Texas governor reiterates opposition to Medicaid expansion

Posted by:  :  Category: Medicare

Reuters---Texas governor Rick Perry suffers  alzheimer's relapse at campaign rally near Dallas recently. Millions of TV viewrs gasped in horror as confused governor tried repeatly to suck an aids dildo--he was finally subdued and rushed off stage. by idropkid“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

Video: In Session, In-Depth: Texas Medicare Debate

Access To Primary Care Is A Challenge For Some Texas Medicare Patients

RAY SUAREZ: The independent Medicare Payment Advisory Commission also looked at the problem last June. Of the six percent of seniors they surveyed looking for a new primary care physician, one in four had a small or big problem getting an appointment. And Medicare itself says fewer than 10,000 doctors have officially opted out of the program in the past two years.
Source: kaiserhealthnews.org

Texas and Medicaid Hypocrisy

Kolkhorst also touts Texas’ plan to use a Medicaid “waiver” to provide Federally Qualified Health Clinics (FQHCs) around the state. A Medicaid waiver is essentially a grant to implement some temporary health program for the Medicaid population in lieu of regular Medicaid. Not only are those clinics literally socialized medicine, but after the federal deficit spending glut is over, Texans will be left to pay the bill.
Source: freedomworks.org

Compare Medigap Plans Medicare Supplemental Insurance Texas

It 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

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 Nursing Homes Plan Major Changes in Response to Budget Cuts

If you find yourself as one of the unfortunate individuals who is affected by Medicare and Medicaid cuts, there are resources out there. Caregiverlist.com provides many aides for those looking for jobs in senior care, including connecting professional caregivers with multiple jobs in their area with 1 job application providing a national Certified Nursing Assistant training school directory with admission requirements and practice exams, providing information on background check laws and requirements for working as a professional caregiver and 10-hr online course to become a certified caregiver.
Source: seniorhousingnews.com

When should I apply for Medicare?

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2.. Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481If you’re not receiving Social Security benefits, however, consider signing up soon. As does the Social Security Administration, Long recommends that you apply three months before your 65th birthday to ensure your coverage begins the month you turn 65.
Source: cnn.com

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

Apply for Medicare Online Using These Four Simple Tips

Bonnie Gortler (@optiongirl) is a successful stock market guru who is passionate about teaching others about social media, weight loss and wealth. Over her 30-year corporate career, she has been instrumental in managing multi-million dollar client portfolios within a top rated investment firm. Bonnie is a uniquely multi-talented woman who believes that honesty, loyalty and perseverance are the keys to success. You will constantly find her displaying these beliefs due to her winning spirit and ‘You Can Do It’ attitude. Bonnie is a huge sports fan that has successfully lost over 70 pounds by applying the many lessons learned through her ongoing commitment toward personal growth and development while continually encouraging others to reach their goals & dreams. It is within her latest book project, Journey to Wealth, where Bonnie has made it her mission to help everyone learn the steps needed to gain sustainable wealth and personal prosperity. Look for Journey to Wealth later in 2013!
Source: bonniegortler.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

Application of Medicare Contribution Tax of 3.8% to Certain U.S. Persons Owning Stock in A Controlled Foreign Corporation or Passive Foreign Investment Company : Federal Taxation Developments Blog

As mentioned, a U.S. shareholder of a CFC is required to include certain amounts in income, i.e., Subpart F income to the extent of earnings and profits, under Section 951(a). The Preamble to the Section 1411 proposed regulations states that constructive or pass through income includible under Section 951 will generally not be treated as dividends in computing NII as dividend income unless expressly provided for in the Code. Still NII treatment will result to the extent the Subpart F income is derived from a trade or business to which the tax applies as provided in Section 1411(c)(1)(A)(ii)(trading trading in financial instruments or commodities) and Prop. Treas. Reg. § 1.1411-4(a)(1)(ii)). As to PFICs, a U.S. person is required to income in income amounts described under Section 193 if the taxpayer makes a QEF election under Section 1295.. Section 1293 inclusions also are not treated as dividends unless expressly provided for in the Code, and, therefore, also are not taken into account for purposes of calculating net investment income (unless the amount is derived from a trade or business to which the tax applies as provided in Section 1411(c)(1)(A)(ii) and Prop. Treas. Reg. §1.1411-4(a)(1)(ii)).  This difference in timing for reporting income for chapter 1 (regular income tax) and chapter 2A (Section 1411), as well as other overlapping provisions, will require a taxpayer to compute separate stock basis for chapter 1 and chapter 2A, subject to making an election under Prop. Reg. §1.1411-10(g) which seems to only be available after 2013 although the Preamble to the regulations when read with the proposed regulations is not entirely clear on this point, i.e., whether such election can be made for a taxable year beginning in 2013.
Source: foxrothschild.com

Howell Rule Applies When Medical Services Were Paid by Medicare, Court of Appeal Concludes : Insurance Litigation & Regulatory Law Blog

In Howell v. Hamilton Meats & Provisions, Inc. the California Supreme Court ruled that a plaintiff’s recovery of medical damages is limited to the amount paid by the plaintiff’s health insurer and accepted by the health care provider as full payment. The Supreme Court’s ruling was discussed by Larry Golub in Collateral Source Rule Inapplicable When Injured Person’s Medical Expenses are Discounted by Health Insurer.
Source: insurancelitigationregulatorylaw.com

– Will Tricare cover longer hospitalizations than Medicare does?

Assuming all those boxes are checked, TFL will cover skilled nursing facility care for an unlimited number of days that a beneficiary requires skilled services that meet the criteria for continuing coverage — that is, skilled services that are directed by a doctor and can only be provided by professionals. Under this benefit, TFL will cover medically necessary skilled nursing care and rehabilitative (physical, occupational and speech) therapies, room and board, prescribed drugs, laboratory work, supplies, appliances, and medical equipment.
Source: militarytimes.com

Comparing Medicare Advantage Plans Missouri

There are several reasons why people choose to enroll in Medicare Advantage plans instead of the Original Medicare plan and a Medicare Supplemental plan.  In order to enroll in a Medicare Advantage plan, you should willingly drop out from your Medicare and sign up for a plan in a private insurance company that offer this plan.  The two big reasons why most people choose to sign up for Medicare Advantage plans are because it has low premiums and there are no health questions asked.
Source: ehealthmo.com

Funding Details: Idaho Medicare Rural Hospital Flexibility Program (FLEX)

The Idaho Flex Grants are designed to support projects that improve healthcare quality, performance, or patient safety in Critical Access Hospitals, or Emergency Medical Systems in CAH areas of Idaho. Grants are designed to allow rural communities to preserve access to primary care and emergency healthcare services.
Source: raconline.org

Physicians Can Now Apply for Higher Medicaid Rates

The higher payments will benefit physicians who participate in both Medicaid fee-for-service and Medicaid HMO plans, said Helen Kent Davis, Texas Medical Association director of government affairs. Further, the rate increase will significantly help those physicians hurt by the cut in payment for the Medicare Part B coinsurance enacted in 2012. For those patients, Texas will not pay the 20-percent coinsurance if what Medicare pays is more than the Medicaid allowable for the same services. However, once the rate increase takes effect, eligible physicians will be paid the full coinsurance because the Medicare and Medicaid allowable for the service will be the same.
Source: dmagazine.com

– Can wife, over 65 but ineligible for Medicare, be put on Tricare Prime?

What you need to do is contact your local Social Security Administration office and make them aware that your wife is not eligible for Medicare Part A under either her own work history or yours. As such, she should be eligible to receive a “Notice of Disapproved Claim” from the SSA. Once you have that in hand, take it to your nearest military installation ID Card/DEERS office. DEERS is the Defense Enrollment Eligibility Reporting System, the Defense Department’s eligibility portal for Tricare. The SSA’s “Notice of Disapproved Claim” should be sufficient to allow your wife to retain eligibility for Tricare Prime, Standard and Extra even though she is already past her 65th birthday, once you update your wife’s DEERs registration file and get a new ID card for her.
Source: militarytimes.com

Say Anything Medicaid Expansion May Cost North Dakota $0.25 For Every Dollar In Federal Money Accepted

Of course, ObamaCare is a taxpayer expense even if it doesn’t come through state taxes. But by forcing ObamaCare to do what it promised to do, Walker is refusing to bailout the federal government on what increasingly looks like a promise they may not be able to keep. In their rush to pass health care reform, Democrats and liberals did not fully consider the cost or consequences of the reform. Forcing ObamaCare to pay for what it says it will pay for places tremendous financial pressure on the federal government.
Source: sayanythingblog.com

The Basics of Medicare Coverage

Posted by:  :  Category: Medicare

Deal 3, Table 7: Initiation enter Trick A~ contract taker leads King of Risks by KevinHutchins314Supplements 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

Video: Medicare Coverage

Medicare’s Reset On ‘Coverage With Evidence Development’

a. Centers for Medicare and Medicaid Services (CMS) issued formal guidances on CED in 2005 and 2006. Several cases that we call CED predate these formal guidances. b. CMS, “Positron Emission Tomography (FDG) and Other Neuroimaging Devices for Suspected Dementia” (accessed on Feb. 28, 2013). c. Cancer types include brain, cervical, ovarian, pancreatic, small cell lung, and testicular. d. CMS, “Positron Emission Tomography (FDG) for Brain, Cervical, Ovarian, Pancreatic, Small Cell Lung, and Testicular Cancers” (accessed on Feb. 28, 2013). e. American College of Cardiology National Cardiovascular Data Registry (ACC NCDR) (accessed on Feb. 28, 2013), approved in 2005, is ongoing with collection of longitudinal data. f. CMS, “Chemotherapy for colorectal cancer” (accessed on Feb. 28, 2013). Nine NCI trials are investigating one or more off-label use of oxaliplatin, irinotecan, cetuximab, or bevacizumab. 2 trials remain closed; 6 trials are permanently closed to new accruals and 1 trial has been temporarily suspended. g. CMS, “Home use of oxygen“ (accessed on Feb. 28, 2013). Long Term Oxygen Trial (LOTT) began in late 2007. h. CMS, “Artificial Hearts” (accessed on Feb. 28, 2013), 3 Trials are ongoing. i. CMS, “Positron Emission Tomography (FDG) for Solid Tumors”  (accessed on Feb, 28, 2013), National Oncologic PET Registry (NOPR) is ongoing. j. CMS, “Pharmacogenomic Testing for Warfarin” (accessed on Feb. 28, 2013), 2 Trials are ongoing. k. CMS, “Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer” (accessed on Feb. 28, 2013), National Oncologic PET Registry (NOPR) is ongoing for performing FDG and NaF-18 PET. l. CMS, “Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for Myelodysplastic Syndrome” (accessed on Feb. 28, 2013), 1 Trial is ongoing. m. CMS, “Magnetic Resonance Imaging (MRI)” (accessed on Feb. 28, 2013); CMS site mentioned ClinicalTrials.gov identifier of NCT 090736, but it was not found on ClinicalTrial.gov website. n. CMS, “Transcatheter Aortic Valve Replacement (TAVR)” (accessed on Feb. 28, 2013), 6 Trials and 1 Registry are ongoing.
Source: healthaffairs.org

Medicare to Cover Addadictomy, Chopadickoffamy

RUSH:  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

Rosetta Releases miRview Kidney Test Validation Study, Anticipates Medicare Coverage Decision

Ohio State University’s Carlo Croce and Stefano Volinia, from the University of Ferrara, look at the RNA and methylation profiles coinciding with survival patterns in individuals with a form of breast cancer called invasive ductal carcinoma. The duo brought together microRNA, messenger RNA, and DNA methylation data on hundreds of invasive ductal carcinoma patients assessed through the Cancer Genome Atlas — a search that uncovered 30 mRNAs and seven miRNAs showing promise as a prognostic signature, particularly for individuals with early stage tumors. The investigators subsequently verified the signature’s ties to survival using data on almost 2,400 individuals with breast cancer from eight patient cohorts.
Source: genomeweb.com

WASHINGTON: Budget: cover uninsured, trim Medicare, tax cigs

Upper-middle class and well-to-do seniors would pay higher monthly premiums for outpatient and prescription drug coverage, a significant expansion of a policy already in effect. The current premiums would be boosted, and the share of beneficiaries exposed to the higher rates would keep growing until it reaches one-fourth of all those in the program. Now, only about 6 percent of Medicare recipients pay higher “income related” premiums.
Source: bradenton.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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

Redrawn coverage maps take telemedicine away from Medicare beneficiaries

Take St. Mary’s County in Maryland, one of those slated to lose telemedicine eligibility, as an example. St. Mary’s County is relatively close to the Washington, D.C. area and has seen its population grow steadily over the past decade. However, the county itself remains very rural with fewer healthcare options for residents than other areas located closer to Washington, D.C. Patients in St. Mary’s County may need to go to Washington, D.C. to get specialist care, which could require hours of travel.
Source: feduc.us

Marci’s Medicare Answers

Original Medicare, the traditional fee-for-service Medicare program offered directly through the federal government, only covers eyeglasses after you have had cataract surgery. Original Medicare generally does not cover routine eye care, such as examinations for prescribing or fitting eyeglasses. However, Original Medicare will cover a standard pair of untinted prescription glasses or contacts, if you need them after cataract surgery. If considered medically necessary, Medicare may cover customized eyeglasses or contact lenses following the procedure.
Source: homeboundresources.com

IG: Lack Of Clarity On ‘Conflicts Of Interest’ May Impact Medicare Coverage Decisions

This is part of Kaiser Health News’ Daily Report – a summary of health policy coverage from more than 300 news organizations. The full summary of the day’s news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.
Source: kaiserhealthnews.org

Should Medicare cover PET scans for the diagnosis of dementia?

The thing is, we can right now help people along the above fronts, but we generally don’t. Our healthcare system is poorly set up to do these things, and we are lacking tools to facilitate. For instance, I don’t yet know of any apps that allow the lay public to easily spot medications that make cognition worse. We could use better resources and technologies to help families learn about delirium and other strategies for cognitive optimization. Re caregiver support and possible dementia, most of what I come across is framed for caregivers of people with a definite diagnosis. We need more for those facing the possible diagnosis. Furthermore, although several effective programs have been developed to support dementia caregivers — the suggestions I make above are pretty typical for supporting dementia caregivers — they are often hard to find on a local level. (I recently tried to find a place to refer caregivers to get the REACH program of education and support; no luck yet.)
Source: kevinmd.com

MEDICARE CHIROPRACTIC COVERAGE

acute low back pain adjustment Ankle Pain arthritis Asheville asheville chiropractor Auto injuries auto injuries and chiropractic back pain Back Pain Relief bad posture Biltmore Park Chiropractic Chiropractor disc bulge disc problems Dr. Michael Masterman Foot Pain headache headaches herniated disc joint pain low back pain Magnetic therapy Massage Therapy MG-33 middle back pain migraine migraine headache muscle pain neck pain nerve irritation Orthotics PEMF poor posture postural strain posture Pulsed Electro-Magnetic Force Running Running Injuries ruptured disc slip disc stress headache tension headache whiplash
Source: biltmoreparkchiropractic.com

Medicare Chief Queried on Medicare Part D Preferred Pharmacy Plans

Posted by:  :  Category: Medicare

Asian & Pacific Islander American Health Forum by congressman_hondaIn recent months, significant questions have been mounting regarding preferred pharmacy plans in the Medicare Part D drug benefit. They have been expressed by patients, community pharmacists (including NCPA), 30+ Members of Congress and a key congressional advisory panel known as the Medicare Payment Advisory Commission. Most recently, they played out at a U.S. Senate Finance Committee hearing April 9 concerning the nomination of Marilyn Tavenner to be the Administrator for the U.S. Centers for Medicare & Medicaid Services (CMS), the agency that runs Medicare.
Source: wordpress.com

Video: Medicare Part D

Help Me with Medicare Advantage and Drug Question

hi all. my name is mike and i will retire in july. i am 66 years old and about to go on medicare for the first time. I recently met with two different agents to talk about medicare. one with bankers life and one with united health. and they are telling me two different things, and I dont know who is telling me the truth. Bankers life is telling Medicare advantage is bad. and I cannot have a separate Pt D plan with it (i can only do it, if the drug plan is built into it). and I should go with them and pay a premium i cannot afford for a medicare supplement. The united health guy is telling me I can have a pt d plan if the advantage plan does not have a drug plan built into it. This would be good for me, because the advantage plan has no monthly premium. He says I should do it like this because the PPO that he offers that does have the drug plan built in, wouldn’t cover some of my drugs, and it would be really expensive, but he was able to find a separate pt d plan that would keep my drug costs down. they are telling me two contradicting things, one is obviously lying. who is telling me the truth?
Source: insurance-forums.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

Do you know your Medicare ABC’s…..and D’s?

Private insurance companies sell policies called Medicare Supplements or termed “Medi-Gap” plans by Medicare and they are designed to fill in the gaps for things that are not covered under Medicare Parts A and B.  The advantage is of these plans is that your out-of-pocket expense does decrease and sometimes covers all of the out-of-pocket expenses.  All Medicare Supplement plans have been standardized by the Government, so no matter what insurance company you go with, the supplements will cover you the same.  There are 10 standardized plans. The disadvantage of a Medicare Supplement plan is that the cost of the insurance goes up every year on your birthday.  After your first year of beign covered under a Medicare Supplement plan the insurance carrier may also raise your rate if they have had bad claims experience on a particular block of business that was not priced right for the risk.
Source: abwahumble.org

Opinion: Medicare Part D helps seniors, keeps costs down

Part D empowers consumers to make choices in the marketplace, stimulating cost-containing competition. The program does that by working exclusively through private plans, whether they be standalone prescription drug plans or comprehensive health plans that offer prescription drugs and are covered under the Part C Medicare Advantage program. Different plans offer different options for coverage, co-payments and premiums, enabling beneficiaries to pick what will work best for them.
Source: healthpolicysolutions.org

Obama’s Budget Cuts $400 billion from Medicare

Many economists suggest merging the deductibles into a single payment of about $500. The merge would cause most patients to pay much more out of pocket, which would ideally create an incentive for patients to avoid unnecessary treatments. However, controversy surrounds whether the added cost will result in more patients avoiding necessary treatments and eventually ending up in emergency rooms.
Source: dmagazine.com

A Health Insurance Disaster: Falling Down the Medicare Donut Hole

Furiously logging into my insurance account did not, in fact, reveal a way for me to submit a claim for reimbursement. It revealed the fine print that I’d conveniently ignored. All of my prescriptions for the rest of December cost me hundreds more than I normally paid, because I’d reached the coverage gap in my insurance. Had I paid attention to the details, I’d have planned for this expense. Instead, I was sideswiped by massive added expenses at the worst possible time of the year. Ultimately, this mistake cost me $1,362.
Source: thesimpledollar.com

Competition and free market principles are saving Medicare

The Congressional Budget Office keeps finding cost savings in Medicare Part D – Medicare’s Prescription Drug Benefit Plan. That’s good news for the about 900,000 Illinois seniors who have Part D plans. Unlike other parts of Medicare, Part D is run entirely by private insurance companies who compete to sign up seniors and then bargain hard with drug companies for the best price on lifesaving drugs. Seniors get to choose what works best for them, and the competition keeps costs in check.
Source: typepad.com

Pharmacists Urge Medicare Part D Plans To Follow CMS’ Lead

An independent pharmacists industry group on Wednesday praised the Centers for Medicare and Medicaid Services’ recently released 2014 rate plan and final “call letter” for the Medicare Prescription Drug program, urging plans administering the program to follow the agency’s recommendations. Read More…
Source: lexisnexis.com

Daily Kos: Remembering the Medicare Catastrophic Coverage debacle: What happens when you piss off seniors

Posted by:  :  Category: Medicare

Joe the Plumber - To Flush The System ... More scams aim to ensnare Brevard seniors - Their ingenuity is boundless, Archer said. (Jul 2, 2012) ... by marsmet524Thus far, the traditional media has reported on opposition to President Obama’s inclusion of Social Security cuts in his budget as “liberal backlash.” Even Rachel Maddow, in introducing this segment that included an interview with David Alexrod, frames it so: “President Obama releasing today what he describes as his compromise budget, compromising with Republicans on cuts to Social Security especially, and in the process enraging some of his own liberal base. Is this a president who thinks he has much to lose by angering the otherwise loyal left, or is this a president who sees having a big visible fight with the left as a way to see himself look centrist, and therefore stronger?” A pissed off liberal base is the least of Obama’s worries, he doesn’t have to worry about running for election again. In fact, a pissed off anybody isn’t his worry. Sure, it could severely weaken him politically and turn him into a lame duck well before necessary, but at least he doesn’t have another race to worry about. However, it’s a bit more of a worry for Democrats who might be willing to support him on this, on two fronts. The first problem is the liberal base the traditional media loves to see get punched, which could most definitely get behind primary challenges to those supporting Social Security cuts. The flip side is a liberal base discouraged and frustrated and unenthused about turning out for a midterm election. See 2010.
Source: dailykos.com

Video:

Sebelius: Insurance Exchanges ‘On Track;’ Premiums Could Rise For Higher

The Associated Press: Upper-Income Seniors’ Medicare Hike President Barack Obama’s plan to raise Medicare premiums for upper-income seniors would create five new income brackets to squeeze more revenue for the government from the top tiers of retirees, the administration revealed Friday. First details of the plan emerged after Health and Human Services Secretary Kathleen Sebelius testified to Congress on the president’s budget …. Currently, single beneficiaries making more than $85,000 a year and couples earning more than $170,000 pay higher premiums. Obama’s plan would raise the premiums themselves and also freeze adjustments for inflation until 1 in 4 Medicare recipients were paying the higher charges. Right now, the higher monthly charges hit only about 1 in 20 Medicare recipients (Alonso-Zaldivar, 4/12).
Source: kaiserhealthnews.org

Home Health Care Agency Our Aging Population Will Benefit From These Non Medicare Agencies

A strategy for successfully aging at home is to consider long term care insurance with a home care rider. It is important that when considering a long term care policy that you also include cost of living rider as well. Many want to stay in the home as they age and lack of planning and forethought may make this impossible. Others purchase a long term care policy, but do not include home care or cost of living riders. As we are living longer and healthier lives, we never know when we will need to use the benefits. Take time to investigate long term care insurance with a reputable provider.
Source: websitetestlink.com

Marci’s Medicare Answers

Original Medicare, the traditional fee-for-service Medicare program offered directly through the federal government, only covers eyeglasses after you have had cataract surgery. Original Medicare generally does not cover routine eye care, such as examinations for prescribing or fitting eyeglasses. However, Original Medicare will cover a standard pair of untinted prescription glasses or contacts, if you need them after cataract surgery. If considered medically necessary, Medicare may cover customized eyeglasses or contact lenses following the procedure.
Source: homeboundresources.com

Proposed Rule Imposes Spending Ratio on Insurers in Medicare Contracts

Health insurers who fail to establish a MLR of .85 may have to pay CMS a “remittance” fee under the proposed rule.  The remittance fee would be based on the difference between 85 percent of the total revenue and the contract’s actual ratio spent on direct benefits, multiplied by the contract’s annual revenue.  If a contract fails to meet the .85 MLR requirement for three years in a row, CMS will stop permitting Medicare beneficiaries to enroll in any plan covered under the contract for a year.  CMS will terminate a contract if it continues to miss the requirement for five consecutive years.
Source: upenn.edu

Health Affairs Blog Post: Population Health Management in Medicare Advantage.

Wellnesss promotion.  A key component of PHM is the ability to promote health and wellness among all individuals, and MAOs reported extensive activities directly for members, including smoking cessation, wellness discounts, and the promotion of healthy lifestyles (exercise and nutrition).  In addition to promoting wellness, PHM requires monitoring of population risk and designing and implementing programs that manage sub-populations based on their risk.  Health risk assessments used universally by MAOs serve to segment populations at risk for disease.  For patients identified as being at risk for chronic conditions, common interventions include targeted health education or outreach to engage members in activities intended to reduce risk factors, enrollment in care management programs, and working with nurses in health education.
Source: ahipcoverage.com

Largely Dismissed Heart Failure Drug May Help Solve Costly Problem for Medicare and Hospitals

Posted by:  :  Category: Medicare

Along with the Ahmed and Bourge, UAB authors of the paper included Kanan Patel, MBBS, MPH, Inmaculada Aban, Ph.D., Connie White-Williams, RN, Ph.D., and Richard Allman, M.D., director of the UAB Center for Aging, who is also faculty at the Veterans Affairs Medical Center in Birmingham. Authors making important contributions from other institutions were Jerome Fleg, M.D., of the National Heart, Lung, and Blood Institute (NHLBI), Gregg Fonarow, M.D., of the University of California, Los Angeles, John Cleland, M.D., of Hull York Medical School, Kingston-Upon-Hull in the United Kingdom, John McMurray, M.D, of the University of Glasgow, Dirk van Veldhuisen, M.D., Ph.D., of the University Medical Centre of Groningen in the Netherlands, Mihai Gheorghiade, M.D., of Northwestern University, Michel White, M.D., of the Montreal Heart Institute, Gerasimos Filippatos, M.D., Ph.D., of Attikon University Hospital in Athens, Greece, and Stefan Anker, M.D., Ph.D., of the Center for Clinical and Basic Research, IRCCS, San Raffaele, in Rome. Drs. Fonarow and Gheorghiade disclosed consulting relationships with industry, with details included in the related journal article
Source: newswise.com

Video: Medicare Supplements in Alabama by Medicare Pathways

YOUR VIEW: Expansion of Medicare under ACA Needed in Alabama

Now that the ACA has been ruled on by the Supreme Court, and the President re-elected, our position makes no sense. It amounts to Alabama taxpayers sending millions of dollars to the federal government to be distributed to other states, while declining to get any back. Duh? Governor Bentley says he doesn’t want to have to set up the machinery to administer it. That sounds like something invented by political speech writers. Florida and Ohio Republican governors have recently signed on and he should also. If we don’t, it won’t be just those with less financial means that are hurt, but also Alabama hospitals and nursing homes who need this money.
Source: al.com

Holding Hands Home Environment Alternatives, Inc. Assisted Living

Holding Hands Home Environment Alternatives, Inc. is an assisted living facility. Assisted living facilities are an apartment-style habitat designed to focus on providing assistance with daily living activities. They provide a higher level of service for the elderly which can include preparing meals, housekeeping, medication assistance, laundry, and also do regular check-in’s on the residents. Basically, they are designed to bridge the gap between independent living and nursing home facilities. When thinking about how to pay for care, assisted living facilities are generally less expensive than nursing homes, if assisted living is a viable option for your loved one.
Source: ourparents.com

Left In Alabama:: Funding Alabama Medicaid in the meantime

African American Political Pundit AmericaBlog An Examination of Free Will Bartcop Blog for Rural America Balloon Juice Blue Gal Booman Tribune Borowitz Report Science Blogs Corrente Crooks and Liars Daily Kos Docudharma Eschaton Firedoglake First Draft FiveThirtyEight Hullabaloo Jack and Jill Juan Cole La Vida Locavore The Left Coaster MyDD My Left Wing NASA Watch Notion’s Capital Oliver Willis Paul Krugman Political Cortex Scoobie Davis Senate Guru Spocko’s Brain Elections@DailyKOS Suburban Guerilla Talk To Action Talking Points Memo The Field Negro The Oil Drum Think Progress US Politics News
Source: leftinalabama.com

UAB may see $34 million impact from sequestration, UA System Chancellor Robert Witt said

“(UAB) is anticipating a 5 to 8 percent cut in federal grant and contract activity,” he said in addressing the board. “That could add up anywhere from $13 to 20 million per year. Add up Medicare payments and the loss of federal contracts and grant activity, the university could be facing a $34 million impact.”
Source: al.com

Nursing Jobs in Alabama: Birmingham, AL

Further informations about this vacancy opportunity kindly see the descriptions. Experienced Geriatric Medicine Physician needed to help develop new program Geriatric Medicine Program: Interdisciplinary team of health professionals that provides individuals with coordinated careCo! mprehensive long term servicesSupports Medicaid and Medicare enrolleesEnables patient to receive care in a center rather than reside in a nursing home The Practice & the Offer: Enjoy the geriatric population in a setting conducive to holistic healingRich benefits packageBC or BE in Geriatric Medicine preferredWonderful opportunity to develop a new program and work with a team Geriatric Medicine Program: Interdisciplinary team of health professionals that provides individuals with coordinated careComprehensive long term servicesSupports Medicaid and Medicare enrolleesEnables patient to receive care in a center rather than reside in a nursing home Birmingham Offers: Population of 1.1 million (MSA)Affordable cost of livingTemperate climate year round; while still experiencing typical four seasonsOutstanding outdoor and sports activitiesExcellent educational systemWorld-class healthcare systemConvenient and central location for travel – . If you were eligible to th! is vacancy, please email us your resume, with salary requireme! nts and a resume to Enterprise Medical Services.
Source: blogspot.com

Massachusetts and Ohio: Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

Posted by:  :  Category: Medicare

Double-Parked by elycefelizThe Centers for Medicare and Medicaid Services (CMS) has finalized memoranda of understanding (MOUs) with Massachusetts and Ohio to test a capitated financial alignment model to integrate care and align financing for people who are dually eligible for Medicare and Medicaid in 2013. CMS also has signed an MOU with Washington to test a managed fee-for-service model. These three year demonstrations will introduce changes in the care delivery systems through which beneficiaries presently receive services and in the financing arrangements among CMS, the state, and providers.
Source: kff.org

Video: Medicare Supplemental Insurance in Ohio by 1 800 MEDIGAP®

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

Medicare Changes for Seniors in Ohio

Governor John Kasich of Ohio announced a medicare medicaid transformation plan with cost saving measures to consolidation of care for  Seniors on Medicare. Kaisch and the State of Ohio had their plan approved the the Centers for Medicare and Medicaid. What the plan  does is coordinate care for Seniors qualify for medicare that are on Medicaid meet low income guidelines.
Source: wordpress.com

$48 Million Medicare Fraud Bust: Identity Theft Rampant in Ohio

“It’s really important that CMS really screens folks coming in the program,” Saccoccio said. “They’re doing a better job of that, but I think it’s going to take a little time before the effects of that are as apparent as they should be. The extent you can get to this stuff earlier rather than later is better.”
Source: medicarewire.com

Ohio Consumers for Health Coverage Statement on Raising of the Medicare Eligibility to Age 67

Would yield only $5.7 billion in actual federal savings in 2014 when the costs of federal ubsidies for 65-66 year olds buying health coverage in the Exchange is considered, along with the federal government’s contribution to Medicaid for persons newly eligible under the Affordable Care Act and the loss of Medicare premium receipts. This is approximately one percent of the total annual cost of Medicare.
Source: progressohio.org

Daily Kos: Remembering the Medicare Catastrophic Coverage debacle: What happens when you piss off seniors

Thus far, the traditional media has reported on opposition to President Obama’s inclusion of Social Security cuts in his budget as “liberal backlash.” Even Rachel Maddow, in introducing this segment that included an interview with David Alexrod, frames it so: “President Obama releasing today what he describes as his compromise budget, compromising with Republicans on cuts to Social Security especially, and in the process enraging some of his own liberal base. Is this a president who thinks he has much to lose by angering the otherwise loyal left, or is this a president who sees having a big visible fight with the left as a way to see himself look centrist, and therefore stronger?” A pissed off liberal base is the least of Obama’s worries, he doesn’t have to worry about running for election again. In fact, a pissed off anybody isn’t his worry. Sure, it could severely weaken him politically and turn him into a lame duck well before necessary, but at least he doesn’t have another race to worry about. However, it’s a bit more of a worry for Democrats who might be willing to support him on this, on two fronts. The first problem is the liberal base the traditional media loves to see get punched, which could most definitely get behind primary challenges to those supporting Social Security cuts. The flip side is a liberal base discouraged and frustrated and unenthused about turning out for a midterm election. See 2010.
Source: dailykos.com

Ohio Health Policy Review: Ohio Medicare

The federal Department of Health and Human Services announced last week that Ohio has been approved to undertake a pilot project to better coordinate care for 114,000 Ohioans who are eligible for both Medicare and Medicaid (Source: "State gets OK to alter Medicare, Medicaid," Columbus Dispatch, Dec. 13, 2012).
Source: healthpolicyreview.org

Budget Battles Brewing Over Medicare, Other Entitlements

The Hill: Pfeiffer: Obama Budget Won’t Push A ‘Romney Economic Plan’  Senior White House adviser Dan Pfeiffer on Sunday defended the president’s budget plan to be unveiled this week, … Pfeiffer on ABC’s “This Week” pushed back against GOP criticisms that the plan withheld necessary entitlement reforms in exchange for even higher taxes, and said House Republicans were seeking to revive the economic plans of failed 2012 presidential contender Mitt Romney. …. Obama defended his forthcoming budget in his weekly address as “Not my ideal plan,” but a “compromise” he was “willing to accept” (Mali, 4/7).
Source: kaiserhealthnews.org

Ohio Democratic Chairman Chris Redfern’s Statement on Romney VP Selection of Paul Ryan, Embrace of Republican Plan to End Medicare As We Know It

“Paul Ryan got his start in politics, as a young staffer just out of college, working for then-Congressman John Kasich’s Budget Committee. Ryan cut his teeth working long, tireless hours for Kasich, helping him slash programs for working families, grinding progress to a halt, and laying the groundwork to shut down the federal government.
Source: ohiodems.org

Medicare hike could also hit some in middle class

The latest proposal ramps up the reach of means testing and sets up a political confrontation between AARP and liberal groups on one side and fiscal conservatives on the other. The liberals have long argued that support for Medicare will be undermined if the program starts charging more for the well-to-do. Not only are higher-income people more likely to be politically active, they also tend to be in better health.
Source: newson6.com

Medicare’s Open Enrollment Closes on Pearl Harbor Day

GET STRAIGHT ANSWERS on Ohio Presbyterian Retirement Services’ radio program, Journey Through Aging. Ohio Senior Health Insurance Information Program’s Director Chris Reeg tells you about helpful statewide resources and gives you practical advice on choosing your best Medicare plan. Click here to listen to her interview. Brian D. Elder of S. L. Pierce Agency talks about choosing your best plan. Elder is a Medicare insurance advisor. Click here to listen to his interview. Elder also did an interview on Medicare Part D. Click here to listen.
Source: swancreekohio.org

The Story of Medicare: A Timeline

Posted by:  :  Category: Medicare

ILGWU senior female members and retirees holding placards urging "fair play for the aged", "hands off social security", "don't mess with medicare", "keep your promises Mr. President", and more. by Kheel Center, Cornell UniversityWritten and produced by Foundation staff, The Story of Medicare: A Timeline serves as a visual timeline of Medicare’s history, including the debate that led to its creation in 1965 and subsequent changes, such as the passage and repeal of the Medicare Catastrophic Coverage Act in the 1980s, the Medicare Modernization Act in 2003, and the Affordable Care Act in 2012. The seven-minute video also highlights the program’s impact on the 50 million elderly and disabled Americans it serves today, as well as the fiscal challenges it faces to ensure its long-term sustainability.
Source: kff.org

Video: History of Medicare in Saskatchewan

Opinion: Medicare Part D helps seniors, keeps costs down

Part D empowers consumers to make choices in the marketplace, stimulating cost-containing competition. The program does that by working exclusively through private plans, whether they be standalone prescription drug plans or comprehensive health plans that offer prescription drugs and are covered under the Part C Medicare Advantage program. Different plans offer different options for coverage, co-payments and premiums, enabling beneficiaries to pick what will work best for them.
Source: healthpolicysolutions.org

FactCheck.org : Ryan Revises History on Medicare Reform

The commission was created by Congress as part of the Balanced Budget Act of 1997. The New York Times reported that Clinton appointed just four of the 17 commission members, and all four of them voted against the report. Clinton himself opposed the final draft report. He issued a statement on the day of the vote that criticized the plan for, among other things, potentially increasing premiums for seniors who remain in the traditional government-run Medicare plan. Why? Clinton and other Democrats feared the subsidies would not keep pace with inflation. 
Source: factcheck.org

Obama’s Social Security, Medicare Cuts

Photo: Courtesy USC Roybal Institute on Aging Traducción al español WASHINGTON, D.C.–The Social Security and Medicare cuts President Obama included in his proposed budget would disproportionately harm Latino Americans and are deeply unpopular in our community. Rather than being part of a “Grand Bargain” offered to Republicans in exchange for possible tax increases, these cuts are a great betrayal of a group that proved essential to the president’s victory in the 2012 election. President Obama won an unprecedented 71 percent of the Latino vote nationwide, allowing him to edge out Mitt Romney in the key swing states of Colorado, Florida, Nevada and New Mexico. What many may not know is that like most Obama supporters, Latinos voted for the president in no small part, because they believed they could rely on him to protect Social Security, Medicare and Medicaid. Latinos Depend More on Social Security Latino voters believed President Obama in his 2011 State of the Union speech when he said we must “strengthen Social Security . . . without putting at risk current retirees, the most vulnerable or people with disabilities; without slashing benefits for future generations; and without subjecting Americans’ guaranteed retirement income to the whims of the stock market.” Social Security matters to Latinos, because we depend on it more than any other group. Three in four (77 percent) Latino households ages 65 or older rely on Social Security for a majority of their income, and over half (55 percent) rely on it for 90 percent of their income. That means Latino seniors are 18 percent more likely than the overall U.S. population to rely on Social Security for a majority of their income and 52 percent more likely to rely on it for 90 percent of their income. A major benefit cut in the president’s proposal would be to switch the formula for calculating annual cost-of-living adjustment (COLA) in Social Security and other programs. This so-called chained-Consumer Price Index (chained-CPI), would allow inflation to erode program benefits over time—and would hit Latinos especially hard. Because we are more likely to have lower career earnings, our Social Security benefits tend to be more modest to begin with—$12,491 each year for the average Latino senior and only and $10,438 per year for the average Latina senior. After 20 years receiving benefits under the chained-CPI—when they would be in their 80s–the average older Latino would lose an accumulated $7,774 in benefits, and the average Latina elder would lose $6,307. After 30 years, the cuts would grow, resulting in total benefit cuts of $17,049 for average Latino seniors and $13,832 for average Latina seniors. Change Would Increase Poverty Worse still, the chained-CPI punishes Latinos for being blessed with higher-than-average life expectancy, often combined with greater levels of chronic illness. Because the chained-CPI cuts benefits more as beneficiaries age, it would hit long-living Latinos harder than most. It’s no coincidence then that some experts fear that the chained-CPI will increase poverty among Latino seniors. More than one in four Latino seniors already lives in poverty—nearly twice the rate among white seniors. The White House claims it will protect “the most vulnerable” chained-CPI, with a special “birthday bump” increase for those seniors at age 76. But in the past, such carve-outs have proven inadequate. An analysis by Social Security Works showed that protecting all vulnerable groups from the chained-CPI would erase half of the budget savings from the measure. Even if significant numbers of Latinos were shielded from the chained-CPI due to their lower incomes, this birthday bump might have unintended consequences. Carve-outs—special treatment–of any kind are likely to be misconstrued as handouts for ethnic groups. We already have to deal with enough nasty stereotypes portraying us as recipients of “welfare” or “government handouts.” Proposed Medicare ‘Pain’ The Medicare benefit cuts President Obama proposes are also a step in the wrong direction that would cause Latino seniors real pain. Rather than dealing with the high costs of health care, the budget shifts health costs to beneficiaries by increasing deductibles, premiums and co-payments. The president’s plan would also create a new surcharge. The White House claims these cuts will make Medicare beneficiaries better health care consumers, but this is a flawed argument. Doctors–not beneficiaries—make medical decisions, so the idea that seniors can shop around for health care is ludicrous. As a result, Latino seniors who cannot afford the higher out-of-pocket costs are liable to forego needed care—until their conditions become more acute and costly to treat. So-called means testing of Medicare will not only affect the rich—over time, it would increase premiums for Latino seniors making up to $47,000 a year. Seniors already spend three times more of their incomes on their direct health care costs as the rest of the population. Under the president’s budget, the reduction in Latino seniors’ income would be two-fold: They would be hit by the chained-CPI, and their out-of-pocket health care costs would increase on top of that. In addition, the president’s budget provision requiring a $100 co-payment per episode for home health care services could severely impact those who depend on home health aides to treat their diabetes and other chronic diseases. This would disproportionately affect Latino seniors who have higher rates of diabetes than the overall population. For example, in Chicago, where diabetes is the most prevalent in the country, 25.8 percent of Latinos over 65 suffered from diabetes compared with 15 percent of non-Hispanic whites. The White House has defended the proposed Social Security and Medicare reductions as “not ideal” measures needed to achieve a compromise with Republicans in Congress. Not the Problem—But a Solution There is no question that the president faces difficult choices as he navigates unprecedented Republican obstruction. But at times, President Obama appears to have adopted the Republican framing as well: That our budget problems are due to over-generous Social Security and Medicare benefits. In fact, Social Security does not and legally cannot contribute one penny to the annual deficit and cumulative national debt. Medicare’s rising costs are due to skyrocketing private health care costs. In fact, Medicare has proven far more effective at controlling medical inflation than its counterparts in the private insurance market. Latinos voted for a president bold enough to start a new conversation about the challenges of aging, health care and economic security, not someone beholden to the same old Republican talking points. A real “adult” conversation on our aging boomer population would begin by acknowledging that America has a retirement security and health care crisis. Social Security and Medicare are the solutions to those crises, not the problem. The Latino community appreciates President Obama’s leadership on immigration rights and health care reform. Now it is time for him to honor his promise to Latinos and other vulnerable elders to protect and strengthen Social Security and Medicare. Eva Dominguez is the executive director of Latinos for a Secure Retirement, an advocacy group in Washington, D.C.
Source: newamericamedia.org

The history of Medicare and its influence on American health care

Several months ago, it appeared that Congress would tackle the issue of correcting the formula in its healthcare reform legislation, but then senators announced they were going to bring up a standalone bill that would overhaul the formula, replace it with a new one, and erase the accumulated cuts in pay. But that bill failed a procedural vote in the Senate, indicating that an SGR bill that offers no way to pay for itself would not be able to earn support from senators who were on the verge of passing trillion-dollar healthcare legislation in the midst of an economic recession.
Source: kevinmd.com

Daily Kos: Republicans trying to rewrite history on Medicare vote

The Ryan Plan was very vague. Despite all the supposed details in the press, it included only a policy statement on Medicare that said that Medicare was to be “reformed” into a program of “premium support” so that seniors would have a “choice” of insurance plans. Extremely vague and benign sounding.   Had it become law, the Congress and the executive branch would had to flesh out the details, by which time the initial vote would be long forgotten and future officeholders would get the blame. Or, if the future officeholders were to be Rs, then they would point out that it happened under Obama.
Source: dailykos.com

The Basics of Medicare Coverage

Posted by:  :  Category: Medicare

BITCH ... Allen West calls Wasserman Schultz ‘vile’ and ‘not a lady’  (7/20/2011) ...item 2.. FSU News -  Yo Mama's Big Fat Booty Band grooves at Sidebar (Mar. 29, 2013) ...item 3.. Chaos - Doin' It Hard by thebootyband ... by marsmet522Supplements 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

Video: What Is Medicare Part-C and Part-D?

Do you know your Medicare ABC’s…..and D’s?

Private insurance companies sell policies called Medicare Supplements or termed “Medi-Gap” plans by Medicare and they are designed to fill in the gaps for things that are not covered under Medicare Parts A and B.  The advantage is of these plans is that your out-of-pocket expense does decrease and sometimes covers all of the out-of-pocket expenses.  All Medicare Supplement plans have been standardized by the Government, so no matter what insurance company you go with, the supplements will cover you the same.  There are 10 standardized plans. The disadvantage of a Medicare Supplement plan is that the cost of the insurance goes up every year on your birthday.  After your first year of beign covered under a Medicare Supplement plan the insurance carrier may also raise your rate if they have had bad claims experience on a particular block of business that was not priced right for the risk.
Source: abwahumble.org

Medicare Part C, Medicare Advantage Plans, What Does It Cover, Who Is Eligible

Before you enroll in a Medicare Part C plan you will have to enroll in Medicare Parts A and B. Generally, individuals are automatically enrolled in both if they are already receiving Social Security. Otherwise you will need to contact your local Social Security office to enroll. Once you are enrolled in Parts A and B you can select a Medicare Advantage Plan. For most people, this can all be done at the same time, when they turn 65 years of age. There is a seven month window to enroll which starts three months before your birthday month and ends three months after.
Source: bradeninsurance.com

Opinion: Medicare Part D helps seniors, keeps costs down

Part D empowers consumers to make choices in the marketplace, stimulating cost-containing competition. The program does that by working exclusively through private plans, whether they be standalone prescription drug plans or comprehensive health plans that offer prescription drugs and are covered under the Part C Medicare Advantage program. Different plans offer different options for coverage, co-payments and premiums, enabling beneficiaries to pick what will work best for them.
Source: healthpolicysolutions.org

Be in the Know About Medicare Part B

There is a monthly premium for Medicare Part B. In 2013, the standard premium is $104.90. Some high-income individuals pay more than the standard premium. Your Part B premium also can be higher if you do not enroll during your initial enrollment period, or when you first become eligible. There are exceptions to this rule. For example, you can delay your Medicare Part B enrollment without having to pay higher premiums if you are covered under a group health plan based on your own current employment or the current employment of any family member. If this situation applies to you, you have a “special enrollment period” in which to sign up for Medicare Part B, without paying the premium surcharge for late enrollment. This rule allows you to:
Source: prescottenews.com

Sequester Hits Thousands of Cancer Patients on Medicare

An explosive story in today’s Washington Post examines how a cancer clinic in New York will be turning away more than 5,000 Medicare patients due to sequestration cuts. The 2% sequestration cuts to Medicare Part B payments to doctors and clinic began on April 1, and clinics are facing tough choices. At least one clinic has decided that the 2% cuts, a result of the failure of Republicans in Congress to compromise with the White House on ways to avert sequestration, will make it too expensive to administer some expensive chemotherapy treatments. While most prescription drugs are covered under Part D, these specialty drugs must be administered in a clinic environment and are therefore covered under Part B.
Source: healthcareforamericanow.org

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

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

Massachusetts Health Stats: What Hypocritical Bastards: Massachusetts Democrats Urge Obama Not to Cut Part C Medicare Advantage

This also has to be completely tying up the far-left-wing bigots that run the super- secret Massachusetts Elder Affairs lobby in their knickers. The Elder Affairs politicians, lobbyists and business people — who are on Councils on Aging, run custodial-care nursing homes, sell long-term care insurance, etc. — have been putting out propaganda against the Part C Medicare voucher program for years. Through SHINE and material they put out at senior centers, the Elder Affairs lobby subtly points seniors away from Part C Medicare coverage, although unlike Original Fee for Service (FFS) Medicare, Part C has catastrophic coverage, annual limits, ER coverage outside the U.S. and many other benefits not included in the FFS version of Medicare. In addition — in Massachusetts but not necessarily everywhere in the U.S. — the combination of public Parts A/B/C cost less than the combination of A/B/D and private Medigap insurance.
Source: typepad.com

Ideas for Reforming the Medicare Benefit Design: A Historical Reminder of Bipartisan Support

Posted by:  :  Category: Medicare

Congressman Kendrick B. Meek by cliff1066™“Under Medicare Parts B and D, certain beneficiaries pay higher premiums based on their higher levels of income. Beginning in 2017, this proposal would restructure income-related premiums under Medicare Parts B and D by increasing the lowest income-related premium five percentage points, from 35 percent to 40 percent, and also increasing other income brackets until capping the highest tier at 90 percent… “…Introduce Part B Premium Surcharge for New Beneficiaries Purchasing Near First-Dollar Medigap Coverage: This proposal would introduce a Part B premium surcharge for new beneficiaries who purchase Medigap policies with particularly low cost-sharing requirements, effective in 2017.” – U.S. Department of Health & Human Services. “Fiscal Year 2014 Budget in Briefing.” 2013.
Source: house.gov

Video: Guide to Medicare Part A and Part B

Obama’s $3.8T Budget Would Save Medicare $370B

President Barack Obama’s $3.77 trillion budget plan for the 2014 fiscal year, if approved, would raise overall federal spending about 6 percent above the current sequester rates, but it would cut Medicare’s budget by an estimated $370 billion through reduced payments to pharmaceutical companies and requiring wealthier seniors to pay higher premiums for Medicare Parts B and D, according to a report by Politico. Payments to hospitals would drop $30 billion for bad debt and other compensation, according to the report. In addition, the chained consumer price index, a metric to estimate inflation in the budget, would be reduced, meaning Medicare payment rates would grow more slowly. The Medicare age would remain at 65, not rising to 67 as earlier Republican proposals attempted. Pharmaceutical companies would have to pay rebates to low-income seniors, translating to $140 billion in Medicare savings, the largest single change to the program in the president’s budget.
Source: beckershospitalreview.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

Health Advocates Push for Medicare Benefit Change

There could also be a problem with instituting the single combined deductible. Parts A and B have different funding sources. Part A is funded through the Hospital Insurance Trust Fund, which gets much of its funding through a payroll tax and premiums from some beneficiaries. Part B benefits are funded through a different trust fund, which gets some of its funding from premiums paid by people for Part B and Medicare Part D, which covers prescription drugs.
Source: telcoretirees.org

– I know I need Medicare parts A and B; what about Part D?

20/20/20 age appeal catastrophic cap child born out of wedlock claims continued care cost share death DEERS dental dependent disabled divorce doctor doctors FEHBP handbook health care reform hospital ID card marriage maternity care Medicare military treatment facilities other health insurance outside the U.S. parents Part A Part B pharmacy pre-existing condition pregnancy reserves secondary insurance social security spouse supplements surgery Tricare For Life Tricare Prime Tricare Standard Tricare Young Adult Program VA widow
Source: militarytimes.com

MD education key to curbing $30B in Medicare errors

With healthcare costs projected to climb to 20 percent of the U.S. gross domestic product by 2020, controlling spending has become a national imperative. Although physicians influence at least 60 percent of healthcare costs, there is a dramatic disconnect between physicians’ fiscal responsibility and their knowledge of healthcare resource management, according to a viewpoint published March 20 in the Journal of the American Medical Association .
Source: healthimaging.com

Do you know your Medicare ABC’s…..and D’s?

Private insurance companies sell policies called Medicare Supplements or termed “Medi-Gap” plans by Medicare and they are designed to fill in the gaps for things that are not covered under Medicare Parts A and B.  The advantage is of these plans is that your out-of-pocket expense does decrease and sometimes covers all of the out-of-pocket expenses.  All Medicare Supplement plans have been standardized by the Government, so no matter what insurance company you go with, the supplements will cover you the same.  There are 10 standardized plans. The disadvantage of a Medicare Supplement plan is that the cost of the insurance goes up every year on your birthday.  After your first year of beign covered under a Medicare Supplement plan the insurance carrier may also raise your rate if they have had bad claims experience on a particular block of business that was not priced right for the risk.
Source: abwahumble.org

OIG Report: Medicare Part B Overpaying for Infusion Medications

OIG recommended that CMS “seek legislative change” over reimbursement policies or include the devices used with such drugs in the next round of competitive bidding. According to “RegWatch,” CMS “partially” has agreed to ask Congress to change the rules and said it will go forward with the competitive bidding suggestion (Wilson, “RegWatch,”
Source: californiahealthline.org

Medicare paid $5.1B for poor nursing home care

Overall, the review raises questions about whether the system is allowing homes to pay for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes’ abilities to meet basic requirements for care. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The report did not name individual homes and did not estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.
Source: publicradio.org