Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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Source: medicare.gov

Video: O’Reilly Webcast: Healthcare 101: Cradle to Grave

Coders! Developers! Data Scientists! Meet the Code

Bryan Sivak joined HHS as the Chief Technology Officer in July 2011. In this role, he is responsible for helping HHS leadership harness the power of data, technology, and innovation to improve the health and welfare of the nation. Previously, Bryan served as the Chief Innovation Officer to Maryland Governor Martin O’Malley, where he has led Maryland’s efforts to embed concepts of innovation into the DNA of state government. He has distinguished himself in this role as someone who can work creatively across a large government organization to identify and implement the best opportunities for improving the way the government works. Prior to his time with Governor O’Malley, Bryan served as Chief Technology Officer for the District of Columbia, where he created a technology infrastructure that enhanced communication between the District’s residents and their government, and implemented organizational reforms that improved efficiency, program controls, and customer service. Bryan previously worked in the private sector, co-founding InQuira, Inc., a multi-national software company, in 2002, and Electric Knowledge LLC, which provided one of the world’s first Natural Language Search engines available on the web in 1998. More posts by Author
Source: medcitynews.com

Making complaints less complex

Each plan has specific rules you’ll need to know and follow when filing a complaint.  If, after filing a complaint, your plan doesn’t address the issue, call 1-800-MEDICARE for assistance. You can also call your State Health Insurance Assistance Program (SHIP) for free, personalized help filing a complaint.
Source: medicare.gov

Medicare Payment Reform and Provider Entry and Exit in the Post

Objective To understand the impacts of Medicare payment reform on the entry and exit of post-acute providers. Data Sources Medicare Provider of Services data, Cost Reports, and Census data from 1991 through 2010. Study Design We examined market-level changes in entry and exit after payment reforms relative to a preexisting time trend. We also compared changes in high Medicare share markets relative to lower Medicare share markets and for freestanding relative to hospital-based facilities. Data Extraction Methods We calculated market-level entry, exit, and total stock of home health agencies, skilled nursing facilities, and inpatient rehabilitation facilities from Provider of Services files between 1992 and 2010
Source: globalhealthhub.org

35 New APIs: Medicare, NYC 311 and Mobile Contact Syncing

BMBets API: BMBets.com helps bettors to find the best betting odds on their bets by processing and comparing odds from the most popular bookmakers. BMBets.com also provides users with the tools that help punters bet with data from Sure Bets or Value Bets. BMBets provides sport betting odds compilation and analysis services using the Oddsmaker engine, which simulates the probabilistic model of a sport event, assess probabilities and turn them into the betting odds. The engine supports offline and real-time (live odds) betting odds generation and analysis. The API uses SOAP protocol and responses are formatted in XML.
Source: programmableweb.com

Compare Medigap Plans Medicare Supplemental Insurance Texas

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSIt is hard to track down online scammers. Therefore, precaution sounds cure. You should never give your sensitive information online and not pay through wire-transfers. Do not click on accessories in emails out of unknown sources for the reason that may contain spy ware and spyware that put you at the risk of masterplans scams. Use the internet only from relied upon e-commerce stores and do not accept any job role offers online without requiring checking the experience of the work. By taking small precautions, you can enjoy a hassle-free from the internet experience and watch over yourself from rip-off.
Source: wholesomefood.org

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

Medicare Supplement Plans For A Retirement

Included as well in Medigap Plans is an element B excess levies benefits. That available at one hundred percent for plans F, I, and J, and 80 portion for plan T. Emergency care outside of the U.S acquired to cover 80 % of the care costs during the first 60 days of each trip. Diane puttman is hoping available for systems C through J. At home recovery effect is available in plans D, G, I, and C. It covers up in order to certain amount during every custodial cleaning visit after an surgery, injury, plus illness for up to a whopping a certain maximum benefit.
Source: espaigessap.com

Medigap Plans Guide on Introduction of Medicare Plan Coverage

If we are retirees and not covered by medicare fully then medical cost then it is impossible to meet the medical costs out-of-pocket and it is best to have a look at website http://www.medigapplansguide.com and get professional help and proper guidance. It is easy and simple to operate but most comprehensive and analytical in the content it provides. It is best to the different insurance companies in the area you live, their plans, amount of coverage and what premium one has to pay, also taking into account, the pre-existing health conditions and the ones that may eventually occur at that age. After comparison, choose the best quote and secure your health with supplement benefits like AARP.
Source: theshakyhands.net

Seniors Flock to Medicare Supplemental Insurance Comparison Site Built by One of Their Own

They say necessity is the mother of invention. In Stephen Pewter’s case, she gave birth to a website that has already helped thousands in the few months since it went live. Pewter, a senior citizen with no formal technology background, created the Medicare supplemental insurance comparison website, Medicaresupplementalinsurancecomparison.net after spending countless hours online looking for a site that would offer comparison information but not require loads of personal data. Pewter’s site asks visitors for just their zip code to deliver quotes from multiple providers doing business in their state. His friends and family were the first to try it in December 2012. Word spread and its popularity snowballed. And, in the month of March alone, more than 5,000 people used the site to help make their Medicare supplemental insurance choices. But, Medicaresupplementalinsurancecomparison.net is not just a place to shop Medicare supplemental insurance quotes. It’s a portal with easy-to-read articles and information to help seniors understand their Medicare coverage and decide what’s right for them with supplemental insurance. It even includes an education center to help seniors navigate some of the most confusing and frustrating situations; like getting reimbursed for payments they’ve made for medical services and requesting payment from an insurance company. Pewter’s old school approach to web development is partly what has made Medicaresupplementalinsurancecomparison.net such a hit. Online experts who’ve reviewed the site attribute its success to its simplicity and ease-of-use. The site is easy to navigate, not intimidating and doesn’t assault visitors with obnoxious ads, graphics or demands for personal information. And what’s more, visitors to the site remain anonymous, which eliminates the sometimes harassing follow-up from vendors that is common with other comparison sites. The thought is that as long as it stays that way, it’ll continue to be an invaluable resource for seniors. About Medicaresupplementalinsurancecomparison.net Stephen Pewter created Medicaresupplementalinsurancecomparison.net in December of 2012 to help his friends and family get the best rates for Medicare supplemental insurance. It grew by word of mouth and now is fast becoming one of the most successful Medicare supplemental insurance comparison websites on the Internet. The website utilizes the absolute latest in price quote technology and has already received rave industry reviews. For more information or to obtain a free Medicare supplemental insurance quote with just a zip code, visit: medicaresupplementalinsurancecomparison.net
Source: sbwire.com

How Medicare Supplement Plans & Medicare Advantage Plans Work

When beneficiaries turn 65 and first become enrolled in both parts of Original Medicare, they fall into their six-month Medigap Open Enrollment Period (OEP), which starts the first day of the month they are both age 65 or older and enrolled in Part B. This may be the best time to buy a Medigap policy because if a beneficiary decides to enroll after this time, their options may be limited and they may have to pay more for coverage. At the same time, beneficiaries also fall into their Initial Enrollment Period (IEP), which runs for seven months starting three months before they turn age 65 and lasts until three months afterwards. During this time, beneficiaries can sign up for any MA or Part D plan that contracts in the county and state in which they reside.
Source: planprescriber.com

Jon Stewart Paraphrases Marco Rubio: ‘Medicare Helps MY Mom, But F _ _ k You’

Posted by:  :  Category: Medicare

It's all there in black and white by Dave77459We encourage users to engage in a respectful discussion of this post, below. Comments are not necessarily representative of MoveOn.org’s views or beliefs, nor are commenters necessarily MoveOn members. This is a community-moderated forum: If you see something offensive, please flag it. If a comment receives enough flags, it will be removed.
Source: moveon.org

Video: Medicare Part F

Cutting Social Security and Medicare? That's the 'Middle'

Activism Director and and Co-producer of CounterSpinPeter Hart is the activism director at FAIR. He writes for FAIR’s magazine Extra! and is also a co-host and producer of FAIR’s syndicated radio show CounterSpin. He is the author of The Oh Really? Factor: Unspinning Fox News Channel’s Bill O’Reilly (Seven Stories Press, 2003). Hart has been interviewed by a number of media outlets, including NBC Nightly News, Fox News Channel’s O’Reilly Factor, the Los Angeles Times, Newsday and the Associated Press. He has also appeared on Showtime and in the movie Outfoxed. Follow Peter on Twitter at @peterfhart.
Source: fair.org

How To Enroll In A Medicare Supplement Plan F Insurance Policy

Finally, be sure to review your coverage each year. All Medigap policies are subject to inflation, just like any other insurance. Most people will see an increase once a year, although some carriers also have “birthday increases,” which means the policy costs will increase slightly whenever your turn a year older. The good news is that you can always shop your policy when rates go up. It’s very easy to change insurance companies as long as you can pass the medical health underwriting. By shopping your policy annually, you can be sure to get the most out of your healthcare insurance dollars each and every year.
Source: return2writing.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

How Does Medigap Work? Medigap 101

At one time, you could buy a Medigap policy that included drug coverage, but this is no longer the case. If you would like drug coverage (highly recommended) you will need to enroll in a stand-alone Part D plan.
Source: medicareprofs.com

Changes in Medicare Supplement Plans Coming in 2010

Seniors are advised to review their Medicare plans to see if they will be effected by the changes or if they can get lower rates with the new plans. They may also wish to consider obtaining Medicare Part D to cover some costs of medications. Medicare Part D helps to reduce the cost of many medications, but may not be used in conjunction with some Medicare Plans. Therefore, it is recommended that all Medicare subscribers review their options with an advisor that can provide specific information and advice on a case-by-case basis to Medicare subscribers.
Source: allabout101.com

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

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

Council on Aging Director Informs Medicare Recipients About Observation Status

This was just brought to my attention. How can our medical system get away with this without us being informed. Getting old and having health issues is bad enough with knowing this. I am going to print this out so I have it with me next time I go in for something. This evilness and our government isn’t taking care of the people that have made this country what it was. Thanks for fighting this battle and I will write to have a say.
Source: patch.com

medicare supplement plan f :) SEO 59 Pligg

Large Deductible strategy F must be the selection for any person over the age of sixty five having a Medicare Supplement Plan. Medicare Supplement Plan F could have the most effective protection, but finding this program for a low cost can be quite a problem.
Source: seo59.info

Rick Perry: White House holding states ‘hostage’ with Medicaid expansion

Posted by:  :  Category: Medicare

Standing Firm Against Expansion by Texas Governor Rick PerryPerry’s comments are a direct rejection of a recent movement among Republican governors in support of Medicaid expansion. Those governors have argued that expansion would provide an economic windfall for their states, offer basic health coverage to the most vulnerable and prop up struggling hospitals.
Source: politico.com

Video: In Session, In-Depth: Medicaid roundtable discussion

The Medicaid door is open, if Rick Perry and Texas lawmakers are “brave enough” to come through it

One analyst wrote that Perry had left open a crack for an Arkansas-like approach. The neighboring state wants to funnel low-income patients through health exchanges, so that public Medicaid dollars would be used to buy private insurance. Regulators signaled their approval in recent days, giving more momentum to the idea. Many states led by Republicans are already considering a similar path, and it makes sense for Texas.
Source: dallasnews.com

Texas governor reiterates opposition to Medicaid expansion

“Seems to me April Fool’s Day is the perfect day to discuss something as foolish as Medicaid expansion, and to remind everyone that Texas will not be held hostage by the Obama administration’s attempt to force us into the fool’s errand of adding more than a million Texans to a broken system,” Perry told reporters at the state Capitol.
Source: medcitynews.com

Perry, Texas Repubs Dig in for Medicaid Battle

A In the ongoing battle over Medicaid in Texas, no one budged Monday. As protesters marched outside Gov. Rick Perry’s office, chanting and calling on leaders to accept federal dollars to expand the program and help more Texans, Perry — flanked by fellow Republicans Lt. Gov. David Dewhurst, Texas Sens. John Cornyn and Ted Cruz, local U.S. Reps. Joe Barton and Michael Burgess and a handful of state lawmakers — said that’s not going to happen. “Texas will not be held hostage by the Obama administration’s attempt to force us into this fool’s errand of adding more than a million Texans to a broken system,” Perry said. “Medicaid expansion is, simply put, a misguided and ultimately doomed attempt to mask the shortcomings of Obamacare. “In short, it’s a prescription for failure, and Texas will not be part of it.” Some estimates show that expanding Medicaid under the federal Affordable Care Act could give coverage to another 1.5 million low-income Texans. Democrats are urging top Republicans to reconsider expanding the program and accept nearly $80 billion over the next decade — even though Texans might have to ultimately pay in about $9 million to help — to do that. “We know this can be done,” said U.S. Rep. Joaquin Castro, D-San Antonio, who stood with local and statewide Democrats at a news conference Monday. “It’s the right thing to do. “I hope [Perry] will give up the swagger and get serious about expanding Medicaid in Texas.” Republican concerns Perry last month reached out to Texas’ congressional delegation, asking for help to lock in “flexible federal funding” that would let Texas reform the current Medicaid program. During a news conference Monday, which followed a roundtable discussion he held with local congressional leaders, protesters marched outside the governor’s office, loudly chanting messages such as “Perry, take the money.” Over the noise, Perry said that even President Barack Obama has called the Medicaid system broken. He said Texans know “there is no such thing as free money” and expanding the program could hurt the state’s economy, lead to tax increases and hurt the state’s budget. He and other Republicans say that from 1990 to 2010, national Medicaid costs increased 445 percent — from $73.7 billion to $401.4 billion — while the national Medicaid caseload increased by 135 percent, from 22.8 million to 53.6 million patients. They also say seven out of every 10 doctors in Texas will not accept new Medicaid patients. “Medicaid is a broken system that is failing Texans and overwhelming the state budget,” Cornyn said. “The program must be fundamentally reformed, and Texas — not the federal government — is best suited to design a healthcare program for its poorest and most vulnerable residents.” Perry said he wants the federal government to give Texas leaders flexibility to work on a separate program that would give participants some “skin in the game” — health savings accounts, co-pays, deductibles and more control over their healthcare spending. He said the federal government should give the match to Texas in the form of a block grant. “Instead of expanding an already broken system, it is imperative that we give states more flexibility than ever to run and reform the programs the best way they see fit,” Barton said. Burgess, an obstetrician, said the simple truth is that the federal government doesn’t have the funds needed to uphold all its promises. “I don’t think the federal government is a reliable fiscal partner,” he said. Democratic response Protesters marching around the Capitol on Monday say they hope Republican leaders will reconsider and accept the funding they say will bring $85 billion to the state over 10 years to help the economy. W. Stephen Love, president and CEO of the Dallas-Fort Worth Hospital Council, was among those disappointed in Texas’ top leaders’ position Monday. “The Affordable Care Act is not perfect, but it helps some of the most vulnerable in our society who hover near the federal poverty level,” he said. “Many feel we cannot bear the cost of Medicaid expansion even though the first three years are fully funded, but there is a significant cost for not expanding Medicaid coverage.” Democrats said expanding the Medicaid program could impact the lives of Texans who now have no healthcare options available to them. Castro, who led the Democrats’ news conference with his brother, San Antonio Mayor Julian Castro, said expanding Medicaid could save countless dollars now being spent on uninsured Texans, who head to the hospital for care they can’t afford. “It’s almost criminal that the governor will put petty partisan politics ahead of the basic economic interests of Texans,” said state Rep. Lon Burnam, D-Fort Worth. “We’ve tried Governor Perry’s plan for 12 years, and after 12 years of Governor Perry’s healthcare policies, we have the highest rate of uninsured in the nation with 6 million Texans without insurance,” said state Rep. Chris Turner, D-Arlington, who also attended the event. “It’s time for a new plan.”
Source: hispanicbusiness.com

Cornyn: Expanding Texas Medicaid Would Weaken It

You might be wondering why so many Medicaid patients would go to the ER for routine care when they have health insurance. The reason is simple: Medicaid offers poor-quality coverage. Because the program reimburses providers at such low rates, an ever-growing share of Medicaid beneficiaries cannot easily find doctors or dentists who will accept their insurance. (We’ve recently seen a number of lawsuits brought by providers and patients against their state Medicaid programs over low-reimbursement policies.) According to the 2012 TMA survey, more than two-thirds of Texas physicians are turning away at least some of the Medicaid patients who come to their offices, because they cannot afford to treat them.
Source: crtpac.com

Perry: Medicaid Under Obama’s Health Care Law Will ‘Bankrupt’ Texas

(TM and © Copyright 2013 CBS Radio Inc. and its relevant subsidiaries. CBS RADIO and EYE Logo TM and Copyright 2013 CBS Broadcasting Inc. Used under license. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.)
Source: cbslocal.com

What on Earth is the Donut Hole? A Brief Explanation of Medicare Part D and the “Donut Hole” » The NeedyMeds Blog

Posted by:  :  Category: Medicare

wordy informative signage by damian mIn 2013, you get out of the coverage gap when you have paid $4,750 out-of-pocket for covered drugs since the start of the year. When you reach this out-of-pocket limit, you get catastrophic coverage. The costs that help you reach catastrophic coverage include what you spent on drugs while in the donut hole and most of the discount on brand-name drugs you received in the coverage gap. If someone else pays for your drugs on your behalf, this will also count toward getting you out of the coverage gap. This includes drug costs paid for you by family members, most charities, State Pharmaceutical Assistance Programs, AIDS Drug Assistance Programs and the Indian Health Service. You continue to pay your drug plan’s monthly premium during the gap, but the premium does not count toward the $4,750 out-of-pocket limit. The amount your drug plan paid for your drugs in your initial coverage period also does not count.
Source: needymeds.org

Video: Medicare Part D – The Donut Hole

Medicare drug costs to fall in 2014, but donut hole widens

Before passage of the ACA, seniors in the gap paid 100 percent of all drug costs. Now, they pay 50 percent out-of-pocket for brand-name drugs, with the rest made up by insurers and discounts from pharmaceutical manufacturers. For generics, they pay 79 percent. Enrollees’ out-of-pocket burden for brand-name and generic drugs will gradually fall to 25 percent by 2020 – the same percentage applied for standard coverage.
Source: medcitynews.com

Closing The Medicare Part D Program Doughnut Hole: The End Is In Sight!

There’s also some encouraging research confirming what a lot of us intuitively sense: that making prescription drugs more affordable saves money down the road by keeping people healthier. When people with diabetes get their insulin regularly, for example, they’re more likely to stay out of the hospital. Of course this is great for them; no one likes going to the hospital. But it’s good for all of us, because hospital care is expensive, and keeping people healthy and out of the hospital is one of the most obvious ways of bringing health care costs under control. Recently, the Congressional Budget Office – the green eyeshade folks who keep track of the cost of everything the government does – concluded that making prescription drugs in Medicare more affordable does, in fact, save some money later on by reducing things like hospital admissions. As a result, filling in the doughnut hole is going to cost about 40 percent less than was previously forecast. At a time of tight budgets, that’s great news for all of us.
Source: smmirror.com

Putting a Donut Hole Back in Medicare: Proposals to Increase Medigap Costs Put Vulnerable Beneficiaries at Risk 

[1] See Medicare Supplement Insurance First Dollar Coverage and Cost Shares Discussion Paper, National Association of Insurance Commissioners (NAIC), Senior Issues Task Force, Medigap PPCA Subgroup, (October 2011), available at: http://www.naic.org/documents/committees_b_senior_issues_111101_medigap_first_dollar_coverage_discussion_paper.pdf.  Also see, e.g., Leadership Council on Aging (LCAO) issue brief “Reforming Medigap Plans by Shifting Costs onto Beneficiaries: A Flawed Approach to Achieving Medicare Savings” (December 2012), available at: http://www.lcao.org/docs/LCAO-Medigap-Issue-Brief-12-12.pdf [2] Medigap Reform: Setting the Context, Kaiser Family Foundation, (September 2011), available at http://www.kff.org/medicare/8235.cfm. [3]Medigap Reform: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs, Kaiser Family Foundation, (July 2007), available at http://www.kff.org/medicare/8208.cfm. [4] See, e.g., previous Weekly Alerts, including finding drug savings in Medicare (November 2011) http://www.medicareadvocacy.org/2012/11/15/deficit-reduction-and-medicare-save-money-without-harming-beneficiaries/ ; Prescription Drug Rebates (July 2011) http://www.medicareadvocacy.org/2011/07/21/debunking-medicare-myths-drug-rebates-for-dual-eligibles/ ; and additional options for achieving Medicare savings (June 2011) http://www.medicareadvocacy.org/2011/06/09/so-what-would-you-do-real-solutions-for-medicare-solvency-and-reducing-the-deficit/.
Source: medicareadvocacy.org

2014 Medicare Part D deductible down as donut hole widens

The Executive Director of Families USA, Ron Pollac, said the move will have a positive and direct impact on what Medicare recipients spend from their pockets. This addresses some of the concerns people have about the sustainability of the program, which is likely to minimize the tendency to shift more cost burdens on the beneficiaries in future budget deliberations. Families USA is a Washington-based health consumer advocacy body.
Source: medicarewire.com

Medicare “Donut Hole” Gets a Little Smaller in 2013

The difference between Medicare Part D plans is that one plan may charge significantly more for specific drugs than another plan. This could also be true if you have a Medicare Advantage plan that includes drug coverage. That’s because they negotiate prices with manufacturers and middlemen.
Source: allsup.com

The Affordable Care Act: The Good, the Bad, and the Ugly

The Affordable Care Act (ACA) is a common term referring to the Patient Protection and Affordable Care Act (PPACA) of 2010. Other terms used are Healthcare Reform and Obamacare. But, what is it? The ACA is a comprehensive piece of legislation that is healthcare specific and touches on just about every aspect of healthcare in the United States, from Healthcare Insurance Exchanges to Accountable Care Organizations, from Medicare to Medicaid, from volume to value, from quantity to quality, and from pre-existing conditions to donut holes. The ACA affects all types of insurance from private to commercial to government. The ACA’s purpose is to provide affordable, accessible, and accountable healthcare. A piece of legislation that covers this magnitude has both proponents and opponents. Here are some of the opinions being expressed (some of these can be construed as both positive and negative):
Source: healthworkscollective.com

Seniors speak out against Medicare Advantage cuts

Posted by:  :  Category: Medicare

TWO YEARS OF RUIN by SS&SS“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

Video: OBAMA TO CUT MEDICARE BY $700bn To Fund OBAMACARE

Medicare Boosts Rather Than Cuts Payments To Advantage Plans

Modern 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

Pitts Statement on CMS’ Decision to Reverse Some Cuts to Medicare Advantage

“I am pleased that CMS seems to be listening to concerns voiced by Medicare beneficiaries and members of Congress by appropriately rolling back some of the proposed cuts to the Medicare Advantage program,” said Chairman Pitts. “While the decision is welcome news, we must not forget the program still faces significant hurdles. In order to fund new entitlement programs, the health care law raided more than $716 billion from Medicare, $308 billion coming from Medicare Advantage. These cuts, which could disrupt coverage for over 14 million Americans, represent another one of the president’s broken promises that if you like your current health care plan you can keep it.”
Source: house.gov

Insurers: Cuts to Medicare Advantage will hit poor, minorities

“Medicare Advantage is a lifeline for millions of low-income and minority Medicare beneficiaries who rely on the high-quality coverage and innovative programs and services these plans provide,” AHIP President and CEO Karen Ignagni said in a statement.
Source: thehill.com

Medicare Advantage “Cuts?” Don’t Believe it. 

The Affordable Care Act (ACA) is beginning to rein in Medicare Advantage (MA) overpayments by bringing MA payment more in line with what traditional Medicare spends on a given beneficiary.  The insurance industry is not only fighting this payment reform, but has launched a campaign against a 2.3% reduction in payment projected for 2014.[1]   This additional "cut" is actually a projected reduction in MA payment growth rate as a result of a statutorily-required formula that bases MA payments on overall Medicare costs.  In short, because Medicare’s costs overall have grown more slowly than expected in recent years, projected payment increases to MA plans will also slow.   Contrary to arguments by the insurance industry – which pushes for more private market involvement in the Medicare program – insurers that choose to offer Medicare plans should not be insulated from market forces that are slowing the rate of growth of health care costs.
Source: medicareadvocacy.org

CMS To Increase Rather Than Cut Medicare Advantage

DR. JIM PALERMO, EDITOR-IN-CHIEF: Dr. Palermo, a 28-year resident of Brevard County, touched the lives of countless people during his 22-year practice of general, vascular and non-cardiac thoracic surgery. In 2002 he transitioned from clinical practice and accepted a position as full-time chief medical officer and vice president of quality management of Health First, which afforded him the opportunity to serve the global community in a more meaningful way. An accomplished author and sought-after expert in the healthcare industry, Dr. Palermo is now an independent consultant focused on healthcare quality and safety, and physician leadership development.
Source: spacecoastdaily.com

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

Analysis: Medicare Advantage Part of Obama Budget Cuts

President Obama often claims he wants to cut the budget smartly, using a “scalpel”–not a meat axe, machete, cleaver or chainsaw, to list a few of his favorite metaphors. He’ll need a more inspired term to describe what he’s now doing to Medicare Advantage, perhaps napalm or WMD. The Affordable Care Act drained $306 billion from this growing version of Medicare that 29% of seniors use to escape the traditional entitlement and obtain modern private insurance, but the Administration is imposing the cuts in ways that are even more harmful than the law requires. The post-election timing is no accident. In 2012 only 4% of the Medicare Advantage cuts were scheduled under the law, but the folks who run Medicare at the Health & Human Services Department improvised a $3.8 billion nationwide “demonstration project” that paid bonus subsidies to Medicare Advantage insurers to improve quality. The project couldn’t demonstrate anything because the payments went to 90% of insurers regardless of quality, but they did cancel out most of the 2012 cuts. That did the trick for voters in Scottsdale or Boca Raton who might have noticed higher costs or lost the coverage they have and prefer. Federal auditors suggested the project was illegal, but in any case it is now winding down and HHS is making up for lost time. Even as Obamacare-mandated cuts of roughly 3.4% hit in 2014, out of nowhere HHS gamed the complex formula to conjure a new 2.2% cut in the fixed payments that insurers receive for each senior they cover under Advantage. Folding in Obamacare’s $8 billion tax on insurers next year that is the equivalent of a smaller subsidy, the Medicare Advantage cuts will total anywhere from 6.9% to 7.8%. Thus Advantage will become the only entitlement for which real spending will fall slightly year over year and continue to decline, even as health costs rise and more people join the program. Mr. Obama would never tolerate this in any other area of government, no matter what tool was used. The cuts translate into lower benefits, higher premiums or both, and the liberal goal is to induce seniors and insurers to flee the program, much as Bill Clinton starved the Advantage forerunner known as Medicare+Choice in the 1990s. Yet for the past several years enrollment has climbed at an 8% to 10% clip annually, versus 3% for normal fee-for-service Medicare. The Administration can’t abide that Medicare Advantage is stealing customers from government control, while also exposing the failure of traditional Medicare’s cost control. Medicare Advantage shows that more dynamic and efficient private alternatives can generate better health-care value than a room of wise men deciding how the government should pay for tens of thousands of services. A shelf of academic and industry research shows that the care coordination and disease management in private plans result in higher quality than fee for service, including lower hospital readmission rates and better outcomes for seniors with chronic conditions. No less than the liberal Princeton health economist Uwe Reinhardt recently conceded that “robust empirical evidence” is convincing him that competition among plans creates “powerful incentives to improve the quality of the care they procure for patients.” This is like the Sierra Club conceding that the coal industry has redeeming qualities. The tragedy is that Medicare Advantage architecture is far from perfect and HHS could save money if it wanted to, in particular by targeting the private fee-for-service plans that mimic all of traditional Medicare’s dysfunctions except with an element of private profit. But that approach conflicts with the Administration’s political goal of strangling Medicare Advantage in the crib. The new HHS payment cuts will be finalized in a week or so, and even some Democrats are protesting that they are too much too fast–including Senate Finance Chairman Max Baucus, who designed the original cuts. Unfortunately for them and their constituents, Mr. Obama would rather destroy a model for true Medicare reform than let seniors choose. READ FULL SOURCE ARTICLE: 03/20/2013
Source: newmediajournal.us

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 Cut Medicare Advantage Reimbursements

“There are going to be some markets that at these rates, if they go the way they’re going, it’s going to be very hard for Medicare Advantage to survive,” Universal American Corp CEO Richard Barasch said in a February 19 conference call with shareholders, the industry publication Health Plan Week reported.
Source: medbill.net

Nothing found for Health

Posted by:  :  Category: Medicare

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Source: locomotivestrategy.com

Video: medicare.wmv

Higher copays seen for Medicare brand

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Source: fiftyplusadvocate.com

Do.You.Think Medicare Member Benefits? Medicare Member Benefits

aarp offers members exclusive discounts brand-name providers retail travel health fitness home questions answers prescription drug transitions exceptions coventry health care s advantra productsimportant information regarding prescription drug benefits medicare member commercial member looking learn viva medicare plus antenna care management innovative high-touch care older adults severe disabling chronic conditions partnership member benefits member explore medicare i m member member home plans &amp benefits pharmacy contracts federal government provide medicare services heather benefits member liability blue medicare ppo greater services received summary benefits blue medicare hmo blue medicare ppo plans set maintain secure connect devices home network plus tips wired wireless networking choosing firewall setting ultimate amazon com smc barricade g wireless broadband router smcwbr14-g electronics big deal home applications just hook printer pc slave amazon com smc barricade g wireless broadband router smcwbr14-g electronics va big deal home applications just hook printer pc slave
Source: gdf-jorge-antunes.com

Dental Coverage: Dental Coverage Of Medicare

As boomers approach retirement, few are fully versed on what Medicare covers. The transition into retirement can be unnecessarily problematic if they expect Medicare to meet all of their health care needs, but six insights can help them prepare.Fort Collins, CO (PRWEB) November 14, 2012 As a proportion of total expenses, Medicare beneficiaries spend twice as much on health care in comparison to
Source: blogspot.com

VIVA MEDICARE Plus Earns Highest Quality Rating Score in Alabama for Second Year in a Row

VIVA MEDICARE Plus has earned the highest overall star rating in the state for the second year in a row, company officials announced today. Alabamas highest ranked Medicare Advantage plan also has experienced the largest membership growth in its service area, according to Medicares enrollment numbers from October 2010 to October 2011, available on http://www.cms.gov.
Source: jobsdomain.us

Top Medicare Part D Plan Costs Spike in 2013

Posted by:  :  Category: Medicare

Horace D. Grant by jajacks62The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.
Source: webmd.com

Video: My New Drug Coverage – 2/21/2013

prior authorization form anthem medicare part d

Medicare Buz » Blog Archive » Windsor. Clarian Health Part D prior authorization forms for specialty drugs. Part D Prior Authorization Form Part D Prior Authorization & Step Therapy Forms for Coventry’s Medicare Advantage and First Health Part D Plans Windsor medicare drug prior authorization form // Free 2 day trial promo to premier passport. This form is for physicians to submit information to Tufts Health Plan to help determine drug coverage and proper payment under Medicare Part B or Part D per the Aetna Prior Authorization Form, free PDF.
Source: blog.cz

Part D Savings Continues, Especially For Cost

The donut hole is the gap in prescription drug coverage offer by a PDP that was part of he original Part D program, put in place to reduce the cost of the legislation that was enacted in 2003 that included Part D. Under the original benefit, as Part D beneficiaries accrued drug expenses, they first had to satisfy a deductible, then 75 percent of their drug costs were covered up to a certain dollar amount. Then, the donut hole kicked in, a coverage gap where the beneficiary was responsible for 100 percent of drug costs. When total out-of-pocket spending reached a specific maximum, the PDP then provided 100 percent coverage for any additional drug costs.
Source: wolterskluwerlb.com

Coventry Announces First Health Value Plus Medicare Part D Plan

who is selling only a PDP to someone 80 years old. Think about it by the time they are 80 they have 4 kids 10 grand kids and 18 greats, they also have 30 neighbors and 40 people at church and 400 people in their circle of influence. Now you have 400 leads that all need medical, dental, life and disability insurance along with home auto and business coverage. What happened to the $30 comission that you complained about? I think many Agents just need to get out of the business anyway because they are smart enough to know what their doing in the first place.
Source: ritterim.com

Medicare Health Plans and Dually Eligible Beneficiaries: Industry Perspectives on the Current and Future Market

Posted by:  :  Category: Medicare

New Online Rx System Makes UM Student 'Top Entrepreneur' Finalist by University of Maryland Press ReleasesThe brief is based on interviews with senior executives at 13 large firms that contract with the Medicare and Medicaid programs and finds almost all of the insurers expect dually eligible beneficiaries will become more important to their business over time. The brief also looks at how insurers currently serve dually eligible beneficiaries, particularly through Special Needs Plans that are part of the Medicare Advantage program.
Source: kff.org

Video: Turning 65 Becoming Eligible for Medicare – 2011

Who is Eligible for Medicare?

While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months. If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, call the Social Security Administration or visit their web site. The toll-free telephone number is: 1-800-772-1213. The TTY-TDD number for the hearing impaired is 1-800-325-0778. You can also get information about buying Part A as well as Part B if you do not qualify for premium-free Part A.
Source: seniorsguideonline.com

Medicare information for EBCI tribal members

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

Obscure Medicare Rule Creates Catch

First, for many, employer-based plans are cheaper, more comprehensive and more familiar than Medicare, so people want to keep that coverage. While enrollment for Medicare Part A (which covers hospital stays) is automatic and requires no premium, Medicare Part B (which covers outpatient care) costs $100 per month and some individuals may opt out. Once the employed spouse retires, then the other spouse signs up for Medicare Part B. Without this protection, late applicants for Medicare Part B would have to pay a penalty, like anyone else who signs up late.
Source: dlklawgroup.com

Ask The Experts: Retirement

Q. I will apply for Medicare Part A when I reach 65 as a FERS retiree. My wife will not be eligible for eight years after, and I will retain my federal Blue Cross/Blue Shield family policy. She also has a state BC/BS policy in which I am included. Her policy does not carry over into retirement, so I will keep mine until she is eligible for Medicare. If I wait until she no longer has me under her policy, will I be entitled to then apply for Medicare Part B without penalty under the Substantially Equal Periodic Payment exception, or do I need to do it when I am eligible for Medicare to avoid the 10 percent-per-year penalty?
Source: federaltimes.com

– Can I join the USFHP when I turn 65 this year?

For years, beneficiaries who enrolled in the USFHP could stay in that plan and keep Tricare Prime indefinitely, even when they turned 65 and became eligible for Medicare, when most other beneficiaries are required to shift to Tricare for Life. However, Congress recently ordered a major change to USFHP eligibility. As of Oct. 1, 2012, the USFHP cannot accept any new enrollees over age 65; they must use Tricare for Life. Those over 65 who were already enrolled in the USFHP before that date can stay in that program indefinitely. As such, if you want to get into the USFHP, you have only a few months to look into that before you turn 65 and are permanently locked out of that option.
Source: militarytimes.com

Oklahoma Medicare Eligibility Requirements

You’re not alone if the term “Medicare eligibility” leaves you scratching your head, wondering if you qualify for the full package of benefits. It’s true, there are a few restrictions, but for the most part, as long as you’re 65 or older and a permanent citizen, you should be qualified for health care benefits through Medicare. In some cases, it’s possible to be eligible for Medicare even if you’re younger than 65. If you have End-Stage Renal disease or have been on Social Security disability benefits for over 24 months, you’re eligible at any age.
Source: oklahomamedicarehealth.com

How Medicare Could Fix U.S. Healthcare

Doctor  and hospital problems:  Medicaid, the state-federal partnership program to pay for care for poor people, usually pays doctors and hospitals quite a bit less than the care actually costs.  Medicare, the program for older Americans, on the other hand, pays what it figures a really efficient operation should cost; that is, less than most hospitals and doctors feel they should get. These unpaid costs are shifted to private insurance, which pays much more than the cost of the care that its policy holders get. But though they are paying much more than the care costs, health insurance companies insist that their policy holders get a “discount.” Therefore hospitals charge people without insurance even more. The uninsured pay the most, perhaps twice as much as insured patients and three or even six times the cost of their care. The result of all this cost shifting has to come together in an operation that ends up in the black.
Source: dailyyonder.com

Obama’s Budget Expected To Call For Medicare Cuts

California Healthline: Healthy Families Savings Goes From $13M To $137K At a legislative hearing yesterday, state officials said the estimates for savings have been reduced for the Healthy Families transition to Medi-Cal managed care. According to the Legislative Analyst’s Office, the original estimated general fund savings for the Healthy Families transition was $13.1 million in 2012-13. The estimate has shrunk to $137,000. Savings for next fiscal year — 2013-14 — were estimated at $52 million and that estimate has been revised to $43 million. Scott Ogus, who represented the Department of Finance at yesterday’s hearing, said there were several factors contributing to the revision. Delays in implementation by the Department of Health Care Services led to caseload changes. DHCS officials have said the department slowed down some of the early phases of the transition so children would have less disruption in continuity of care (Gorn, 4/5).
Source: kaiserhealthnews.org

Celebrities Turning 65 in 2013

The oldest members of the baby boomer generation celebrated their 65th birthday on the first day of 2011, which amounted to roughly 10,000 individuals. According to the Pew Research Center, about 10,000 more Americans will cross that threshold every day for the next 19 years, which also includes a growing number of well known celebrities and public figures. Steven Tyler, Al Gore, and Olivia Newton-John are among the famous people born in 1948 to turn age 65 and become Medicare eligible this year. They will join the over 49 million individuals in 2012 already enrolled in the Medicare program, a population that is expected to reach a total of 80 million beneficiaries in 2030, double the number in 2000.
Source: planprescriber.com

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

Posted by:  :  Category: Medicare

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

Video: Medicare Supplemental Health Insurance

Medicare Health Insurance Supplement Insurance In A Boon Towards Senior CitizensCanadian English

Still another thing to think of is if the doctors you at the use are inside a to be looked upon with the Medicare health insurance parts and choices you choose. For instance, which has the Medicare Comfort Plan only doctors who contract his or her services with Medicare health insurance can be deemed. These docs have pre-approved the right set dollar measure per services a Medicare has believed upon as prolonged as you observe a certain cir of doctors. This may not necessarily quite bode well assuming that you have been doing with your health-related professional for 30 plus years and are typical not wanting of these a drastic change in health be concerned providers at this type of point in available free time.
Source: canadaenglishcenter.com

Best Medicare Supplemental Car Insurance For Better Will Benefit

Another thing to recognize is if currently the doctors you already use are proficient to be detected with the Medicare health insurance parts and software programs you choose. For instance, that includes the Medicare Advantage Plan only researchers who contract their services with Treatment can be encountered. These docs have pre-approved a set dollar quantities per services this Medicare has established upon as prolonged periods of time as you catch sight of a certain round of doctors. This may not necessarily quite bode well if you have recently with your medical doctor for 30 nicely years and are not wanting these types a drastic change in health health care providers at this amazing point in time.
Source: thepalmbeachsteakhouse.com

Medicare Supplemental Health Insurance Insurance Plans Which Is The Best

Such as we put steps in older life, a feature hostile to healthcare becomes much more more critical to assist you to our well-being. We all want the Best Medicare health insurance Supplemental Plan which often to be available. When searching for the perfect of applications and an insurance plan company that contains extraordinary customer service, we always award a lot coming from all time on comparison many options available. This is really vigorously when going that can turn 65 in addition becoming appropriate when considering healthcare for at first chance. However, high are minor things you can do to create sure you decide on a plan on comprehensive benefits straight from a health insurance company that allows for great customer work.
Source: starship7170.com

Buying Supplemental Health Insurance

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

Produce Information On Medicare Supplements First

A single aspect of plan for Medigap Plans is the first three pints of blood. This is obscured in all plans, but in schedule K it is up to 50 percent, and plan S is up so that you can 75 percent. This is likewise true for the hospital deductible befit. The Skilled Nurse Facility daily coinsurance covers a specific amount per day for the days 21-100 of each benefit period. This is one advantage of plans 3 through L. For plan I and L, it can be 50 percent moreover 75 percent respectively. The part B annual deductible is obtainable for plans C, F and K.
Source: europeanpeaceaction.org

An Assessment In Between Medigap And Also Medicare Advantages Options

You are able to the fact is get a variety of medicare health supplement leads online if you only have got to seek performed by persons regarding getting medical care insurance. A good thing just about any medicare insurance professional are capable of doing is aim to find some of the medicare health insurance insurance leads as well as medicare supplements prospects. In case you move through looking for a lot of the health care insurance leads you could consider sorting out those who are old above 60mph five and enquire these to choose medigap strategies. These types of prospects will definitely mean medigap qualified prospects as most of people just have no idea of the idea.
Source: carreiradaindia.net

Daily Kos: Obama budget cuts Medicare benefits and provider payments

On the other hand, the proposals for seniors aren’t a positive move. At least Obama didn’t include the hike in the Medicare eligibility age that he had previously offered to Boehner, but what he does include could be another hit for seniors, on top of the chained CPI. Cutting out Medigap policies would increase out-of-pocket costs for seniors. Those costs have been steadily and steeply rising [pdf] for seniors already over the past two decades. Adding more means testing to the program (wealthier individuals already pay higher premiums for Part B, the part that covers physician services and supplies) shifts the program further from from universal coverage and opens it up to more and more means testing, and toward a stigmatized and politically vulnerable poverty program.
Source: dailykos.com

Your Current Simplistic Truths Of Medicare Supplement Insurance

One particular aspect of insurance policy for Medigap Plans will be the first three pints of blood. This is covered in all plans, but in intend K it is up to 50 percent, and plan M is up that would 75 percent. This is true for a healthcare facility deductible befit. The Skilled The nursing profession Facility daily coinsurance covers a certain amount per day for the 21-100 of an individual benefit period. This is good results of plans J through L. For plan E and L, it can be 50 percent not to mention 75 percent respectively. The part B per year deductible is accessible for plans C, F and S.
Source: arhavitso.org