Prosperity Protection Counselors

Posted by:  :  Category: Medicare

"Every citizen should be a soldier. This was the case with the Greeks and Romans, and must be that of every free state." ` Thomas Jefferson. by eyewashdesign: A. GoldenWithout a doubt Medicare Supplement Plan F is by far and away the most popular plan for people on Medicare Part A and Part B. The reason it’s so very popular is that this plan covers 100 percent of the gaps in Medicare Part A and Part B. For a relatively low monthly premium you can simply show your Medicare card and your Medigap Plan F card to any doctor, specialist, or hospital in the country that accepts Medicare, get treatment, and go home with no bills. Not bad coverage huh? Yes this plan is the most expensive, but for many people who are coming off employer health care and used to deductibles along with getting 80 or 90 percent coverage this plan is usually far cheaper with substantially better coverage.
Source: ppc12.org

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

Perform Getting The Extremely Medicare Supplement Results In

Another aspect of policy coverage for Medigap Plans is the first three pints of blood. This is paid for in all plans, but in intend K it is up to 50 percent, and plan S is up to 75 percent. This is true for the hospital deductible befit. The Skilled The nursing profession Facility daily coinsurance covers a specific amount per day for the 21-100 of an individual benefit period. This is a benefit of plans K through L. For plan K and L, it can be 50 percent and as well as 75 percent correspondingly. The part B per year deductible is accessible for plans C, F and S.
Source: hi-see.org

Insurance: What is the Best Solution when you are still working at 65?

You have paid into Medicare through your payroll deduction. This means that you are entitled to Part A of Medicare at 65, which covers Hospitals, Skilled Nursing Facilities, Blood and Hospice. You must then enroll in Part B, which covers Professional Services. The cost of Part B for the average worker for 2013 is $104.90 and higher for individuals with modified adjusted gross income (MAGI) over $85,000 and couples with MAGI exceeding $170,000. Part A and B comprise the coverage for basic health plans. Once you enroll in Part B, then you must select a plan for Prescription Drugs and either a Medicare Supplemental plan or a Medicare Advantage plan. At age 65, a plan F Medicare supplement plan will cost approximately $125 per month and a prescription plan will run from $15 to $100. So, if you paid $50 for a prescription plan, $125 for the supplement and $104.50 for Part B, your total would be $279.50 per month. But here is the comparison; Plan F will pay all costs not paid by Medicare primary benefits. Most group health plans have Co-payments, Co-sharing (80/20 percent plans) and an out of pocket maximum to reach before they pay 100 percent of claims. Thus your true out of pocket will be a combination of the out of pocket maximum and the group premium. Group plans are the primary Payor or claims, not Medicare, and claims will be paid according to the Group plan model.
Source: desertstarweekly.com

Rural Resources on Medicare Part D Prescription Drug Benefit Introduction

Medicare Part D is the prescription drug benefit added to Medicare in 2006. It was created through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and provides elderly and disabled people on Medicare access to prescription drug coverage from private prescription drug plans.
Source: raconline.org

Treatment Supplement Plans: Get Yourself At The Annually Enrollment

Also there are other strategies that may be necessary that end up being not covered by just Medicare as highly. Needs certain as vision care, dental care and thus hearing care is designed to all become most of the responsibility of the individual if they begin to do not need the proper other insurance. With the skyrocketing selling prices of healthcare having no signs about slowing down the instant soon, it could not take very much long at virtually for the space in Medicare a policy to quickly will become financially ruinous because of an individual product with the remaining bill. This type of can have an absolute devastating effect at the financial constancy of any individual who is unable to operate due to any kind of disability or which living on a fixed income.
Source: journalofinternationalservice.org

What is the Cadillac Medicare Advantage plan

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

Cigna Medicare Plans And Blue Cross Medicare Plans An Overview

Posted by:  :  Category: Medicare

HMO (Health Maintenance Organization) skeleton are the smallest costly option. The outcome of descend cost is reflected as limited access to illness care. Plans have a set monthly fee, casing doctors inside of the plan. If you revisit a doctor outward of the plan, you are then accountable is to bill. Within a since plan, you have since the correct to select a Primary Care Physician (PCP) who will look after your care. The HMO CIGNA medicare skeleton cover periodic and surety caring costs, referrals to a network dilettante or trickery when necessary, treatment for injuries and illness. There is no need of profitable any extra fees in HMO skeleton as it has no fees for doctor visits. The CIGNA Part D outline is called CIGNA Medicare Rx offers coverage for 94% of existing drugs, access to over 58,000 network pharmacies, no deductibles for select plans, no copayments for familiar drug and diseases similar to diabetes and drug pressure. The CIGNA outline D in spin offers 3 variety of skeleton namely, Plan 1, Plan 2 and Plan 3.
Source: yuanshyang.com

Video: COWEL’s Mountain San Diego Active Chiropractic #2

Free Insurance Agent Websites: Cigna Medicare Advantage plans

CIGNA Medicare supplement plans have been an integral part of the insurance industry with having served customers for over 220 years. This kind of insurance plan can be very beneficial for all people including senior citizens who may be suffering from constant medical issues due to their advanced ages. The company enjoys a lot of goodwill among the community and here are some of the benefits that come with buying this plan.
Source: blogspot.com

CIGNA to Pull Out of PFFS Business in 2011.

Medicare Advantage has, over the past few years, been harder and harder to sell and become such a pain – with all of the regulations, Scope of Appointment form scrutiny, commission reductions, replacement prohibitions, etc. This has now been topped off by a president who wants to eliminate the medicare advantage altogether. See the video of President Obama saying so here. We are already starting to see the effects in one of the major carriers, CIGNA, pulling out of the 2011 Medicare Advantage bidding process. The Department of Health and Human Services fired off a letter to CIGNA and others, telling them that they must avoid raising rates on their members if they want to stay in the Medicare Advantage market. This, while they’re simultaneously cutting the subsidies to the carriers for providing the same service. CIGNA responded by declining to participate in national Medicare Advantage going forward. This is a trend that will continue. To the extent that they can get away with it – to remain profitable, the insurers will have to increase monthly premiums to their Medicare Advantage clients. They will also have to increase co-payments and other internal costs passed on to the members. HHS has made it clear, however, that they will not be approving such changes. So, backed into a corner, more will be making their exit from the marketplace. This will be a horrible blow to the seniors, as I predicted in this video that got rave reviews from all except for AARP – who wrote me a Cease & Desist letter for mentioning what they were up to. They got their bill, and now the results that I predicted are coming true. YouTube – Medicare News You Need to Know This will be a huge opportunity for those agents wanting to help potential clients with medicare supplement choices, as the Medicare Advantage market will begin to dwindle starting in November with thousands of members getting letters explaining that they have 1) Guaranteed issue into any medicare supplement provider for 1/1/11 and 2) They MUST pick a new plan/provider by 1/1/11 or the government will pick one for them. This happened last year when Coventry left the Medicare Advantage market and it was a huge boost to our enrollment in medicare supplements. That was just the first break, and the tidal wave is coming. Will it be hard for low income seniors? Absolutely. Somebody will have to write applications for seniors going onto medicare supplements, though, and it might as well be you. —- Agents wanting to take advantage of the new opportunities should visit: www.sellmedicarebyphone.com
Source: insurance-forums.net

Eligible Georgia Retirees Switching to Medicare Advantage Plans

What Does the Change Really Mean for My Doctors? It was detailed in July 15th letter that your doctor (provider) would need to accept the changes in the plan to accept the MA terms. From all the research and discussions that I have had with both doctors and insurance vendors, it does not seem like there will be many changes they believe (view the letter with all enclosures by clicking here). There are no networks. You may see any provider that accepts Medicare and is willing to accept CIGNA/UHC’s terms and conditions. The really important point to make is to have your provider agree to accept the new plan changes (information on the plan was given in the July 15 letter). Along those lines, I have received a few emails talking about the problems with finding Medicare Advantage doctors. Numerous articles have said that the vast majority of doctors will not refuse Medicare or Medicare Advantage from current patients – they wish to continue the relationship. Some doctors may or may not accept new patients, but a study by the Center for Studying Health System Change found that nearly 75% of doctors accepted all or most new Medicare patients in 2008 (Study: Most Physicians Still Accepting Medicare Patients, Fierce Health Finance). How Much Will This Cost Me? First, remember that the State of Georgia is subsidizing your coverage by nearly 75% of the total costs. This is one of the benefits that was “given” to you, so if you were to opt out of the MA plan, it will cost you hundreds of dollars per month for the same coverage. In other words, unless you feel like you have no other option and money to burn, opting out is not an option… (who has money to burn??) The good news about the changes is that it will actually save you money every single month for your coverage. Currently, a PPO covered participant pays $32.90 for single coverage ($142.40 for family). The standard option MAPD PFFS plan will cost $19.30 for single coverage and $38.60 for family coverage (all dependents eligible for MA plan). A mix of eligible and non-eligible Medicare participants in family coverage will have higher costs, but that is to be expected. The premium coverage option for the MAPD PFFS plan will cost $59.30 for a single and $118.60 for a family (all dependents eligible for MA plan). The benefits here are a lower out-of-pocket maximum, lower hospital costs, reduced co-pays, and a better prescription drug benefit. The choice is yours, but weigh the costs by looking at your 2008 and 2009 medical expenditures. The standard plan could cost you more based on your needs… (Check the July 15 letter above to compare the coverages on the Plan Summary enclosure) If you want to check out the retiree rates as set by the SHBP, please click this link to open the PDF. What If I Don’t Choose? According to the information sent with the July 15 letter, “If you are not enrolled in a MAPD PFFS option and do not make an election during the ROCP, your coverage will roll to the MAPD PFFS option of the healthcare vendor you are currently covered. Kaiser members who do not make an election will default to the CIGNA Medicare Access Plus Rx (PFFS) – Standard Plan.” Conclusion Any change is tough to accept in anything… especially medical coverage. The unknown is more of a worry than the known even when it may be better. In five years, few people may even remember this change unless there are real problems. If that starts to happen though, you can almost be assured that the SHBP and its vendors will try to make things right. The State Health Benefit Plan covered 693,716 people as of September 1, 2009, and that is far too big a number to think that they will just accept mediocre results. Try to work with your doctors and try to work with the insurance vendors. The vendors are there to help, so let them help. Both CIGNA and UHC told me that if a doctor is not accepting the plan after you discuss it with them, get the vendor involved. They may be able to help explain it from an ease of use and payment perspective. Just a hint the vendors gave me.
Source: theeducatorsretirement.com

insurance: MEDICARE ADVANTAGE/MEDICARE HEALTH PLANS

Medicare Advantage/Medicare Health Plans SHIIP Publications: Frequently Asked Questions About Medicare Advantage PFFS Plans Is A Medicare Advantage Private-fee-for-service Plan Right For Me Medicare Advantage Comparison Guide (2008) Your Guide To Medicare Private-fee-for-service Plans Medicare Advantage Summaries of Benefits SHIIP Publications: Aarp Medicarecomplete Choice Aarp Medicarecomplete Plus Plan 1 Aarp Medicarecomplete Plus Plan 2 Advantra Freedom – Plan 1, Plan 2 (005), Plan 5 (001) Advantra Freedom – Plan 2 (010),plan 3 (006-013), Plan 5 (002) Advantra Savings (msa) – Plan 1 Aetna Medicare Open Plans America’s 1st Choice – Patriot Plus And Presidential Plus America’s 1st Choice – Patriot-presidential Blue Medicare HMO Plans Blue Medicare PPO Plans Cigna Medicare Access Plans One, Two And Three – Version A Cigna Medicare Access Plans One, Two And Three – Version B Cigna Medicare Access Plans One, Two And Three – Version C Cigna Medicare Access Plans One, Two And Three – Version D Evercare – Dh – Special Needs Plan Evercare – Ih – Special Needs Plan Evercare – Mh – Special Needs Plan Fidelis – Secure Comfort – Special Needs Plan Fidelis – Secure Comfort Plus – Special Needs Plan Fidelis – Secure Independence – Special Needs Plan Health Net Pearl – Plans 009-014-015 Healthmarkets Care Assured Plans Humana – Special Needs Plan Humana Goldchoice – H1804 -216 Sb08 Humana Goldchoice – H1804-007 Sb08 Humana Goldchoice – H1804-016 Sb08 Humana Goldchoice – H1804-217 Sb08 Humana Goldchoice – H1804-278 Sb08 Humana Goldchoice – H1804-279 Sb08 Humanachoiceppo – H3405-001 Sb08 Humanachoiceppo – H3405-002 Sb08 Humanachoiceppo – Regional – R5826-003 Sb08 Securehorizons Medicaredirect Plan 3 Securehorizons Medicaredirect Plan 3a Securehorizons Medicaredirect Rx Plan 51 Securehorizons Medicaredirect Rx Plan 51a Securehorizons Medicaredirect Rx Plan 54 Securitychoice Classic-enhanced-plus-enhance Plus – Area A – Securitychoice Classic-enhanced-plus-enhanced Plus – Area B Securitychoice Essential-essential Plus Southeast Community Care – Dual Plus Plan – Special Need Plan Southeast Community Care – Plus Plan Sterling Option I Sterling Option Ii Sterling Option Iii Sterling Option Iv Today’s Options – Basic Plus, Value Plus, Premier Plus Today’s Options – Basic, Value, Premier Today’s Options Powered By Ccrx Unicare 2008 Msa Summary Benefits WelLCare Benefit Summary A WelLCare Benefit Summary B WelLCare Benefit Summary C WelLCare Benefit Summary D WelLCare Benefit Summary E
Source: blogspot.com

Cigna’s Management Presents at Barclays Global Healthcare Conference (Transcript)

Well, there’s a lot of resource and effort put into it. At the end of the day though, what you’re fundamentally talking about is changing the business operations of the primary care physician’s office to focus on a totally different set of metrics and incentives than they have in fee-for-service, and it’s extremely helpful. Here in Miami, the Leons only do business — the only patients they see are Medicare Advantage patients. So it’s not easy, but it’s at least a lot more practical to change those business operating models to focus on the right kinds of incentives. In most network models, you have a range of offices. You might have thousands of primary care doctors in some of these networks, some of whom only have 5% or 10% of their business in Medicare Advantage. And it’s a lot more challenging to get the kinds of changes it takes. The other thing for us that’s been a challenge — we’ve actually made pretty good progress on the Part C side. A couple of years ago, CMS changed the measures and more heavily weighted a lot of Part B measures on the pharmacy side. And we’ve been slower than I’d like to react to that. I hope we’re focused and have the right tools in place to improve our scores on Part D, but that’s really been more of what’s kept us below 4 stars in a lot of our markets.
Source: seekingalpha.com

Illinois, Massachusetts, Ohio, and Washington: Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

Posted by:  :  Category: Medicare

Romney Ryan Plan for Medicare and SSI by DonkeyHoteyThis policy brief compares demonstration programs in Illinois, Massachusetts, Ohio and Washington state that will introduce changes in the care delivery systems through which people who are dually eligible for Medicare and Medicaid receive services, as well as changing the payment approach and financing arrangements among the Centers for Medicare and Medicaid Services, the states and providers.
Source: kff.org

Video: DC Report – Social Security, Medicare Cuts in Obama Budget Plan

New Hope for Those Denied Medicare Benefits?

There is a re-review process for certain Medicare beneficiaries who were denied benefits for rehabilitative services. The denial must have become final and appealable after January 18, 2011. A further appeal need not have been filed. The re-review process only applies to services that were actually received by the Medicare beneficiary.  In other words, if Medicare denied benefits and no further rehabilitative services were received the Jimmo settlement will not help you.  Medicare can only pay for services received. If skilled care was stopped because Medicare wouldn’t cover, you may be able to get it restarted under this new standard.  First, you’ll need your doctor to explain in writing why skilled care or therapy is necessary.  Keep in mind that all the normal Medicare requirements still apply.  For example, skilled nursing care requires the 3 day hospital stay first.
Source: estateplanandassetprotection.com

Mass. Medicare Reimbursement Rates Draw Scrutiny

When hospital executives talk about Medicare, they often bemoan low reimbursement rates, but Massachusetts hospitals have been enjoying reimbursement rates that are now drawing protests from 21 states. Medicare regulations require that all providers in a state receive reimbursement rates that are at least as high as those given to a state’s rural hospitals. In Massachusetts, only one hospital out of 82 qualifies as rural: Nantucket Cottage Hospital. The hospital serves the island of Nantucket’s approximately 10,000 permanent residents, though that total swells to approximately 50,000 people in summer. This is due to the amount of vacation homes on Nantucket, where the median home price is over $1 million.
Source: nonprofitquarterly.org

After Expanding Coverage, Massachusetts Focuses On Taming Costs

Although no other state has required the health care industry to publish its prices, 11 states have taken preliminary steps to shed light on the real cost of medical care.  Colorado, Kansas, Maine, Maryland, Minnesota, New Hampshire, Oregon, Tennessee, Utah, Virginia and Vermont are in various stages of developing so-called “all payer claims databases” that collect and analyze the widely varying prices health care providers charge private insurers, Medicare, Medicaid, uninsured individuals and other payers. In all other states, these transactions are considered confidential business information and kept under wraps.
Source: kaiserhealthnews.org

Medicaid expansion is a good thing. Ask Mitt Romney!

Bobby Jindal, the governor of Louisiana and one of the five republican governors to refuse Medicaid expansion, said he would rather improve the economic condition of the residents of Louisiana, so that they can purchase private insurance, than expand Medicaid. With Republican majorities in the state senate and house, I am wondering who is stopping Mr. Jindal from doing that. By the way Louisiana takes more federal dollars than it contributes to the federal government. I know he admonished the Republican Party not to be a stupid party, after the recent shellocking in the elections, but am not sure of his wisdom regarding how he is going to suddenly turn the economy around and provide healthcare coverage to citizens of Louisiana without some federal help.
Source: bitterpilldoc.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

Medicare payment boost in Massachusetts prompts angry letter to Obama

James Merlino, M.D., is the chief experience officer of the Cleveland (Ohio) Clinic health system, where he leads initiatives to improve the patient experience, as well as physician-patient communication, referring physician relations and employee engagement. He is also a practicing staff colorectal surgeon at its Digestive Disease Institute and co-chair of the Cleveland Clinic Diversity Council. He is also the founder and current president of the nonprofit Association for Patient Experience.
Source: fiercehealthcare.com

Arkansas Moving Forward With Plan to Accept Medicaid Expansion

Speaking of Obamacare, it looks like the Arkansas plan to accept its expansion of Medicaid coverage is on track. This is good news coming from a conservative state. I’m agnostic about whether their proposal to privatize delivery is a smart idea—probably not, since it will increase costs, though you never know—but it’s nice to see that it’s going forward one way or the other.
Source: motherjones.com

Massachusetts’ Goo Goo McDonough Wants to Spend Make

For those of you who don’t like parables (or who don’t manage money well), the mechanic is the far-left-wing Congressional Budget Office (CBO), the $1000 is the CBO’s 2010 estimate of future Medicare expenditures — net of senior premiums, the $800 is the CBO’s 2013 estimate of future Medicare expenditures — net of senior premiums, and the $200 is what the CBO calls a technical correction to its 2010 estimate. A technical correction is a correction not related to any change in the law or the economy.
Source: typepad.com

21 States Demand Extinction of Massachusetts’ Rural Hospital Medicare Loophole

A tiny 19-bed island hospital in Nantucket, Mass., has caused ire among 21 other states for allowing all other Massachusetts hospitals to benefit from extra Medicare money at other states’ expense, and those states want legislation to rectify the matter, according to a report by the Boston Globe. Medicare adjusts payments to hospitals and other providers based on where they are located geographically. In essence, rural hospitals set the floor for Medicare payments within a state, as urban hospitals must be paid at least as much as rural hospitals for wages paid to physicians and staff. A July report from the Institute of Medicine found this system lacked “accuracy” and needed several changes. Nantucket Cottage Hospital, owned by Boston-based Partners HealthCare, is located on an island where property values exceed $1 million. It pays above-average wages in an area with high living costs, but because it is the only rural hospital in Massachusetts, it sets minimum wages for the 81 other hospitals across the state due to Medicare’s geographic payment adjustments. For Massachusetts, that has led to an extra $256.6 million and $367 million annually in Medicare funding over the past two years — at the expense of other states, according to the report. Nine states, including Massachusetts and California, are paid the extra Medicare money out of a national pool by decreasing payments to other states as part of an amendment enacted in 2011 to the national health law. According to the report, Texas, New York, Michigan, Florida and Illinois are hurt the most by the rural funding structure at the cost of tens of millions each year. The American Hospital Association and CMS have pointed out flaws in the payment structure, and 21 states are urging Congress to change the payment model in February during discussions on the federal debt ceiling, according to the report.
Source: beckershospitalreview.com

National RN Upadate: DC Actions, Stop Social Security Cuts, Charity Care, Massachusetts

The largest U.S. organization of registered nurses, National Nurses United (NNU), issued its strongest warning today: Cuts in Social Security and Medicare would do harm to America’s elderly and disabled, vulnerable populations whose resources already place them in the margins. NNU called upon lawmakers to withdraw from all considerations of these cuts. Although Social Security contributes nothing to the federal deficit, Congress could increase revenue for the Social Security trust fund by raising the payroll tax income limit.
Source: nationalnursesunited.org

Massachusetts Medicare and Medicaid

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Source: massestatelawyer.com

Senators Urge CMS To Reform Medicare Fraud Prevention Program

Posted by:  :  Category: Medicare

Last week, a bipartisan group of senators urged the Obama administration to reform a program designed to identify and deter Medicare fraud following an HHS Office of Inspector General report that found the program to be ineffective, The Hill’s “Floor Action Blog” reports (Cox, “Floor Action Blog,” The Hill, 1/11).
Source: ihealthbeat.org

Video: Senior Medicare Fraud 30 720p

Health care reform leads to telephone scam

My elderly Mom lives in Washington state and this sounds like exactly what happened to her this week. Two people talked to her, she was told this same story about a Medicare card and asked to read all the numbers on the bottom of her check. She was asked to repeat them again to another individual who said the information was being recorded. When she began questioning them she was hung up on. Unfortunately she did not get their phone number but at least had the presence of mind to believe it to be a scam but she had already given out her banking information. I have spent the last 2 days closing her bank account and opening a new one. She feels totally mortified that she would fall for such a scam but of course it sounded like an official call and she was easily preyed upon because she is aging and vulnerable. I hope these crooks can be caught and stopped.
Source: csbj.com

Understanding the purpose of Medicare fraud hotline:

With the world economy trying to do its bit to bring out absolute reforms in health care, Medicare fraud seems to dampen the efforts in a big way. Not only are the Medicare fraudsters slowing down the developmental initiatives by the government but also are making inroads for a serious threat to the benefits for the patients. In order to tackle these conditions it is important to make use of Medicare fraud hotline that will ensure to keep the Medicare provider in check.
Source: fraudfinder.net

Attorney General Koster

“Medicare & You” goes paperless

Posted by:  :  Category: Medicare

Medicare for All by juhansoninand access all the same information found in your printed handbook. You can learn what’s new for the year, how Medicare works with your other insurance, get Medicare costs, and find out what Medicare covers. Even better, the handbook information on the web is updated regularly, so you can instantly find the most up-to-date Medicare information.
Source: medicare.gov

Video: Medicare & You: American Heart Month

Chatham/Avalon Park Community Council: Mather More Than A Cafe Presents Medicare & You April 2, 2013

                                      Mather More Than A Cafe”
Source: blogspot.com

Get the Facts on Medicare and Social Security

Prior to Election Day, AARP volunteers delivered more than 200,000 petitions along with a report entitled “Americans Have Their Say about Medicare and Social Security” to both the Democratic and Republican National Committees.  The petitions now call on President Obama to give Americans straight talk about what he would do to put Medicare and Social Security on stable ground for the future. 
Source: aarp.org

Medicare and Social Security

I cannot believe what your plans are for Medicare and Social Security. I voted for you twice and you promised that you would not touch these programs. Was this just political talk? I don’t understand why you cannot stand up to the Republicans. I thought that you would stand for the every day average man and woman, but I guess I was wrong. I am very dissapointed in what you are planning on doing, I think you should reconsider and stop and think of the people that voted for you and be the President that we voted for.
Source: lettertobarackobama.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

Medicare and You 2013: Florida Medicare and Medicaid

There are several pieces to the Medicare program, and each comes with specific enrollment rules and costs. It is important to understand how these parts work together, along with how they work with other senior healthcare coverage you may have such as Veteran’s Healthcare or Employer/Retiree Insurance.
Source: agingwisely.com

Need Help Picking Right Medicare Advantage Plan for Mom!! » Toni Says

*Some plans are $175 co pay per day for 20 days which can be a maximum                                       $3500 if you are in the hospital for over 20 days or might be $150 co pay per                             day for days 1-5 with a maximum of $750 maximum stay if you are                                                 inpatient hospital for more than 5 days (example only)
Source: tonisays.com

Don’t Believe What You’ve Heard About Immigrants and Welfare

For the most part, foreigners who want a green card need a company or blood relative to sponsor them and accept responsibility for them. Of course, green-card holders could lose their jobs or relatives and end up on welfare. The dearth of proof for the view that people flock to the U.S. for welfare is long-standing. In fact, according to the Agriculture Department, which administers food stamps, Latinos in recent years have increasingly flocked to states such as Tennessee, Arkansas, Alabama, Texas and the Carolinas, which have stingy benefits and plentiful jobs, instead of to traditional gateways, such as New York and California, which have relatively generous programs.
Source: reason.com

Insurance: What is the Best Solution when you are still working at 65?

You have paid into Medicare through your payroll deduction. This means that you are entitled to Part A of Medicare at 65, which covers Hospitals, Skilled Nursing Facilities, Blood and Hospice. You must then enroll in Part B, which covers Professional Services. The cost of Part B for the average worker for 2013 is $104.90 and higher for individuals with modified adjusted gross income (MAGI) over $85,000 and couples with MAGI exceeding $170,000. Part A and B comprise the coverage for basic health plans. Once you enroll in Part B, then you must select a plan for Prescription Drugs and either a Medicare Supplemental plan or a Medicare Advantage plan. At age 65, a plan F Medicare supplement plan will cost approximately $125 per month and a prescription plan will run from $15 to $100. So, if you paid $50 for a prescription plan, $125 for the supplement and $104.50 for Part B, your total would be $279.50 per month. But here is the comparison; Plan F will pay all costs not paid by Medicare primary benefits. Most group health plans have Co-payments, Co-sharing (80/20 percent plans) and an out of pocket maximum to reach before they pay 100 percent of claims. Thus your true out of pocket will be a combination of the out of pocket maximum and the group premium. Group plans are the primary Payor or claims, not Medicare, and claims will be paid according to the Group plan model.
Source: desertstarweekly.com

Oklahoma Medicare Enrollment Process

Posted by:  :  Category: Medicare

Gang of Six - Cartoon by DonkeyHoteyOriginal Medicare (Part A and B) is certainly a big help with medical expenses, but it doesn’t cover everything. In fact, with deductibles alone, out-of-pocket expenses can be in the thousands. Medicare supplement insurance, also called Medigap, is designed to help cover the gaps in coverage that Original Medicare doesn’t cover. If you’re considering Medicare supplement insurance, remember that the best time to buy is during Initial Enrollment when you first turn 65. If you purchase during this time, you cannot be denied coverage, even with known health problems.
Source: oklahomamedicarehealth.com

Video: Family Health: Oklahoma Medicare Regulations

Medicaid Proves Its Worth in Oklahoma

Despite these compelling benefits, some assert that Oklahoma would be better off not expanding Medicaid. Critics claim that Medicaid is an “outdated program” and “a broken system.” In reality, Oklahoma’s Medicaid program, SoonerCare, is an indispensable cornerstone of the state’s health care system, providing affordable, efficient care to hundreds of thousands of low-income children, expecting mothers, seniors, and persons with disabilities. Oklahoma’s Medicaid program has proven its worth in many ways:
Source: okpolicy.org

Medicaid proves its worth

Oklahoma’s Medicaid program has developed high-quality, cost-effective programs.  Oklahoma has implemented a number of programs in recent years to improve the quality of care and service for Medicaid patients and to reward providers for better, more cost-effective care. Oklahoma’s online eligibility and enrollment system is one of the most advanced in the nation. A recent article in the national journal Health Affairs  stated, “when it comes to enrolling its citizens in Medicaid, Oklahoma is a shining example of how to do things right” and suggested that other states learn “from the vision and transparency of Oklahoma’s leaders.” 
Source: okpolicy.org

One state where the Medicaid expansion battle lingers on: Oklahoma

Yet another development that could affect Fallin’s thinking in weeks to come is the anticipated recommendations from the Leavitt group, tasked with coming up with an Oklahoma solution to the health-insurance dilemma. That well-respected firm, hired in January for $500,000, was founded by former Utah governor Michael O. Leavitt, who also served in the Cabinet of President George W. Bush. Because of both the study’s significant cost and its consultant’s pedigree, it just about has to be taken seriously. Will a Medicaid element be among the consultant’s recommendations? Some insiders think so.
Source: medcitynews.com

Sequestration, Medicaid and Mortality

We just sent another $Billion to Pakistan, increased defence spending(any know how many African countries we have soldiers deployed in?), are still funding the Albatross F-35, increasing monies for the Epic Fail “War O Drugs” and now feel the need to rob not only these Funds, but are considering playing voodoo math, again, with Social Security, ALL of which have one thing in common. Those monies belong to US. We pay out of our income separate from other taxes as a hedge or policy for catastrophe. Some forgot to warn us the biggest catastrophe might be theives in Congress and the Administration. Shame on them for doing this, but shame on us if we re-elect any of them, again!
Source: dailyyonder.com

Fraud Alert: Oklahoma seniors targeted by telephone phone scam

Callers are informing seniors there are new Medicare cards being sent but information for direct deposit is needed. The scammer asks which bank the senior uses and then provides its routing number before demanding the account number from the senior.  Routing numbers, the first set of numbers on the bottom of the check, are available online to the general public and allows scammers to give the impression they are officials of Medicare. When the scammers encounter resistance to provide an account number, they will threaten to withhold the “new Medicare” card.
Source: city-sentinel.com

AARP Oklahoma protect Social Security and Medicare express KTEN TV 17/05/11

2012 About anyone Apartments Bankruptcy Beautiful City college colleges Cool cost County Estate find Football from good home house images insurance jobs Know Live News Nice Norman Oklahoma Part people photos Pictures Real Roofing school Should Sooners State Texas there Time Tulsa University video. weather
Source: wordwd.com

Release: OKGOP Calls Out House Dems for Defending ObamaCare

Barack Obama Catholic Dodd-Frank EPA Facebook Townhall fiscal cliff Frank Lucas Governor Fallin Inhofe James Lankford Jim Inhofe Jobs John Doak Katie Henke Keystone Pipeline Keystone XL Markwayne Mullin Mary Fallin Matt Pinnell Mitt Romney Obama ObamaCare OKGOP Oklahoma Oklahoma Democratic Party Oklahoma Republican Party Patrice Douglas Paul Ryan Peter Hodges Rob Wallace Ron Paul Scott Inman Scott Pruitt Sean Burrage Senator Inhofe Steve Fair Straw Poll taxes Todd Lamb Tom Coburn Tom Cole unemployment Victory 2012 voter registration Wallace Collins
Source: okgop.com

Registration Began for Medicare EHR Incentive Program

Not all areas of the country will be implementing registration at the same time, so it is important to have an EHR representative to guide your facility through the process. Registration for the EHR incentive program will launch in January for Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas.
Source: fpwgiftregistry.com

How To Enroll In A Medicare Supplement Plan F Insurance Policy

Posted by:  :  Category: Medicare

DAMN!! -- I THINK WE'RE F*%KED by SS&SSFinally, 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

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

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

Medicare Supplement Insurance Information

(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

Perform Getting The Extremely Medicare Supplement Results In

Another aspect of policy coverage for Medigap Plans is the first three pints of blood. This is paid for in all plans, but in intend K it is up to 50 percent, and plan S is up to 75 percent. This is true for the hospital deductible befit. The Skilled The nursing profession Facility daily coinsurance covers a specific amount per day for the 21-100 of an individual benefit period. This is a benefit of plans K through L. For plan K and L, it can be 50 percent and as well as 75 percent correspondingly. The part B per year deductible is accessible for plans C, F and S.
Source: hi-see.org

Prosperity Protection Counselors

Without a doubt Medicare Supplement Plan F is by far and away the most popular plan for people on Medicare Part A and Part B. The reason it’s so very popular is that this plan covers 100 percent of the gaps in Medicare Part A and Part B. For a relatively low monthly premium you can simply show your Medicare card and your Medigap Plan F card to any doctor, specialist, or hospital in the country that accepts Medicare, get treatment, and go home with no bills. Not bad coverage huh? Yes this plan is the most expensive, but for many people who are coming off employer health care and used to deductibles along with getting 80 or 90 percent coverage this plan is usually far cheaper with substantially better coverage.
Source: ppc12.org

Insurance: What is the Best Solution when you are still working at 65?

You have paid into Medicare through your payroll deduction. This means that you are entitled to Part A of Medicare at 65, which covers Hospitals, Skilled Nursing Facilities, Blood and Hospice. You must then enroll in Part B, which covers Professional Services. The cost of Part B for the average worker for 2013 is $104.90 and higher for individuals with modified adjusted gross income (MAGI) over $85,000 and couples with MAGI exceeding $170,000. Part A and B comprise the coverage for basic health plans. Once you enroll in Part B, then you must select a plan for Prescription Drugs and either a Medicare Supplemental plan or a Medicare Advantage plan. At age 65, a plan F Medicare supplement plan will cost approximately $125 per month and a prescription plan will run from $15 to $100. So, if you paid $50 for a prescription plan, $125 for the supplement and $104.50 for Part B, your total would be $279.50 per month. But here is the comparison; Plan F will pay all costs not paid by Medicare primary benefits. Most group health plans have Co-payments, Co-sharing (80/20 percent plans) and an out of pocket maximum to reach before they pay 100 percent of claims. Thus your true out of pocket will be a combination of the out of pocket maximum and the group premium. Group plans are the primary Payor or claims, not Medicare, and claims will be paid according to the Group plan model.
Source: desertstarweekly.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

‘Remarkably Friendly’ Hearing For Acting Medicare Chief

Posted by:  :  Category: Medicare

DC Voting Rights by dbkingMARY AGNES CAREY: They’ve known each other a long time, and he explained how they met when he was first in the Virginia House of Delegates, and he talked about what a great job that Marilyn Tavenner has done – not only as a nurse but as a hospital administrator. She ran Virginia’s Department of Health and Human Resources. He expressed his confidence in her and talked about her qualifications. At the end of his remarks, which I thought was very interesting, he said to Republicans: Look, I don’t care for the 2010 law, I don’t support the ACA, but I support Marilyn Tavenner.
Source: kaiserhealthnews.org

Video: Medicare vs Medicaid 612-309-9184 Minnesota Medical Assistance Minneapolis Elder Law Attorney

Settlement May Bring Easier Qualifications for Medicare

The Medicare board has had a longstanding practice to require a likelihood of medical or functional improvement before a beneficiary could receive coverage for skilled nursing or therapy services, whether institutional or home-based. That left many care recipients in a lurch. If this settlement goes through and becomes practice, then the requirement is no longer “improvement” but “maintenance.” Accordingly, Medicare will provide services if they are needed to “maintain the patient’s current condition or prevent or slow further deterioration.”
Source: hunterestategroup.com

Sixth Circuit: Violations of Conditions of Participation Insufficient Basis for FCA ClaimsHall Render

In rejecting the District Court’s grant summary judgment regarding the Medicare billing number for the facility, the Court noted that the lower court again relied on conditions of participation, not conditions of payment. MedQuest bought a physician’s private practice and continued to operate the facility using the former physician’s billing number. The Government argued that the facility’s former enrollment and approval in Medicare was as a physician’s practice and not an IDTF. Because Medquest was using the billing number for a physician’s practice, the Government argued it was violating its conditions of payment. The Court found the Government had failed to provide any “statutes, regulations, or interpretive rules” that provided a basis for such argument. Absent a relevant regulatory provision providing a condition of payment, there could be no FCA violation. While such noncompliance with conditions for participation was insufficient for claims under the FCA, the Court did note that the Government could legally enforce such conditions through administrative actions such as suspension or even disqualification from the Medicare program.
Source: hallrender.com

Obama’s pick for Medicare and Medicaid finally gets a hearing

“Her skill in doing that [controlling costs] is a skill that’s very precisely matched with the need of the moment," Kaine said. "How to keep patient care first – because that’s her first attribute – but nevertheless wrestle with difficult cost control issues…Cost control is ultimately about health care access and Marilyn understands that.”
Source: mcclatchydc.com

Understanding Your Medical Claims: Skilled Nursing Facilities: Medicare Qualifications

If you do not agree with the decision, you can file an appeal. You will be responsible for SNF charges if Medicare denies the appeal and determines you do not meet the requirements for additional SNF care. One such option is a fast (expedited), review or an immediate appeal. During this process, an independent reviewer called a Quality Improvement Organization will look at your case and decide if your health care needs to be continued. The SNF should give you information on how to contact them within the allotted timeframe. Be prepared to supply information (evidence), why you think you need the additional stay.
Source: blogspot.com

– Can I just stick with VA care?

 Your VA disability rating is totally unrelated to your Tricare eligibility.  The VA and Tricare are unrelated programs.  The VA may file claims with Tricare only for services that you receive from one of the few VA medical centers that is registered with Tricare as an authorized provider.   I believe that you became eligible for Tricare automatically if you became entitled to retired, retainer, or equivalent pay when you retired from the Army.  You can confirm your Tricare eligibility by calling the DEERS Support Office, toll-free, at 1-800-538-9552.    If you have a family, your wife and unmarried children under 21, or under age 23 if the child is a full-time college or accredited trade school student, also became eligible at the same time.  You must enroll them in Tricare for them to use the program.   Medicare and Tricare also are unrelated programs that were created by, and are governed by, different federal laws.  You must call the Social Security Administration for information concerning your Medicare eligibility at age 65.  All questions concerning Medicare should be directed to Social Security or Medicare.  Medicare cannot officially answer any questions concerning Tricare.   If you become legally entitled to Medicare Part A without cost at any age or for any reason, the federal law that governs Tricare requires you to enroll immediately in Medicare Part B.  Failure to be enrolled in Medicare Part B when your Part A entitlement becomes effective will result in the immediate loss of your Tricare eligibility including your free Tricare Pharmacy Program and your becoming ineligible for the Tricare plan called Tricare for Life, or TFL.  Your Tricare eligibility cannot be restored until and unless you are enrolled in Medicare Part B.  For official confirmation of this rule, please contact the DEERS Support Office, above.   You may be inadequately informed about your health care guarantees under the VA system.  As I understand the law, a 50 percent disability rating guarantees you free medical care only for your service-connected conditions.  Your other health care needs could be denied or require payment on your part.  There is no guarantee that you can continue under the VA system for your other medical care.  I strongly recommend that you contact the VA to discuss these things with that office.   You should also contact the Social Security Administration to discuss the consequences of failure to enroll in Medicare at least 90 days before the month when you will be 65 years old.   Important note:  Social Security and/or Medicare will provide information under Medicare law about when you must enroll in Medicare Part B.  They will provide information that, while true, does not take into account the special circumstances of Tricare beneficiaries.    The law that governs Tricare has a different requirement concerning when you must enroll in Part B.  You must conform to requirements of the Tricare law or lose your Tricare eligibility when you become legally entitled to Medicare Part A.  That is, Tricare law requires that all Tricare beneficiaries (except active duty family members and USFHP members) must enroll in Medicare Part B at that time.  For most people, that will be on the first day of the month of their 65th birthday.   When you become entitled to Medicare and are enrolled in Medicare Part B, you will become eligible for Tricare for Life, or TFL.  Medicare will become your primary health insurance and Tricare Standard will act as a free Medicare supplement for the rest of your life.  The vast majority of your Medicare claims and medical bills will be paid in full by their combined payments (Medicare plus Tricare Standard) under TFL.  Your only premium costs for TFL will be the monthly premium for Medicare Part B.   I believe you have no such guarantees under the VA system if you do not have a 100 percent, permanent and total, service-connected disability.  Most likely it will also be necessary for you to live within a reasonable commuting distance from a functioning VA medical center.  You can use Tricare and Tricare for Life nationwide.  Without your having a 100 percent disability, the VA will not provide medical services for your family members. Tricare will.  Check these things with the VA.
Source: militarytimes.com

The Biggest Reason For Medicaid Expansion

Posted by:  :  Category: Medicare

The PARTY Is OVER ...item 4.. Today, Mitt Romney Lost the Election (Sep 17, 2012 6:02 PM ET) ...item 5.. James Brown - Get On The Good Foot, Soul Power, Make It Funky Soul Train 1973 ... by marsmet471Once more we have a warning that there may be an evolved strain of an old bug that may cause havoc among humanity soon. If not this one there will be another and another ad infinitum. Yet if we have our doctors and clinics open only to the wealthy, you have to know medicine will not be able to hold back the ravages for long. When a fourth of our population is allowed to access only the most expensive form of health care and then only at a time of dire emergency it is like opening up the banquet hall to diseases.
Source: blogforiowa.com

Video: Medicare Information for Iowa by Medicare Pathways

Groups push for Medicaid expansion

The loose coalition that included AARP, the American Cancer Society and Iowa Catholic Conference, has support of Democratic lawmakers. Sen. Jack Hatch, D-Des Moines, and Rep. Lisa Heddens, D-Ames introduced legislation Tuesday that would make more Iowans eligible for the program that provides health benefits for about 400,000 Iowans.
Source: thegazette.com

Editorial: Making the case for Iowa’s expansion of Medicaid

For Arnie, health insurance under Medicaid will mean he has access to primary care and case management, as well as to emergency room care and hospitalizations. This may enable him to better keep on his medications, manage his diabetes and be less prone to acute episodes resulting in high-cost hospitalizations and emergency room care. In any event, if he is hospitalized or receives emergency room treatment, the hospital will have a billing source, which will reduce the amount of charity care the hospital provides (which is factored into charges to insured patients).
Source: cciaction.org

Money Smart Week at Johnston Public Library

Social Security; Helping Married Couples File for Maximum Lifetime Benefits Thursday, April 25   6:30 pm to 8:00 pm Married couples often make the mistake of filing for their Social Security benefits based solely on their age, as if they were single. This mistake can cost a couple tens of thousands of dollars over the course of their retirement. If you are married, between the ages of 55 and 68, and have not yet filed for Social Security or have questions about the way you have filed, this presentation is for you. This class is free and open to the public, but pre-registration is required. Please register online at www.johnstonlibrary.com or by calling the library at 515-278-5233.
Source: iowalivingmagazines.com

The Right Care, At The Right Time, In The Right Place

For years, the hospice and palliative care community has made the case that hospice enrollment creates cost savings for Medicare. A new report published in the March issue of Health Affairs indicates this is the case – that hospice patients have lower Medicare costs, reduced use of hospital services and that hospice care improves overall care quality. The study was conducted by the Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. Researchers looked at the most common hospice enrollment periods and found that hospice patients had significantly lower rates of hospital and intensive care use, hospital readmissions and in-hospital death when compared to the matched non-hospice patients. Moreover, these savings appear to grow as the period of hospice enrollment lengthens.
Source: iowacityhospice.org

Bleeding Heartland:: Latest Iowa Medicaid expansion news and discussion thread

Our estimates of new federal and state spending resulting from Medicaid expansion in Iowa differ from the Milliman, Inc. estimates.7 For example, this report uses the Urban Institute estimates of $459 million in direct Medicaid savings from 2014 to 2020 due to the Medicaid expansion, while Milliman estimates that the state will save $118 to $206 million, exclusive of the “woodwork” enrollment effect which would occur regardless of whether the state expands Medicaid.8 While the estimates vary in magnitude, they are similar in that they indicate a net state savings associated with a Medicaid expansion because of the higher federal matching rates for those who are newly eligible in an expansion. In contrast, our estimates for additional federal matching revenues generated by the Medicaid expansion ($4.1 billion from 2014 to 2020) is in the range of the federal revenue estimates produced by Milliman ($2.7 to $4.8 billion), so those are closer. All estimates-others and ours-are approximate since it is impossible to know in advance exactly what the condition will be of the state’s economy, how many people will participate or how high medical costs will be in the future. However, our projections provide a general sense of the overall magnitude and direction of expected economic and budgetary impacts.
Source: bleedingheartland.com

Today’s NewsStand (March 11, 2013)

Branstad should pass Medicaid expansion Opponents argue that the program has become overly costly thanks to particularly lax eligibility rules that have undermined the program’s function as part of the social safety net. Such opponents of Medicare expansion argue that the program should be fixed rather than expanded, its means test pared down. This may well be true, but the fact of the matter is that Medicaid expansion is simply a better policy than Governor Branstad’s Healthy Iowa initiative. Branstad should read the writing on the wall and reverse course. To opt for an inferior program for any reason, politics or ignorance, would be a disservice to Iowa. (University of Iowa Daily Iowan)
Source: iowahospital.org

Iowa Patch Poll: Is Gov. Branstad Wrong to Oppose Medicaid Expansion?

The key thing to me is the idea that no one in this country should be made to suffer, lose their life, or bankrupt their economic future in order to have access to quality medical care. We are one of the richest countries in the world with fabulous standards of living widespread throughout our country. I am not a proponent of "socialism," but the hard facts are that as medical care prices have increased, it has put it out of the reach for most Americans without help from either insurance or the government. If anybody who is negatively commenting on this had cancer, but not the money to treat it, thus facing certain death, they might change their opinion quickly. Quite frankly if it meant that my taxes increased slightly to help pay for this, and I did not get to order out food as often, or could not buy an house with 3-4 bathrooms. (I have lived in the same house with 1 1/2 baths for 35 years) so be it. I do not know how Terry Brandstad, or people that support him, can sleep well at night knowing that his plan would disallow 10s of thousands of Iowans health care when it could be available with help from the federal level. Is their any decency left in our state or just a bunch of people yapping their individual politics!
Source: patch.com

Pawlenty touts Medicare proposal during Iowa trip

Former Louisiana Gov. Buddy Roemer, considered to be another possible GOP presidential hopeful, joined Pawlenty at the Waukee event, laying out a detailed plan to create jobs by overhauling the nation’s trade, energy and tax policies. He said America is addicted to Middle Eastern oil, corporations that don’t back taxes and special interests that have cost the nation jobs.
Source: publicradio.org

Phone Scams Target Medicare Beneficiaries in California

Posted by:  :  Category: Medicare

Judy by Thomas HawkCallers claiming to be with the Medicare program tell their targets that a replacement Medicare card is coming in the mail but a bank account number is needed first, according to a press release from Ramsey’s office. Sometimes, the caller will ask for a Medicare card number, which can be used for identity theft since it’s tied to a Social Security number.
Source: medbill.net

Video: Medicare HMO-POS Explained – Rob Merritt interviews Tony Prince in Laguna Woods, CA

California Duals Demonstration Project

Last week, the California Department of Health Services and the Centers for Medicare and Medicaid Services reached an agreement to implement a dual eligible demonstration that will transform the way Medicare and Medi-Cal services are delivered to Californians that qualify for both programs.  Under the agreement, or
Source: neurocommunity.org

How Medicare is Improving Coordination of Your Care

No sorry. I went to ER last year and they wanted me to sign an 8 page contract, which I could not read at the time due to my injury, but would not treat me unless I signed it. I waited until my wife could come in and I was able to read it after an hour, also she brought my reading glasses. It said they can share my medical records with ‘anyone they feel needs to know, including family, friends, employers,police, military, ANYONE. This was at county hospital. I would not sign it and they would not treat me even though I had internal bleeding from a fall. I stood my ground and suffered for it. I could post it here. Read it. Anytime you are treated, or get insurance, or any medical care, read what you sign and tell me. People just sign away their rights to privacy. Insurance companies are the worst, trading your medical records, and as I said, you have no way to set the record strait if there is false information. It may even say you are an alcoholic or smoke cigarettes and you are not, don’t, and when you try to get new health coverage they will have that information and either hit you with huge premiums or deny you, true or not, because people are allowed to give away your records without even notifying you. And speaking of records, do you know you are not even allowed to see all your own records? Medical records or any other records, information about you? You are not allowed to even see your own records the authorities have and can see. They don’t want you to know.
Source: patch.com

Roundup: Feds Cut N.Y. Medicaid Payments $1.2B; 93,000 Fewer Kids Enroll In CHIP In Pa.

California Healthline: Changes Set Stage For ‘Shakeout’ Of Medical Suppliers, Services Shifts in contracting practices — part of the trickle-down effects of health care reform — are going to change the landscape of medical equipment and service suppliers in California, stakeholders predict. … Bob Achermann, executive director of the California Association of Medical Product Suppliers … predicted the number of California businesses providing medical supplies and services may be cut in half over the next few years. Two changes are at the heart of the “thinning of the herd,” as Achermann calls it. One is state-driven: California is shifting beneficiaries of Medi-Cal — California’s Medicaid program — from fee-for-service to managed care. The second is a federally mandated change in the way Medicare contracts with suppliers (Lauer, 4/1).
Source: kaiserhealthnews.org

Report estimates health plan overbilled Medicare $424M

The inspector general found in November that Medicare overpaid nursing homes by about $1.5 billion in 2009 based on claims that patients needed "ultra high" levels of therapy. The report found that claims were "upcoded" because the records showed that the patients either did not need or get the therapy in many cases. The Washington Post also examined "ultra high" therapy use in 2010, focusing on a chain that operates dozens of homes in California.
Source: californiawatch.org

The State of California Medicare and Medicaid – February, 2013

Right now the eligible age for Medicare is 65. Some in Congress have proposed raising that age to 67 or higher to help save money. A move to 67 would save the federal government an estimated $150 billion by 2022 if the policy were enacted in 2014, but would make Medicare unavailable to seniors aged 65 and 66.
Source: amanteandassociates.com

William Henning: Medicare cuts bad medicine for vulnerable California communities

Meanwhile, Part D has been a singular fiscal success, posting what is nothing short of an astonishing record for a federal program. The Washington-based think tank Heritage Foundation found that Part D’s cost growth has come in 41.8 percent below its original cost estimate — a total savings projected at $264.6 billion for taxpayers. Additionally, according to the Journal of the American Medical Association, improved access and adherence to medicines through Part D saves Medicare about $1,200 per year in hospital, nursing home and other costs for each senior who previously lacked comprehensive drug coverage — a $12 billion-per-year savings for Medicare.
Source: santacruzsentinel.com

California Medicare Coalition, CMC Meetings

Presenter: Elaine Wong Eakin, Executive Director, California Health Advocates Elaine discusses what the Improvement Standard is and how the Jimmo settlement agreement ends that Standard. Medicare beneficiaries can now no longer be denied necessary skilled maintenance services provided in the home health, nursing home or outpatient therapy settings on the basis of showing no improvement. View Webinar Download the Webinar slides
Source: cahealthadvocates.org