Guiding you in the right direction: Medicare and Hearing Aids

Posted by:  :  Category: Medicare

OBAMACARE WATCH: MORE DARKNESS THAN LIGHT AND OF COURSE TAXES AND PENALTYS by SS&SSIf Medicare and hearing aids are of concern to you, you should become a wise consumer. Learn as much as you can about the Medicare HMO you plan to choose and make sure that they offer additional benefits such as vision care and hearing aids. These plans will generally offer services for auditory evaluations and fittings for the hearing aid. Medicare sometimes pays the full amount and other times you may be asked to meet a deductible. It depends on your specific coverage.
Source: eldercareresources.info

Video: Does Medicare Insurance Cover Hearing Aids? : Medicare Insurance Questions

Are Hearing Aids Covered By Medicare?

Most hearing problems are relatively easy to correct with hearing aids. The problem becomes that a large majority of the people that need the hearing aids are living on a fixed income and are unable to afford the $3,000 to $5,000 out of pocket. If medicare or medicaid would cover the hearing aids then these people would have the means to get them, resulting in a dramatic improvement in their quality of life. It is been proven over and over again that if you have a positive outlook on life and are happy then you are healthier. I wonder how much money would be saved on treatment of physical ailments if the insurance companies were to focus on improving peoples quality of life so that they are upbeat and happy. Providing hearing aids seems like an easy place to start.
Source: empowernetwork.com

What Medicare doesn’t cover

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Source: bankrate.com

Medicare and Listening to Aids

If Medicare insurance and listening to aids tend to be of concern for you, you should be a wise customer. Learn around you can concerning the Medicare HMO you intend to select and ensure that they provide additional benefits for example vision treatment and listening to aids. These programs will usually offer providers for oral evaluations as well as fittings for that hearing help. Medicare occasionally pays the entire amount along with other times you might be asked to satisfy an insurance deductible. It depends on your particular coverage.
Source: kidneycancersymposium.net

Why Doesn’t Medicare Pay For Hearing Aids Or Eyeglasses?

Hearing aids are elective to, just like glasses. Patients are responsible for 100% of the bill. However Medicare, in certain circumstances, will cover the cost of a prosthetic device. Often though, the cost of prosthetics far outweigh the costs of a hearing aid. This elective also extends to routine hearing tests, which are also the responsibility of the Medicare patient. Regulations vary by the state however, so there may be some exceptions to the contrary. Though most states operate under the same mindset. One exception, though limited, is coverage based on an advantage plan; a secondary premium insurance add on.
Source: seniorcorps.org

Medicare and Hearing Aids

Hearing loss is very common among aging adults. Your hearing loss may stem from several causes, though the most common is sensorineural. That means that the tiny hairs inside your ears have been damaged and are deteriorating, usually because of aging. You losing your hearing if you notice that straining to hear thing clearly makes you tired, or if you watch the mouths of people around you to understand what they are saying. Other troubling signs of hearing loss include having difficulty hearing people in public places where there is a lot of ambient sound, or if you often find yourself asking people to repeat themselves.
Source: totalmedicare.com

Medical Billing Codes: Medical Billing Codes Hearing Aids

The Agency covers replacement parts for cochlear devices through the Agency Hearing Aids and The Agency has adopted Medicare-established limits for billing needle EMGs (CPT codes 95860 – 95870) as follows: CPT Code Brief Description Limits 95860 Agency Medical Request Coordinator
Source: blogspot.com

Don’t wait too long before you get hearing aids

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Source: hearing-aid-news.com

Study Links Cognitive Deficits, Hearing Loss

One consequence that may help explain Dr. Lin’s findings is social isolation. When people have a hard time distinguishing what someone is saying to them, as is common in older age, they often stop accepting invitations to dinners or parties, attending concerts or classes, or going to family events. Over time, this social withdrawal can become a self-fulfilling prophecy, leading to the loss of meaningful relationships and activities that keep older people feeling engaged with others.
Source: nytimes.com

Insurance is now paying for hearing aids

Insurance is now paying for hearing aids, at least Blue Cross PPO: Hearing evaluations In Network 100% covered; limited to one exam every 24 months Out of Network 60% of maximum allowance after deductible; maximum allowance is the lesser of providers billed charges or 100% of base Medicare rate excluding Medicare adjustments Hearing aids In Network 80% covered after deductible is met; children to age 19 for treatment of congenital defect only: Check with plan. Out of Network 60% of max allowance after deductible; to age 19; treatment of a congenital defect;max allowance is lesser of provider bille This is a huge help for me.
Source: alldeaf.com

Does Medicare Pay for Long Term Care?

Our hospital social worker informed us that my father had stabilized; meaning he no longer had acute (short term) medical needs and had crossed the threshold into custodial care.  There was nothing more that could be done for him there. We were informed he was being released from the hospital and we had seven days to figure out our next steps. It was suggested that we put him in a skilled nursing facility for the remainder of his life, because his prognosis was not good and his medical needs were too great for someone like my 70 year old mother to handle.  We were told that if we chose to put him in a home that Medicare would pay for 20 days, and we would have a co-payment for the next 80 days.  After that, we would be responsible for all of the costs.
Source: thelongtermcarepro.com

Michigan Gov. Rick Snyder calls for Medicaid expansion

Posted by:  :  Category: Medicare

32.Detroit by Tomato GeezerSnyder is expected to run into resistance from Republican lawmakers opposed to the health law. Hospitals, doctors and others in favor of Medicaid expansion joined Snyder at his announcement. He said Medicaid expansion would save the state $200 million a year initially because more people who now receive mental health services and medical care from state-funded programs will instead be covered with federal money. He called for setting aside $100 million a year of those savings so Michigan can kick in for new enrollees down the line. This is the second time in less than 18 months that Snyder has bucked his own party on a major healthcare question. His call to implement a state-run online marketplace where the uninsured can get taxpayer-subsidized private coverage died in the GOP-controlled Legislature. Michigan now is on the path toward a partnership exchange controlled primarily by the federal government. In 30 states led by Republican governors, six governors have called for enlarging Medicaid. Ohio’s John Kasich earlier this week reiterated his opposition to what he called “Obamacare” and the requirement that people have health insurance but said expansion makes sense for Ohio. By expanding Medicaid in 2014, Michigan could add about 470,000 people to a program that already serves about one in five state residents. Three years of full federal funding for newly eligible enrollees are available from 2014 through 2016, gradually phasing down to 90% in 2020 and after. The match rate for existing Medicaid participants is 66%. To qualify, household income must be below 138% of the federal poverty level, about $15,000 for an individual. Conservatives are concerned deficit-burdened Washington will renege on the 90% deal and also have a philosophical resistance to expanding government programs, particularly one as large as Medicaid.
Source: modernhealthcare.com

Video: Medicare Supplement – What is right for you?

Michigan Liberal::: Medicaid expansion the latest thing to be obstructed for no real reason

For MI Bloggers: – MI Bloggers Facebook – MI Bloggers Myspace – MI Bloggers PartyBuilder – MI Bloggers Wiki Statewide: – Blogging for Michigan – Call of the Senate Dems – [Con]serving Michigan (Michigan LCV) – DailyKos (Michigan tag) – Enviro-Mich List Serve archives – Democratic Underground, Michigan Forum – Jack Lessenberry – JenniferGranholm.com – LeftyBlogs (Michigan) – MI Eye on Bishop – Michigan Coalition for Progress – Michigan Messenger – MI Idea (Michigan Equality) – Planned Parenthood Advocates of Michigan – Rainbow Mittens – The Upper Hand (Progress Michigan) Upper Peninsula: – Keweenaw Now – Lift Bridges and Mine Shafts – Save the Wild UP Western Michigan: – Great Lakes Guy – Great Lakes, Great Times, Great Scott – Mostly Sunny with a Chance of Gay – Public Pulse – West Michigan Politics – West Michigan Rising – Windmillin’ Mid-Michigan: – Among the Trees – Blue Chips (CMU College Democrats Blog) – Christine Barry – Conservative Media – Far Left Field – Graham Davis – Honest Errors – ICDP:Dispatch (Isabella County Democratic Party Blog) – Liberal, Loud and Proud – Livingston County Democratic Party Blog – MI Blog – Mid-Michigan DFA – Pohlitics – Random Ramblings of a Somewhat Common Man – Waffles of Compromise – YAF Watch Flint/Bay Area/Thumb: – Bay County Democratic Party – Blue November – East Michigan Blue – Genesee County Young Democrats – Greed, Eggs, and Ham – Jim Stamas Watch – Meddling Outsider – Saginaw County Democratic Party Blog – Stone Soup Musings – Voice of Mordor Southeast Michigan: – A2Politico – arblogger – Arbor Update – Congressman John Conyers (CD14) – Mayor Craig Covey – Councilman Ron Suarez – Democracy for Metro Detroit – Detroit Skeptic – Detroit Uncovered (formerly “Fire Jerry Oliver”) – Grosse Pointe Democrats – I Wish This Blog Was Louder – Kicking Ass Ann Arbor (UM College Democrats Blog) – LJ’s Blogorific – Mark Maynard – Michigan Progress – Motor City Liberal – North Oakland Dems – Oakland Democratic Politics – Our Michigan – Peters for Congress (CD09) – PhiKapBlog – Polygon, the Dancing Bear – Rust Belt Blues – Third City – Thunder Down Country – Trusty Getto – Unhinged MI Congressional District Watch Blogs: – Mr. Rogers’ Neighborhood (CD08)
Source: michiganliberal.com

Oregon May Provide Model For Restructuring Medicaid In Alabama

Last October, a commission established by Bentley began researching ways to restructure the state’s Medicaid program to make it more efficient. The group concluded that Alabama should follow Oregon’s path. “It will be a heavy, heavy lift,” says state health officer Don Williamson, who headed the group. But he said the overhaul is necessary if the state is ever going to expand Medicaid. Otherwise, he said, “we will find ourselves with a program that simply collapses under the weight of the expansion.”
Source: kaiserhealthnews.org

House Republican aims to repeal Medicare doctor pay cuts

The 16-year-old “sustainable growth rate” (SGR) provision calls for reductions in doctor pay as a way to control spending by Medicare. Congress has prevented the SGR from taking effect through temporary measures, but that has run up the fiscal and political costs of finding a permanent solution.
Source: medcitynews.com

The Difference Between Medicaid and Medicare

The obvious downfall to Medicare is the limit on coverage. Rehabilitation oftentimes falls far short of the 100 day maximum. The other downfall to Medicare is that it only pays for skilled nursing and does not cover the treatment of all diseases. For example, a nursing home stay because of Alzheimer’s or Parkinson’s will not be covered under Medicare even though the patient is receiving medical care. If you are staying in a nursing home longer than 100 days or suffer from a debilitating disease like Alzheimer’s the best option to pay for long term or even permanent nursing home care is Medicaid.
Source: michiganelderlawyer.com

Michigan Medicare Patients Risk Losing Essential Health Care Federal Government Urged to Resolve Flawed Physician Payment Formula by Year’s End

The cuts will stem from the SGR, a flawed formula created by Congress 15 years ago to determine how much physicians get paid for treating Medicare patients. It has cost billions of government dollars to adjust the rate over the last 15 years to prevent drastic payment cuts to physicians, as
Source: broadcasteverywhere.com

Newsroom – Blue Cross Blue Shield of Michigan broadens Medicare options with new Medicare Advantage PPO product

October 1 is the first day BCBSM and Medicare Advantage carriers across the nation can market their Medicare Advantage products for 2010. Beneficiaries in BCBSM Medicare Advantage products will receive letters in the next 10 days about the new product line-up. "Blue Cross remains fully committed to providing products to Medicare beneficiaries and will continue to have the broadest array of Medicare Advantage products in the state," said Mark Owen, BCBSM vice president for federal and individual business. "It’s important for Medicare beneficiaries to know that there is no immediate change to their coverage. They have until the end of the year to make their selection for 2010." In addition to the three BCBSM products for 2010, seniors also can select from three Medicare Advantage products offered by Blue Care Network, the BCBSM-affiliated HMO. "We will be working with insurance agents and other groups across the state to reach out to Medicare beneficiaries to help them navigate these product and premium changes," said Owen. Seniors who meet low income guidelines can receive subsidies from the state and/or federal government to pay for all or part of their premiums. Medicare Advantage premiums vary by product and region. The new PPO product is expected to provide beneficiaries with value for their premium. For example, the BCBSM Medicare Plus Blue PPO, which includes Part D prescription drug coverage, will cost between $61 and $141 a month (premiums vary by geographic region), while traditional BCBSM Medicare Supplemental (Medigap) Plan C plans cost $183 when combined with a stand-alone Part D BCBSM prescription drug program. Medicare Advantage plans offer Medicare benefits through private health insurance plans and most include Part D prescription drug coverage. When you purchase a Medicare Advantage plan, you do not need to also purchase a Medigap policy. Medicare Advantage plans are regulated solely by the federal government, while Medigap plans are regulated by the state. The announced product changes are only for Medicare beneficiaries who directly purchase their Medicare Advantage products, not for beneficiaries enrolled in a group plan. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Source: bcbsm.com

Medicaid expansion has skeptics in biz groups

Kahn, a physician, said Snyder failed to mention that Medicaid rates for primary care physicians will rise to equal Medicare rates for only two years. “The end result of that will be what? The physicians will stop seeing the patients,” Kahn said. “Because an insurance card is not access, it’s having someone take care of you — that’s access.” At that point, people may then go back to using the emergency room as their primary care provider, and then the uncompensated care costs rise again, negating some business savings, Kahn said. Over the last several months, Snyder had expressed concern that expanding Medicaid would flood hospital emergency departments with thousands of newly insured patients who could not find primary care doctors. But a survey last month by the Center for Healthcare Research found that more than 81 percent of doctors said they would be willing to accept Medicaid patients if the state expanded the program. Jack Billi, M.D., a board member of the Michigan State Medicaid Society and a physician executive at the University of Michigan Health System, said it is possible that some physicians could stop accepting Medicaid in 2016, when rates drop about 30 percent from Medicare levels. “We will have a temporary improvement in reimbursement for office visit codes for primary care physicians,” Billi said. “Medicaid rates do not cover costs now. Many doctors accept Medicaid because they see it as a duty for the underserved and for the community.” Some of the groups that support Medicaid expansion include AARP Michigan, Michigan Association of Community Mental Health Boards, Michigan Association of Health Plans, Michigan Health and Hospital Association, Michigan Osteopathic Association, Michigan Primary Care Association, Michigan State Medical Society, the Detroit Wayne County Health Authority and the Greater Detroit Area Health Council. Jay Greene: (313) 446-0325, jgreene@crain.com. Twitter: @jaybgreene
Source: crainsdetroit.com

Michigan Fraud Lawyer: Michigan Medicare Fraud Strike Force

The investigation was triggered by the Medicare Fraud Strike Force. Since its inception in March 2007, the strike force has charged more than 1,330 defendants who collectively have fraudulently billed Medicare for more than $4 billion. Working in conjuncture with the FBI and HHS, the strike force hopes to increase accountability and decrease the presence of fraudulent providers.
Source: blogspot.com

Michigan’s Rick Snyder Becomes 6th GOP Governor to Expand Medicaid

Michigan Gov. Rick Snyder became the sixth GOP governor to recommend an expansion of the state’s Medicaid program to include individuals slightly above the poverty line, marking the second time in recent years he’s branched away from his party’s staunch resistance to the federal health law, according to a report by the Washington Post. The move would cover 470,000 previously uninsured poor Michigan residents in the long term, while saving the state an estimated $200 million annually by shifting the cost of various state-funded mental health and medical services to the federal government. Under the Patient Protection and Affordable Care Act, the feds will pay 100 percent of the expansion cost for three years and 90 percent after that. Snyder proposed reserving half of the savings in the first three years to cover Michigan’s share of the tab until 2035, according to the report. Gov. Snyder joins Ohio, Arizona, New Mexico, Nevada and North Dakota on the list of GOP-governed states that have urged embracing the expansion. The governor supported a state-run health insurance marketplace that was shot down in his Republican-controlled legislature and is now working toward a partnership exchange that would share control with federal regulators.
Source: beckershospitalreview.com

CARR ALLISON Medicare Compliance Group: Court Follows Sixth’s Circuit Decision that Providers May Assert a Private Cause of Action

, No. 12-CV-11329, 2013 U.S. Dist. LEXIS 17721 (E.D. Mich. Feb. 11, 2013), State Farm denied coverage of medical treatment provided by Michigan Spine on the basis that the treatment was related to preexisting conditions of the individual insured, and unrelated to the accident at issue.  As a result, Medicare paid for those medical expenses.  Michigan Spine filed a claim for recovery against State Farm, asserting that it had a private cause of action for double damages under the Medicare Secondary Payer Act.  In response, State Farm argued that Michigan Spine had no standing to bring a claim under the Medicare Secondary Payer Act because no court had determined that State Farm was liable for the medical services in question.
Source: blogspot.com

Medicaid expansion puts spotlight shortage of primary care providers

The latest findings are particularly worrisome because they come on top of an existing national shortage of primary care doctors. A report by the Association of American Medical Colleges found that the United States needed 9,000 more primary care doctors than it had in 2010 and projected that the shortfall would grow to nearly 30,000 in 2015, when millions more Americans will have health insurance coverage thanks to President Obama’s Affordable Care Act. (The Agency for Healthcare Research and Quality estimates that in 2010 there were 209,000 primary care physicians in the U.S.)
Source: mylocalhealthguide.com

New Ad From Democrats Attacks Michigan Lawmaker on Medicare

The attack ad represents part of a larger strategy by Democrats to make a prominent issue of Medicare, which they perceive as a major political weakness of Mr. Ryan’s budget plan. That tack has already extended to some Congressional races, including ones in Montana and Florida.
Source: nytimes.com

Daily Kos: Kaiser report details Medicare options

Posted by:  :  Category: Medicare

Medicare for All by juhansoninMedicare 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: Kaiser Medicare Part D Insurance – Compare to over 180 Comp

Kaiser: Medicare Reform Ideas

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

Kaiser: Medicare Reform Ideas

“I think one of the interesting advantages you have in this regard is how public health is more closely integrated into healthcare than here in the UK (here: separate organisations, separate data) and that is something to leverage along with the sticks. Perhaps treating a lack of willingness to engage in self-health should be treated as a form of Long Term Condition – it may be something like this …”
Source: healthworkscollective.com

Kaiser Family Foundation Medicare options

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Source: wordpress.com

Experts Discuss Basics of the Medicare Program

Panelists included: Centers for Medicare & Medicaid Services Deputy Administrator Jonathan Blum; Juliette Cubanski, associate director in the program on Medicare Policy at the Kaiser Family Foundation; and Sheila Burke, adjunct lecturer in public policy at Harvard’s Kennedy School of Government.
Source: c-span.org

Medicare Cracking Down on Hospice Industry: Kaiser

AAHomecare AARP Alliance for Home Health Quality and Innovation Almost Family Amedisys Amedisys Inc. American Association for Homecare American Association for Long Term Care Insurance Apria Healthcare Group Brookdale Senior Living Care.com Center for Medicare Advocacy Centers for Medicar & Medicaid Services Centers for Medicare & Medicaid Services CMS Ensign Group featured First Care Home Health Care Gentiva Health Services Gentiva Health Services Inc. HHS Home Health Depot Home Health International Houston Compassionate Care Humana IntegraCare Intel-GE Care Innovations Jordan Health Services Kindred Healthcare LHC Group Inc MedPAC NAHC National Association for Home Care & Hospice National Hospice and Palliative Care Organization New York Times Paraprofessional Healthcare Institute Partnership for Quality Home Healthcare PHI Scripps Health Sentara Healthcare The Ensign Group Univita VA Veterans Health Administration Visiting Nurse Association
Source: homehealthcarenews.com

Medicare Advantage 2013 Spotlight: Plan Availability and Premiums

This data spotlight report examines trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2013, premium levels and other plan features. It finds almost all plans offered this year will be available again in 2013, despite concerns that reductions in payments to plans under the Affordable Care Act would result in widespread pullouts from Medicare Advantage plans. If all beneficiaries choose to remain in their current plans, monthly premiums would increase about 10 percent, or $4, on average. The analysis also examines the types of plans available (HMOs, PPOs, etc.), changes in out-of-pocket limits, and the availability of special needs plans.
Source: kff.org

beSpacific: Kaiser Report

“With Medicare expected to be a key part of Washington

Blue Cross Blue Shield of Texas Medicare Supplement Plan

Posted by:  :  Category: Medicare

Medicare Supplement Insurance in Texas, like all other traditional forms of coverage does have rate increases and I dislike them as much as you do. BCBS seems to have some of the most stable rates in the industry, where some carriers have pounded the rates some 10 and 12% these guys have not exhibited that type of behavior. They actually experienced a rate decrease this last October which was a pleasant surprise to most seniors. Of course there is no way of knowing what may or may not happen from one year to the next so yes, they could raise rates soon, but so far so good.
Source: medicareinsurancetexas.com

Video: Blue Cross Blue Shield Medicare Supplement-Compare 180 Comp

Blue Cross Blue Shield of North Dakota launches SilverSneakers® fitness program to Medicare Supplement members

About Healthways Healthways (NASDAQ: HWAY) is the largest independent global provider of well-being improvement solutions. Dedicated to creating a healthier world one person at a time, the Company uses the science of behavior change to produce and measure positive change in well-being for our customers, which include employers, integrated health systems, hospitals, physicians, health plans, communities and government entities. We provide highly specific and personalized support for each individual and their team of experts to optimize each participant’s health and productivity and to reduce health-related costs. Results are achieved by addressing longitudinal health risks and care needs of everyone in a given population. The Company has scaled its proprietary technology infrastructure and delivery capabilities developed over 30 years and now serves approximately 40 million people on four continents. Learn more at www.healthways.com or www.silversneakers.com.
Source: bcbsnd.com

Does Blue Cross Offer The Best Medicare Supplemental Insurance?

Blue Cross and Blue Shield offers many good health insurance programs. They do not necessarily offer the best Medicare Supplemental Insurance, but they offer low-cost plans that many people can afford easily. The plan that this large insurance conglomerate offers work best for people who are just over the limits necessary for Medicaid but who do not earn enough for the more expensive plans from the large company. The network also provides a large network of health insurance providers. A person with Blue Cross and Blue Shield knows that the insurance that he has will be accepted mostly anywhere.
Source: seniorcorps.org

Oklahoma Blue Cross Blue Shield Medicare Supplement Plan Options

“Marc has made my dreaded experience with Medicare supplement insurance easy. I had no idea what to do, what plan to choose, etc. I had BC/BS as a group insurance through my employer until I retired, which I didn’t do until the age of 70 (another problem). Marc never lost patience with me, bless his heart, telling me who I needed to contact, what papers I needed to complete for Social Security for Part B, etc. Initially, he called to introduce himself by phone, which was a big plus because I am pretty computer illiterate. I talked to him personally. How about that? When I had an email question, he would answer it immediately, return a phone call immediately, and was completely available for help at any time. I asked for his business cards to recommend him to friends who are going through the same dilemma. My entire experience with Mr. Lallier has been awesome!! “
Source: oklahomamedicarehealth.com

Anthem Blue Cross Medicare Supplement

Over seventy years of Blue Cross; since 1937.  While much has chanced in the short span of seven decades, two things have remained constant; our original business philosophy of putting customers first and our commitment to innovation and progress.  We are leaders in senior health care and are continuing to build on our tradition of developing innovative products that offer choice, quality, and health security for our seniors.  We offer more plans than ever before, including the new Modernized Medicare Supplement plans, Medicare Advantage HMO plans, and the very popular
Source: johnconner.com

Blue Cross Blue Shield Medicare Supplement Plans: Under age 65 « Insurance News from Crowe & Associates

United/AARP will offer plans to those under age 65 as well but only down to age 50. For those on Medicare age 50 to age 64, AARP will offer plan A, B and C.   Plan A has the exact same benefits as the Anthem plan A discussed above.  Plan B covers the same thing as plan A supplement but also will cover the Hospital Part A deductible.  Plan C covers Basic benefits, 20% coinsurance, Part A and B deductibles and skilled nursing facility.  With the extra coverage comes additional cost as plan C with AARP costs over $230.00 a month
Source: croweandassociates.com

Anthem Medicare Supplement Insurance Quotes in Ohio

In order to qualify, individuals must switch from an existing supplemental policy to a new  Anthem plan with equal or lesser coverage.   This means if you currently own Plans F or J, you can switch to a modernized Plan F (Plan J is no longer for sale as of June 2010) with no health questions asked.   Likewise, you could switch from Plan G to Plan G or Plan N to Plan  N, etc.
Source: ohioinsureplan.com

House Republican aims to repeal Medicare doctor pay cuts

Posted by:  :  Category: Medicare

Romney Ryan Plan Cat Food by DonkeyHoteyThe 16-year-old “sustainable growth rate” (SGR) provision calls for reductions in doctor pay as a way to control spending by Medicare. Congress has prevented the SGR from taking effect through temporary measures, but that has run up the fiscal and political costs of finding a permanent solution.
Source: medcitynews.com

Video: Medicare Supplement Plans (How to Find)

Research Finds Link Between Poor Health And Seniors Switching Out Of Private Medicare Plans

A study released Thursday, by Gerald Riley, a researcher at the Centers for Medicare & Medicaid Services (CMS), adds to those concerns. The study looked at more than 240,000 people who dropped out of Medicare Advantage plans in 2007, and compared them with beneficiaries who remained in traditional Medicare the entire time. In the six months after leaving the private plans, the former Medicare Advantage patients used an average of $1,021 in medical services each month, while the patients in the control group cost Medicare $710 a month, the study found.
Source: kaiserhealthnews.org

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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

Medicare Open Enrollment: last chance to review and compare plans

With the holiday season upon us, it’s easy to get busy this time of year. Some pretty important tasks can get left to the last minute. One of those important tasks is ensuring you are in the right health insurance plan in Medicare.  Selecting the right plan is a personal choice, and a lot of thoughtful consideration goes into finding the right match.  But just like the holidays, those key dates come whether or not you are ready.
Source: medicare.gov

Last Chance to Disenroll from Your Medicare Private Health Plan

Beneficiaries who disenroll from their private plan may need to join a stand-alone Medicare prescription drug plan in order to maintain drug coverage. Medicare Rights advises beneficiaries who are choosing a plan to consider not only premium and copayment costs, but also whether the drugs they take are on the plan’s formulary (list of covered drugs) and whether they can use the pharmacies they prefer. Beneficiaries should also check to see whether the plan places any restrictions on the drugs they take. Restrictions can take the form of quantity limits, prior authorization and step therapy. To learn more about choosing a Medicare prescription drug plan that best meets your needs, visit Medicare Interactive.
Source: utahboomersmagazine.com

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

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

Assessing Risk: Medicare Advantage vs. Medigap vs. Drug Coverage Only

As Medicare’s open enrollment season draws to a close, it’s a good bet that seniors are still sifting through all those brochures and flyers that have come in the mail the last several weeks.’  My husband received 22.’  Some used tried-and-true scare tactics that Medicare insurance sellers have relied on forever to get him to open the envelope and bite.’  Others simply designed ways to gauge his interest in hopes that a salesperson could get in the door. Under current government rules, health insurance agents must make an appointment before coming to a senior’s home.’  That’s the government’s way of protecting them from pushy salespeople making cold calls.’  The theory is that an agent who is invited in will help seniors compare plans and choose the best one; though, the ‘best’ may very likely be what helps the agent or insurance company the most.’  Flyers are mere appetizers for the main course served by an agent.’ ‘  The first solicitation from First United American blared on the envelope:’  ATTENTION: NEW 2011 MEDICARE PRESCRIPTION DRUG COVERAGE INFORMATION HAS ARRIVED.’  The next one said:’  SECOND NOTICE:’  PLEASE REVIEW MEDICARE PRESCRIPTION DRUG COVERAGE FOR 2011.’  The second notice bit, of course, was to make the envelope look like something official from the government. Both were pushing a prescription drug plan, called a PDP in Medicare-speak.’  It’s meant to be used along with an old-fashioned Medigap policy that does not cover prescription drugs.’  I spotted some scary fine print.’  It said that if you sign up for the drug benefit, your membership in a Medicare Advantage (MA) plan may end.’  No more doctor, hospital, or drug coverage from that plan.’  I wonder how many seniors missed that warning. Emblem Health sent three messages.’  Two pushed plans using scary language highlighting changes in the law to get people interested in their brand of MA plan.’  One said:’  ‘ACTION REQUIRED’ and noted that’  ‘due to the recent changes in health care legislation, you will no longer be able to switch Medicare Advantage Plans after December 31.”  Another warned my husband ‘may not have a second chance to get the right Medicare Advantage coverage,’ and urged him to get the facts to make the right choice by calling for a free Medicare decision guide.’  Another of Emblem’s solicitations contained a short survey to fill out and return.’  The company would then send along a copy of the decision guide. What was missing from most of these solicitations was real information.’  The AARP-UnitedHealthcare solicitation for Medigap policies gave the table of standard benefits and premiums for New York.’  That’s kind of helpful.’  Their solicitation for Medicare Advantage plans was more explicit.’  The envelope enticed with ‘Looking for a plan with a monthly premium starting at $0?’ ‘ The flyer for United’s MedicareComplete plan gave a brief summary of benefits: zero monthly premium, zero annual medical deductible, zero copayments for routine physicals, immunizations and preventive screenings.’  What a deal!’  But a good consumer needs to know more. First of all, the new heath law allows all of those services without copayments whether you have a Medicare Advantage plan or not, so United wasn’t offering anything special here.’  There were other caveats.’  What about staying in a network and the lack of freedom to go to any doctor?’  What about coinsurance (a percentage of a medical bill that you are required to pay) that you might have to pay: for chemotherapy drugs, for example?’  To find out more, a shopper would need to call the company, visit with a sales agent or use Medicare’s website, not a simple task. So I suggest a simple rule no matter whether you use an agent or the government website: the Medicare option you choose boils down to your risk vs. premium calculation.’  A combination Medigap policy with a stand-alone drug benefit may cost more upfront than a Medicare Advantage plan with no monthly premiums and deductibles.’  But if you are seriously ill, the combo plan may be cheaper in the end when you consider the hidden costs of an MA plan that may not be disclosed when you sign up. ‘ In our ZIP code alone there are 84 options.’  Mindboggling!’  There’s no way anyone can choose “the best” from that kind of crowd, which raises a point I have made before ‘ do we really need all that choice in health care?
Source: cfah.org

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

What Medicare doesn’t cover

Posted by:  :  Category: Medicare

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

Video: Medicare dental insurance Denver

Oregon May Provide Model For Restructuring Medicaid In Alabama

Last October, a commission established by Bentley began researching ways to restructure the state’s Medicaid program to make it more efficient. The group concluded that Alabama should follow Oregon’s path. “It will be a heavy, heavy lift,” says state health officer Don Williamson, who headed the group. But he said the overhaul is necessary if the state is ever going to expand Medicaid. Otherwise, he said, “we will find ourselves with a program that simply collapses under the weight of the expansion.”
Source: kaiserhealthnews.org

The Medicare Sales Season Begins: As Always, Buyer Beware!

It happens every fall’sellers bombarding seniors with pitches for Medigap policies and Medicare Advantage plans’some legit and some not.’  Having watched this rite for years, I was intrigued by an envelope that arrived in the mail announcing on the front:’ ‘  ‘The U.S. Government has APPROVED new benefits not available in your current Medicare plan.”  Why, I am not even eligible for Medicare, let alone Medigap coverage.’  Presumably, that big, bold, enticing statement referred to the new preventive care benefits tucked into the health reform law passed last March. A letter inside began with this pitch in large, black letters: ‘Get free information about a new lower-cost health coverage option only for seniors’ and gave a number to call.’ ‘  Who doesn’t like something for nothing?’  I read on and learned that I was ‘eligible for several new health plans,’ some of which the letter said would save me money.’  The letter went on.’  An outfit called SafePath Benefits, or SBI, was ‘uniquely qualified’ to help me ‘understand and appraise these changes.” ‘  The letter said that SBI is not an insurance company.’  They are ‘Benefit Advisors who analyze health plans and recommend the ones that suit you best.”  Once a decision is made, advisers are available to answer questions and ‘provide solutions’ when ‘new options become available.”  Solutions?’  Sure sounded like they would be selling insurance.’  The envelope and letter were lead generators as they are called in the insurance biz’ways to snag sales prospects.’ ‘  The letter advised that there was no charge for the consultation service.’  That raised an immediate red flag.’  What business can afford to offer a completely free service without being paid by someone? The envelope also contained a small flyer noting that SafePath was ‘Your advocate in health care’ and an affiliate of a 100-year-old not-for-profit health services provider serving the five boroughs of New York City.’ ‘  But which provider?’  The flyer didn’t say.’  There was also a form to return indicating that I wanted a free consultation about my health care choices.’  It offered the phone number of a Benefits Advisor. When I called, a customer service rep explained that SBI was a benefits adviser for health plans.’  ‘We are not an insurance company,’ she said.’  ‘We do not touch your Medicare or Medicaid insurance.”  She said SBI had what she called ‘licensed advisers who explain any supplemental plans you may need.”  She mentioned prescription drug plans, dental, and eye glasses.’  ‘We just give advice to elders,’ she said and pointed out the free consultation, adding that advisers could meet me in a library or in an apartment building rec. room since people didn’t like strangers coming into their homes. ‘If you need a new plan, we’d refer you to Mutual of Omaha, AARP, Nationwide.’  It’s supplemental insurance,’ she said.’  At the end of our conversation she said they were a ‘sales agency licensed by the state.’ Wanting to know more, I checked with Google and found three sites that made it clear SafePath was recruiting sales people.’  One site said that ‘SafePath Benefits Inc. (SBI) is a newly formed wholly owned for-profit subsidiary of Metropolitan Jewish Health System.’  SBI is licensed in New York to provide accident, life and health insurance products to the senior market.”  Another site revealed that’  ‘SafePath Benefits Inc. is an insurance agency focused on the senior market in New York City.”  It also noted that the firm ‘has built a robust product portfolio’ and that there were immediate openings for Benefits Advisors/Producers.’  In insurance lingo, producers usually means sales agents. A third site gave a job description for a ‘Benefits Adviser.”  It said: ‘As a Benefits Advisor, you will present various lines of insurance from Medicare Supplements and Medicare Advantage, to life, disability, dental and more.’  SBI’s seasoned management team will work with you on strategies yielding high close ratios and high paying commissions.” ‘  In other words, they expect their advisers to sell.’  One requirement for the job was the ability ‘to conduct a consultative sale.’ Seniors can be forgiven if they don’t understand what’s going on.’  I don’t understand either.’  The bottom of the letter said:’ ‘  ‘SafePath Benefits, Inc. is a New York State licensed sales agency.”  But what are they licensed to sell?’  The letter didn’t say or disclose any license number so I phoned the New York State Department of Insurance, where officials told me they had issued no insurance license to SafePath Benefits, SBI, or Metropolitan Jewish Health System. Spokesman Andy Mais said the department had just checked the websites I looked at and ‘based on the websites they are soliciting for insurance in which case they should be licensed as an insurance agency.”  Said Mais:’  ‘We are opening an investigation as of today.’
Source: cfah.org

Health Products for Members: Health Insurance, Dental Insurance, Fitness

AARP Health is a collection of health related products, services and insurance programs made available by AARP. Neither AARP nor its affiliate is the insurer. AARP contracts with insurers to make coverage available to AARP members.
Source: aarp.org

Where can I find good dental insurance when I live on social security, and receive medicare?

Traditional Medicare does not offer dental insurance except under rare circumstances where injury is involved. But if you have a supplemental policy to Medicare Part B the insurance company you subscribe to might also offer dental insurance as a separate policy that is not connected to Medicare. The same would apply to your insurance provider of Part D prescription coverage. Once again, it would be a separate policy. So if you have one or both of those you should contact both providers for information in that regard. Also, if you are in a Medicare Advantage plan you might discover that your insurance company/provider will provide dental insurance at a fairly attractive rate. The only other alternative would be to join a company plan that provides reduced cost dental care at non standard rates. I live near Houston and for years have noticed in advertisements where several different dental provider companies regularly push their own plans. One even uses an attractive come-on that says "join today and get your teeth fixed tonight." Last I should mention that most insurance companies who offer dental coverage also offer eye coverage. I am on Medicare but do not carry either dental or eye coverage with a stand alone policy. I also pray a lot! Good luck. Check the yellow pages in your phone book for other possibilities.
Source: zmla.net

Health Insurance… Get Informed!: Dental Discount Plans Beat Dental Insurance… MUST READ!

( CI – news – people ), AARP, etc. its much like a shopping mall frenzy when deciding on a single plan. Should you buy individual dental insurance? Probably not, unless you need insurance as a spur to get yourself to the dentist for regular checkups and cleanings. Instead, consider a dental discount plan, if you can find a good one in your area. For about $100 a year you get access to a network of dentists who have agreed to work for the sort of reduced fees they accept when they sign up for an insurance plan’s preferred provider network. Cigna says 82% of the dentists in its group dental network also participate in its discount plans and accept the same rate for both. In its Miami plan an exam might be $36 instead of $69; a crown $535 instead of $981. Discount plans may not be an option if you live in the boondocks. You can find out the story in your state by searching at INeedDentalBenefits.com, maintained by the dental plans’ trade association. Searching Florida, we found 19 discount plans serving Miami, including Aetna and Cigna plans offered through Dentalplans.com. The plans cost $80 to $140 a year for a single person. Picking one can be tricky, since each has different providers and discounts. But you can switch plans every year if the discounts don’t add up as advertised or your otherwise pricey periodontist switches plans. The same Florida search found 21 insurance plans for a Miami resident. One problem is that stand-alone dental insurance has a surprisingly low annual limit on benefits–typically $1,200, not counting preventive care. A Miami resident pays $478 a year for AARP’s basic plan with a $1,000 cap or $664 for a plan with a $1,350 cap. Nor is AARP unusual. The average individual dental insurance plan costs $554–and that’s for a limited network of providers, meaning full coverage at only certain dentists. The premium will vary depending on where you live but not based on your age. Even using one of the plan’s chosen (i.e., cheapie) dentists, you’ll have a 20% copay for routine fillings and a 50% copay for crowns and bridges. Benefit: You typically get free twice-a-year cleanings and exams, and these don’t count toward the coverage limit. So what you’re doing is prepaying preventive dental expenses and buying a little bit of insurance for other ones. That little bit of insurance, however, comes with annoying gotchas. You may find that some big-dollar items–implants under certain conditions–aren’t covered at all. (Read the fine print.) Plus, there are usually waiting periods–as long as 18 months–before you’re covered beyond a basic exam, X-rays and extractions. Still, some financial advisors favor insurance as a way to manage continuing high dental costs. Thomas Rogers, a financial planner in Portland, Me., helped his own mother pick a plan that costs $588 a year, with a $1,500 cap. So far in 2009 she’s had $2,056 in dental expenses, with $1,104 paid by insurance. “I realize now that anything at all can happen, even to those who think they have great teeth,” says Rogers’ mom, Ann Carman, a 71-year-old retired professor of Japanese language and literature. Another approach to cutting dental bills: a tax deduction. One of Rogers’ clients, a 64-year-old retiree in Florida without insurance, was hit by $30,000 in dental bills over four years. She was able to knock $3,000 off her taxes over that period by taking the dental work as a medical-expense deduction. Note that you can deduct dental and other medical expenses only to the extent that they exceed 7.5% of your adjusted gross income. That means that if you are going to claim a tax break, you want to get all your expensive work done in a calendar year; if you’re relying on insurance, you’ll want to spread the work out, if possible, to get the maximum covered over several years. Article via: http://www.forbes.com/forbes/2009/1116/investing-dentist-medicare-dental-discount-plans-beat-insurance.html By: Ashlea Ebeling,
Source: blogspot.com

Calif. Telehealth Project Aims To Boost Dental Care for Thousands

you know, all these articles I read about dental care for children. I never had dental care when I was a kid. I went through all the many teeth that came out when I was a kid in Chicago. The teeth that became my permanent teeth served me until I was 17 when I went in to the air force. All my teeth were fine except a wisdom tooth that was pulled. Now, at 76, 11 years after I retired and no longer have dental insurance., I can’t go to a dentist because I can’t afford it. WHAT ABOUT US! WHAT ABOUT OLDER AMERICANS WHO DON’T HAVE DENTAL INSURANCE. ? We just don’t count. No dentist will help us. There are dentists here in the U.S. that will volunteer to go to other countries to help adults with dental problems but not here in the U.S. WHY???? I live on Social Security and a very small pension. I can barely scrape enough together to pay my bills, GASOLINE(tell the govt to nationalize the oil companies).and my health care. Yes I have MEDICARE, but there is no coverage for DENTAL CARE.
Source: californiahealthline.org

Last Chance to Disenroll from Your Medicare Private Health Plan

Posted by:  :  Category: Medicare

Beneficiaries who disenroll from their private plan may need to join a stand-alone Medicare prescription drug plan in order to maintain drug coverage. Medicare Rights advises beneficiaries who are choosing a plan to consider not only premium and copayment costs, but also whether the drugs they take are on the plan’s formulary (list of covered drugs) and whether they can use the pharmacies they prefer. Beneficiaries should also check to see whether the plan places any restrictions on the drugs they take. Restrictions can take the form of quantity limits, prior authorization and step therapy. To learn more about choosing a Medicare prescription drug plan that best meets your needs, visit Medicare Interactive.
Source: utahboomersmagazine.com

Video: 2012 Medicare Part D Annual Enrollment Period

Hurricane Sandy: Medicare extends enrollment period for those affected

The Centers for Medicare & Medicaid Services “understands that many Medicare beneficiaries have been affected by this disaster and wants to ensure that all beneficiaries are able to compare their options and make enrollment choices for 2013,” Arrah Tabe-Bedward, acting director for the Medicare Enrollment and Appeals Group, wrote in a Nov. 7 letter to health insurance companies and State Health Insurance Assistance Programs.
Source: nhregister.com

MEDICARE OPEN ENROLLMENT PERIOD IS CLOSING

Mostly cloudy. Slight chance of light rain or light snow in the late morning and early afternoon. Slight chance of light snow late in the afternoon. Blustery. Highs in the lower 40s. Southwest winds 10 to 20 mph with gusts up to 30 mph early in the morning becoming west and increasing to 15 to 25 mph with gusts up to 35 mph in the late morning and afternoon. Chance of precipitation 20 percent.
Source: patch.com

Medicare 102: Understanding Medicare Enrollment Periods

The Key word here is “SPECIAL.” If you have a special circumstance, such as moving out of a plan’s service area, or an involuntary loss of employer coverage because you are retiring at the age of 65 or older, than you may qualify for an SEP. There are many other circumstances which may make you eligible for an SEP. The length of the SEP can vary based on the circumstance. If you have enrolled into an Advantage Plan for the first time in your life during ICEP, or have dropped a Medigap policy to go into an Advantage Plan for the first time in your life, you have an SEP which lasts for the first 12 months of your enrollment in the Advantage Plan. This allows you to revert back to Original Medicare, enroll into a Medigap policy without being underwritten (though you may be subject to a higher premium due to age), and purchase a prescription drug plan.
Source: amac.us

Medicare Annual 2012 Open Enrollment Period

* Medicare Advantage plans see changes. Medicare Advantage participants should review 2013 plan changes as soon as they receive information from their providers. Changes could include costs such as premiums, deductibles and co-pays, as well as changes to covered procedures, tests and other provisions. Some plans may be eliminated, requiring enrollees to choose a new plan for 2013 or default to traditional Medicare Part B. Enrollment in Medicare Advantage plans continues to increase, with 10 percent more Medicare beneficiaries choosing these plans for 2012 compared to 2011. The average number of plans available to eligible individuals declined slightly from 24 plans in 2011 to 22 plans in 2012. The average number of plans for 2013 will not be known until later this year.
Source: disabled-world.com

With 3 days left in Medicare’s Annual Enrollment Period, what can you do to save money on Medicare in 2013?

At eHealth, Jodie Jensen trains licensed agents about the Medicare program so that they can better assist customers with questions. As the oldest daughter in her family, it fell to Jodie to take care of her aging father and help him choose a Medicare plan, an experience that had such a huge impact on her life and her family’s finances that it motivated her to change her career and become a licensed Medicare agent.
Source: ehealthinsurance.com

3 Tips for Avoiding Pitfalls in Medicare Enrollment

IAM is an SEC registered investment adviser with its principal place of business in the State of Texas.  IAM and its representatives are in compliance with the current registration and notice filing requirements imposed upon registered investment advisers by those states in which IAM maintains clients.  IAM may only transact business in those states in which it is noticed filed, or qualifies for an exemption or exclusion from notice filing requirements.  Any subsequent, direct communication by IAM with a prospective client shall be conducted by a representative that is either registered or qualifies for an exemption or exclusion from registration in the state where the prospective client resides.  For information pertaining to the registration status of IAM, please contact IAM or refer to the Investment Adviser Public Disclosure web site (www.adviserinfo.sec.gov).  For additional information about IAM, including fees and services, send for our disclosure brochure as set forth on Form ADV using the contact information herein.
Source: iaminvest.com

Medicare Open Enrollment Period through Dec. 7

With more benefits, better choices and lower costs, the Centers for Medicare & Medicaid Services (CMS) is encouraging people with Medicare and their families to begin reviewing drug and health plan coverage options for 2012. The Medicare Open Enrollment Period – which began earlier this year on Oct. 15 – has been expanded to last seven weeks and will end on Dec, 7. This will give seniors and people with disabilities more time to compare and find the best plan that meets their unique needs. Across the country, HHS officials will hold 150 events in the days leading up to Medicare’s Open Enrollment Period to inform and educate people with Medicare.
Source: sundancetimes.com

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

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

Deductibility of Medicare premiums as Self Employed Health Insurance Deduction

Posted by:  :  Category: Medicare

Background Prior to 2010, self-employed individuals were not allowed to take an above the line self-employed health insurance deduction under Section 162(l) for Medicare premiums. Health insurance is only considered deductible under the statute if it is established by your trade or business.  The purpose of the health insurance deduction is to equalize the treatment of owners of corporations who are allowed to exclude health care benefits as a fringe benefit and self employed individuals who cannot. Since Medicare is established by the Federal government the IRS did not consider Medicare premiums deductible as self employed health insurance. Recently the IRS reversed their opinion on the matter referencing Notice 2008-1. Notice 2008-1 states that as long as the self employed individual’s business ultimately pays for the health insurance and follows certain reporting requirements, the health insurance premium payments are deductible as above the line for the self employed individual. The Office of Chief Counsel IRS Memorandum extended Notice 2008-1 to apply to self employed individuals who pay Medicare premiums. Now all Medicare premium parts-A, B, C and D-paid by the self-employed individual for themselves, their spouse and dependents are deductible as self employed health insurance. The premium payments need not be paid directly by the self-employed individual. For example, the S corporation of a more-than-2% shareholder can make the payments directly and the self-employed individual is entitled to the deduction. 
Source: marcumllp.com

Video: Conway v. Paul on Medicare $2000 Deductible

Obama’s 2013 State of the Union Address: Tragedy Has Many Faces

The President also called for an Immigration bill, much needed no doubt. But that bill is currently being drafted in part by business interests, multinational tech companies in particular. As part of the immigration deal, multinational tech companies will be allowed to double the quota of jobs given to foreign skilled engineers from their offshore subsidiaries, raising the annual total of jobs under the H1-B visa program from current 65,000 to 130,000. So jobs will be created by the immigration bill, but not for American college youth, who are now being crushed under a mountain of student debt with little guarantee of a high paying job upon graduation. (And instead of expunging that debt in whole or part, as has been done for the banks these past five years, the President merely exhorted colleges and universities to stop raising annual tuition by double digit rates).
Source: jackrasmus.com

Medicare Part A deductible to rise by $32 in 2010

The beneficiary pays the deductible when admitted as a hospital inpatient. Medicare Part A pays for skilled nursing facility, inpatient hospital, hospice and certain home healthcare services. Beneficiaries must pay an additional $275 for days 61 through 90 in 2010, and $550 for lifetime reserve days. Only about 1% of Medicare beneficiaries have to pay a premium for Part A services.
Source: mcknights.com

DSCC Hits On $2K Medicare Deductible Again

Noah, If Conway has done more in the last few days to help your support of Rand Paul, apparently you were not a strong supporter anyway. I just had a friend murdered in Eastern KY this past week and he was killed by a guy on drugs. Drugs arent a problem in EKY according to some senate candidates though huh? Lets let the local governments take care of this problem. Grow up people, this is real stuff!
Source: pageonekentucky.com

Medicare Part B deductible for SE for spouse if husband has Schedule C

I know for certain that Part B is deductible for the self-employed person but still uncertain about Part B for the spouse.  It is unclear if you can take both Part B on Line 29 and some people say they are taking both and some only are taking one. Has anyone seen anything else to clarify this deduction???
Source: intuit.com

Medicare Premiums Now Deductible by Self

The Tax Law Tips blog is written by Jeffrey A. Quinn of Ashley Quinn, CPAs and Consultants, Ltd. (with contributions from Nolo editors). Jeff is a Certified Public Accountant in both Nevada and California, with more than 40 years of experience in providing professional accounting and tax services. Jeff is also a contributor to Nolo’s Tax Savvy for Small Business. A member of both the California Society of Certified Public Accountants and the American Institute of Certified Public Accountants, Jeff holds a M.S. in Taxation from Golden Gate University, and a B.S. in Accounting from the University of San Francisco.
Source: nolo.com

Oregon May Provide Model For Restructuring Medicaid In Alabama

Posted by:  :  Category: Medicare

3.4 million kids will have Medicare funded dental health care - that's why we vote Greens by Greens MPsLast October, a commission established by Bentley began researching ways to restructure the state’s Medicaid program to make it more efficient. The group concluded that Alabama should follow Oregon’s path. “It will be a heavy, heavy lift,” says state health officer Don Williamson, who headed the group. But he said the overhaul is necessary if the state is ever going to expand Medicaid. Otherwise, he said, “we will find ourselves with a program that simply collapses under the weight of the expansion.”
Source: kaiserhealthnews.org

Video: Medicare Dental Plans | Medicare supplemental Plans dental plans

Filling the gaps in Australia's dental workforce

The piece by Peter Brooks and Mike Morgan points up serious health issues that arise not only from inadequate access to routine dental care but to the structure of dental practice and access in Australia; it is dominated by a fee-for-service approach to provision of dental services and inadequate provision for ensuring that those at risk for developing adverse health outcomes are poorly provided for within an integrated health system. Women with peri-odontal disease are at higher risk of adverse pregnancy outcomes, the burden of chronic dental inflamation is manifest in a range of chronic diseases and difficulties of access for people who have high dental needs as a consequence of some underlying condition such as Hepatitis C infection, or being in high-risk categories for CJD.
Source: edu.au

Help protect Medicare dental cover for People with Chronic Disease

Many people with chronic disease such as diabetes, cancer, mental health problems, immune compromise or bleeding disorders, cannot afford private dentistry, and rely on the Medicare Chronic Disease Dental Scheme to pay for dentistry to protect their health. Government plans to close this scheme immediately, and send patients with chronic disease back to the public dental waiting list. Government intends only a 30% increased public dental spending, which is very much less than would be needed to satisfy even current demand, so people with chronic disease will not receive timely or comprehensive care needed. The Medicare Chronic Disease Dental Scheme has been very successful, with 1.5 million Australians treated. It has a low complaint rate of just one complaint per 1,500 patients. The Medicare Chronic Disease Dental Scheme forms a sensible basis for expansion to eventually include the entire Australian population under dental Medicare.  You can read more and sign the petition here:
Source: arafmi.org

Features of Medicare Dental Plans

Medicare and dental procedures: – In general, medicare does not cover the usual dental caring like teeth cleaning, cavity filling, dental extractions, implantations, crowning etc. But certain other dental health care policies cover routine dental treatments and checkups. In ordinary health care plans, dental care also will be taken up if certified by the physician as necessary along with other ailments. In addition, there are medicare dental coverages at reduced cost for the convenience of patients.  Of late, basic dental care treatments such as yearly dental checkup and teeth cleaning are included in the medicare coverages. As per this plan, once in a year, the dental patients are charged only at 50 % for one cavity filling, one root canal treatment and crown repairs. The medical savings account as per the medicare plan is another alternative to cover the dental expenses. The deposit to this account is made from the medicare account of the policy holder. Occasions when medicare covers dental services
Source: affordable-dentalplans.org

Calif. Telehealth Project Aims To Boost Dental Care for Thousands

you know, all these articles I read about dental care for children. I never had dental care when I was a kid. I went through all the many teeth that came out when I was a kid in Chicago. The teeth that became my permanent teeth served me until I was 17 when I went in to the air force. All my teeth were fine except a wisdom tooth that was pulled. Now, at 76, 11 years after I retired and no longer have dental insurance., I can’t go to a dentist because I can’t afford it. WHAT ABOUT US! WHAT ABOUT OLDER AMERICANS WHO DON’T HAVE DENTAL INSURANCE. ? We just don’t count. No dentist will help us. There are dentists here in the U.S. that will volunteer to go to other countries to help adults with dental problems but not here in the U.S. WHY???? I live on Social Security and a very small pension. I can barely scrape enough together to pay my bills, GASOLINE(tell the govt to nationalize the oil companies).and my health care. Yes I have MEDICARE, but there is no coverage for DENTAL CARE.
Source: californiahealthline.org

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

Medicare Fraud Scheme in Manhattan

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2.. Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481Kazarian was a “Vor,” a term translated as “Thief-in-Law.” The term refers to a member of a select group of high-level criminals from Russia and the countries that had been part of the former Soviet Union, including Armenia. Vors offer prestige and protection to criminal organizations in return for a share of criminal earnings and use their position of authority to resolve disputes among criminals. Kazarian used his status as a Vor within the criminal community to assist the Mirzoyan-Terdjanian Organization, an Armenian-American organized crime ring that engaged in an extensive range of criminal offenses including the operation of a $100 million dollar Medicare fraud billing ring. As part of his involvement with the group, Kazarian engaged in extortion on the organization’s and his own behalf.
Source: sandpointpr.com

Video: Company accused of massive Medicare fraud

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

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

Medicare Fraud Enforcement and Prevention Act of 2013 (H.R. 418)

So, yes, we display the House Republican Conference’s summaries when available even if we do not have a Democratic summary available. That’s because we feel it is better to give you as much information as possible, even if we cannot provide every viewpoint.
Source: govtrack.us

FBI raid more about Medicare fraud than Sen. Bob Menendez.

“Any allegations of engaging with prostitutes are manufactured by a politically motivated right-wing blog and are false,” Menendez’s office said in a statement Wednesday, following the raid on Melgen’s clinics in West Palm Beach and two other South Florida locations.
Source: typepad.com

Medicare Fraud Whistleblowers Will Receive Over $7 Million After Convincing Jury that Nursing Home Provided Worthless Care to Residents

Qui Tam 101 Blog is published for informational purposes only; it contains no legal advice whatsoever. Publication of Qui Tam 101 Blog does not create an attorney-client relationship. Qui Tam 101 is the blog of Nolan & Auerbach, P.A. and it is intended primarily for other attorneys and regulatory professionals. No part of Qui Tam 101 Blog –whether information, commentary, or other– may be attributed to Nolan & Auerbach, P.A.’s clients. Readers should be aware that Nolan & Auerbach, P.A. represents whistleblowers in the drug, medical device, and health care industries, and therefore Qui Tam 101 Blog may occasionally report on news that relates to Nolan & Auerbach, P.A. clients. Qui Tam 101 Blog will always strive to be unbiased in its reporting. All information on Qui Tam 101 Blog should be double-checked for its accuracy and current applicability. Copyright 2009 Nolan & Auerbach, P.A.
Source: false-claims-act.net

New Medicare fraud detection system saves $115 million

The rest of the money, about $84 million, is projected savings flowing from those actions. For example, if a fraudulent provider has been billing Medicare for roughly $100 million a year for wheelchairs that patients never receive and they are kicked out of the program, officials estimated the program would save $100 million the next year. Medicare has been a highly sensitive political issue for the Obama administration since Democrats lost the House in 2010, partly due to a backlash from seniors over program cuts to help finance the president’s healthcare overhaul. Since then, top officials have emphasized the administration’s stewardship of Medicare, touting better benefits and an all-out campaign against fraud. Lawmakers from both parties, including Sen. Tom Carper, D-Del., and Sen. Orrin Hatch, R-Utah, have pressed health officials for months to release results on the system, complaining that without data, there’s no accountability for the money spent and the promises made. The system’s projected savings are only for one year, but anti-fraud administrator Peter Budetti noted the actual savings could be much more because a provider that has been banished from the program could have stayed in the system for years, racking up hundreds of millions of dollars in bad claims. The bulk of the projected savings came in referrals to law enforcement that remain under investigation, but will likely result in payment suspensions or kicking providers out of the program. Federal health officials did not say how many cases were pending, but estimated about $68 million in potential savings in that category. Federal health officials have struggled with how to measure the success of the Fraud Prevention System. In the past, it was measured by how much money law enforcement officials recovered. Now, it’s based on how much money is saved before it’s paid. Data from the new system also launched 536 new investigations and provided information for another 511 already in progress, but it’s unclear what actions had been taken based on those investigations. “We have shown this technology can work in fighting healthcare fraud, and we have seen encouraging results. The system is designed to grow in sophistication and complexity, helping the government stay one step ahead of fraudsters,” Budetti said. The new screening technology, which was mandated by Congress, is housed in the Baltimore area in a $3.6 million command center. In the past, investigators individually screened each claim as it came in, determining on face value whether it looked suspicious. Under the new system, claims are run through a series of sophisticated computer models that can spot suspicious billing patterns and put that claim in the context of all the claims from that provider and claims from other providers in a particular industry. For example, does a storefront wheelchair retailer in Los Angeles, for example, have lots of customers in San Francisco, more than 350 miles away?
Source: modernhealthcare.com

Medicare Fraud Sting Operations by Federal Government Includes Senior Volunteers Spying on Doctors and Health Care Providers: Expect to See More National Stings and Sweeping Arrests of Medical Pros in the Future

As a part of the new resources dedicated to fighting fraud, the Obama Administration has significantly expanded funding for Senior Medicare Patrols – groups of senior citizen volunteers who educate and empower their peers to identify, prevent and report health care fraud. In 2012, the Secretary awarded 54 states and territories with funding to support the Senior Medicare Patrol programs Last year, these programs taught more than 2 million beneficiaries how to look for Medicare fraud. Local Senior Medicare Patrol offices provide assistance when such issues are identified, so that mistakes are corrected and suspected fraud referred to the appropriate authorities. Since 1997, more than 1.5 million seniors and their caregivers have contacted the Senior Medicare Patrol to ask questions or report potential fraud.
Source: dallasjustice.com

Carson pastor pleads guilty to $11 million in Medicare fraud

Agbu admitted to owning Bonfee Inc., a fraudulent medical equipment supply company, and acknowledged that he paid patient recruiters to approach Medicare beneficiaries and convinced them to give him their Medicare information in exchange for specialized power wheelchairs, officials say.
Source: latimes.com

Medicare Fraud – 90 individuals arrested

Medicare Fraud Strike Force Operations in seven cities have led to charges against 91 individuals – including doctors, nurses and other licensed medical professionals – for their alleged participation in Medicare fraud schemes involving approximately $429.2 million in false billing, Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced in late in 2012. Dozens of individuals were arrested or surrendered as indictments were unsealed across the country. Together, those indictments charge more than $230 million in home health care fraud; more than $100 million in mental health care fraud; and more than $49 million in ambulance transportation fraud. HHS also suspended or took other administrative action against 30 health care providers following a data-driven analysis and based upon credible allegations of fraud. Under the Affordable Care Act, HHS is able to suspend payments until the resolution of an investigation. The joint Department of Justice and HHS Medicare Fraud Strike Force is a multi-agency team of federal, state and local investigators and prosecutors designed to combat Medicare fraud through the use of Medicare data analysis techniques. The defendants charged are accused of various health care fraud-related crimes, including conspiracy to commit health care fraud, health care fraud, violations of the anti-kickback statutes and money laundering. According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and oftentimes never provided. In many cases, court documents allege that patient recruiters, Medicare beneficiaries and other co-conspirators were paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could submit fraudulent billing to Medicare for services that were medically unnecessary or never provided. In Dallas, 14 individuals – including two doctors and two registered nurses – are charged for their alleged participation in various fraud schemes involving a total of $103.3 million in false billings. In one case, three defendants – a medical doctor and two registered nurses – are charged with participating in a fraud scheme at Raphem Medical Practice and PTM Healthcare Services which led to approximately $100 million in fraudulent billing for home health care services. According to court documents, Dr. Joseph Megwa signed approximately 33,000 prescriptions for more than 2,000 unique Medicare beneficiaries from 2006 to 2011.  Many of these Medicare beneficiaries had primary care physicians who never certified home healthcare services for them.  Seven individuals are charged in Houston for their participation in a fraud scheme at a hospital which led to $158 million in fraudulent billing for community mental health center services. The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. To learn more about the HEAT program, please go to: www.stopmedicarefraud.gov
Source: gp1.com

Make 2013 a year for preventing Medicare fraud!

This might seem like too big of a resolution for just one person, but if we work together, we can accomplish anything we set our minds to. When it comes to protecting, detecting, and reporting Medicare fraud, the community is the best defense. The National Hispanic SMP (NHSMP) needs to the support and involvement of older adults, their families, and caregivers to help stop Medicare fraud in our community. The NHSMP is part of a whole network of leaders, agencies, and organizations working to fight Medicare fraud across the country:
Source: nhcoa.org

Senators Urge CMS To Reform Medicare Fraud Prevention Program

The OIG report looked into activities from April 2010 to March 2011 and found that the Medicare Drug Integrity Contractor, or MEDIC, program identified most of the few cases referred to law enforcement through passive and external means, such as a fraud hotline, rather than proactive, internal means, such as research and investigation. Specifically, the report found that:
Source: californiahealthline.org

Beware of Medicare Fraud Calls

These calls are completely fraudulent. Medicare will NEVER ask for a beneficiary’s Medicare number unless the beneficiary initiates the call, and they will NEVER ask for a bank account number under any circumstances. The only beneficiaries that need to get new Medicare cards are those who are first applying for Medicare coverage, or those who have asked for a new card because their card is lost or damaged.
Source: mauryriversc.org