will win on appeal, wrote Glassman, Prime’s lawyer. He also contended that the SEIU had urged the patient to complain about her diagnosis.
Source: californiawatch.org

Pozen warns that inaction on fiscal cliff is likely

The federal tax code, revised on January 1 by enactment of the American Taxpayers Relief Act, will close the budget deficit by about $550 billion. Given $420 billion in defense cuts made in 2011, Pozen estimated that Congress would agree to no more than an additional $300 billion in cuts from the defense budget, or half of the amount called for under sequestration. Greater cuts, he said, would meet with insurmountable opposition on both sides of the aisle, in part because of concerns the nation might otherwise be unprepared for an international crisis; and because such cuts would be politically unpalatable in Congressional districts that benefit from military spending.
Source: lifehealthpro.com

More Coloradans may be eligible for Medicaid under governor’s plan

“Reducing the number of uninsured not only means more Coloradans will lead healthier lives, but it also provides a boost for the state’s economy. Healthier workers and increased federal funding will bolster the economy,” the Colorado Center on Law and Policy said. “In addition, privately insured Coloradans could see an indirect benefit as insurance companies often defray the health costs for the uninsured by raising the insurance premiums paid by other Coloradans.”
Source: gazette.com

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

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

Saving money on health costs: Extra Help program

monthly premiums, annual deductibles, and prescription copayments in your Medicare drug plan. Did you know that the Extra Help program is estimated to be worth about $4,000 dollars per person, per year? Even if you’re not sure you’d qualify, it’s worth filling out an application to see.
Source: medicare.gov

Barefoot Bay Suncoast Florida residents may qualify for free health club membership through Silver Sneakers Program

I 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

Brown University’s student health plan will cover sex changes

Posted by:  :  Category: Medicare

TTT #5... 259365 by paloeticThe LGBTQ Center does not keep any sort of statistics on the number of transgender students at Brown, or the number who would like to change their sexual characteristics. Nevertheless, Garrett said, the LGBTQ Center has promoted the added health care coverage for many years, on the theory that the high costs of sex changes have prevented transgender students from seeking surgeries and hormone treatments.
Source: dailycaller.com

Video: Health Insurance Hemet

New health insurance program pays docs for keeping patients healthy

Patients whose doctors are a part of AzCC will see subtle changes in the way they are treated. For example, doctors may call to check-up on patients and talk to them about how they want to work on preventive care. Patients may also noticed longer clinic hours so that they can to go to their primary care doctor instead of going to an urgent care clinic, said UHC CEO Jeri Jones.
Source: tucsonsentinel.com

Health insurance application rejected? Review these 5 options

Insurers of last resort: Check your state’s designated insurer that’s required to provide coverage to everybody. Created under healt reform, pre-existing condition insurance plans (PCIPs) provide federally administered insurance coverage to people who previously have been denied insurance because of a pre-existing condition. But be aware that it could be costly. “The expenses may be high,” says Zaleznick, “but if you really need medical care, it could be extremely valuable for right now.” (See: “Uncle Sam slashes PCIP health plan premiums.”)
Source: insurance.com

Student marries early to gain Obamacare benefit

AB 32 AB 109 aging aging with dignity Ashby Wolfe Bay Area breast cancer bridge to reform budget children City Heights diesel Every Woman Counts global warming Greater Sacramento greenhouse gas health insurance health reform Healthy San Francisco Housing in-home care Medi-Cal nutrition oakland obesity pesticides pollution prevention prison realignment regulation Richmond San Francisco San Joaquin Valley SB 375 Schwarzenegger single-payer smoking Southern Boarder Southern California taxes tobacco transit unemployment wellness youth
Source: healthycal.org

Choose the Best Health Insurance Plan for You

Next, think about co-pays, the costs you share with the insurance company. You may be responsible for a set amount, say $15, for an office visit, and $100 for a trip to the emergency room. Insurance plans also often have co-insurance, where you’ll share an 80/20 or 90/10 or similar agreement with the insurance company. They’ll pay 80 percent of the bill, and you’ll be responsible for the balance, up to your out-of-pocket maximum, after which insurance should pick up 100 percent of the bill. The higher your out-of-pocket maximum is, the lower your premiums will be. You should weigh this aspect of each plan carefully.
Source: patch.com

After Newtown shootings, questions about mental health insurance coverage

Insurance companies now also farm out their mental health benefits to a third party so that ins company doesn’t have to follow parity rules because the primary ins company doesn’t “offer” mental health benefits. They still limit visits and require a ton of paperwork for approvals. If you have to fax records, spend hours on paperwork/the phone every 5 sessions, get properly submitted claims rejected regularly, and reimbursement gets magically cut below the rate you were originally given, you learn to avoid that company… so a person is left calling around struggling to find someone. The paperwork to get on many insurance panels (so you can bill them) takes months and you have to complete 100+ pages worth for some. Then they say sorry, we have enough providers in your area so aren’t accepting more. Then many of the providers on their list dropped the insurance company years ago but have not been removed so the company can say look at our long list. Many community mental health facilities have a 3 month plus wait because they are overwhelmed.
Source: nbcnews.com

Use About Medicare Health Insurance To Obtain Advice

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 marsmet524About medicare webinsurance and information Congratulations! You turned 65! Happy Birthday! This could be one of the best days of your life! You are now eligible for To the best of health that you may live another 65 years!Medicare! What is Medicare? This is an amazing program so pay attention. Be happy and thankful. No more dealing with insurance companies, paying large premiums, having to pay for an office visit or prescription co pays. No lab test co pays, hospital bills, procedures not covered, and surprise bills not covered. Having to argue with health insurance companies or creditors calling and threatening suits for unpaid bills that you were not even aware of. That is, if you pick a good medicare health insurance plan. There are many plans, if you pick a good medicare supplement plan, your nightmares of dealing with health insurance companies are over with. In fact no more paper work, having to file for claims, or to speak to someone, who can’t help you, puts you on hold to transfer you to another bimbo or hangs up after an hour. These health insurance companies are very smart, they want you to get frustrated and give up. They are in the business of getting your hard-earned money without having to pay for your care when possible. They are in the business to make money; not to keep or make you healthy. Medicare puts an end to all of these insurance company nightmares. Medicare puts you in charge. You are no longer at the mercy of the insurance companies. Medicare puts you in the driver’s seat. Medicare allows you to take control of your health care. Although Medicare is a government program, it is unique in that you get to decide what is best for you and not some faceless bureaucrat. So once again be happy that you are now eligible for Medicare healthcare. Pick a good Medicare supplement plan and enjoy a long happy stress free life. Congratulations and Happy Birthday again. I wish you the best of health and may you live another 65 years!
Source: blogspot.com

Video: What is a Medicare health insurance exchange?

Medicare Targets Health Plans With Low Ratings

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

Do we really know what is going on with health care spending?

#4:  “Looking ahead, Medicare spending is projected climb at a rate the country can’t afford.”  Probably true, but maybe the trajectory isn’t quite as worrisome as it used to be—or is it?  On one hand, the government report cited earlier, projects that, “The slow growth in spending per beneficiary from 2010 to 2012 combined with the projections of spending growth at GDP+0 for 2012-2022 is unprecedented in the history of the Medicare program. If sustained, the slower growth would improve Medicare’s ability to meet its commitments to seniors and persons with disabilities in future generations.”   But the qualifier “if sustained” leaves a lot of room for doubt. The Fiscal Times notes that, “ ‘Even though spending per beneficiary is projected to grow at or below the rate of per capita GDP, the number of Medicare beneficiaries is projected to grow at approximately 3 percent a year,’ the HHS report says. The 50 million beneficiaries today will grow to more than 85 million in 2035. ‘As a result, aggregate Medicare spending will account for a growing share of GDP over the next decade.’”
Source: kevinmd.com

Your Money Matters Healthcare in Retirement

Medigap In general Medigap is supplemental insurance specifically designed to cover some of the gaps in Medicare coverage. Although the name might lead you to believe otherwise, Medigap is provided by private health insurance companies, not the government. However, Medigap is strictly regulated by the federal government. There are 10 standard Medigap policies available (Plans E, H, I, and J are no longer available for sale, however, if you already have one of these plans you can keep that plan). All plans may not be offered in your state, yet all are standardized and certified by the U.S. Department of Health and Human Services so that each plan provides exactly the same kind of coverage no matter what state you live in (except for Massachusetts, Minnesota, and Wisconsin, which have their own standardized plans). Every Medigap policy offers certain basic core benefits, such as coverage of certain Medicare Part A and B coinsurance and co-payments. Other plans offer additional benefits, such as coverage of Medicare Part A and B deductibles, and charges that result when a provider bills more than the Medicare-approved amount for a service. Medicaid
Source: cltv.com

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

Health Reform in 2013: What’s Happened, What’s Left & What it Means for Providers

With just one year remaining before the largest parts of the federal health reform law take effect, 2013 will be a busy year for hospitals as they prepare for the biggest changes in healthcare since Medicare was introduced in 1965. The Obama administration has embarked on a comprehensive overhaul of the way Americans deliver and pay for healthcare, aiming to make care more affordable through eliminating waste, incentivizing efficiency and requiring more recipients to pay in. It plans to achieve those goals at the cost of the traditional funding mechanisms and levels that providers have come to rely on, which could spell disaster for the unprepared. Being prepared requires providers to not only know and adapt to what’s coming, but also to be able to explain what has changed to their patients and business partners. The Patient Protection and Affordable Care Act represents enormous upheaval to the healthcare industry’s status quo, so here is a recap of what’s happened, what’s to come, and what hospitals should be doing to ready themselves for the PPACA. Reform so far President Barack Obama signed the PPACA into law March 23, 2010, but the lead-up to its passing was a hard fought battle. There were rumors of “death panels” enabling government-sponsored euthanasia resulting from rationed funding for healthcare. A public health insurance option intended to compete with private insurers was rejected twice. And although the Supreme Court upheld the constitutionality of the law’s contentious individual health insurance mandate in June 2012, it struck down the requirement for all states to expand their Medicaid programs, relegating that part of the law as optional for each state. Much of the law so far has begun to turn the wheels of the health industry in the direction of growing primary care, promoting and protecting consumers’ access to coverage and introducing funding models that share payors’ risk and gains with providers. 2010 — Expanding access to more people, the 2010 law immediately began to disburse tax credits for small businesses’ health plans and rebates to seniors for prescription drugs. Children could no longer be denied coverage due to pre-existing conditions, and some state and federal insurance plans were created for adults with pre-existing conditions who had been uninsured for six months or more. Young adults under 26 not offered insurance from their employer were permitted to stay on their parent’s plan.  Anticipating the boost in demand, education assistance was established to attract more primary care nurses and physicians into underserved areas. Within the health plans themselves, types of preventive care became covered without charging a copay or deductible, and no lifetime limits on hospital stays or other essential benefits can be imposed. More assistance is given to seniors buying Medicare Part D-covered drugs and receiving preventive services, and at the same time the Obama administration added defenses against corruption and unreasonable business practices. Extra funding was pumped into fraud-busting programs to cut unlawful billing of Medicare, Medicaid and CHIP, and into state groups with authority to review or regulate insurance premium increases. 2011 — In 2011, a major limit on insurance companies was imposed that required them to spend at least 80 to 85 percent of premium dollars on healthcare or quality improvement, rather than administrative costs or profits, or else send rebates to customers. Gradual reductions to insurance companies in the Medicare Advantage program began, slowly shrinking the $1,000 bonus paid per beneficiary on average compared with traditional Medicare. Elderly and disabled beneficiaries gained a wealth of new services designed to decrease the amount of time they spent hospitalized, free preventive care for certain services, assistance designing care plans and coordinating support services when they were discharged from a hospital visit, and freedom for states to use Medicaid funding to pay for cheaper at-home care versus nursing home admittance. Medicare beneficiaries also began to receive a 50 percent discount on Part D-covered brand-name prescription drugs. Money was granted to public health programs and services to help Americans purchase sensible private insurance. Efforts to build and renovate community health centers gained new financial support, and payments for rural providers went up. 2012 — Last year saw a swath of changes including the advent of accountable care organizations established in order to design cost effective approaches to care delivery in exchange for sharing in CMS’ savings. In October 2012, hospitals meeting certain benchmarks for electronic health records became eligible for incentive payments as part of provisions included in the American Reinvestment and Recovery Act. That same month, CMS began its value-based purchasing program, which alters how much it pays hospitals through Medicare depending on its performance on various quality measures including patient satisfaction and hospital readmission rates. 2013 — Beginning this year, funding changes to Medicaid will reimburse primary physicians at Medicare rates through 2014. The federal government will also increase funding to states that craft Medicaid programs with better benefits for preventive care. And a national pilot program to promote bundled payment models has gone into effect, which would allow providers to take on risks and profit potential from efficient use of Medicare funds. Coming soon There’s more to come from the law, especially next year in 2014.  That’s when nearly all adults and children must obtain health insurance or pay a fine, which will be the greater of 1 percent of income or $95 per adult ($285 for a family) next year but will balloon to the greater of 2.5 percent of income or $695 ($2,085 per family) by 2016. Penalties for much wealthier families can grow as high as the average basic-level government-approved health plan’s annual premiums. Employers of more than 50 full-time workers will need to offer minimum essential coverage or pay a fine for each eligible worker above a threshold who is not offered coverage. Each state will have an online health insurance marketplace, referred to as an exchange, that will offer qualified private plans for individuals and small businesses, and screen customers to see if they are eligible for subsidies, tax credits or Medicaid. Enrollment for these begins in October this year, with coverage going live Jan. 1, 2014. All but a few Republican states have shunned the idea of running their own exchanges, opting instead for the federal government to take on the job. Supporters say the marketplaces increase competition and will benefit consumers, thus creating less need for government insurance programs. One of the most hotly contested features of the PPACA, even today, began to receive funding in 2011. The Independent Payment Advisory Board, an appointed panel of healthcare experts, will be charged with making binding cost-cutting plans for Medicare payments beginning in 2015 that Congress can override only through new legislation that achieves the same level of savings. Republicans have vowed to eliminate the IPAB, and even some Democrats have raised an eyebrow at the concept. Originally, the law intended for all states to be required to expand Medicaid to more poor and childless adults at 133 percent of federal poverty line. But when the Supreme Court nixed that mandate, the Obama administration fell back on incentivizing states to volunteer to expand Medicaid with a guaranteed three years during which the increased cost of the expansion will be covered entirely by the federal government. After that, states will only contribute 10 percent of the extra cost. Medicare Disproportionate Shares payments, the lifeblood of some critical access and safety-net hospitals, will plummet 75 percent in October, but they’ll be offset by larger payments based on a hospital’s proportion of uninsured served and uncompensated care provided. What hospitals can do to get ready It’s going to take strong hospital leadership to weather what could either be a windfall or a typhoon. Following is some advice from healthcare leaders and experts for how to prepare for the flood of changes and regulations. Expect upfront costs. The law’s goal is to lower healthcare costs over the long term, but in the short term, most will feel the changes in their checkbooks. Doug Fenstermaker, a former hospital CFO now serving as managing director and vice president of healthcare at Atlanta-based Warbird Consulting Partners, says he’s skeptical of significant savings for providers in the near future, because the cost of implementing the law has a lot of upfront cost. “It is hard to tell whether the PPACA will result in a lower amount of GDP being consumed by healthcare and if costs will actually decline. In the short-term, that is not at all likely, as investments in infrastructure to make it all work will skyrocket,” he says. While the law aims to improve coordination in the delivery of care and better use of ramped up technology to lower costs, the initial capital cost of that infrastructure will take time to be paid off. Preserve margins with more savings, not more revenue. Bundled payments, Medicare Advantage and shared savings programs with CMS and private insurers can be lucrative for health systems, especially if fewer patients are uninsured. True, that may bring a flood of new patients, says Aurelio Fernandez, executive vice president and chief operating officer of Memorial Healthcare System in Hollywood, Fla., but political instability in his state and Washington alike means he’s not counting on seeing revenues rise. “I’m not basing our future on the ability of generating [additional] revenues, but on having cost-efficiency,” Mr. Fernandez says. Back in 2011, he says Memorial’s leaders did a study and learned its cost structure was too high. So in 2012 he says they embarked on a cost reduction initiative that looked at contractual arrangements, staff reductions and eliminating unnecessary services through partnerships. They set a system-wide cost reduction goal of 5 percent, in excess of $75 million, by the end of their fiscal year which ends this April. So far they’ve reached 85 percent of that goal, even after realizing costs to implement their EHR system this year. Track your performance. The sharp drop in Medicare Disproportionate Share funding will be a blow to systems like Dignity Health. The San Francisco-based organization’s Vice President of External and Government Relations Wade Rose says since Dignity Health is among the California’s largest providers of Medicare services, the cuts will be a challenging obstacle. He and his system’s leaders support the law overall, but he acknowledges that expectations are quite high on providers’ to fix inefficiencies that are easy to identify but difficult to improve because of changes that must be systemically implemented. “The reality on the ground can be very different than the elegant logic of the bill,” Mr. Rose says. In response, his team is gathering and analyzing copious amounts of data to learn where they can be more efficient, from speeding up imaging test results to designing a nurse’s station to maximize productivity, and tracking the impact of these changes on performance. Mr. Rose says that’s why this law might be more successful than efforts of the past — he says 95 percent of the bill has to do with delivery system change, rather than mere funding changes. Look beyond a hospital’s four walls. Some of the greatest cost inefficiencies occur after elderly patients leave providers’ care. Not following physicians’ orders after being discharged from the hospital can lead to higher readmissions, which the health reform law now penalizes through lower reimbursement rates. As a result, many hospitals have focused much of their efforts into transitioning seniors from the hospital to the home, helping them help themselves stay healthy. Nathan Anspach, CEO of Phoenix-based John C. Lincoln Health Network’s accountable care organization says his organization’s solution was to collaborate with physicians, clinicians and pharmacists within the ACO to design a systemwide formulary plan. “We see a pretty significant dollar savings,” he says. “We’re all about the 5 to 60 rule — 5 percent of our members will use 60 percent of the resources of our ACO,” Mr. Anspach says. He and his team have addressed that with greater attention on patients with chronic conditions like congestive heart failure and diabetes. Keep patients satisfied. Among other metrics, hospitals have begun to see patient satisfaction account for a rise or deduction of up to 1 percent in their Medicare reimbursements. In an era where providers’ margins are shrinking for a number of reasons, hospitals can hold on to what’s theirs with a focus on patient experience, says Kristin Baird, a registered nurse and CEO of Baird Group, a Fort Atkinson, Wis.-based healthcare consulting firm. “Patient satisfaction, once seen as fluffy or soft, is now an important measure that cannot and should not be ignored,” Ms. Baird says. “Consumer Assessment of Healthcare Providers and Systems surveys have leveled the playing field and give the consumer a voice along with other important outcomes. Healthcare organizations recognize now, more than ever, that providing good service directly impacts the bottom line. That realization has not been so clear before.” Partner to absorb risk. It’s no secret that hospitals are employing more physicians, and that trend of employing or contracting with physicians is likely to continue, says Adam Powell, PhD, a health economist and president of Boston-based healthcare consulting firm Payer+Provider Syndicate in Boston. “In 2013, I expect to see acceleration in the wave of payor-provider integration and hospital consolidation that began in 2012. The recent merger between Baylor Health Care System and Scott & White Healthcare is but one example of how integrated delivery systems are expanding by merging with hospital systems. Hospitals are increasingly being asked to own their risk, and merging with payors and integrated delivery systems provides them the know-how to do so,” Dr. Powell says. “Providers are hoping that mergers will provide them with both more leverage in negotiating with payors and economies of scale that will enable them to lower their costs.” As scrutiny builds over unnecessary inpatient care, Mr. Fenstermaker says hospital systems are likely to divest specialties that aren’t core to the business in favor of integrating those services with other systems. For this reason, he says he expects rural hospitals will begin to operate more like ambulatory care clinics and transfer more patients to larger hospitals’ specialty centers. The current number of primary care physicians will struggle to meet the anticipated demand brought on by the newly insured, so Mr. Fenstermaker predicts the industry will rely more heavily on physician assistants, practical nurses and technology to compensate for the physician shortage. Related Articles on Healthcare Reform: CMS Announces Bundled Payment Initiative Participants Vermont Progresses Toward Single Payor Healthcare System Obama Won’t Cut Medicaid More Willing to Budge on Medicare
Source: beckersasc.com

Another Reason We Need Medicare for All

This builds upon previous research that shows the Great Recession has seriously impacted older Americans’ ability to retire. An estimated 62 percent of working Americans now report they’re planning to put off their retirement — up from 42 percent in 2010 — largely due to job losses and financial insecurity. These issues go hand-in-hand particularly because, as health care costs continue to rise, Americans are increasingly worried about being able to afford their insurance coverage…
Source: politicsplus.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

Arkansas Medicare health plan benefits

Medicare health plan provides coverage for medical needs of people who do not have enough coverage or require additional coverage for specific medical needs. It is a plan offered by the private insurance companies that contracts with Medicare to provide the coverage to eligible individuals. The insurer has significant savings on medical expenses when opting for the Medicare health plan. This plan provides all the benefits that are available with the Medicare Plan provided by the Federal State in Part A and Part B of the plan.
Source: medicarearkansas.com

Fewer to get health insurance under reform law, CBO says

Do you need a physician who actually LISTENS to you and SPENDS TIME with you? I provide therapy and medications, if indicated. I am Shalini Varma MD and practice psychiatry without the intrusion of third party payors. I am a Board Certified Psychiatrist by the American Board of Psychiatry and Neurology and I find confidentiality to be of utmost importance. Why should your insurance company, your job, and multiple in betweeners (coders, billers, front desk staff) know about your illnesses? I answer all my own calls, I make my own appointments and I bill the patient myself. No one gets in the middle of the doctor patient relationship that both my patients and I value highly. I am able to see patients within 2 weeks, and I spend quality time. There is no rush in your appointments with me, and I do not type your note into a computer while I am meeting with you. Your health is extremely important. Please take care of yourself as such. DrVarmaMD.com.
Source: nbcnews.com

Community Health Plan: Fallon Community Health Plan Medicare Advantage

Posted by:  :  Category: Medicare

Excellus (upstate NY) SecureHorizons (national Medicare Advantage plan acquired by United Healthcare) Rhode Island Medicaid Fallon Community Health Plan (MA) Blue Cross and Blue Shield of Tennessee Cardiac Imaging No separate entity or program; cardiac imaging is part of overall program
Source: blogspot.com

Video: Election Debate with President Clinton and Robert Dole in Hartford, Connecticut (1996)

Fidelis adds urological surgeons to network

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

Is Choosing a Health Plan Like Buying a Car or Canned Goods?

Do consumers buy health insurance like they buy canned peas?’  Or should they?’  That’s the big question market place advocates have been trying to answer now for more than a decade.’  The government and others have thrown gobs of money at this vexing problem trying to figure out the best combination of stars, bars and other symbols that will catch the shopper’s eye. The hope is that patients will also become good consumers, always choosing the best options whether it’s a doctor, hospital, or an insurance policy.’  The danger is that if they don’t, and things go wrong, they will be blamed for the bad outcomes. An ethicist I heard speak recently was troubled by all the emphasis on health care choice which she called ‘ ‘simplistic market rhetoric.” ‘  ‘The emphasis on choice blames the victim for not reading the fine print when they have made a wrong one,’ she said. That brings me to the problem of Medicare Advantage plans and the apparent wrong decisions millions of seniors are making.’  The Centers for Medicare and Medicaid Services (CMS), which runs the Medicare program, rates Medicare Advantage plans using a star system’the more the better.’  The stars supposedly offer clues about plan quality including whether plan members get timely screenings and vaccinations and how how quickly they respond to complaints.’  But a consulting firm, Avalere Health, did a little study and found that seniors choosing Medicare Advantage plans pick the ones with fewer stars, not more. Avalere said that nearly 50 percent of Medicare beneficiaries chose plans that merited only two or three stars.’  The number may be higher.’  CMS says that seniors pick plans based on costs and their ability to see a doctor they like, not ratings. As someone who helped invent health plan ratings in a previous job, I’ve come to agree with that assessment, and that raises the fundamental question of how useful all these stars and bars are in the first place.’  To find out, I did a quick survey of the Medicare Advantage plans that are available in Manhattan where I live.’  There are 103 choices, way too many for the average senior to wade through and make an intelligent decision.’  Most people would throw up their hands and ask their best friends or run for the nearest insurance agent to help narrow the choices.’  That solution presents other problems which I will explore in later posts. But if seniors decide to examine the ratings, they still may make their decisions based on price and the plan’s network of doctors.’ ‘  To use the quality ratings, they’d first have to decide which rating factors were most important to them’screening tests, chronic care management, how the plan responds to complaints, how responsive it is when members need care.’ ‘  That’s tough.’  If you’ve already had timely screenings, why do you care how good the plan is at making sure other people get them?’  The way plan representatives talk to customers on the phone may be important. Once you make those decisions and start inspecting the stars, you run smack into another problem. Many of the plans have the same ratings.’  Looking at the stars that summarize all of the quality dimensions, I find that Aetna’s standard plan HMO rates three stars but so does its value plan HMO. ‘ So does GHI’s PPO II and Healthfirst’s ‘ 65 Plus Plan HMO.’  And how much better are these plans than the Fidelis Medicare Advantage Part B Reduction HMO-POS, or for that matter, Aetna’s standard plan PPO?’  They merit three and a half stars.’ ‘  Then there are a slew of plans for which there is too little information to rate.’  That would turn a shopper off right there. In sum, there are a lot of problems with Medicare’s ratings and seniors know that.’  CMS says it is going to reassess them, and there will be updated info out in the fall.’  Down the road the better plans will get bonus payments from the government.’  That, too, raises another question.’  Will the plans really be that good, or will they simply be teaching to the test?
Source: preparedpatientforum.org

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

New York Methodist Hospital (NYM) is a 651-bed (including bassinets) voluntary, acute-care teaching facility in Park Slope. NYM offers Institutes in Advanced and Minimally Invasive Surgery; Asthma and Lung Disease; Cancer Care; Cardiology and Cardiac Surgery; Digestive and Liver Disorders; Diabetes and other Endocrine Disorders; Vascular Medicine and Surgery; Family Care; Neurosciences; Orthopedic Medicine and Surgery; and Women’s Health. NYM also provides a Pediatric After-Hours Center and a dedicated pediatric emergency department. NYM is affiliated with the Weill Cornell Medical College and is a member of the NewYork-Presbyterian Healthcare System.
Source: nymetroparents.com

REPORT: Iran’s Revolutionary Guards overseeing missile fire

“The IDF continues to operate surgically in the Gaza Strip – precise strikes, not against outposts, not against police stations, but against rocket-launching sites,” he said. “So far, a very harsh blow has been dealt to the long-range fire of Hamas and Islamic Jihad.”
Source: wordpress.com

insurance: MEDICARE ADVANTAGE/MEDICARE HEALTH PLANS

Medicare Advantage/Medicare Health Plans SHIIP Publications: Frequently Asked Questions About Medicare Advantage PFFS Plans Is A Medicare Advantage Private-fee-for-service Plan Right For Me Medicare Advantage Comparison Guide (2008) Your Guide To Medicare Private-fee-for-service Plans Medicare Advantage Summaries of Benefits SHIIP Publications: Aarp Medicarecomplete Choice Aarp Medicarecomplete Plus Plan 1 Aarp Medicarecomplete Plus Plan 2 Advantra Freedom – Plan 1, Plan 2 (005), Plan 5 (001) Advantra Freedom – Plan 2 (010),plan 3 (006-013), Plan 5 (002) Advantra Savings (msa) – Plan 1 Aetna Medicare Open Plans America’s 1st Choice – Patriot Plus And Presidential Plus America’s 1st Choice – Patriot-presidential Blue Medicare HMO Plans Blue Medicare PPO Plans Cigna Medicare Access Plans One, Two And Three – Version A Cigna Medicare Access Plans One, Two And Three – Version B Cigna Medicare Access Plans One, Two And Three – Version C Cigna Medicare Access Plans One, Two And Three – Version D Evercare – Dh – Special Needs Plan Evercare – Ih – Special Needs Plan Evercare – Mh – Special Needs Plan Fidelis – Secure Comfort – Special Needs Plan Fidelis – Secure Comfort Plus – Special Needs Plan Fidelis – Secure Independence – Special Needs Plan Health Net Pearl – Plans 009-014-015 Healthmarkets Care Assured Plans Humana – Special Needs Plan Humana Goldchoice – H1804 -216 Sb08 Humana Goldchoice – H1804-007 Sb08 Humana Goldchoice – H1804-016 Sb08 Humana Goldchoice – H1804-217 Sb08 Humana Goldchoice – H1804-278 Sb08 Humana Goldchoice – H1804-279 Sb08 Humanachoiceppo – H3405-001 Sb08 Humanachoiceppo – H3405-002 Sb08 Humanachoiceppo – Regional – R5826-003 Sb08 Securehorizons Medicaredirect Plan 3 Securehorizons Medicaredirect Plan 3a Securehorizons Medicaredirect Rx Plan 51 Securehorizons Medicaredirect Rx Plan 51a Securehorizons Medicaredirect Rx Plan 54 Securitychoice Classic-enhanced-plus-enhance Plus – Area A – Securitychoice Classic-enhanced-plus-enhanced Plus – Area B Securitychoice Essential-essential Plus Southeast Community Care – Dual Plus Plan – Special Need Plan Southeast Community Care – Plus Plan Sterling Option I Sterling Option Ii Sterling Option Iii Sterling Option Iv Today’s Options – Basic Plus, Value Plus, Premier Plus Today’s Options – Basic, Value, Premier Today’s Options Powered By Ccrx Unicare 2008 Msa Summary Benefits WelLCare Benefit Summary A WelLCare Benefit Summary B WelLCare Benefit Summary C WelLCare Benefit Summary D WelLCare Benefit Summary E
Source: blogspot.com

Health Benefit Cost Growth Accelerates, Survey Says

The union said in a statement that the state required the fund to participate in a new program — the Family Health Plus Buy-In Program — beginning in 2008. The union said it expected that by joining the program, many of its members would qualify for state assistance for health-insurance coverage. “Instead they raised insurance rate increases without any increase in funding, and then cut Medicaid funding to the same workers nine times in the last three years,” the union said in a statement.
Source: wordpress.com

The American Spectator : The Spectacle Blog : GOP Report Charges AARP Getting “Kickbacks” In Dem Health Care
Bills

Richo, you are ignorant with to regards to the actual benefits that the Medicare Advantage Plan provides. I was skeptical when I was first informed by an insurance agent that there would be no monthly fees. I then learned that my medicare payments through Social Security, the $96.00 monthly, would be paid to the Medicare Advantage provider in return for my Medical Insurance coverage, both “A” and “B”. I also get a good discount on my one perscription drug of a least 70% over what I was paying with my Medicare “D” through Anthem. In addition, The SilverSneakers program for maintain my physical health is a big plus. I am 71 years old and in good physical condition. I enrolled in the Silversneakers program through our newly constructed YMCA. I paid the $75.00 joiner fee and The Medicare Advantage pays my monthly membership. How can you argue that this is not a cost savings for those of us who have been retired and needed assistance with our health insurance cost? Would you please e-mail your reply or rebutal. Jack, Wabash, Indiana
Source: spectator.org

Fidelis Care Partners with Little Falls Hospital for Health Insurance …

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Source: medicinestore.in

New health insurance program pays docs for keeping patients healthy

Posted by:  :  Category: Medicare

The Tears of a Health Festival by Korean Resource Center 민족학교Patients whose doctors are a part of AzCC will see subtle changes in the way they are treated. For example, doctors may call to check-up on patients and talk to them about how they want to work on preventive care. Patients may also noticed longer clinic hours so that they can to go to their primary care doctor instead of going to an urgent care clinic, said UHC CEO Jeri Jones.
Source: tucsonsentinel.com

Video: The Obama Plan in 4 Minutes

Pathway to citizenship may increase Obamacare cost $300 billion

Sen. Marco Rubio, R-Fla.. center, answers a reporter’s question as he and a bipartisan group of leading senators announce that they have reached agreement on the principles of sweeping legislation to rewrite the nation’s immigration laws, during a news conference at the Capitol in Washington, Monday, Jan. 28, 2013. From left are Sen. John McCain, R-Ariz., Sen. Charles Schumer, D-N.Y., Sen. Marco Rubio, R-Fla., and Sen. Robert Menendez, D-N.J. (AP Photo/J. Scott Applewhite)
Source: dailycaller.com

Fast facts on Illinois health insurance exchange plans

A. The federal government will operate an exchange website for online enrollment, a call center for telephone enrollment and customer support, and a so-called “Navigator” program offering in-person enrollment assistance. The state also will offer an In-Person Assistance program to supplement the federal Navigator program, focused on geographic and demographic populations not served by the federal program.
Source: chicagobusiness.com

Health reform could save $168M in charity care

“Implementation of the (health law) in Minnesota … could result in reduction of projected hospital uncompensated (care) by between $134 million and $168 million by 2016,” the report states. It projects a range of possible future costs and savings to account for variables that might drive the estimates up or down.
Source: medcitynews.com

Health insurance application rejected? Review these 5 options

Insurers of last resort: Check your state’s designated insurer that’s required to provide coverage to everybody. Created under healt reform, pre-existing condition insurance plans (PCIPs) provide federally administered insurance coverage to people who previously have been denied insurance because of a pre-existing condition. But be aware that it could be costly. “The expenses may be high,” says Zaleznick, “but if you really need medical care, it could be extremely valuable for right now.” (See: “Uncle Sam slashes PCIP health plan premiums.”)
Source: insurance.com

Health Care Programs A Clear Target In Deficit Reduction Efforts

National Journal: Poll Shows Public Wants Entitlements Left Untouched As Democrats and Republicans in Washington remain at odds over how to reshape the nation’s finances and prevent it from falling over the fiscal cliff, the public is supportive of cutting spending and at the same time more protective than ever of entitlement programs such as Medicare. Traditional cleavages of class and race, age and income, and even region are apparent in the latest edition of the United Technologies/National Journal Congressional Connection Poll, but they are far more muted than on issues such as President Obama’s reelection or the fate of his signature health care law. When it comes to the tax and spending issues that are at the heart of negotiations in Washington, primarily between the president and House Speaker John Boehner, the public is eager to defend the entitlement programs that both leaders have acknowledged need to be reined in if the nation’s $16 billion debt is to stop growing, let alone shrink (Cooper, 12/4).
Source: kaiserhealthnews.org

Clinton Takes On Health Care

General Electric is putting six million dollars into a “Healthymagination” private/public health program that gives people online tools to improve their health. GE has also pledged to take nationwide a program that they started in Cincinnati, Ohio. There, GE worked with hospitals, nonprofits and government to improve coordination in patient care and encourage hospitals to publish what they charge for various procedures. GE says the program has already saved the region 200 million in emergency room costs over the past two years.
Source: healthycal.org

Insurance FREE The secrets: China will expand the health insurance program of rural residents

Ministry of Health of China said that the list of diseases covered by health insurance program of rural residents will be expanded in 2013. In 2012, the health insurance covers 20 major diseases, and in 2010 – only 2. Life Insurance Auto insurance The government also reported that the government subsidy of the insurance program will increase in 2013 to 280 yuan. In total, from 60 yuan, which must pay the participant, the annual insurance fee of 340 yuan. In 2012 it amounted to 290 million yuan, of which 240 million yuan was state subsidies. Medical Insurance
Source: blogspot.com

Finding the Right Medigap Insurance

Posted by:  :  Category: Medicare

Although all the Medigap plans are standardized, Medigap rates may vary from one insurer to another. According to a study carried out by Weiss Ratings premium rates for Plan A range from a low of $439 to a high of $5776. This shows that you cannot assume that all insurers offer the same rates. It is best to shop around and compare rates from different insurers. You should also compare the cost of Medigap plans at different ages such as 65 and 70. This will give you a good idea of your annual premiums. In addition, factor out-of-pocket expenses in your Medigap plan costs. This includes expenses for purchasing prescription drugs or processing claims.
Source: seanbrock.com

Video: Protect your Family with Medicare Supplement Insurance

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

Newsroom – Insurance Commissioner Ruling on Medigap Rates Clarifies that Blue Cross Blue Shield of Michigan Does Pay Taxes

DETROIT  – Today’s ruling by the Michigan Insurance Commissioner — that Blue Cross Blue Shield of Michigan must discount its premiums on Medicare Supplemental policies by an amount equal to 1% of the company’s total revenue — makes clear that BCBSM is liable for paying a state-imposed annual assessment of about $181.5 million based on 2008 revenue.
Source: bcbsm.com

What Medigap Insurance Has That Medicare Advantage Doesn’t

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

Weiss Ratings Introduces Medigap Pro for Insurance Professionals

“Since 1997, Weiss Ratings has taken the lead compiling Medigap pricing data for the insurance market,” said Melissa Gannon, vice president of Weiss Ratings. “With the launch of Medigap Pro, Weiss is able to deliver Medigap market intelligence conveniently and affordably, giving insurance professionals the information they need to educate and inform their clients in a very competitive space.”
Source: weissinc.com

Economist’s View: ‘Brave, Honest Conservatives’ and Social Insurance

Posted by:  :  Category: Medicare

INFOGRAPHIC - Why Social Security Needs To Be Rescued by Third Way…Unsurprisingly, most Americans are split between various misconceptions of what Social Security and Medicare are. Many, particularly right-wing politicians and their media mouthpieces, see them as pure tax-and-transfer programs: they gather money from one set of people and give it to another set of people. This feeds easily into the makers-vs.-takers line, with payroll taxes on workers going to fund benefits for non-workers. From this point of view, they are bad bad bad bad bad and should be cut. Many others, particularly beneficiaries and people who hope to see beneficiaries, see them as earned benefits. The common conception is that you pay in while you’re working, so you earned the benefits you get in retirement…, you’re just getting back “your” money that you set aside during your career. Both of these perspectives are wrong, the latter more obviously so. Most people, during their working careers, do not pay nearly enough in payroll taxes to pay for their expected benefits. This is most obvious for Medicare… The problem with the tax-and-transfer argument is only slightly more subtle. Sure, at any given moment some people pay taxes and others collect benefits (and many do both, since Medicare is funded by general revenues). But most of us will both pay and receive at different points in our lives. So both programs are really more like income-shifting arrangements… In the inaugural address, I think the president got it basically right. They are risk-spreading programs. You don’t get back exactly what you put in: they have a certain degree of progressivity (although less for Social Security than is commonly imagined). Their main function is to protect people against extreme outcomes by pooling a limited share of our resources. Yes, rich people end up paying payroll taxes for insurance they end up not needing. But that’s how insurance always works: you pay the premiums hoping you won’t need it. And the key fact is that most young people, whey they start paying payroll taxes, don’t know what their own personal outcomes will be. … Like any insurance scheme, you can make everyone better off simply by moving money around between different states of the world. These particular insurance schemes, as the president said, have a moral element to them. They are a way of expressing out solidarity with each other as Americans, people united, however loosely, in a common endeavor. They also have an economic element to them. People protected against bad outcomes are more willing to take the risks needed for a vibrant and prosperous society. They are something to celebrate, not something to be embarrassed about whenever the Republicans come after them.
Source: typepad.com

Video: Does Social Security Disability Approve Claims That Are Based on Subjective Medical Conditions?

Say ‘I support Social Security’

MIKE I PRETTY MUCH AGREE WITH MOST OF THE COMMENTS THAT PEOPLE HAVE SHARED WITH US. I DO WISH TO SAY,”THAT THE SOCIAL SECURITY SYSTEM WOULD NOT BE IN THIS MESS IF IT WASN’T FOR OUR GREEDY GOVERNMENT THINKING OF IT AS THEIR PIGGY BANK TO TAKE MONEY OUT AS THEY PLEASED AND SPENDING IT ON WHATEVER THEY WANTED”.IT WAS NEVER MENT TO BE AN ‘OPEN ACCOUNT’ FOR GOVERNMENT SPENDING.I SAY,THE PEOPLE RESPONSIBLE SHOULD BE HELD ‘ACCOUNTABLE’FOR THEIR ACTIONS AND PAY EITHER BY FINES OR IMPRISONMENT.THIS WOULD PUT A STOP TO ALL OF THE ‘WRONG’THINGS OUR GREEDY GOVERNMENT OFFICIALS ARE DOING AND GETTING AWAY WITH.WE NEED THEM,(ALL) TO BE HELD ACCOUNTABLE.THEY ARE NO BETTER THAN ‘CRIMMENALS’AND SHOULD BE TREATED AS SUCH!!!!!
Source: bankrate.com

Social Security Disability Claim

SSDI is the primary kind of Social Security Disability benefit, the system pays benefits to individuals who become disabled and are unable to work. Social Security helps disabled persons return to work, and will continue to pay disability benefits until he or she is able to work again on a regular basis.
Source: insurancejusticelawyer.com

An Anecdote About Social Security Disability Insurance

My wife is deaf and gets SSDI. Since we didn’t need the money, we asked to be removed from the program. We are not in any way wealthy, we just don’t need charity. Then when she tried to use my military medical insurance, she was denied coverage because we involuntarily withdrew from SSDI. So I had to pay for Tricare and Medicare. So she went back on SSDI because I can’t afford two insurance policies. Then they learned we have a daughter and forced us to take even more money for her. They were emphatic that the law requires it and we have no choice. SSDI is a perverse system. I know many people who legitimately rely on it, but it has far too many perverse incentives to exploit it and penalties if you don’t.
Source: ricochet.com

Social Security: Now What?

What was particularly interesting about this survey is that it asked Americans if they agreed preserving Social Security would be worth raising Social Security taxes for not only wealthy Americans but also working Americans.  As the table below (taken from the National Academy of Social Insurance) demonstrates, 82% of Americans agreed that paying higher Social Security taxes would be worth keeping the program. 71% of Republicans and 97% of Democrats were also in favor of lifting the payroll tax cap on income (which is currently capped at $113,700).
Source: thepolitic.org

Wall Street’s Newest Hedge Fund: Social Security

As Senator Bernie Sanders has warned, “Social Security faces an unprecedented attack from Wall Street, the Republican Party and a few Democrats. If the American people are not prepared to fight back, the dismantling of Social Security could begin in the very near future.”
Source: fryingpannews.org