Medicare Boosts Rather Than Cuts Payments To Advantage Plans

Posted by:  :  Category: Medicare

DAMN!! -- I THINK WE'RE F*%KED by SS&SSModern HealthCare: Limited Funding In an effort to scale back use of high-priced imaging of questionable value in cancer treatment, Medicare has proposed ending reimbursement for post-treatment positron emission tomography scanning in prostate cancer patients and limiting its use to one scan for most other cancer indications. Use of the technology, which involves injecting F-18 fluorodeoxyglucose (FDG) into the blood so the PET scan can identify regions of heightened metabolic activity, a sign of cancer metastasis, has grown sharply in recent years. The CMS, in giving preliminary approval to payments for the technology in 2005, required manufacturers and radiologists to establish a registry to monitor outcomes from its use. The evidence garnered from that registry convinced the CMS that the scans provided no useful information for oncologists treating prostate cancer patients who had already completed their initial therapy, according to the March 13 proposed decision memo (Lee, 3/30).
Source: kaiserhealthnews.org

Video: Medicare Supplement AARP Plan F Select is A Good Option

InsureBlog: Medicare Advantage Cuts

For just a few dollars more than most pay for a Medicare Advantage plan you could own a Medicare supplement insurance plan N and have much less out of pocket exposure than you will have under a Medicare Advantage plan.
Source: blogspot.com

The Basics of Medicare Coverage

Supplements are offered by many companies and, within every company, monthly premiums are based on which level of coverage you choose, among other underwriting issues (where you live, when you purchase the insurance, etc.). Those levels are distinguished by the letters “A” through “F” and every company’s “A” plan will offer the same benefits as any other company’s “A” plan, and so on through “F.”
Source: westminstervillagenorth.com

Summit Medigap: What Is Medicare Supplement Plan F?

(doctor visits and required medical equipment). Currently, there are at least 11 supplement plans referred to as Medigap policies that fill any coverage gaps involved with Parts A and B. One of these is Plan F. It’s important to know that not every company offers all 11 supplement plans. However, if they do offer at least 2 of them, they are required to offer Plans C and F. Plan F premiums typically cost between $65 and $295 per month. The premium will vary depending on the insurance carrier and the state you live in. Coverage Provided By Plan F The coverage required of Medigap coverage plans is mandated and regulated by the Centers for Medicaid and Medicare. Plan F also has a “high deductible” plan because it will not pay for any type of services covered by Medicare until the plan beneficiary has paid an out-of-pocket minimum of $2,000. Once that deductible has been met, Plan F will cover 100% of the co-insurances, co-pays, and deductibles of Parts A and B including hospice care co-insurance as well as preventative services. If you get the regular Plan F you will have no deductibles or coinsurance. When speaking to an insurance professional it’s important to make sure which Plan F you are being quoted. Comparisons There are only two supplements that covers any deductible expense of Part B, one of which is Medicare supplement Plan F. Additionally, this is the only supplementary plan that covers excess Part B charges. These charges typically accrue if doctors can legally charge more than what Medicare considers as reasonable service charges. Other supplement plans will usually pay for expenses that Medicare classifies as allowable. Finally, the excess amount that is allowable according to Medicare is covered by F. Is Plan F Right For You? Medicare supplement Plan F is viewed as one of the most popular plans because it covers 100% of the gaps encountered with Plans A and B meaning that it provides the highest amount of coverage of any of the Medigap insurance plans. For many individuals, the plan may seem a bit confusing initially. However, if you answer a few questions, it will not only explain the plan more thoroughly, you will be able to decide whether or not it is right for you. Basically, if you are someone who is willing to pay for 100% coverage, then this plan is tailored to meet your personal needs. With Medicare supplement Plan F, your only expenses will be your monthly premiums. For more information regarding this supplement plan, you can visit the official Medicare website or speak to a licensed insurance professional.
Source: blogspot.com

House GOP Plan Would Move Medicare to Pay

House Republicans have proposed a plan that would slowly shift Medicare reimbursement to a combination of fee-for-service and pay-for-performance, according to a Medscape Medical News report. The newly revealed plan, which is not yet a bill, would give medical societies and other provider organizations the task of coming up with performance metrics to measure physician performance, according to the report. Clinicians and HHS would also be able to work together and create specialty-specific payment criteria. The Republican plan would also repeal Medicare’s sustainable growth rate formula.
Source: beckershospitalreview.com

Medigap Plans Connecticut

[…] AARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 aetna Medicare Anthem Anthem High F plan Anthem Medicare Anthem Medigap Anthem Supplement Donut Hole High Deductible F supplement how to choose a Medicare Advantage plan How to choose a Medicare plan how to choose a plan How to choose a supplement how to enroll in a medicare plan MAPD Med Advantage Medicare Medicare Advantage Medicare Advantage plans Medicare Complete Medicare Complete connecticut Medicare Connecticut Medicare part B Medicare part D Medicare plan Medicare prescription drug plans Medicare Supplement Medicare Supplement Connecticut Medigap Medigap rates 2013 Medigap rates NY 2013 Original Medicare Part D united healthcare United Healthcare AARP United medicare complete United Medicare complete 2013Source: croweandassociates.com […]
Source: croweandassociates.com

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 Health Support (formerly CCIP)

Posted by:  :  Category: Medicare

About 14 percent of Medicare beneficiaries have heart failure, but they account for 43 percent of Medicare spending.  About 18 percent of Medicare beneficiaries have diabetes, yet they account for 32 percent of Medicare spending.  The initiative assessed whether the benefits of better managing and coordinating the care of these beneficiaries would result in reduced health risks, an improved quality of life, and savings to the Medicare program and the beneficiaries.
Source: mymedicaregov.info

Video: Two Useful (but frustrating) Websites: MyMedicare.gov and Missouri Case.net

MyMedicare.gov Login Medicare Health Insurance

Medicare is health insurance for people at age 65 or older, under 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD). ESRD is permanent kidney failure requiring dialysis or a kidney transplant. The different parts of Medicare help cover specific services if you meet certain conditions.
Source: newsnidea.com

The Good Will Hunting Paralegal: Use MyMedicare.com to Get Lien Information Fast

Shortly thereafter, I was chirpily advised my place in the queue was 147. Then Medicare played muzak by some Yanni wannabe that sounded like a cat practicing yodeling, followed by creepy Twilight Zone music (the hairs on the back of my neck rose, and I almost bailed on the call at that point, which I think was Medicare’s intent). Occasionally a recorded voice message came on and made me jump in surprise. Midway through the call, I regretted the 36 oz big gulp sweat tea I had with lunch, but figured out it would be completely uncool to take the phone headset with me to the loo.
Source: practicalparalegalism.com

What Are My Medicare Options

Medicare supplement insurance will actually cover the 20% that original Medicare (parts A and B) doesn’t cover. So when you go to the doctor, for example, you show your Medicare card and your supplemental insurance card. Instead of the insurance carrier taking over your original Medicare and filling in the gaps, the supplement will leave your Medicare as is and add additional insurance. The benefit of this plan is that it allows you to see any doctor that takes Medicare as opposed to the Advantage plan that usually requires you to be in a network. The drawback of this plan is that it can be quite expensive and isn’t affordable for a lot of folks.
Source: jewishjournal.com

Link Of the Day: MyMedicare.gov

Visit the site, sign up, and Medicare will mail you a password to allow you access to your personal Medicare information. MyMedicare.gov also allows you to view your adjudicated claims information, access online forms and publications, and receive important messages from Medicare. If you are uncomfortable entering your information into the website, you can also assign a family member or other caregiver the right to check your statements online for you. The important thing is that you can keep track of your claims and will know the moment something is fishy!
Source: myhealthcafe.com

Seniors speak out against Medicare Advantage cuts

“Living on a small restricted limited income in a world where the cost of living goes up regularly, my Medicare Advantage plan has consistently provided me with coverage that has allowed me to get the medications I need, see the doctors who treat me best, and have dental care for the past four years,” said Marietta Hanley of Auburn, N.Y. “A cut to this program would be devastating to me.”
Source: benefitspro.com

More than 40,000 Seniors Have Contacted Congress to Oppose CMS’ Proposed Cut to Medicare Advantage

CMS recently proposed a 2.2 percent reduction in Medicare Advantage payments for 2014, at a time when medical costs are projected to increase by three percent. The new proposed payment cut compounds the hundreds of billions of dollars in Medicare Advantage cuts and new health insurance tax on Medicare Advantage policies included in the Affordable Care Act (ACA).  A recent report from Oliver Wyman estimates that the cumulative impact of these cuts and the new health insurance tax will result in an estimated 6.9 to 7.8 percent payment cut to Medicare Advantage plans in 2014, leading to benefit reductions and premium increases of $50 to $90 per month for a typical Medicare Advantage beneficiary.  New Oliver Wyman data provide a breakdown of how much seniors will be impacted in specific states.
Source: ahipcoverage.com

project manager for mymedicare.gov

*Highly rated because of his ownership of an early Apple II. __________________________________________________ “Nerdometer” is a scientific ranking system based on questions asked on the air and then put into an algorithm which includes knowledge of trending phrases like “volume, velocity, and variety.” The Final Four Ranks are the much coveted “Nerd,” the well-respected “Geek,” challenging “Wannabe,” and the unmentionable “Luddite.” ________________________ John Gilroy has worked for ARMATURE since 2005. You can reach him at 703-674-2464 or john.gilroy@armaturecorp.com. In 1991 John developed The Computer Guys on WAMU 88.5 FM, National Public Radio in the nation’s capital. In 1994 “Ask the Computer Guy” ran as a question-and-answer column for over ten years in The Washington Post. This led to hundreds of speaking invitations and television appearances. In 2006 Federal News Radio gave John the opportunity to create a weekly interview program called Federal Tech Talk w/John Gilroy. By 2012, he had completed over 250 influential interviews with everyone from Vint Cert (father of the Internet) to Jimmy Wales (father of Wikipedia).In September of 2011 John was asked to become an adjunct professor for the Technology Management graduate program at Georgetown University.
Source: techtuesdayblog.com

Medicare to Cover Addadictomy, Chopadickoffamy

Posted by:  :  Category: Medicare

The PARTY Is OVER ...item 4.. Today, Mitt Romney Lost the Election (Sep 17, 2012 6:02 PM ET) ...item 5.. James Brown - Get On The Good Foot, Soul Power, Make It Funky Soul Train 1973 ... by marsmet471RUSH:  The Medicare under Obamacare is now gonna start doing sex-change operations, is the point.  I didn’t finish that story.  “For the first time since 1981, when it dubbed sex-change operations ‘experimental,’ Medicare has opened the door to covering transexual operations, adding to the growing list of operations that would be allowed under Obamacare.  Acting on a new request, the Centers for Medicare & Medicaid Services said it is starting a new analysis that could lift the spending ban for sex-change operations with a goal of making a decision two days after Christmas and on the eve of Obamacare kicking in Jan. 1.”
Source: rushlimbaugh.com

Video: DNC Chair Gets Blitzed By Wolf On False Medicare Attacks

Why today's seniors object to the dissolution of Medicare

Privatization / corporatization of health care in the U.S. is the reason why our health care is prohibitively expensive, and can boast of only mediocre outcomes, at best. Nowhere else in the industrial world do citizens find themselves going bankrupt over medical care, and most industrial countries achieve substantially better health outcomes, and at lower cost, than we do. All Mr. Ryan’s plan will do is perpetuate our current dysfunctional system, with CEOs of health insurance companies being paid 7-figure salaries while nameless clerks deny coverage and the people they ostensibly “serve” find themselves having to choose between paying for food, or the mortgage, or clothing on the one hand, and paying off that hospital or doctor bill on the other, knowing that the “non-profit” hospital or physician may well take them to court if they choose to eat rather than pay for medical care.
Source: minnpost.com

The Centers for Medicare and Medicaid…

The Centers for Medicare and Medicaid Services, after originally calling for reducing Medicare Advantage payments in February, seem to have reversed course, now projecting that combined growth in Medicare Advantage rates and fee-for-service rates will be 3.3%. Though it’s unclear precisely what that may mean for health insurers, the markets are taking it as a positive: HUM +9%, AET +2.3%, WCG +4.1%, UNH +4% AH.
Source: seekingalpha.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

Raiding Medicare: How seniors will pay for Obamacare

Other hospitals will be forced to operate in an environment of scarcity, with as many as 40 percent in the red, according to Foster. That will mean fewer nurses on the floor, fewer cleaners, and longer waits for high-tech diagnostic tests. It will affect all patients. Obamacare’s defenders say that cutting Medicare payments to hospitals will knock out waste and excessive profits. Untrue. Medicare already pays hospitals less than the actual cost of caring for a senior, on average 91 cents for every dollar of care. No profit there. Pushing down the reimbursement rate further, as the Obama health law does, will force hospitals to spread nurses thinner. When Medicare reduced payment rates to hospitals as part of the Balanced Budget Act of 1997, hospitals incurring the largest cuts laid off nurses. Eventually patients at these hospitals had a 6 to 8 percent worse chance of surviving a heart attack and going home, according to a National Bureau of Economic Research report.
Source: dailycaller.com

The American Spectator : Get Ready for Obamacare Premium Defaults

“…Medicaid was a means-tested program that gave states flexibility to set eligibility standards and benefits. It “was not exactly at the heart of the proposal; it was really an afterthought and was a rider on the main bill until shortly before passage,” wrote health policy analyst Emily Friedman in the Journal of the American Medical Association. In a 2002 interview, a former legislative draftsman told book author David G. Smith that “he could scarcely recall working on Medicaid and doubted that it took as much as an afternoon of their time,” although there had been previous drafts of the proposal from the Department of Health, Education and Welfare. Medicaid was “put together in a rather slapdash manner” because its architects viewed it as temporary way of appeasing proponents of universal health care, which they wrongly assumed would be passed after the election of a Democratic president in 1968. Wilbur Cohen, LBJ’s undersecretary of health, later said the absence of reliable data was to blame for the administration’s failure to realize that Medicaid would quickly become such a massive entitlement program. “We thought in terms of several millions persons, but never 10 or 20 million,” he said in the mid-1970s.”
Source: spectator.org

Study: Star Rating System Resonating With Seniors

Posted by:  :  Category: Medicare

Medpage Today: Seniors Favor Higher-Rated Medicare Plans First-time enrollees in Medicare Advantage plans and those switching plans were more likely to enroll in ones with a higher star rating, a study of nearly 1.3 million Medicare beneficiaries found. An increase of one star in the ratings made it 9.5 percent more likely a first-time Medicare Advantage enrollee would choose a given plan, the study published in Tuesday’s Journal of the American Medical Association found. Similarly, for those switching plans, a higher star rating was associated with a 4.4 percent greater chance of enrollment. … But awareness and use of Medicare Advantage’s star-rating system has been mixed, Jack Hoadley, PhD, of the Health Policy Institute at Georgetown University, in Washington, wrote in an accompanying editorial (Pittman, 1/15).
Source: kaiserhealthnews.org

Video: Jed Weissberg, MD, Talks About Medicare Advantage Health Plans and the Special Enrollment Period

Medicare Star Ratings: Consumers Ignore, Industry Debates

best practice case examples brand/differentiation business advantage Centers for Medicare and Medicaid Services choose a doctor choose a hospital clinical quality consumerism customer service doctor interactions doctor ratings emotional needs empowered patients EMR electronic medical records hospital ammenities hospital ratings leadership online ratings online reputation patient-centered care patient experience patient ratings patient satisfaction pay-for-performance showcase social media staff attitude staff interactions technology wait times
Source: patientexperience.com

Kaiser Permanente Leads the Nation with Six 5

About Kaiser Permanente Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.
Source: kp.org

Medicare Advantage Plan Star Ratings and Bonus Payments in 2012

To encourage Medicare Advantage plans to provide quality care, the 2010 health reform law authorized Medicare to pay plans bonuses beginning in 2012 if they receive four or five stars on the program’s five-star quality rating system, or are unrated.  Building on that provision, the Centers for Medicare and Medicaid Services subsequently launched a demonstration that allowed more plans to receive bonuses and increased the size of the bonuses to encourage plans to maintain or improve their rating.  
Source: kff.org

The Government Wants Seniors Out of Bad Medicare Plans

Time will tell whether the half million Medicare beneficiaries will leave their poor performing plans or will stay put until the government closes them down—if it does. Earlier this year, a report from the National Bureau of Economic Research, a private nonprofit group, showed that seniors rarely switch plans even when they might get one with a cheaper premium. Other factors like restrictions on drugs or whether their doctors are in the plan may trump price, meaningless satisfaction ratings, and yes, the government’s stars. Perhaps the shopping process CMS has set up is just too darn hard.
Source: cfah.org

Registration for Medicare EHR Incentives To Open on Jan. 3

Posted by:  :  Category: Medicare

James and Adena by babyslimeMany of the states that are ready to begin registration in the next few months plan to issue their first incentive payments by late January or early February 2011 (Modern Healthcare, 12/23). Other states might not launch their incentive programs until spring or summer of 2011 (Kraynak, HealthLeaders Media, 12/23).
Source: ihealthbeat.org

Video: Dr. Blumenthal Discusses Registration for EHR Incentive Programs

Humana Inc(NYSE:HUM), UnitedHealth Group Inc.(NYSE:UNH) Jumps As US to raise Medicare Advantage payment rate

Jean Jadhon career began at ABC 6 News. She worked as a production assistant, intern, and finally a reporter. Then, her husband’s job took her to Omaha, NE, where she spent a year working as the mreporter. Having grown up in Minnesota, and graduating college in Rochester. She has a degree in Mass Communications, and reported, anchored and produced for her campus news show. She was also the managing editor of the student newspaper. Jean Jadhon says she is excited to be back, and loves the people of Southeast Minnesota. When she is not working, she likes to spend time at home with her husband Damian, and two kids; Aiden and Lucy.
Source: usmarketbuzz.com

Registration Opens for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs

While the Medicare EHR Incentive Program is administered by CMS, the Medicaid EHR Incentive Program is voluntarily offered and administered by the states. California, Missouri, and North Dakota are expected to open registration for the Medicaid Incentive Program in February 2011, with other states likely to offer the program during the spring and summer of 2011. Registration marks a major step for providers in the process of obtaining incentive payments under the EHR Incentive Programs. Under these programs, Medicare and Medicaid incentive payments totaling as much as $27 billion from 2011 to 2021 will be available for payment to eligible professionals (EPs) and eligible hospitals for the “meaningful use of certified EHR technology.” Providers are encouraged by CMS to register and participate early to obtain the maximum incentive payments.
Source: lexisnexis.com

Registration for Medicare EHR Incentive Payments Starts January 3rd

Starting on January 3rd, 2011, registration for the HITECH Electronic Health Record Medicare Incentive Payments will open.  This registration is available for both eligible professionals and eligible hospitals, including Critical Access Hospitals.  The registration link will be available starting on January 3rd and can be accessed here.  Registration for the Medicaid EHR Incentive Payments will be available for the following states:  Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee, and Texas.  In February, registration will likely open in California, Missouri, and North Dakota.  It is anticipated that other states, including Washington, will  launch their Medicaid EHR Incentive Programs during the spring and summer of 2011.
Source: omwhealthit.com

Medicaid Expansion Passes Colorado Senate Committee

Posted by:  :  Category: Medicare

Medicaid expansion is a cornerstone of the federal health care law, though states can choose whether to opt in. Gov. John Hickenlooper has already expressed his support for the program, but Aguilar said it is important to put the program through the legislative process to ensure that any future changes would also have to be heard by the assembly.
Source: cbslocal.com

Video: Linda Gorman on Colorado’s Medicaid Expansion

What Is Medicaid’s Valuable House Rule?

According to the DRA, the valuable homes of individuals residing in a nursing facility that exceed a certain dollar amount in equity may be counted against them in determining income-based eligibility for Colorado Medicaid. However, the potential Medicaid recipient may be excused from this rule if they currently have a spouse, a child under the age of 21, or a disabled or blind child that is living in their home on a full-time basis.
Source: thehugheslawfirm.net

No public opposition to Colorado Medicaid expansion, after years of fights

Republican Sen. Ellen Roberts of Durango wanted to know more about claims that new managed care programs in Medicaid will bring down costs in the long run. Those are worthy questions as well, since the savings Colorado has claimed so far from new managed care are not quite as impressive when the added costs of those programs are taken into account. Colorado has said a program putting hundreds of thousands of Medicaid patients into medical management plans cut $20 million from what would have been spent on health care for those patients under standards Medicaid. But those new management programs cost the state $17 million to provide, meaning a net savings of about $3 million the first year. Colorado claims those savings will scale up as more and more Medicaid patients are added to management plans, but few other states have practical results to prove it.
Source: denverpost.com

Opinion: Medicaid expansions will help Colorado’s economy

Established in 1965, Medicaid has functioned as a jointly-funded federal and state government health program. Currently, more than 670,000 Colorado citizens are enrolled in Medicaid, with 60 percent being children and 18 percent being the aged or individuals with disabilities. Medicaid expansion would enable Coloradans to qualify for Medicaid coverage provided they fall under 138 percent of the federal poverty level (FPL). The level equates to an annual income of $15,415 for a single individual and $31,809 for a family of four.
Source: healthpolicysolutions.org

Study: Expanding Medicaid Cheaper Than Not In Colorado

Brown’s analysis says not expanding will be more costly, in part, because, “even if Colorado chooses not to expand … (Medicaid) enrollments … are expected to grow due to other provisions of the ACA.” Those include the ACA’s requirement that most Americans have health insurance and the expectation that some people seeking coverage in the state’s insurance exchange will discover they are Medicaid eligible instead.  Medicaid rolls could also grow, according to Brown, because of a “reduction in employer-sponsored insurance in response to ACA’s other provisions,” including employers using more part-time employees to escape the law’s requirement for many employers to cover full-time employees.
Source: kaiserhealthnews.org

Colorado Will Expand Medicaid, Claims Cost Savings Are In Progress

Denver Post: Colorado Plans Medicaid Expansion, Claims Cost Savings In Process Colorado plans to expand Medicaid coverage next year to cover more than 160,000 additional low-income adults, aided by cost-control savings of more than $280 million over the next 10 years, Gov. John Hickenlooper announced Thursday. “This is a step toward what we have talked about for a couple of years: How can we make sure we’re making Colorado the single healthiest state in America?” Hickenlooper said. Through 2016, the federal government covers the entire cost of the expansion, which comes under provisions of the Affordable Care Act. The governor said he anticipates that even when federal funding for the expansion is reduced, “not one dollar of general-fund money will be used to replace it” (Simpson, 1/3).
Source: kaiserhealthnews.org

Medicaid Expansion Hearing Features Uninsured Olathe Mother of Three

“Luckily, neither of us has been sick. But, neither of us has been to a doctor for a physical since high school and we’re not able to take the kinds of preventive health measures we probably should to keep ourselves healthy and strong. If we ever did get seriously sick, I’m not sure how we’d pay the medical bills,” Tish told lawmakers with emotion in her voice.  “We’re gambling with our health, gambling with our financial security and gambling with our children’s futures. We don’t like it, but on our family budget, private health insurance just is not an affordable, realistic option.”
Source: coloradokids.org

Medicaid Expansion Colorado

Colorado will spend in the range of $286 to  $470 million to cover new enrollees by the end of the first six years of the Medicaid expansion.  This is 1.8% to 2.9% more than what Colorado would have spent on Medicaid during that timeframe without the implementation of Medicaid Expansion. According to the governor this represents an estimated $128 Million sticker price to Colorado, according to the Governor the state has identified at least 280 Million dollars in savings, these funds will be recovered through better use of technology, and medical cost reductions.
Source: medicaidexpansion.com

Medicare information for EBCI tribal members

Posted by:  :  Category: Medicare

If you are already getting Social Security retirement or disability benefits, you will be contacted a few months before you become eligible for Medicare and sent the information you need.  You will be enrolled in Medicare Parts A and B automatically.  However, because you must pay a premium for Part B coverage, you have the option of turning it down.
Source: theonefeather.com

Video: Medicare Part B_1.wmv

Medicare Part B Premium 2011 and 2012: Are Costs On The Rise?

Your Medicare Part B Premium is taken out of your social security check, usually on a monthly basis. If you can not afford to carry Medicare Part B agencies are available to assist you. They are: Medicaid, Supplemental Security Income, Qualified Medicare Beneficiary (QMB) Program, Specified Low-Income Medicare Beneficiary (SLMB) Program or theQualifying Individual (QI) Program. You can still be accepted even if your income is above the qualifying income limits.
Source: seniorcorps.org

Medicare A and B Cost and Benefits 2013

AARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 aetna Medicare Anthem Anthem High F plan Anthem Medicare Anthem Medigap Anthem Supplement Crowe and associates High Deductible F supplement how to choose a Medicare Advantage plan How to choose a Medicare plan how to choose a plan How to choose a supplement how to enroll in a medicare plan MAPD Med Advantage Medicare Medicare Advantage Medicare Advantage plans medicare b Medicare Complete Medicare Complete connecticut Medicare Connecticut Medicare part B Medicare part B cost Medicare part D Medicare plan Medicare Supplement Medicare Supplement Connecticut Medigap Medigap rates 2013 Medigap rates NY 2013 Original Medicare united healthcare United Healthcare AARP United medicare complete United Medicare complete 2013
Source: croweandassociates.com

Medicare Coverage Gaps 2013: Deductibles and CoInsurance

Just like your Part B premium, your Part D premium surcharge will be based on your modified adjusted gross income. Most people will pay the amount billed by their insurance company. But, if you filed an individual tax return for 2011 and your modified adjusted gross income was more than $85,000, your Part D premium surcharge for 2013 is shown in the table below. If you filed a joint tax return for 2011 and your modified adjusted gross income was more than $170,000, your Part D premium surcharge for 2013 is also shown in the table below. The Social Security Administration will compute your premium for you. However, we recommend that you double-check their computation against your 2011 tax return.
Source: asourparentsgrowolder.com

Understanding the Medicare Debate

The first option is Medicare Part C (also known as Medicare Advantage). This choice allows Medicare recipients to enroll in a private health insurance plan specifically approved and contracted by Medicare. These plans are offered by Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO). You can consider Medicare Advantage an “umbrella” plan that includes all the underlying benefits of Medicare Parts A and B, plus a menu of additional coverage and benefits (including prescription drug coverage) that you choose from for an additional fee. Medicare Advantage plans are separate from Medicare. An important consideration is that most of these plans require you to go to doctors and other providers within their HMO or PPO service network or pay higher co-pays for going out of network.
Source: sentryfinancialplanning.com

Would it ever make sense to delay signing up for MediCare Part B ?

Because Medicare Part B premium is based on look back on Federal Income Tax returns from 2 years prior to retirement, a person’s Medicare Part B premium can be as high as $335.7 a month if the adjusted gross income prior to retirement was over $214000. There is a permanent penalty if one delay taking out MediCare Part B. But the gross income will usually drop after retirement. If a person is in very good health, and have some reserve in HSA, does it make sense to just take MediCare Part A for hospitalization cost, and delay signing up for part B for 2 years, when the premium will drop to $105 a month? ( using 2013 numbers) To put it in actual numbers If Part B premium is $335.7 a month , it will be $4028.4 a year or $8056.8 for 2 years. Or an overcharge of $2768.4 a year or $5536.8 for 2 years just because of the higher pre-retirement income. If one delays taking Part B for 2 years, the basic monthly premium for Part B with penalty will be $126 a month, or $21 more a month or $252 a year. It will take 22 years for the penalty to become equal to the overcharge. So if one wait till 67 to start signing up for Part B, the breakeven point is 89 years old. The Math ignored premium increase, but it also did not take into account investing the overcharged amount into let say a well ran mutual fund to increase that $5536.8 overpayment of premium for 2 years.
Source: early-retirement.org

Medicare open enrollment: Did Obamacare secretly increase Part B premiums?

Here’s what’s happening. The 2003 law that set up these high-income premium surcharges also stated that the income thresholds were to increase every year to account for general inflation. But the Affordable Care Act freezes the thresholds at their current level through 2019, which will over the next six years snare more and more beneficiaries as incomes in general rise (or at least we hope they do). The Kaiser Family Foundation estimates that by 2019, about 14 percent of Medicare beneficiaries will be paying these higher premiums.
Source: consumerreports.org

Research Roundup: Comparing Medicare Budget Plans

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98JAMA Pediatrics: Nurse Staffing And NICU Infection Rates –Neonatal intensive care units (NICU) – which provide care for infants who are critically ill – are costly and require a significant amount of nursing services. Little is known, however, about the adequacy of nurse staffing at these units. Using data from 2008 and 2009, researchers analyzed the relationship between adherence to national staffing guidelines and hospitals-associated infections among very low birth-weight (VLBW) infants. “Our results document widespread understaffing relative to guidelines: one-third of NICU infants were understaffed… ,” the authors write. “In VLBW infants, NICU nurse understaffing relative to guidelines was associated with a sizable increase in infection risk.” They conclude that their findings “suggest that the most vulnerable hospitalized patients, unstable newborns require complex critical care, do not received recommended levels of nursing care. Even in some of the nation’s best NICUs, nurse staffing does not match guidelines” (Rogowski et al., 3/18).
Source: kaiserhealthnews.org

Video: Medicare Supplemental Insurance Comparison

Uwe E. Reinhardt: Comparing the Quality of Care in Medicare Options

Both traditional Medicare and Medicare Advantage plans are monitored annually through surveys of patients, using the Consumer Assessment of Health Care Providers and Systems, known in the trade as Cahps. The findings from this survey make it possible to compare traditional Medicare with Medicare Advantage plans on quality. As Medpac reports in Table 12-8 of Chapter 12 of the March 2012 report, the commission found little difference in the relatively few quality-performance scores of the traditional Medicare and Medicare Advantage plans.
Source: nytimes.com

Summit Medigap: How To Compare The Different Medicare Supplement Plans

1990, Medicare standardized their different plans in order to decrease the amount of confusion that consumers were experiencing as they compared different coverages offered by the different healthcare insurance providers. As a result of this standardization, it is easier for the consumer to understand the comparison of these different benefits and the associated cost comparisons between healthcare insurance providers. As a result, the terms “MediGap plans” and “Medicare supplement” basically mean the same thing and are commonly used interchangeably. As a result of having so many Medicare plans to choose from, it is important to research each one in order to decide which will be best for your personal needs and situation. One of the first things to be aware of when searching for supplement plans and comparing the ones you find is that many websites who advertise these are only there for one reason and that is to collect your personal information. In many cases, insurance providers will purchase leads or develop lead generators to accomplish this instead of actually doing what they advertise. Basically, these companies don’t know the proper ways of developing new business so they resort to these somewhat underhanded methods. Many of these companies make it appear as though they actually sell the different Medicare supplement plans but the reality is that they will collect your personal information and sell it to numerous insurance agents. Here are two ways that you can tell if they are legitimate healthcare insurance and Medicare supplement plan providers. First of all, there will be a toll-free number to call and secondly, there will be a statement promising that they will never sell your personal information to anyone else. Do price comparisons of these different Medicare plans when searching through the different companies that offer them. The better insurance brokers will be able to provide you with these comparisons from those insurance providers operating in your local area. In most cases the prices will differ despite the fact that the supplement plans they offer are identical. Remember, it is better to do plenty of research in order to make a well-informed decision when purchasing the Medicare supplement plan that is right for you.
Source: blogspot.com

AARP Medicare Complete Connecticut (review) « Insurance News from Crowe & Associates

AARP Medicare Complete Regional PPO- The regional PPO is a United Healthcare plans that has the AARP branding.  This plan has in network benefits that are similar to the HMO 2 but it has slightly higher copays, offers out of network coverage and costs $24.00 a month.  The main reason someone would select this plan instead of the HMO 2 is to have the out of network coverage.  This plan will still provide coverage when you visit non participating providers.   This plan should not be confused with the AARP Medicare Supplement plans.  For more info on Medicare Supplement plans CLICK HERE
Source: croweandassociates.com

CONNECTURE ACQUIRES DRX, A LEADING PROVIDER OF INFORMATION SYSTEMS FOR MEDICARE

Connecture is the leading provider of Web-based information systems used to create health insurance marketplaces and exchanges. Its industry-proven solutions enable consumers, employers and brokers to more easily shop for, purchase and renew health insurance while minimizing back-office administrative expenses for health plans.  Connecture’s solutions are provided to health plans, state insurance exchanges, private exchanges and insurance brokers.  More than 25 million Americans shop for their health insurance through systems built by Connecture, and more than half of the nation’s 20 largest plans rely on them to sell, administer and manage their plans and products effectively.  For more information, visit www.connecture.com.
Source: drx.com

What Is The Best Method For Making A Medicare Supplement Plans Comparison?

A list of physicians and healthcare professionals, by geographical location, can be found on the official Medicare website: https://questions.medicare.gov/find-a-doctor . This is an easy and convenient method to find participants in local areas. Every year there is an open season when individuals have the opportunity to make a Medicare supplement plans comparison to ensure both providers and services will continue. As with the original Medicare Parts A and B, the monthly fees for Medicare supplement plans are reviewed and adjusted on an annual basis. The Medicare monthly costs for Parts A, B, and D can be found at www.medicare.gov/costs/ . Supplemental insurance carriers will notify participants of any changes in annual fees or altered services during the November to December timeframe. Anyone who wants to change or drop a current insurance carrier can do so during the annual open season, January through March. Comparing costs today will lower individual expenses tomorrow.
Source: seniorcorps.org

What is the Cadillac Medicare Advantage plan

A plan’s network of providers: People often think Medicare Advantage plans are only offered as part of healthcare management organizations (HMOs), but many are also preferred provider organizations (PPOs). With HMOs and PPOs, insurance companies typically have a list doctors, specialists and hospitals that are preferred so when you go to those providers, you presumably pay a lower price for care. Either that, or the insurer covers more of your out of pocket costs, or both. Your costs typically differ if you get “in network” care versus “out of network” care. You’re more likely to think of a plan that includes your doctors, specialists and hospitals at a lower price to be a Cadillac plan.
Source: ehealthinsurance.com

Comparing Medicare prescription drug plans

Also, be aware that if you’re a low-income beneficiary and your annual income is under $16,755 or $22,695 for married couples living together, and your assets are below $13,070 or $26,120 for married couples, you may be eligible for the federal Low Income Subsidy known as “Extra Help” that pays Part D premiums, deductibles and copayments. For more information or to apply, call Social Security at 800-772-1213 or visit socialsecurity.gov/prescriptionhelp.
Source: pomeradonews.com

Medicare Open Enrollment: What’s your back

Nobody likes to think of back-up plans when it comes to our health, but health can be as unpredictable as the weather. It’s hard to know what you’ll feel like next week, much less what health care you’ll need next year. But that’s exactly what you need to think about when you’re shopping for health coverage during Medicare Open Enrollment – which ends on December 7.
Source: medicare.gov

Medicare Supplement Insurance Plans in Texas — Texas Insurance Blog

First, let’s start with Original Medicare. Medicare is separated into different Parts, A and B. Part A deals with your inpatient hospital coverage and your Part B deals with your outpatient medical services. Many people think that Original Medicare is an 80/20 insurance coverage. This is the case for the Part B portion, after the annual Part B deductible has been met. Part A is a little different though. There is a per benefit period deductible that must be satisfied per admittance and daily co-pays for specific numbers of days admitted in the hospital and/or skilled nursing facility. To simplify things, there is quite-a-bit of out-of-pocket exposure by just having Original Medicare by alone.
Source: texasinsuranceknowledge.com

Daily Kos: Insurers score another win, turn Medicare pay cut into increase

Medicare Advantage plans are good business for the health insurance industry. Though only a little more than a quarter of Medicare beneficiaries buy these supplemental plans, they’re big business. They’re also relatively expensive for the federal government, which subsidizes them. In fact, the Government Accountability Office found that over the past three years, the federal government has overpaid insurers between $3.2 billion and $5.1 billion. That’s something the Obama administration wanted to change, needing to find every cost-cutting measure possible to implement Obamacare. That’s why the administration tasked the Centers for Medicare & Medicaid Services (CMS) with cutting those subsidies and why it proposed the 2.3 percent cut. The cut would have not been in benefits, but America’s Health Insurance Programs (AHIP) didn’t want MA enrollees to know that. So they did what every powerful industry group does: use some scare tactics and an Astroturf campaign.
Source: dailykos.com

A Call for Mandatory Disclosure of Corporate Political Spending

Second, over the years, this issue has been caught, legislatively speaking, in a weird deadlock between Democrats and Republicans that involves, oddly enough, corporate philanthropic grantmaking. As readers know, corporate grantmaking through 501(c)(3) corporate foundations that file 990s gets disclosed, but direct grants from companies’ executive offices, marketing and PR arms, community relations divisions, etc. can be, and frequently are, done without disclosure. For some years, a Republican member of Congress would introduce a bill calling on disclosure of corporate charitable giving. Democrats (and leading nonprofit associations) have consistently opposed corporate charitable disclosure, saying that disclosure would make corporations apprehensive about supporting some causes and charities. Democrats would instead counter that if Republicans wanted disclosure of corporate philanthropic spending, they should be willing to require the disclosure of corporate political spending. And that’s where the debate would always grind to a halt.
Source: nonprofitquarterly.org

AHIP Statement on Final 2014 Medicare Advantage Payment Rates

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SS“By being responsive to the more than 160 members of Congress from both parties who raised concerns about the impact of the proposed payment rate on seniors, CMS has taken an important step to help stabilize Medicare Advantage at a time when the program is facing significant challenges. We are currently reviewing the final rate announcement and will continue to work with policymakers in both parties to strengthen this critically important part of Medicare that provides high-quality, affordable coverage to more than 14 million seniors and people with disabilities.”
Source: ahipcoverage.com

Video: Medicare supplement Insurance Plans VS Medicare Advantage plans

Get 'rock solid' with Medicare Advantage

When providers partner with Benefits365, they receive educational pieces on Medicare Advantage that they then provide to beneficiaries. One way to do that is through monthly statements. The idea: A beneficiary calls Benefits365 to switch from Medicare to Medicare Advantage, and both the beneficiary and the provider benefit from working with the latter vs. the former.
Source: hmenews.com

CMS Plans to Increase Payments to Medicare Advantage Insurers in 2014

“The policies announced today further the agency’s goal of improving payment accuracy in all our programs, while at the same time ensuring program stability and preserving beneficiary choice,” Jonathan Blum, acting principal deputy administrator of CMS, said in a statement.
Source: dmagazine.com

Senior Marketing Specialists : SMS: Government Increases Reimbursements for Medicare Advantage Plans in 2014

Fear over the continuation of Medicare Advantage plans in 2014 was put to rest by government rulings Monday, April 1, 2013 when the Obama administration reversed a proposed 2.3 percent pay cut for private Medicare plans, replacing it with a 3.3 percent raise.
Source: blogspot.com

CMS Changes Gear to Raise, Not Lower, 2014 Medicare Advantage Rates

Doubling back on its push to cut Medicare Advantage payments, CMS announced it would instead increase its rates to Medicare Advantage plans by 3.3 percent next year rather than the 2.3 percent slash it had originally planned. One in four Medicare beneficiaries pay more to be on Medicare Advantage, which pays a flat rate to the private insurers who administer the plans in an effort to promote cost-efficiency and preventive care. Beneficiaries’ out-of-pocket expenses are capped, unlike traditional fee-for-service Medicare. Health insurance lobbying group America’s Health Insurance Plans aired an arsenal of advertisements during the public comment window claiming seniors feared health costs would rise beyond what they could afford.
Source: beckersasc.com

Promoting Greater Value for Enrollees in Medicare Advantage and Drug Plans

New limits on overhead and profits for health plans in Medicare Advantage and Medicare drug plans will increase value for the over 14 million seniors and persons with disabilities enrolled in Medicare Advantage and over 35 million Medicare beneficiaries in drug plans offered by private insurance companies.  This step is part of the Affordable Care Act’s efforts to ensure that consumers get the most health care for their dollars.  Last year, we issued a rule to make sure that insurance companies generally spend at least 80 percent of the premiums paid by consumers in private health plans on health care or activities that improve health care quality, instead of paying for administrative costs or overhead.  Today’s proposal for people with Medicare is similar to last year’s rule benefiting consumers in the private health insurance market.
Source: cms.gov

Seniors speak out against Medicare Advantage cuts

“Living on a small restricted limited income in a world where the cost of living goes up regularly, my Medicare Advantage plan has consistently provided me with coverage that has allowed me to get the medications I need, see the doctors who treat me best, and have dental care for the past four years,” said Marietta Hanley of Auburn, N.Y. “A cut to this program would be devastating to me.”
Source: benefitspro.com

Sequester (GOP) Blamed for Medicare Woes, Not Obamacare Cutting $714 Billion Out of the Program

Posted by:  :  Category: Medicare

waiting room N I M H by drivebybiscuits1Washington Post says: “Legislators meant to partially shield Medicare from the automatic budget cuts triggered by the sequester, limiting the program to a 2 percent reduction — a fraction of the cuts seen by other federal programs.  But oncologists say the cut is unexpectedly damaging for cancer patients because of the way those treatments are covered.”  And even those cuts are not real. As the AP says, legislators exempted Medicare and Medicaid from the sequester.  There aren’t any cuts in Medicare.  All of this is manufactured and made up.  But the idea here is to — you’ve got, what, really in this year, $25 billion in sequester spending that’s being reduced.  They’re not budget cuts.  It’s spending being reduced.  Spending from a projected amount, not, again, reduced spending from a baseline.  The whole idea is Republicans have to be blamed for this.  And it’s Republicans causing cancer patients to die. 
Source: rushlimbaugh.com

Video: I’m running for President, Protecting SS and Medicare. Part 7.AVI

Benutzer:DerekKunz – wda

Knowledge Medicare Medicare is a plan that aids an incredible number of American seniors acquire inexpensive medical insurance protection. Unfortunately when individuals are making the move to Medicare they are met with a lot of complicated pieces of mail and ads. The reality is that Medicare could be simple to realize once you break it along. Parts of Medicare You will find several principal elements of Medicare Part A, Part M and Part Deb. There’s also a Medicare Part C nonetheless it is just a private insurance software called Medicare Advantage, which all on your own private insurance plan and walks you out of Medicare. Medicare Part A was the first to enter into existence and assists with Hospital Coverage. Medicare Part B is made soon after and will help you with well patient and out patient companies like browsing your neighborhood doctor’s office. Ultimately Medicare Part Deborah was created and it is there to greatly help seniors buy prescription medicine insurance. Expenses of Medicare Medicare isn’t totally taken care of and each element will cost money to you if you use the company. Medicare Part A doesn’t charge most people a regular advanced but there’s an allowable and coinsurance for each little bit of its protection. Medicare Part B includes a regular quality of $104.90 (2013). Portion M also has a deductible of $140 and constant coinsurance of 20% off your medical costs. Component D features a monthly quality that differs based away from what medications you’ll need. it could add up quickly while this seems there are approaches to reduce these charges. Medicare Complement Programs Medicare supplemental insurance was presented to greatly help seniors cover the spaces left in the coverage from Medicare Part A and Part W. There are five Medicare complement ideas that may complete all or only a few of the protection holes, based on which plan you choose. Although somewhat higher priced, the Medicare supplement insurance coverage that populate many or all the gaps, like Medicare supplement plan F and plan H, will make sure that you don’t need certainly to pay something in addition out of pocket. You must seek the advice of a competent Medicare complement insurance broker If you’ve any additional issues, as check out the post right here.
Source: wda-innsbruck.at

Have The Medicare Supplemental Health Insurance Policies ImmediatelyWorld Order of Forest Watchers

Acknowledge that there is in fact more to a new actual cost akin to Medicare than an initial premiums when it comes to Medicare Part An actual and B. You will have co-pays and subjected office visits to meet. This is where the different products in Medicare supplement insurances come straight to play. Medicare health insurance supplemental plans while policies help to cover deductible and additionally co-pays. Any single policy offers very different coverage options. You will yearn to determine exactly what policy will give good results best for your situation.
Source: forestwatch.org