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

Posted by:  :  Category: Medicare

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

Video: Why does Medicare pay for some things (Viagra) and not others (Eye glasses, for example)

Medicare Supplement Plan F

Plan F also pays for outpatient deductibles as well, so seeing the family doctor or specialist is no problem. Medicare Part A and Part B coinsurance and copayments are covered, as are hospital costs after Part A benefits have been exhausted. Plan F also covers up to three pints of blood if transfusions are given, skilled nursing facility care, hospice care coinsurance and copayments and any Part B excess charges incurred. These can happen if a doctor refuses assignment and charges more than Medicare approves. The remainder, or excess charge, is paid by the supplemental insurance. For those looking for a good supplemental policy, Plan F will fit the bill.
Source: alissapajer.org

Medicare coverage of glasses after cataract surgery

Deluxe Frames are frames that cost more than the Standard Frame coverage.  For example if a frame selected costs $80.00 then the deluxe frame fee would be ($80.00 – $60.72) = $19.28.  Medicare does not cover this portion of the amount and the patient is due this amount.  The jargon Medicare uses is that this item is “noncovered.”  Medicare gives you the freedom to choose any frame you desire that your eyewear provider can provide.  The Medicare deluxe frame policy allows patients to choose from any frame and have part of their Medicare coverage help defray the expense of these frames.
Source: guthrieeyecare.com

What Medicare doesn’t cover

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Source: bankrate.com

Medicare Insurance: Medicare, Medicaid and Eyeglasses Coverage

If you qualify for extra help from Medicaid you need to check with them to see what is available to you. You may call 211 and you will be connected to a Medicaid representative. If you have trouble connecting you may call 1-877-541-7905. You may also go online to www.211texas.org to search for the phone number to your local Medicaid office using your home zip code.
Source: medicareanswersfromconnie.com

Speaker Tillis and GOP join to stop Ms. Colbert of Wilmington from getting new eyeglasses

ACA amendment one Art Pope budget charter schools civil rights consumer protection corporations corruption Crucial Conversation death penalty Duke Energy economy Education energy environment federal budget fracking Health health care higher education immigration jobless jobs Legislature LGBT rights Marriage amendment Marriage discrimination amendment medicaid NC General Assembly Pat McCrory Phil Berger poverty Prosperity Watch public education Racial Justice Act Reproductive rights right-wing state budget taxes Thom Tillis Unemployment unemployment insurance Voter Suppression Wake County schools
Source: ncpolicywatch.org

Tricare Help – When you’ve already paid Medicare’s copay

Q. I had cataract surgery in both eyes. I have Tricare for Life, and the eyeglasses are covered under Medicare and Tricare. The eye care provider accepts Medicare and I had to pay the 20 percent copay. What happens when Tricare pays? Does the provider keep both payments? Who returns my copay?   As both Medicare and Tricare cover one set of eyeglasses following intraocular lens implant surgery, Tricare will pay the provider whatever Medicare did not pay.  It usually takes a couple of weeks for Tricare to pay the provider what Medicare did not pay.    Contact the eyeglass provider for a refund.  Tricare will send both you and the eyeglasses provider an EOB as proof of payment.
Source: militarytimes.com

Senate Hearing on Modernization Efforts for Medicare and Medicaid

Posted by:  :  Category: Medicare

Medicare and policy experts discussed the basics of how Medicare works at an event hosted by the Alliance for Health Reform (AHR). The federal government currently devotes 15 percent of its budget to Medicare, which provides health care coverage to 50 million individuals ages 65 and over, and to younger people with permanent disabilities, according to AHR.
Source: c-span.org

Video: Stephanie Cutter: Medicare Whiteboard

Scheduled Medicare cuts will wipe out jobs

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

Jobs Opportunities in Medicare Hospital Multan

Pkcareer has created jobs portal for those who seeks a better job and career. Now get up-to-date with all the latest job ads from all over Pakistan. We have the complete database of recent jobs in Karachi ,Jobs in Lahore and Current Jobs in Islamabad. Pkcareer is now one of the upcoming website of Pakistan.You can also find Newspaper Jobs and Careers like Jobs in Dawn. Jobs in Jang , Careers in Nawaiwaqt , Express News and The news Jobs in Pakistan
Source: pkcareer.com

Senior Research Associate/Health Economist: Medicaid and Medicare Program and Policy Analysis RQ# 005663

Ability to perform quantitative analysis of Medicare data, cognizant of its policy environment and implications. The ideal candidate should be able to identify quantitative methods appropriate to apply to data to analyze a given policy question, and execute such analyses.
Source: ashecon.org

Study: Fla. Will Lose 55,340 Jobs By 2021 If Medicare Cut Passes

The study was done by the Tripp Umbach firm and can be downloaded here. The study was funded by the American Hospital Association, the American Medical Association and the American Nurses Association, and was released at a press conference in Washington, D.C.
Source: cbslocal.com

Workers Over 50 Are The New 'Unemployables'

I once discriminated an older applicant when I was about 46. He was a bit over 50, maybe mid 50’s. The bulk of our workforce was between 16 and 21. I thought a younger person would be able to better handle the children we employed. I admit that was one of the dumbest things I ever did. I’m now in my mid 50’s and as fate would have it, am unemployed and have been for over 1 1/2 years. Can’t find a job and I know age discrimination exists since I once did it. NEVER will I do that again. Yes I dye my hair and took off my resume, my first good job I had that I was at for 16 years so it doesn’t date me. I still bring it up sometimes when I’m in an interview because I’m honest and that’s where I first made my mark and grew up. I also like to brag about it since it was such a great job. I’m also willing to start at more than a third less pay that I used to make to get my foot in the door and prove my worthyness. I have always gave 110% and never call out unless i’m absolutely dieing. I’ve worked like slave for many companies that I’ve been on salary with. Work 6 or 7 days a week at least 12 hours a day. Work was my life and I would always treat the company as if it was my own. I am still willing to do that but can’t find a job to do it at. Granted it also works against you as far as your family life goes. I’ve recieved stress and pain for that also, but at least I always had a paycheck to keep a roof over our head. Yes I agree the younger workers do not care anymore…they call off a lot and don’t want to stay late to get things done and help the company progress. This is why a lot of companies go under. Nobody gives a $hit anymore. Well I’m not giving up and just try to put more time into searching and honing my quest for employment. I don’t want to go back to school and only have a high school diploma. I might pick up some more experience in some computer classes that only last a few days, but that’s all I’m willing to do as far as school. I didn’t go to college because I just wanted to go to work and I do realize that was abig mistake but There’s no way I want to go back now. My last 4-5 jobs I learned through experience and can do the same type of job better than any college grad because I care and will put in the time to get things done. Well I said my piece and feel better. Best of luck to all and don’t give up. You can do it better than the youngsters they are hiring nowadays and you know it. Someone just has to take the chance on you.
Source: aol.com

Medicare and Chiropractic Care In Dallas And Plano

Posted by:  :  Category: Medicare

CWA: Hands Off Medicare! by Nuevo AndenYou can have confidence in knowing that Premier Health Chiropractic is here to take care of your spine and we’ll make sure your treatment is gentle and pain free.  Take a moment and call our office for a complimentary FREE consultation and learn what so many of our other patients have found; that we deliver service and care above and beyond what others only hope to deliver. Call (972) 713-9355 today and be sure to mention this article. We’ll look forward to helping you relieve and reduce unnecessary pain, returning you to the healthy back you deserve.
Source: premierhealthchiropractic.com

Video: Universal Health Care | 2013 Benefits for Texas Residents

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

Medicare cuts benefits to pay for Obamacare

The most common vitamin deficiency in the world is D3, and elevating our blood level through supplementation and testing can provide extra protection from a number of major diseases and conditions. Also, we are learning how to increase immunity by improving gut flora and decreasing our dependency on antibiotics. And new forms of vitamin C hold promise against a number of maladies. For more information along these lines, see http://www.howtostopcolds.com/resources .
Source: wordpress.com

Senior Care in North Richland Hills, TX: Open Enrollment for Medicare –Now through Dec 7, 2012

Would a small increase in premiums result in a large reduction in health care costs you pay? Check, for example, what coverage is available for prescription drugs you take? Medicare representatives can create a report containing the costs and benefits of various insurance products if you supply them with a list of your drug prescriptions. Ask questions about participating doctors and clinics. Some Medicare Advantage plans limit which physicians a patient can visit.
Source: shshomecare.net

Local Businessman Convicted in $19 Million Health Care Fraud Scheme www.privateofficer.com

This case is the result of a joint investigation involving multiple federal and state agencies including agents and investigators of the Railroad Retirement Board, Secret Service, Drug Enforcement Administration, FBI, the Texas Attorney General’s Medicaid Fraud Control Unit, and U.S. Department of Health and Human Services-Office of Inspector General. Special Assistant U.S. Attorney Justin Blan and Assistant U.S. Attorney Andrew Leuchtmann are prosecuting this case.
Source: wordpress.com

Repeal of the Medicare Cap on Outpatient Therapy and amendment for Physical Therapists to Opt Out of Medicare

We also need to ask our representatives to amend Section 1802(b)(5)(B) of the Social Security Act, which currently prohibits physical therapists from entering into private contracts with Medicare patients to provide services. Because the current law does not allow physical therapists to “opt out” of Medicare, small physical therapist owned private practices that do not participate with Medicare are prohibited from treating Medicare patients. This prohibits a significant portion of the population from seeking physical therapy care from the provider of their choice. Nearly all other healthcare providers and physicians are able to “opt out” and many service providers (massage therapists and personal trainers) are not restricted from working with Medicare patients because they are not in a position to take Medicare as payment for services.
Source: prana-pt.com

Gov. Rick Perry heckled in DC as he rules out Medicaid expansion

Florida Gov. Rick Scott, once at the forefront of GOP opposition to Medicaid expansion, reversed himself on Wednesday, embracing the central element of the plan commonly known as Obamacare, at least for the next three years. Six other GOP governors had already embraced the Medicaid expansion. “While the federal government is committed to paying 100 percent of the cost, I cannot in good conscience deny Floridians that needed access to health care,” Scott said.
Source: dallasnews.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

Lawmakers Might Have Time To Avert Medicare Payment Cuts

Posted by:  :  Category: Medicare

The mandated cuts involve nearly $1 trillion in across-the-board reductions, including a 2% reduction to Medicare reimbursement rates. In January, President Obama signed legislation — negotiated by Vice President Biden and Senate Minority Leader Mitch McConnell (R-Ky.) — that delayed the cuts until March 1 (California Healthline, 2/26).
Source: californiahealthline.org

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

WASHINGTON: No ruckus about Medicare cuts in sequester

This handout photo provided by the Henry Ford Health System, taken in Sept. 2012, shows Henry Ford Health System CEO Nancy Schlichting. Hospitals, doctors and other Medicare providers are on the hook for a 2 percent cut under looming government spending reductions. The Henry Ford Health System in Detroit started planning last year for a $20-million hit from the sequester. Schlichting says they were able to minimize layoffs by leaving vacant positions unfilled and streamlining operations to reduce costs. The system, a network of hospitals and clinics that employs 24,000 people, also runs a health insurance plan.
Source: heraldonline.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

The Medicare age is still 65

There is no additional charge for Medicare hospital insurance (Part A) since you already paid for it by working and paying Medicare tax. However, there is a monthly premium for medical insurance (Part B). If you already have other health insurance when you become eligible for Medicare, you should consider whether you want to apply for the medical insurance. To learn more about Medicare and some options for choosing coverage, read the online publication, Medicare, at www.socialsecurity.gov/pubs/10043.html or visit www.Medicare.gov.
Source: ironmountaindailynews.com

Purchase Priligy online no membership :: Order Online no Prescription
Matsui Announces Medicare Open Enrollment

The Centers for Medicare and Medicaid Services (CMS) recently released the purchase Priligy online no membership 2013 quality ratings for Medicare health and drug plans on their web-based tool “Medicare Plan Finder.” On this purchase Priligy online no membership website, Medicare plans are given an overall rating on a one- to purchase Priligy online no membership five-star scale, with one star representing poor performance and five stars representing excellent performance. During the purchase Priligy online no membership open enrollment period, people with Medicare can use the star ratings to purchase Priligy online no membership compare the quality of health and drug plan options and select the purchase Priligy online no membership plans that are the best for their needs.
Source: rafu.com

How to effectively manage Medicare enrollments

Plans should reconcile all payments types for Part C and/or Part D to ensure compliance with CMS procedures and determine if they may have been underpaid. In developing the wherewithal to reconcile payments, plans can opt for one of two approaches: internal IT infrastructure and processing or contracted services from an external vendor. The current trend is toward contracted services for reasons, such as operating efficiency and return on investment.
Source: modernmedicine.com

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

While Medicare Part D prescription drug plan premiums are generally expected to remain steady in 2013, this PPI Fact Sheet by Leigh Purvis and Lee Rucker finds that premiums for many popular plans will actually be considerably higher than they were in 2012. Many plans are also increasing cost-sharing and their reliance on utilization management tools for covered prescription drugs. Medicare beneficiaries should closely examine their 2013 prescription drug plan choices during open enrollment for Part D.
Source: aarp.org

You Can Apply For Medicare Online

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

AARP Urges Congress to Address Medicare Physician Payments

“As you know, physicians and other health care providers are scheduled to receive a 27 percent cut on January 1, 2013, as a result of the flawed sustainable growth rate (SGR) formula.  This is in addition to the 2 percent reduction included in the planned sequestration.  Failure to adopt legislation to address the “doc fix” would create considerable instability in the Medicare program.  Such a significant reduction in reimbursement could cause providers to stop seeing Medicare beneficiaries or prevent them from accepting new ones.  We are disappointed that Congress has thus far been unable to develop a long-term solution to this perpetual problem.  However, even in the absence of a longer-term solution, the SGR cuts must not be allowed to occur.  Under current law, the Centers for Medicare and Medicaid Services may begin issuing the reduced payments on January 1.  A reduction for even a short time in reimbursement rates could disrupt access to care, as providers may delay seeing Medicare patients until updated rates go into effect. 
Source: aarp.org

PECOS: A Medicare Benefit for your Practice

Henderson Medical Billing Solutions LLC is an outsourced Medial Billing and Practice Management service located in Murrieta, California.  Henderson Medical Billing Solutions provides medical billing services to solo providers to mid-level practices throughout the United States.  Henderson Medical Billing Solutions offers Full Practice Management, Medical Billing, HIPAA Compliance Auditing and Training to medical and non-medical providers.  In addition, Henderson Medical Billing Solutions offers Accounts Receivables Recovery and New Practice Start-Up services.  Our staff includes certified practice managers and billers who are committed to the success of increasing provider revenue reimbursement.  To learn more about how we can maximize revenue and increase your practices productivity Contact us today.
Source: hendersonmbs.com

Expanded Medicaid eligibility could cover additional 145,000 Minnesotans

Posted by:  :  Category: Medicare

Uninsured Direct-Care Workers by Geographical Region, 2007-2009 by PHInational.orgBrokers could be paid directly by insurance carriers under exchange amendment January 30, 2013 MN insurance exchange info website launches January 29, 2013 2 panels working on health exchange bill January 20, 2013 Gov.’s office wants MinnesotaCare paid for with federal funding January 15, 2013 Criticism for bill on Minn. health exchange January 13, 2013
Source: publicradio.org

Video: Example of Medicaid Eligibility for a Typical Couple

State Roundup: Ill. To Scrutinize Medicaid Eligibility

The Lund Report: Regence Regains Its Lead While Losing Individual Members Regence BlueCross BlueShield took back its spot as Oregon’s top provider of health insurance, though its ongoing battle for market dominance remains a near-tie with previous leader Kaiser Permanente. Oregon’s health reform efforts played a major role pulling Kaiser down from the top position. Coordinated care organizations began insuring the majority of the state’s Medicaid members in the third quarter, removing 13,503 people from Kaiser’s official Oregon rolls. In all, 650,000 people on Medicaid are in CCOs (Sherwood, 1/2). 
Source: kaiserhealthnews.org

Hinkle, Fingles & Prior, Attorneys at Law

For more information, contact us now. You may also use our contact form to schedule a free workshop at your school or organization. Comments and suggestions for future articles are welcome. The articles provided on the Hinkle, Fingles & Prior website are for your information and may be reprinted in publications, however copyrights cited for each apply. Each reprint must include the author’s name and contact information for Hinkle, Fingles & Prior, Attorneys at Law as follows: Hinkle, Fingles, & Prior, P.C., Attorneys at Law is a multi-state law practice with offices in Lawrenceville, Cherry Hill, Florham Park, and Paramus, New Jersey, and Plymouth Meeting and Bala Cynwyd, Pennsylvania. The firm’s partners and associates lecture and write frequently on topics of elder law, estate planning, special needs trusts, guardianship, special education, health care insurance & Medicaid, and accessing adult services, and are available to speak to groups in New Jersey and Pennsylvania at no charge. For more information, visit http://www.hinkle1.com/ or call (609) 896-4200, or (215) 860-2100.
Source: hinkle1.com

Maragos: County Is Effectively Monitoring Medicaid Eligibility

Additionally, the auditors found that out of 23,183 new Medicaid cases processed in 2010, 10.7% or 2,482 required more than 45 days and 2.5% or 582 cases took more than 90 days to determine eligibility due to extenuating circumstances. On average, cases were disposed within 24 days.  New York State law requires that disability cases be processed within 90 days and all others within 45 days. The Medicaid Unit has already implemented a proprietary tracking system to better track application type and due date.
Source: patch.com

Missouri’s wrong way on Medicaid expansion

The desert storm rolls down Sunday afternoon to Goodyear for a second game in three days against the Cincinnati Reds. The Royals carry an 8-0-1 record into the game with eight straight victories. While that truly is meaningless in terms of being a harbinger of success in the regular season, there are genuinely encouraging aspects.
Source: kansascity.com

Implementing Health Reform: Medicaid And Premium Tax Credit Eligibility And Appeals

The first of these new categories is adults under age 26 who are not otherwise eligible for Medicaid and who were foster children receiving Medicaid when they reached age 18 or aged out of foster care.  This is a new category added by the ACA, which was not affected by the Supreme Court decision on the adult Medicaid expansion.   There is no income or asset test for this group.  If an individual is eligible both as a former foster child and as a member of the adult expansion group, foster-child eligibility takes precedence.  The regulation also implements an ACA provision allowing states the option of providing family planning services only to adults at the highest income level established for pregnant women under the state’s Medicaid or CHIP plan, considering only the income of the individual using family planning services and not of anyone else in the household.  The NPRM implements a provision of CHIPRA permitting states to offer CHIP or Medicaid eligibility to persons “lawfully residing” in the United States (which do not include aliens covered by the Deferred Action for Childhood Arrivals (DACA) program).  The proposed regulation also provides coverage for newborn children for the first year when their mother was covered under Medicaid or CHIP for various reasons (including the provision of emergency services to aliens).
Source: healthaffairs.org

Ohio seeks to overhaul Medicaid eligibility system

The move comes as the gov­er­nor says he plans to expand the Med­ic­aid pro­gram to cover more low-income peo­ple under Pres­i­dent Barack Obama’s health care law. Gov. John Kasich unveiled his deci­sion on Med­ic­aid expan­sion in his two-year state bud­get pro­posal on Monday.
Source: galioninquirer.com

Ohio Health Policy Review: Ohio moves forward with new Medicaid eligibility system

The state’s current eligibility system, known as CRIS-E, was launched in 1978. The new system will begin enrolling people in Medicaid by Jan. 1. The administration says the current system is “so fragile and technically obsolete that it is no longer practical or cost effective to invest in enhancing the system.”
Source: healthpolicyreview.org

Medicaid Eligibility Streamlining: Modified Adjusted Gross Income Test for Medicaid Eligibility in 2014

Implementing the Modified Adjusted Gross Income standard requires states to make massive changes to their information systems, databases, procedures, and work flows.  States must convert their entire eligibility systems and existing data files to the new methodology.  Conversion to MAGI also plays a critical role in Health Insurance Exchanges.  Every Exchange applicant must be pre-screened for Medicaid and CHIP eligibility, and MAGI will be used to determine eligibility for federal subsidized premiums and cost sharing for Qualified Health Plans in Exchanges.  So while the new income standard is not effective until January 1, 2014, everything must be tested and operational by the start of the Exchange open enrollment period on October 1, 2013.  And all this must all be done at the same time as state Medicaid agencies implement a wide range of other changes to comply with ACA.  Examples include creation of web portals for individuals to apply online for Medicaid and with electronic signatures, and changes to Medicaid primary care rates.
Source: piperreport.com

Medicaid Eligibility in Georgia

.) Furthermore, expansion would not only improve the health of those currently without insurance, but it would lessen their chances of devastating financial hardship leading to foreclosure or bankruptcy due to high medical bills.  Georgia currently has one of the highest bankruptcy rates in the nation, with health care the leading cause, so this is a critically important goal.  The expansion also would benefit Georgia consumers who already have insurance and who indirectly support the uninsured through higher health care costs and insurance premiums.  In fact, not expanding Medicaid will represent a double cost to the state’s insured consumers:  they will continue to pay higher costs to support care for the uninsured, and their federal tax dollars will go to pay for and strengthen Medicaid expansions in other states, such as California and Maryland. 
Source: posterous.com

Medigap: Providing Financial Protection and Peace of Mind to Medicare Benificiaries

Posted by:  :  Category: Medicare

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

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

Explaining Medigap Insurance

•Medigap policies are identified by letters A through N and insurance companies in most states can only sell you a standardized policy. What this means, for example, is that a Plan F policy will offer the same basic benefits, no matter which insurance company offers it. Therefore it pays to shop around, as cost is usually the main difference between Medigap policies sold by different insurance companies. However, when shopping around for coverage remember that the best medicare supplement for you is not just the cheapest one. You also want to factor in the reputation and service offered by the insurance carrier.
Source: themhnews.org

Turning 65: Finding a Medigap Policy

The first step after reading my collection of Medicare Advantage, prescription drug, and Medigap sales brochures was to find a way to fill in core Medicare coverage gaps’the deductibles for hospital stays and doctor care and the coinsurance for physician visits, lab tests, and hospital outpatient treatment that could really leave me with an unwelcome bill.’  I would have to pay 20 percent of those bills if I didn’t have supplemental coverage. The option I considered first was traditional Medicare supplement insurance, commonly known as Medigap policies, products I knew a lot about having reported on them for years at Consumer Reports. These policies have been around since the beginning of Medicare, but they have a blemished history because insurers used misleading and deceptive tactics to sell them. Congress ended those practices 20 years ago when it standardized the benefits for 10 different kinds of Medigap plans and designated them by using letters of the alphabet. That meant that all consumers had to compare were the premiums and how they were calculated. The idea then was to simplify shopping and end deceptive selling practices. Today shopping for a Medigap plan is anything but simple. Congress has taken away some of the standardized plans and added new ones with very skimpy coverage’a potential landmine for consumers on fixed incomes who choose them. The push to give consumers more information has actually made the job of picking a Medigap plan so much harder. The government’s website tells me that I can choose from among 96 Medigap different policies offered by sellers in New York City. Do I really need that many on top of some 43 choices for Medicare Advantage plans and 30 for prescription drug plans? Alphabet Soup Like any reasonable shopper, I checked out what the government’s handbook Medicare & You had to say about Medigap plans. Not much, it turned out. It said there were two new plans, M and N, and that plans E, H, I, and J are no longer available. It didn’t say what those plans covered. For an explanation of the coverage provided by any of the standardized plans’either old or new’I had to visit www. Medicare.gov or phone 1-800-Medicare, the New York insurance department, or contact the state health insurance counseling and assistance program. It almost seemed like the government does not want seniors to choose Medigap policies but rather steers them toward Medicare Advantage plans, for which there was far more information in the handbook. (I will discuss those in a later post.) I tackled the government website, which was confusing from the get-go. The first page of all the Medigap policies available in New York had columns listing the benefits with green checks and red x’s showing what was and was not covered.’  Okay, I got that, but what were the question marks that appeared next to the benefits?’  Take Policy A, for example, the page showed there was no coverage for the Part A hospital deductible’this year $1,132.’  But a blue question mark raised the question: was it covered or not? ‘ From that page, I was supposed to choose which combination of benefits and coverage I wanted and find out what policies were sold in my Zip code. Plan F was my choice, and the website advised that there were 14 policies for sale in my Zip code.’  Plan F is the most comprehensive and would cover me in case doctors don’t take Medicare’s payment as payment in full, sticking me with what’s called an ‘excess charge.”  In the past, most docs have accepted Medicare’s ‘ payment levels, but that may be less likely in the future as doctors get more persnickety about not taking Medicare patients.’  I wouldn’t take that risk.’  Others might, since Plan F is the most expensive.’  It’s a risk benefit calculation’higher monthly premiums versus the possibility of a large bill down the road uncovered by insurance. Since all insurers selling Plan F must offer the same benefits, I needed to know only two things’the monthly premium and how companies figure premium increases each year.’  Medicare’s website was not very helpful. ‘ It gave only a price range for Plan F policies’$197 to $422 and contact information for the 14 companies. I guess I was supposed to call them.’  When it came to how premiums would be calculated, I would give the website a grade of C.’ ‘  A section called ‘Additional Tools & Information,’ gave a clear explanation of the three ways to determine premium increases, but crucial information was missing. Pricing by Age? In general, community-rated policies are best because premiums don’t change just because you get older.’  Issue-age policies are cheaper for younger buyers, and their premiums don’t increase with age.’  However, they are not common.’  Attained age-rated policies become the most expensive in the long run because premiums do rise as you get older.’ ‘  In all cases, premiums will go up each year because health care will only get more expensive.’ ‘  That’s a good reason to avoid policies that might pile on extra costs just because your biological clock is ticking.’ ‘  Since income often shrinks in the later retirement years, this is ‘need-to-know’ stuff, but the government apparently believes that insurers don’t have to tell you.’ ‘  Only five Plan F sellers disclosed their pricing methods: they all used community rating.’  Were the others mum because their methods are unfavorable to consumers?’  I would not buy a policy from a company that failed to reveal its pricing method. Still, I needed actual premiums so I called the Health Insurance Information Counseling and Assistance Program.’ ‘  HIICAPs, as they are called, can be found all over the country.’  The one for New York City was lodged at the city’s Department for the Aging.’  I wanted to know more about how premiums would be calculated in the future, but the counselor I talked to didn’t know much.’  When I asked what community rating was, she replied, ‘Every state has a different rating depending on where you live.” ‘  As for attained-age rating, ‘I don’t know what that is,’ she admitted.’  The department offered a booklet that listed prices for only eleven companies selling Plan F.’ ‘  There was no plan with a premium of $197 as the website suggested.’ ‘ ‘  I did learn that all Medigap plans sold in New York were community rated, a protection unavailable in most other states. As the booklet directed, I visited the website of the New York State Department of Insurance for more current information.’  Eleven sellers offered premiums ranging from $251 to $409.’  State Farm, one of the sellers that sent a marketing brochure, had the highest premium; United Healthcare, the other marketer contacting me, had the lowest.’  I ruled out State Farm; it was too expensive.’  The UnitedHealthcare/AARP policy seemed ideal.’  I still had questions so I called the company’s toll-free number seeking answers. Can I always buy a Medigap policy even if my health changes?’  ‘A qualified yes,’ said a customer service rep.’  If I am outside of my open enrollment period’the six months that begins in the month I turn 65 and enroll in Part B’ and outside the 63-day period for previous coverage, then there is a pre-existing condition waiting period, he explained.’  Does an insurer have the right to refuse me coverage if I get sick in the future?’  If I stay on my previous employer’s retiree plan and the employer drops the coverage as many have been doing, then I might need a Medigap plan someday.’  Yes they can refuse, he said, but not in New York.’  If I moved to another state, I could be out of luck. Having picked a Medigap policy, it was time to choose a prescription drug plan to go with it.’  Congress won’t let insurers sell drug coverage as a benefit included in a Medigap plan.’  Picking the right prescription plan adds a whole new layer of difficulty to an already-complicated task. I’ll tackle that challenge in next week’s post.
Source: cfah.org

Schuette opposes Blue Cross mutual insurer conversion plan

Michigan Attorney General Bill Schuette joined several consumer and seniors groups today in opposing two bills headed for approval in the state Legislature that would allow Blue Cross Blue Shield of Michigan to convert into a nonprofit mutual health insurance company. The Michigan House today voted in favor of Senate Bills 61 and 62. The legislative package now goes to the Senate for final approval. Schuette said the bills do not go far enough to protect seniors against rising health care prices for Medicare supplemental insurance policies. “We need a full and complete commitment to seniors, one that protects them from the looming ‘Senior Cliff,’ which could cause skyrocketing Medigap rate increases for Michigan’s most vulnerable,” Schuette said in a statement. “When the existing Medigap rate freeze ends in 2016, (176,000) Michigan seniors will either face higher rates or be left on their own to find new coverage if Blue Cross drops the Medigap plans. That is unacceptable, and as a result, I cannot support the legislation.” Those rates would be, on average, 66 percent higher. In a statement to Crain’s, Andy Hetzel, Blue Cross’ vice president of corporate communications, said the legislation protects seniors for several years and will offer them low-cost options in the future. “It ensures Blue Cross Medigap rates won’t increase by one penny for three more years, after which the most vulnerable seniors will continue to receive subsidies,” Hetzel said. “The Michigan marketplace provides many affordable choices for Medicare beneficiaries, including numerous Medicare Advantage plans, in addition to Medigap.” One provision in the legislative package, which Gov. Rick Snyder negotiated with Blue Cross, would require the state’s largest insurer to contribute $1.56 billion over 18 years to a newly formed nonprofit foundation. Some of the proceeds would be used to defray seniors’ Medigap premiums. Schuette said the foundation would subsidize Medigap premiums an average of $24 million per year for five years starting in 2016. However, Schuette said those subsidies “will be insufficient to replace the current $180 million annual subsidy that keeps Medigap affordable for thousands of Michigan seniors.” Schuette also criticized the Blue Cross bills for not allowing the attorney general to continue to oversee future Blue Cross rate increases. Speaker of the House Jase Bolger, R-Marshall, said Blue Cross reforms are needed to make even health insurance regulations under ObamaCare. “They’re important to taxpayers because they make the Blues pay taxes, and they’re important to seniors because they add Medigap assistance,” Bolger said in a statement. Two groups opposed to the Blue Cross legislation are AARP Michigan and Michigan Consumers for Healthcare. Michigan Consumers suggested the Blue Cross bills be amended to include a 40-day rate-review process for all insurance company rate hikes, including Blue Cross. “These new procedures establish clear criteria for rejecting unjustified rate increases, establish a meaningful 30 day public comment period and require the Insurance Commissioner to take action on rates deemed unjustifiable,” Michigan Consumers said on its website. “This proposal levels the playing field by ensuring all insurers go through the same process without effectively abandoning rate review and allowing a functional monopoly to set insurance rates in Michigan.” For 32 years, Blue Cross has been regulated under Public Act 350 as a “charitable and benevolent” company and held in trust for the people of Michigan. But experts contended Blue Cross’ mission had to change for when the Patient Protection and Affordable Care Act, or ObamaCare, goes into full effect on Jan. 1, 2014. Under reform, all insurers – not just Blue Cross – must offer policies to people with pre-existing health conditions.
Source: crainsdetroit.com

Medigap Plans and the Affordable Health Care Act

Medicare does not cover every type of medical expense or treatment. For this reason many senior citizens feel they should choose MA (Medicare Advantage) private plans for insurance. This is because they feel Medicare Medigap plans may be too expensive. Mistakenly too many seniors think the MA plans are best because they low, or even zero monthly premiums. The MA plans also frequently cover prescription drugs, vision and other problems. The problem is that all MA plans have many hidden charges that come out of the wallet of those trusting seniors. In some cases these unexpected costs can add up to many thousands of dollars.
Source: seniorcorps.org

beSpacific: Kaiser Report

“Nearly one in four people with Medicare have private Medicare supplemental insurance plans, known as “Medigap” plans that help with health care expenses not otherwise covered by Medicare. This analysis provides a detailed look at the Medigap market, including national and state trends in enrollment and premiums for the various Medigap plans. Though Medigap policies by law must offer a set of standardized benefits, the analysis finds that monthly premiums for identical plans vary greatly both across the country and within states. Also, more than half of all Medigap enrollees in 2010 were in plans that cover Medicare’s entire Part A and B deductibles, according to this analysis. These enrollees could potentially be affected by policy changes to discourage or prohibit “first dollar” Medigap coverage, as proposed in some of the recent debt-reduction recommendations. The report is authored by researchers at the Kaiser Family Foundation and the University of California at Los Angeles.”
Source: bespacific.com

Medicaid vs. Medicare & How SSDI or SSI Benefits May Apply

Posted by:  :  Category: Medicare

Medicaid, Medicare and SSDI are government programs that may help those with disabilities receive healthcare services and pay for basic necessities. Medicaid and Medicare are government healthcare programs that may be available, depending on the individual’s circumstances. Those who receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) for their disability could be eligible for one or even both healthcare programs.
Source: brentadams.com

Video: Dental Insurance Commercial for Folks on Medicare

Medicare Eligibility and Senior Health Care

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

Can I deduct health insurance on my tax return?

Itemize medical expenses while you can – Not everyone has medical expenses high enough to deduct them on their federal tax returns, but even fewer will be able to do so next year. 2012 is the last year you’ll be able to itemize and deduct medical expenses in excess of 7.5% of your adjusted gross income. As a result of health reform, that threshold is being raised to 10% for the 2013 tax year. So, if you itemize on your federal tax return, do the math. Qualifying medical expenses in excess of 7.5% of your adjusted gross income for 2012 may be itemized. You can refer to IRS Publication 502 for more information about qualifying medical expenses, but these may include monthly premiums you pay for coverage (including some Medicare premiums), copayments, deductibles, dental expenses, and costs for some services not covered by your insurance plan. You may even deduct mileage accrued while driving to and from regular appointments. This deduction isn’t for everyone, but if you (or one of your dependents) were seriously ill or hospitalized last year, you may qualify.
Source: ehealthinsurance.com

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

Medicare Open Enrollment: More is better

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

Features of Medicare Dental Plans

In a world where the number of diseases is constantly increasing, the importance of an insurance cover cannot be compromised with. Having an insurance cover for themselves as well as for their family members is now being seen upon as necessity by the society in general. However due to burgeoning insurance costs, getting an insurance isn’t an easy thing. Thus, many people, in order to save a few bucks, skip dental insurance. They are being penny wise and pound foolish. For, any overlooking of a problem may lead to it becoming a bigger problem, which may cost the people their own lives and a far more expensive medical bill. An optimal solution for people, who want to avoid footing an expensive dental insurance bill, is Medicare dental plans. These plans are unique in the sense of their wide scope of coverage of health conditions. There are different types of Medicare plans available and purchasers should do their share of research on these plans before buying one. The benefit provided by these plans is a reimbursement of the dentist’s bill after the concerned authorities have examined the reports. Generally, these dental plans do not cover mundane dental services like routine checkups, crowning, teeth extraction, filling of cavity or even various teeth implantation. However, there are various other health covers that insure a purchaser’s regular visits to a dentist’s office. The features are mentioned as follows:

Medicare Advantage: Providing Quality Care to More than 14 Million Beneficiaries

Posted by:  :  Category: Medicare

Self Portrait Day 37 by HopkinsiiMedicare Advantage plans are a valuable resource in protecting beneficiaries from unpredictable out-of-pocket costs. In 2012, all Medicare Advantage plans offered an out-of-pocket maximum limit for beneficiary costs, and about 78 percent of Medicare Advantage enrollees are in plans that have annual out-of-pocket maximums of $5,000 or less. These out-of-pocket maximums – which are not offered by the Medicare FFS program – help protect Medicare beneficiaries from catastrophic health care expenses that otherwise might pose a serious threat to their financial security.  Medicare Advantage plans also help reduce out-of-pocket costs for enrollees by reducing premiums for Part B and Part D, and by limiting cost-sharing for Medicare-covered services, including primary care physician visits and inpatient hospital stays.
Source: ahipcoverage.com

Video: Medicare Enrollment | Medicare Sign Up | Apply for Medicare

More Time to Enroll in Medicare If You Live in Storm Areas

Thanks to the marvels of medical science, our parents are living longer than ever before. Adults over age 80 are the fastest growing segment of the population; most will spend years dependent on others for the most basic needs. That burden falls to their baby boomer children. In The New Old Age, Paula Span and other contributors explore this unprecedented intergenerational challenge. You can reach the editors at newoldage@nytimes.com.
Source: nytimes.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Office of Statewide Benefits provides information on Medicare Parts A, B enrollment

Failure to enroll and maintain enrollment in Medicare Parts A and B upon eligibility may result in the subscriber being held financially responsible for the cost of all claims incurred, including prescription costs. Retirees and spouses enrolled in Medicare Parts A and B must provide a copy of their Medicare Identification Card to be enrolled in the state of Delaware Special Medicfill plan.
Source: udel.edu

California Medicare Supplement Open Enrollment

California Medicare Supplements, have what is called an (IEP), which is a special (initial enrollment period) when you are going to turn 65. This special enrollment period will allow any senior who is turning 65 to enroll in any Medicare Supplement plan of their choice guaranteed issue. Seniors can enroll three months before their birth month, the month of their birth, and three months after their birth month.
Source: healthbrokerdave.com

Local Teacher Confused about Changes to TRS Medicare Plans » Toni Says

On page 31 of the 2013 Medicare & You handbook it  states that an inpatient hospital stay begins the day you’re formally admitted with a doctor’s order. You must have 3 full days past midnight stay “formally admitted” and doesn’t include the day you are discharged. So that makes 4 days.  I would determine the stay begins when the doctor has “formally” written the order not when you are in the ER waiting for a room.  Don’t confuse signing papers when you arrive at the hospital with being formally admitted. Your doctor has to do sign that order.
Source: tonisays.com

Lawmakers Might Have Time To Avert Medicare Payment Cuts

The mandated cuts involve nearly $1 trillion in across-the-board reductions, including a 2% reduction to Medicare reimbursement rates. In January, President Obama signed legislation — negotiated by Vice President Biden and Senate Minority Leader Mitch McConnell (R-Ky.) — that delayed the cuts until March 1 (California Healthline, 2/26).
Source: californiahealthline.org

Want to get Social Security but not Medicare? That’s illegal

Despite having paid thousands of dollars each in Social Security and Medicare taxes during their working lives—for which they never sought reimbursement—the five plaintiffs were told by officials at the Social Security Administration and Department of Health and Human Services that they had to forfeit all of their Social Security benefits if they wished to withdraw from (or not enroll in) Medicare. This determination resulted from internal policies that were put in place during the Clinton administration and strengthened by the Bush administration. The plaintiffs sought a judicial ruling that would prohibit SSA and HHS from enforcing these policies, which they believed conflicted with the Social Security and Medicare statutes. A sharply divided U.S Court of Appeals for the D.C. Circuit eventually upheld them. By its decision not to hear the case, the Supreme Court let that controversial ruling stand.
Source: teapartypatriots.org

Tips to Demystify Medicare Open Enrollment

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. (Incidentally, people who have high blood pressure or who are concerned about heart health should also 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: alexisabramson.com

Tips for Navigating Medicare Part D Open Enrollment

Yesterday kicked off the 2013 Medicare Part D open enrollment period, during which millions of Medicare-eligible Americans over 65 and persons with disabilities can choose a new Part D plan that best fits their needs. As Medicare Today recently highlighted in a survey, 90 percent of seniors are satisfied with their Part D plan, with more than six in 10 seniors reporting that they would not be able to fill all of their prescriptions without Part D. But if you aren’t one of those satisfied people, shop around. In the coming weeks, our hope is that we can assist in pointing people to helpful tools that enable comparing and evaluating options.
Source: phrma.org

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

While Medicare Part D prescription drug plan premiums are generally expected to remain steady in 2013, this PPI Fact Sheet by Leigh Purvis and Lee Rucker finds that premiums for many popular plans will actually be considerably higher than they were in 2012. Many plans are also increasing cost-sharing and their reliance on utilization management tools for covered prescription drugs. Medicare beneficiaries should closely examine their 2013 prescription drug plan choices during open enrollment for Part D.
Source: aarp.org

Medicare Targets Health Plans With Low Ratings

Posted by:  :  Category: Medicare

Nurse Alliance Action at RNC by SEIU InternationalMedicare 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

Video: Is Freedom Blue PPO a Medicare Supplement?

Horizon Blue Cross Blue Shield of New Jersey’s Mobile Medicare Outreach Moves Into Monmouth County

Horizon Blue Cross Blue Shield of New Jersey, the state’s oldest and largest health insurer, is a tax-paying, not-for-profit health services corporation, providing a wide array of medical, dental, and prescription insurance products and services. Horizon BCBSNJ is an independent licensee of the Blue Cross and Blue Shield Association, serving more than 3.6 million members with headquarters in Newark and offices in Wall, Mt. Laurel, and West Trenton. Learn more at www.HorizonBlue.com
Source: patch.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

Anthem Blue Cross Medicare Supplement Plan F

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

Privately Run Medicare Plans are Really Expensive

Austin Frakt draws my attention today to a new article about the administrative costs of Medicare. Exciting stuff! Long story short, Kip Sullivan of the Minnesota chapter of Physicians for a National Health Program wants everyone to understand just what’s involved in figuring out the true administrative costs of Medicare. The cost of collecting payroll taxes is one frequently overlooked element, for example. More interestingly, though, there’s a large and growing gap between the overhead calculations of the Medicare Trustees and those of the National Health Expenditure Accounts. Why is that?
Source: motherjones.com

Sequestration Set to Kick in, Cut Medicare by Billions

After two months of failed negotiations, the across-the-board spending cuts — better known as sequestration — will go into effect today pending a last-minute grand bargain, which many in Washington, D.C., do not expect. Yesterday, the U.S. Senate floated two proposals to avoid the sequester, but both flopped. Sen. Harry Reid (D-Nev.), the majority leader, proposed a deal that would have reduced the deficit through a 50-50 measure: 50 percent increased taxes, 50 percent spending cuts from defense and agricultural programs. Sen. Reid’s proposal, which lost on a 51-49 vote, would have exempted Medicare and Medicaid, according to an AHA News Now report. Sens. Jim Inhofe (R-Okla.) and Pat Toomey (R-Pa.) proposed a counter deal that would have required President Barack Obama to submit a “sequestration replacement plan” of $85 billion in spending cuts by March 15. Defense cuts would have been limited to $42.6 billion. The vote failed 62-38. Sequestration, which was postponed until today through the fiscal cliff bill at the end of last year, will cut $85 billion this fiscal year, which ends in October. According to a Congressional Budget Office (pdf) report released last month, Medicare will be reduced by 2 percent, resulting in $9.9 billion in cuts. Medicaid and Social Security are exempt from cuts. Hospitals, physicians and others were originally expected to see Medicare payment reductions of $11.1 billion, but the two-month delay from Congress lessened the impact slightly. Medicare reimbursement cuts to providers will not go into effect until April, “thereby delaying some of the effect on outlays until the following fiscal year,” according to the CBO report. Many hospital and health system executives have been preparing for the impacts of sequestration since the national deficit talks first began in the summer of 2011. Most hospitals will lose millions in Medicare reimbursements, with larger providers taking cuts up to eight figures. David Blom, president and CEO of OhioHealth, an 18-hospital system based in Columbus, Ohio, told Kaiser Health News his system expects to lose $12 million on $2.5 billion in revenue. “Let me say this about sequestration: I fully understand how the national debt reduction needs to be really high on our agenda,” Mr. Blom told KHN. “Sequestration is unfortunate, in my opinion, to be making across-the-board cuts without really redesigning the system or just reforming the system. Can we live with it? Yes. I think we’re able to live with it because we’ve anticipated it for some time. What I’m concerned about is even this sequestration won’t be enough. So what is the next thing we’ll be living with to deal with this national debt situation?” Medicare will remain a high-priority issue for hospital executives this year and into 2014, where some say adept budgeting will become paramount. “We budget very conservatively when it comes to projected [Medicare] reimbursements,” Dan Moncher, CFO of Firelands Regional Medical Center in Sandusky, Ohio, said earlier this year. “We try to make sure our budget reflects the operating margin of a high-performing hospital — that’s our goal. But that means we have to take a good, hard look at costs, staffing levels that are appropriate and maintaining the highest quality of care with [appropriate] staffing levels.”
Source: beckersasc.com

AIDS Patients Need Access to Medicare :
Eastern Group Publications

Comments are intended to further discussion on the article topic. EGPNews reserves the right to not publish, edit or remove comments that contain vulgarities, foul language, personal attacks, racists, sexist, homophobic or other offensive terminology or that contain solicitations, spam, or that threaten harm of any sort. EGPNews will not approve comments that call for or applaud the death, injury or illness of any person, regardless of their public status. Questions regarding this policy should be e-mailed to service@egpnews.com.
Source: egpnews.com

Physicians and Experts Discuss Medicare Reform

A senior official from Blue Cross Blue Shield of Massachusetts Tuesday said trying to find significant health care savings by cutting benefits is a “fool’s errand.” Dana Safran said the effort in her state has shown that greater savings can be achieved through the supply side of health services. She spoke at an event on Medicare costs and outcomes hosted by the National Journal in Washington. The discussion looked at ways to end Medicare’s current structure, which pays based on the quantity of services provided rather than the health of the patient.
Source: c-span.org

Pelosi Again Rejects Proposal To Change Medicare

Posted by:  :  Category: Medicare

Rogue Magazine (October 1964)  Volume 9 Number 5 - Water Balloons ...item 1.. routinely use devious devices -- wears us down like rabid trial lawyers until we give in (August 15, 2011 / 15 Av 5771) ... by marsmet542The Hill: Obama: Sequester Would Deal ‘Huge Blow To Middle-Class Families’ The president devoted a significant amount of his (weekly Saturday) address to outlining the real-world consequences that would result if the sequester was implemented. On Friday, top administrative aides warned the cuts would hamper law enforcement, hurt federal education programs, withhold mental health services and furlough thousands of workers. “If the sequester is allowed to go forward, thousands of Americans who work in fields like national security, education or clean energy are likely to be laid off,” Obama said. “Firefighters and food inspectors could also find themselves out of work – leaving our communities vulnerable. Programs like Head Start would be cut, and lifesaving research into diseases like cancer and Alzheimer’s could be scaled back” (Sink, 2/9). 
Source: kaiserhealthnews.org

Video: Medicare Home Health Changes: 2011 & Beyond

How to Deal with the Medicare Imaging Cuts

Second, remember this: The world is what we make it much of the time. Things don’t happen to you, you can make them happen or not in many cases. Complaining about the changes, if you think they are wrong, will not affect them. You have to act, not just complain. The ACR, ASNR and other societies spoke up about the changes. The changes imposed were less than originally proposed, though they will still have a large impact. In the future, if we want to have the changes we want, we must all support those organizations or speak up and speak out to our representatives and lobbyist to tell them what we believe and need. If you like or don’t like a change, make sure your voice is heard. You may not always get the changes you want. But you’ll never get them if you don’t speak up.  
Source: diagnosticimaging.com

New Medicare Benefits and Changes for 2011

Once your total drug costs reach $4,550 (see the Ms. Medicare column "Paying Less for Drugs in the Doughnut Hole" for details about how this is calculated), you are eligible for "catastrophic coverage" and your prescription costs drop to a lower copay for the remainder of the year. Last year, when there were no doughnut-hole discounts, $250 rebate checks were sent to all affected Part D subscribers. Because of the discounts now in place, there will be no rebate checks for 2011 expenses. Another 2011 change for Part D subscribers is that if you have a high annual income (more than $85,000 for individuals and $170,000 for couples) and pay higher-income premiums for Part B, you’ll also pay a higher premium for Part D drug coverage.
Source: aarp.org

Older Americans Have Been Highly Resistant to Medicare Changes

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

What Medicare changes could mean to local hospitals

Topics: Centers for Medicare and Medicaid Services, Healdsburg District Hospital, Health Care Update 2-18-2013, Kaiser Permanente, Marin General Hospital, Medicaid, Medicare, North Bay Business Journal 2-18-2013, Novato Community Hospital, Palm Drive Hospital, Patient Protection and Affordable Care Act of 2010, Petaluma Valley Hospital, Queen of the Valley Medical Center, Santa Rosa Memorial Hospital, Sonoma Valley Hospital, St. Helena Hospital, Sutter Medical Center of Santa Rosa
Source: northbaybusinessjournal.com

Medicare to adjust payment for dialysis drugs after overspending millions

The overpayment occurs because the government reimburses hospitals and clinics under an assumption that the drugs are being given at the higher doses widely used in 2007. Since then, however, the use of the drugs has declined significantly, partly because of repeated government warningsabout their safety and partly because Medicare removed the financial incentives for using larger doses.
Source: globalregulatoryscience.com