Medicare Deductibles and Co

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, there is NO cap on the dollar amount you have to pay!  It could be 20% of $10,000 or it could be 20% of $100,000, whatever 20% of your Part B medical cost are! This could present a huge risk to your financial wellbeing! You may also have to pay Part B excess charges that some doctors who don’t accept assignment can charge! Medicare allows up to
Source: medigapexperts65.com

Video: Medicare Part A Benefit Periods

Number of the Week: Disability Fund Three Years From Insolvency

I have issues with awarding SSID to people who have drug and alcohol addiction. I also agree with the person below who suggested that people receiving benefits, unless they are clearly unable to work, need to be retrained and given jobs, particularly if they are suffering from depression, anxiety or back pain. People who work are more emotionally stable, in general. It would also help if we had universal health care so that low income people can get decent medical care.
Source: wsj.com

Understanding Medicare Benefit Periods

Under Part A the patient must pay a deductible for every "hospital benefit period." Unlike most health insurance, where deductibles must be satisfied once every year, usually between January and December, there can be several Medicare hospital benefit periods in a calendar year. In 2010 the Part A deductible per benefit period is $1,100. A benefit period begins on the day a patient enters the hospital and ends after there has not been any hospital or skilled nursing care for 60 days. If the patient is discharged from the hospital or a skilled nursing facility and returns to either within 60 days of discharge, it is considered to be the same benefit period and there is no need to pay another deductible. However, if the patient remains out of skilled medical care (either hospital or skilled nursing facility) for more than 60 days and then goes back to the hospital, a new benefit period begins and another Part A deductible of $1,100 is required.
Source: texasagingnetwork.com

Medicare A and B Cost and Benefits 2013

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

Medicare Part A explained

Skilled Nursing Facility Care – Skilled nursing facility benefits provided by Part A includes the cost of a room (semi-private), as well as the insured’s meals. Medicare Part A also covers skilled nursing and rehabilitative services, and certain other medically necessary skilled nursing facility services and supplies.  Medicare will not cover long term nursing facility stays, and coverage ends after a 20 day period.  Medicare will cover any additional costs for the next 80 days after a deductible of $148.00 per day to you, but after 100 days Medicare will not pay for any additional nursing home services.
Source: askmedicareblog.com

The Medicare Maze: Observation Stays, Nursing Home Costs, and “Invisible Patients”

We have all been traveling and have found ourselves party to a conversation because of proximity or bad cell phone etiquette. Some of these conversations are irritating, but I was looped into an interesting one the other day. Sitting in the Charlotte airport, two older men who looked like they were returning from a golf vacation started talking about enrolling in Medicare. One had just done it and the other had lots of questions. The recent enrollee said that he had registered through the Social Security web site; it took only ten minutes and was very easy. He told the other man that he only needed to sign up for part A, not for part B.
Source: wingofzock.org

A Simple Primer on Medicare Benefits Written for Patients and YOU!

Strategist, Rehabilitation Management, MediServe a Mediware Company; Darlene is a PT with an MBA in Healthcare Management, in her role, as a Rehab Mgmt Strategist she brings information to leadership that help guide practice strategy. Her focus is to assist clients nationally in the use of charting data to drive clinical and financial performance in support of decisions for best practices in meeting rehabilitation compliance, outcomes, revenue and efficiency. Since February 2011, Darlene has visited more than 30 IRF locations to assist in guiding C.O.R.E. (Compliance, Outcomes, Revenue, Efficiency/Effectiveness), performance improvement plans. Working in rehab medicine for greater than 30 years, Darlene spent 12 years in executive leadership as a Director of Rehabilitation and Operations. Therapy oversight included three post-acute service lines: acute inpatient rehabilitation (IRF), skilled and outpatient hospital-based services and is LEAN trained in healthcare. At various points in her career, Darlene had oversight of rehabilitation admissions, marketing, quality improvement, dietary & maintenance. Her responsibilities have included compliance toward Federal Regulations and leading CARF and Joint Commission standards of practice. Her experience includes Quality Improvement Chair, Lean Healthcare Trainer Certification and Vice President of the Board of Directors for the Ohio Association of Rehabilitation Facilities (OARF). Darlene lectures and writes blogs on post acute care topics that include federal guidelines, post acute admissions, managing outcomes, documentation, and rehabilitation marketing. www.mediserve.com/blog
Source: mediserve.com

Three Midnight Rule For Medicare SNF Explained: Will CMS Pay?

Medicare will pay a portion of these SNF costs (the rest of which are picked up by patient’s supplemental policies) for a up to 100 days for every benefit period.   Once these days are used up,  the patient will be financially responsible for any other skilled nursing benefits until the next benefit period begins.  How does Medicare define a benefit period?   A benefit period ends when you have not been in a hospital or in a  SNF for 60 consecutive days.  Once a new benefit period begins you will need another three midnight stay to qualify for additional SNF days (up to 100 days every benefit period).  If Medicare won’t pay for additional days, neither will the supplemental policy as these policies will usually only cover the portion of approved days that Medicare doesn’t cover. Most patients who use up 100 days of SNF benefits would never go another 60 days in a row without being admitted to the hospital.  They use up their 100 days for a reason. They cannot avoid living at home without avoiding frequent hospital level care.  Clinically, what I see is that most patients who have used up their 100 days in a benefit period will are palliative care candidates or require long term care in a nursing home.
Source: blogspot.com

Grant Opportunity to Improve Healthcare for Medicare, Medicaid

Posted by:  :  Category: Medicare

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The Centers for Medicare & Medicaid Services (CMS) has released a Funding Opportunity Announcement for round two of the Health Care Innovation Awards. Under this announcement, CMS will spend up to $1 billion for awards and evaluation of projects from across the country that test new payment and service delivery models that will deliver better care and lower costs for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) enrollees.
Source: eatsmartmovemoresc.org

Video: Medicare Supplement in South Carolina by 1 800 MEDIGAP®

Medicaid Expansion Popular In Southern States, Despite Govs’ Opposition

Tampa Bay Times: Tampa Chamber: Businesses Concerned By Legislature’s Inaction On Medicaid Expansion For Tallahassee, refusing additional federal funds to expand Medicaid may turn out to have been the easy part. It will take longer, a half-dozen Hillsborough legislators acknowledged Tuesday, to come up with an alternative to provide health care coverage to an estimated 1 million uninsured Floridians. … Some Tampa businesses, (Greater Tampa Chamber of Commerce Chairman Gregory Celestan told local legislators), are “very concerned about significant additional health insurance costs” because of the Legislature’s “refusal to expand Medicaid.” “We will be at a competitive disadvantage when recruiting new businesses or adding jobs,” Celestan added. “How would you respond?” (Danielson, 5/21).
Source: kaiserhealthnews.org

RS Medical Settles Medicare Fraud Charges

RS Medical has agreed to settle Medicare fraud claims following a whistleblower suit by one of its South Carolina employees, U.S. Attorney Bill Nettles said. The Vancouver, Wash.-based company, which maintains an Upstate location at 1200 Woodruff Road, has agreed to pay $1,214,665 to settle the claims against it, he said.  According to Nettles, employees of RS Medical in South Carolina and Illinois submitted claims to Medicare for Transcutaneous Electrical Nerve Stimulation (TENS) Units, conductive garments for TENS Units, back braces, cervical traction systems, muscle stimulators, and custom-fit knee braces that either lacked physician orders, lacked the required supporting documentation, and/or lacked medical necessity.  The investigation in the District of South Carolina began in February of 2011 when whistleblower Sally Balentine filed a qui tam lawsuit in federal court under the False Claims Act, Nettles said.   The False Claims Act allows the government to bring civil actions against entities that knowingly use or cause the use of false documents to obtain money from the government or to conceal an obligation to pay money to the government.   Under the False Claims Act, Balentine is entitled to a share of the government’s recovery, Nettles said. She will receive approximately $242,933 from the proceeds of the settlement, he said. Additionally, Balentine will receive $80,000 for her attorney fees and costs.  The settlement was the result of a coordinated effort by the U.S. Attorney’s Office for the District of South Carolina and agents from Health and Human Services Office of Inspector General, and United States Postal Service Office of Inspector General, Major Fraud Investigations Division, Nettles said. If you suspect Medicare or Medicaid fraud, report it by phone at 1-800-447-8477 (1-800-HHS-TIPS), or E-Mail at HHSTips@oig.hhs.gov.
Source: patch.com

MedicareBob’s Blog: Oconee County South Carolina Medicare Advantage Plan Summary:

Hello I am Robert W. Bache, I am a licensed South Carolina Medicare Insurance Agent. I represent all of the top Insurance Companies in South Carolina to perform telephonic enrollments. Here are the $0.00 Premium Medicare Advantage Plans (Part C) that are available to people that live in Oconee County South Carolina. Date: 05/09/2013 Please call me with any questions, toll free: 1-855-368-4717. Please follow me on Facebook: www.facebook.com/robert.bache.Medicare Oconee County South Carolina $0.00 Premium Medicare Advantage Plan options
Source: blogspot.com

Medicaid Expansion Would Help Working South Carolinians

SCDHHS Director Tony Keck suggests that major portions of the uninsured will be covered under the Health Insurance Marketplace (what we used to call the Exchange). If South Carolina fails to expand Medicaid, businesses with more than 50 employees could face $30-$46 million in potential shared responsibility liabilities according to Jackson-Hewitt Tax Service as employees making between 100 percent and 138 percent of the Federal Poverty Level, but not covered by their employer, enroll through the new Healthcare Marketplace. If South Carolina expanded Medicaid, those employees would be Medicaid eligible and their employers would not be subject to the shared responsibility tax liability of $2,000 to $3,000 per employee who enrolls through the Marketplace.
Source: theruoffgroup.com

Ambulance Company Pays $800,000 to Settle Claims of Medicare Fraud

The lawsuit was originally filed by Sandra McKee, a social worker who worked at a dialysis center where Williston’s ambulances dropped off patients. McKee sued under the qui tam provision of the False Claims Act, which allows private parties to sue on behalf of the United States for fraudulent use of government funds.  The government then decides whether to intervene in the lawsuit.
Source: employmentlawgroupblog.com

Home Health Providers Brace for DME Medicare Rule Change

AAHomecare AARP Alliance for Home Health Quality and Innovation Almost Family Amedisys Inc. American Association for Homecare American Association for Long Term Care Insurance Apria Healthcare Group Care.com CellTrak Technologies Inc. Centers for Medicar & Medicaid Services Centers for Medicare & Medicaid Services CliftonLarsonAllen CMS Emeritus Senior Living Ensign Group featured Federal Bureau of Investigation Gentiva Health Services Inc. Genworth HHS Home Health Depot Home Health International Humana IntegraCare Intel-GE Care Innovations Jordan Health Services Kindred Healthcare LHC Group LHC Group Inc Medistar Home Health MedPAC NAHC National Association for Home Care & Hospice National Hospice and Palliative Care Organization New York Times Paraprofessional Healthcare Institute Partnership for Quality Home Healthcare PHI ResCare HomeCare Scripps Health Sentara Healthcare The Partnership for Quality Home Healthcare VA Visiting Nurse Association
Source: homehealthcarenews.com

Private Medicare Plans Overpayed by Billions

The Government Accountability Office (GAO) has released a report on the results of an audit that looked at funds being distributed to private Medicare beneficiaries compared to public, fee-for-service payments. The GAO suggests the Centers for Medicare and Medicaid Services (CMS) did not accurately calculate payment rates for the two categories, allowing private Medicare Advantage (MA) plans to code for higher payments than traditional Medicare. Estimates are as high as $5.1 billion in overpayments between 2010 and 2012 to MA. GAO is urging CMS to implement better beneficiary questioning techniques to help stop the problem.
Source: schealthcarevoices.org

Mutual of Omaha Medicare Supplement Rate Adjustment in SC July 2013

Mutual of Omaha does offer a 7% household discount and there is no policy fee when you apply.  Those who decide to purchase a Mutual of Omaha Medicare supplement will enjoy their personal service and fast, reliable claims payments from a financially strong, stable and secure company.  Click here for more on Mutual of Omaha Medicare Supplemental insurance.
Source: medicare-supplement.biz

Biediger on Medicaid Expansion: “Take it and do some good”

Biediger presented financial figures that showed LMC would lose close to $80 million in Medicare reimbursement and Medicaid and Medicare Disproportionate Share Funds from 2014 through 2020, regardless of whether the state accepts the expansion. If South Carolina accepts the expansion, LMC could see $176 million from 2014 through 2020. As well, 300,000-400,000 more South Carolinians would have health coverage. And, an estimated 44,000 jobs would be created, according to a study from the University of South Carolina. Most of the state’s uninsured aren’t lazy stereotypes, but people working two low-income jobs, neither of which provide health insurance, Biediger pointed out.
Source: lexmed.com

What is the Initial Enrollment Period for Medicare?

Posted by:  :  Category: Medicare

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On the other hand, if you are 65 and not yet receiving benefits from SSA or RRB (because you’re still working), you will not be enrolled in Part A or Part B automatically even if you are eligible. You will need to sign up for Original Medicare during your Initial Enrollment Period or face a late enrollment penalty. You can submit an application online to the SSA, fill out a paper application at your local Social Security office, or call Social Security at 1-800-772-1213. If you worked for a railroad, you should contact the RRB. If you wait until your birthday or sign up during the last three months of your Initial Enrollment Period, your Medicare Part B start day will be delayed.
Source: ehealthmedicare.com

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

CMS Hosts Calls on Medicare Shared Savings Program Application Process : Health Industry Washington Watch

CMS has scheduled two calls to discuss the application process for the ACA’s Medicare Shared Savings Program for the January 1, 2014 start date. This initiative is designed to help providers participate in accountable care organizations to improve quality of care for Medicare patients. A June 20 call will feature an overview and updates to the Shared Savings Program application process, and a July 18 call will provide an opportunity to ask questions of CMS subject matter experts.
Source: healthindustrywashingtonwatch.com

National Provider Calls: Medicare Shared Savings Program Application Process

Ms. Stamer has extensive experience advising and assisting health care providers and other health industry clients to establish and administer compliance and risk management policies and to respond to DEA and other health care industry investigation, enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. A popular lecturer and widely published author on health industry concerns, Ms. Stamer continuously advises health industry clients about compliance and internal controls, workforce and medical staff performance, quality, governance, reimbursement, and other risk management and operational matters. Ms. Stamer also publishes and speaks extensively on health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns including a number of programs and publications on OCR Civil Rights rules and enforcement actions. Her insights on these and other related matters appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications.  You can get more information about her health industry experience here. If you need assistance with these or other compliance concerns, wish to ask about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here. 
Source: wordpress.com

Medicare Liens Including Medicare Set Asides Apply to Medical Damages Only!

This is not that uncommon in cases of very serious injuries where significant and sometimes permanent medical treatment is required. However, there are numerous potential areas for negotiation with Medicare’s over inclusive liens. For instance, in cases of serious personal injury, there are often very significant recoverable damages unrelated to medical expenses, either past of future. Medicare is not entitled to claim liens against settlement amounts that are unrelated to medical expenses paid or to be paid by Medicare.
Source: newmexicoinjuryattorneyblog.com

The Year 2013 Medicare Advantage Guidelines

Posted by:  :  Category: Medicare

Reseveratrol can be found in some common foods and drinks you probably even now eat. One of the on the whole common drink sources is red a bottle of wine. Peanuts and red grapes also entail this compound. A glass towards red wine and a cup connected red grapes or peanuts all provide you about the same amount of resveratrol antioxidant. While any resveratrol may provide your own health benefit, the levels of resveratrol antioxidant extract that are being tested in the entire lab are much stronger than actual can find in food. Fortunately, there are resveratrol supplements available the idea are made from sources like violet wine or Japanese knotweed that obtain a lot more resveratrol in all involved.
Source: paginasweb390.com

Video: Medicare Coverage

‘Will My Family Be Eligible For Subsidized Coverage?’

A. Chances are good that your company plan is self-funded, meaning your employer pays for workers’ health-care claims directly rather than contracting with an insurer. The bigger the company, the more likely it is to be self-funded. Eighty-one percent of workers at companies with 200 or more employees are in a self-funded plan, compared with 15 percent of workers at smaller firms, according to the Kaiser Family Foundation’s 2012 survey of employer-sponsored health benefits. (Kaiser Health News is an editorially independent project of the Kaiser Family Foundation.)
Source: kaiserhealthnews.org

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

On private insurance, but under Medicare Regulations. Anyone else encounter this?

I also like to point out that I think that the whole issue is ripe for a class-action suit, making decisions about treatment without medical contact, cutting medical records, etc. The “damages” aren’t huge on a case-by-case basis but I suspect they could be quantified. It also would help a case that we don’t really care about $$$$ as much as getting coverage, in which case the only people making money on it would be the attorneys, which would likely enhance their interest in the case. I suspect that the Medicare guidelines and the weak and conservative AMA guidelines for supply needs stem from budgetary shortfalls but I am certain that were the issue to be explored, there’s a significant probability that actionable graft and corruption that would be a hook for the case.
Source: tudiabetes.org

Screening Medicare Coverage

Depending on your Medicare plan, you likely qualify for pre-symptomatic screenings for many conditions. Screening is the application of a test to pre-symptomatic individuals to classify them with respect to their likelihood of developing a particular disease. The following are recommended screening for individuals over the age of 65.
Source: medicarebenefits.us

Higher Payments for MA Plans May Be Offset By “Spillover” Benefits Throughout the Health System

In 2012, two reports from the Government Accountability Office (GAO-12-719T and GAO-12-51) noted that payments to MA plans should better reflect the health status of beneficiaries, and differences should be adjusted between MA plans and traditional Medicare providers in reporting beneficiary diagnoses. In doing so, CMS could achieve “billions of dollars” in additional savings. According to the GAO, CMS is not doing enough to improve the accuracy of the adjustment made for differences in coding practices between MA plans and traditional fee-for-service, and CMS needs to use more current data, allowing for all relevant differences in beneficiary characteristics between the two beneficiary populations.
Source: wolterskluwerlb.com

Subsequent Year Medicare Supplemental Insurance Changes

Task C is known for providing Border Plans, such as PPO or The hmo plans. Part C plans are often implemented by private healthcare companies the idea are approved by Medicare Security from medical mishaps with medicare supplement plan f. Contributors receive their healthcare services directly by means of those private companies. Generally, Medicare insurance Part C includes Part A plus Part B coverage as well for the reason that a prescription drug coverage plan.
Source: huronvalleyschool.org

The Year 2013 Medicare Advantage Guidelines

LTCI plans are there to cover custodial care or nursing home care in which there are no medical needs being treatment Wealth Advisors advocate medicare supplement plan f plans for all seniors. LTCI plans are subject to full underwriting in pay for to have one issued. Price tag for the plan varies based via age at issue, coverage levels, additionally medical status. These policies are created to cover many different needs related to your ADLs so an LTCI should stop being thought of as only nursing your own home care since in reality, they guard home care and assisted care too. Again all of these are convalescent or custodial care situations where Medicare does certainly offer any benefits.
Source: salonstylesforyou.com

Oral Health and Medicare Beneficiaries: Coverage, Out

This brief describes the oral health of Medicare beneficiaries, examines sources of dental coverage for the Medicare population, and examines the utilization of dental services, out-of-pocket spending on dental care, and access problems. This analysis uses data from the National Health and Nutrition Examination Survey (NHANES), the Medicare Current Beneficiary Survey Cost and Use file (MCBS), the National Health Interview Survey (NHIS) and the Kaiser Family Foundation Survey of Health Care Among Nonelderly People with Disabilities and Seniors on Medicare, 2008.
Source: kff.org

Get ready for your summer trip

You have Medicare, so your health care services and supplies are covered when you’re in the U.S., which includes Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. But, if you plan to travel overseas or outside the U.S. (including to Canada or Mexico), it’s important to know if your Medicare coverage will be different.
Source: medicare.gov

The Year 2013 Medicare Advantage Guidelines

The original source? An avalanche of new patients that now getting FREE medical care (although NOTHING in this world is actually free) are flooding the system. The U.S. does Not possess enough doctors to treat them. Thus, there will be longer and even longer waiting lists as the pediatrician shortage gets worse. Prior to you go for buying Medicare supplemental leads you must know about all the rules of the Medicare coverage-what that they cover and what they do not only. A Medicare is like an government program. There are one or two complicated rules for various levels of all Medicare coverage. Without government’s proposed cuts in Medicare and also Medicaid spending, baby boomers reaching 63 this year may need to reevaluate retirement plans if they don’t currently have enough money saved to cover forthcoming healthcare costs which are only likely to escalate. Medicare health insurance Part B is the Medical insurance protection plan. Part B will guard the cost of doctor visits, residential health care, and lab tests. Additionally, some medications and medical machines are covered under Medicare Part B, that include items such as diabetic test bunches and wheelchairs. Some of these rich corporations are making poor working people depend on Medicare at a period when Medicare is offering less as time pass and charging poor people very much more Blue Cross adds benefits to medicare supplement plan f policies in California. With no benefits, your only alternative might be appear to other solutions such as searching Medicare-supplement or “Medigap” coverage, which many individuals can’t afford because they don’t have sufficient income to pay for supplemental rrnsurance policy. For some women, they don’t have an income except social security retirement benefits, from this also Medicare fees are taken. Inconclusive whether to enroll in a Medicare health insurance Advantage plan or a Medicare vitamin and mineral when you are Medicare-eligible? Ones Medicare Advantage plan often has simply no premiums to pay, and it for the most part includes prescription-drug features. A Medicare health insurance supplement, on the other hand, require a releatively high premium. One’s own total out-of-pocket costs, though, will fluctuate aaccording to the extent that anybody use hospitals, physicians, and other health-care providers. The deductibles and coinsurance could amount to more within an Medicare Advantage plan than you would likely pay in premiums for a Medicare insurance supplement, which often pays what Medicare insurance does not. Treatment Supplement plans are usually more step-by-step in design, but also come among a higher premium. Medicare Advantage plans sometimes come with a verbal of a vision program as carefully.
Source: typepad.com

Medicare Advantage and Medigap

Posted by:  :  Category: Medicare

In 2012, my 84 yo Father-in-law switched from traditional Medicare and a Medicare supplement to the AARP/United Healthcare Medicare Advantage plan. Unknown to him, this switch required him to contact the supplement provider (Blue Cross of FL) to cancel his supplemental insurance. He did not do that. For the past year and a half, Blue Cross has been automatically withdrawing $154 from his bank account every month. When he balanced his checkbook, he ignored this charge. 3 weeks ago, he was hospitalized with a stroke. My wife has power of attorney so we are paying his bills. We noticed the Blue Cross charges while reviewing his monthly bank statements. I called Medicare and they said cancelling the supplement was not automatic even though it is illegal for a company to sell someone with Medicare Advantage a supplement plan. Blue Cross billing doesn’t work on weekends so I’ll be calling them tomorrow. When he switched to Medicare Advantage, which includes RX coverage, his old Part D plan was automatically cancelled. It seems odd that the Medicare Supplement was also not cancelled. Oh well, he should be in line for a $2500+ refund from Blue Cross. We’ll see.
Source: early-retirement.org

Video: AARP Medicare Supplements | United Healthcare Supplement

Medicare ensures no interruption in services as UHC and UHIC plans terminate

Affected beneficiaries can choose to enroll in another Medicare Advantage or Prescription Drug Plan if they do not want to remain in Original Medicare or the newly assigned PDP. They have been granted a special election period during which they may make one change in their Medicare health care and prescription drug plan coverage. This special election period is in effect now through May 31. Coverage in the new plan is effective the first of the month following their plan selection. If a beneficiary calls 1-800-MEDICARE by March 31 and enrolls in a plan, the beneficiary’s coverage in the plan will be effective on April 1.
Source: thisisreno.com

United Healthcare Telesales

Are you an Insurance Forums member yet ? To sign up for your FREE INSTANT account, please fill out the form below ! Username:     Password:   Confirm Password:     E-Mail:   Confirm E-Mail:          Question of the day:   2+7 equals I agree to forum rules 
Source: insurance-forums.net

UHC Announces Changes to its Medicare Advantage Audits

UHC will no longer use MedAssurrant, the contractor that previously conducted its payment integrity audits. UHC will also make changes in the way that it conducts its Risk Adjustment Date Validation (RADV) audits. These audit request letters will be more clear about the reason for the audit and provide consistent information on follow-up medical record review, audit requests, and post-audit claim payment determinations. UHC will also update its payment integrity and recovery practices. Currently, UHC asks physicians to refund the full amount paid on the original claim and then resubmit the claim using the recommended coding. In the first quarter of 2012 physicians will only need to resubmit the claim with the recommended coding and refund only the difference between the amount UHC originally paid and the amount that should have been paid using the new coding. Physicians who disagree with UHC’s recommended coding should appeal the claims.
Source: wordpress.com

UnitedHealthCare Buys Another Company XLHealth HMO Medicare Advantage Managed Care With Heavy Analytics

XLHealth’s expertise in improving care for Medicare beneficiaries with elevated health risks, which includes its innovative and nationally recognized clinical model of care, will enhance UnitedHealthcare’s already strong Medicare Advantage portfolio. This acquisition will allow UnitedHealthcare to better serve chronically ill and dual eligible members. Ninety percent of Medicare beneficiaries have at least one chronic condition and nearly half of all beneficiaries have three or more conditions. In addition, dual eligible individuals represent a disproportionate share of Medicare beneficiaries with chronic diseases. With this acquisition, UnitedHealthcare will seek to build on the XLHealth model of care to better serve Medicare Advantage members in markets across the country.
Source: blogspot.com

Regional VP For United Healthcare In SoCal Discusses Important Medicare Information

[…] STUDIO CITY (CBSLA.com) — Regional Vice President for United Healthcare Medicare & Retirement in Southern California, Michael McCarthy, stopped by KCAL9 Sunday to make Medicare beneficiaries aware of the enrollment deadline!Source: cbslocal.com […]
Source: cbslocal.com

United Healthcare Medicare Advantage Changes Brand in 2012

No, the Secure Horizons Medicare Advantage plan is not going away, but the branding for Secure Horizons is.  The plan is to start by branding the Medicare Advantage plan as AARP Secure Horizons by United Healthcare so that anywhere you see the Secure Horizons brand you will also see by United Healthcare.  Starting in 2012 you will see AARP United Healthcare without the Secure Horizons.  This is because most seniors are familiar with the United Healthcare branding as they probably had or knew someone who had United Healthcare medical insurance at some time in the past.  The Secure Horizons branding was not familiar to most seniors, and was just causing confusion. See my post reviewing their plans:
Source: medicare-plans.net

Madame Defarge: Avoid Working w/ United HealthCare, Medicare Advantage Plan, unless you are an IN

Well, I’ve got nothing better to do than to organize a bunch of paperwork to send to United HealthCare Appeals Department which entails printing out all of the patients’ outpatient psychotherapy notes, creating a face page, sending a copy of it to the NC Insurance Commissioner as the client did not understand that a Medicare Advantage company can be an oxymoronic term.  Almost one-half year’s worth of weekly billing had been rejected x2 (it takes time to wind thru their system while I continue to honor my relationship w/ the client and see her) on the basis of:                           Error Code: 0979: Member Self Directed Out of Network So, for United Healthcare, if the Medicare provider is not ‘in network’ to that company, if the client picks that company as their Medicare Provider, you will not be paid.  The woman on the line at United HealthCare, as she tried to talk the client out of switching back to Medicare insisted, “You could have seen oe of the providers we have” to which the client stated, “But I’ve been seeing Dr. Hammond since my husband died”—–indicating that the administration of United Healthcare has no idea of the nature of outpatient therapy.  Hey: just switch over to that fella down the road.  Right. She called them the other day to switch back to regular Medicare—–where I recommend ALL my clients to stay.  I haven’t had any recent trouble w/ Humana but two years ago they insisted I send all of my patients’ session notes in order to pay me.  And by the way, that reminds me that the company that Humana had outsourced the outpatient mental health care only authorized until mid-year. Whoopee!  More paperwork to create for Humana.  WE NEED A ONE PAYER SYSTEM THAT IS CENTRALLY ADMINISTERED.
Source: blogspot.com

2013 Medicare Trustees’ Report Gives the HI Trust Fund 2 More Years

Posted by:  :  Category: Medicare

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Social Security projections, however, remained the same as predicted in 2012, which anticipates a 2033 depletion. Social Security disability insurance also remains the same with a predicted 2016 depletion. SSDI applications have grown from fewer than 300,000 in 1990 to 850,000 today. The applications have increased by 30% since just 2007 and SSDI has become the unemployment alternative for middle age males in a soft job market. Due to this increased volume of applications, ALJs reviewing those applications on behalf of CMS feel as if they do not have adequate time to review the applications that typically contain over 500 pages of medical records, notes form doctors and evidence provided by experts and are approving questionable claims they otherwise would have denied if given adequate time to investigate. In a federal lawsuit filed by the ALJ union in April, over 1400 judges allege that CMS expects them to decide over 700 claims per year causing them to rush evaluations to the detriment of the taxpayers. The alleged productivity goal is outlined in the agency directive and the suit alleges that directive violates both the Social Security Act and the Administrative Procedures Act.
Source: medval.com

Video: Introduction to Medicare – Strengths, Weaknesses, and Applications of Medicare Data

How Could Medicare Applications In California Make Any More Bewildering

Those are the only premiums get yourself a for Medicare. Most people pay just .40 for their particular Medicare which is really cheap insurance which is also pretty decent insurance coverage. You are required to have a nice Medicare Prescription Medicine plan. When you purchase not to you have to pay a penalty in the future if you intend to enroll in an insurance plan. Joanna was quiet happy now. Your girl advised some related with her friends pertaining to the different medicare plans in addition helped them to understand the Medicare criteria. As she had a fair idea about the various regulations and rules so she was launched working as that Medicare consultant and as a result helped lots people today that in selecting a better plan. Payments for lost belongings, flight insurance, customized liability insurance, daily living allowances, not to bring up emergency evacuation recommendations can all participate in with a all-inclusive travel insurance life insurance policy. Regular traveling may require an increasingly extensive insurance insurance coverage. Different policies have varying discomforts as explained below. Nc Medicare Supplement plans are required when Federal statute offer you certain “Guaranteed Issue” periods to females whose existing insurance plans are ending or changing in some way. These “Guaranteed Issue” situations allow you to decide a Medicare Enhance plan of choice without answering any health questions or just having a Medical Information Bureau health background check. medicaresupplementplanfguide.com also known as medigap policies are designed to pay just what the government run medicare insurance system does not. The plans will definitely be generally listed received from Plan A that will help Plan L when which they everyone have pre fixed benefits set up by the medicare system. Every one of the plans are often Identical from provider to carrier and the rates are actually not, so components . to do just a little shopping around certain that that you obtain the best policy for the investment. The lots of popular plan is probably Plan Fahrenheit because it coverings most of the benefits at a very reasonable rate bear in mind Plan J is considered quickly becoming increased popular as created by late for your additional benefits preventative care and usually the at home convalescence benefits. On behalf of about everyday 0 of coverage, insurance for canceling and interruption is going to be good coverage and if you’re making large advance deposits as well if your get-away arrangements require you really to keep at specified dates. Even with non refundable payments people can have their entire travel rate reimbursed when individuals experience cancelled or delayed flights. When a individual needs to change reservations from any kind of double to single accommodations if per companion can never ! longer join the main trip so in the following is a prepare that can cover such expenses. Overall, the bankruptcy of Guardian Healthcare is a concern for many providers, members and some other affected groups. However, because Medicare insurance has granted this SEP, which makes it possible to choose a new plan without charges or underwriting, could certainly take advantage about this one-time opportunity either to select a many more comprehensive Medicare Assist plan or find a new Advantage plan. A person’s have Medicare unlike your old orthodox major medical coverage there is not an limit on how much money you could owe during when you really of a season. On traditional giant medical policies there are annual spend limits, typically separate for in and associated with network care. With Medicare you face out network costs moreover unlimited cost spending. A lot of the costs will depend what amount you use care but they still exist. Keep in mind that Medicare was not ever intended to devote all of your debts. It is there to help you afford the medical care that you seek. You may be eligible for very low income assistance to formulate your prescription drug estimates or even all the premiums as ideally. Check to see if you are blessed with state programs, go to seminars, stop by using at your regional senior center and therefore centers on your aging.
Source: typepad.com

How Could Medicare Applications In California Constitute Any More Huge

Those are the only premiums pay out for Medicare. Most people pay just .40 for a person’s Medicare which is rather cheap insurance and is also pretty decent insurance coverage. You are required to have a Medicare Prescription Remedy plan. If you choose not to you have to pay a penalty in the future if you plan to enroll in an insurance plan. Joanna was quiet delighted now. Your girl advised some associated with her friends pertaining to the different medicare plans in addition helped them to understand the Medicare directives. As she had a fair idea about the various foibles so she working working as a huge Medicare consultant and helped lots ladies in selecting a different plan. Repayments for lost belongings, flight insurance, professional liability insurance, day to day living allowances, not to emergency evacuation benefit can all take part in with a effective travel insurance policy. Regular traveling may require and then cleans extensive insurance contract. Different policies have varying complications as explained down further. N . c . Medicare Supplement plans are required merely by Federal statute to offer certain “Guaranteed Issue” periods to men whose existing insurance plans are ending or increasing in some journey. These “Guaranteed Issue” situations allow you to decide a Medicare Enhance plan of choosing without answering any health questions or having a Some medical Information Bureau health background check. MedicareSupplementPlanFGuide.com also known by means of medigap policies are meant to pay just what the government power medicare insurance unit does not. The plans tend to be generally listed faraway from Plan A to allow them to Plan L when which they everyone have pre set benefits set mass popularity by the medicare health insurance system. The whole the plans can be Identical from crate to carrier yet somehow the rates are not, so elements to do just a little shopping around make sure that that you obtain the best policy for the extra bucks. The nearly all popular plan is undoubtedly probably Plan F because it covers most of a new benefits at an reasonable rate however Plan J is quickly becoming even more popular as linked late for it has a additional benefits precautionary care and the at home curing benefits. On behalf of about everyday 0 of coverage, insurance for termination and interruption definitely is good coverage and if you’re making large advance deposits or if your voyage arrangements require you really to keep at specified dates. Even with un refundable payments travelers can have that entire travel expense reimbursed when they experience cancelled or it may be delayed flights. When a individual needs to differ reservations from a double to a person accommodations if per companion can no longer join the entire trip so right here is a coverage that can joint such expenses. Overall, the bankruptcy to do with Guardian Healthcare is an issue for many providers, members and opposite affected groups. However, because Medicare insurance has granted this SEP, which can help you choose a modern plan without charges or underwriting, could certainly take advantage of such a one-time opportunity to either select a many more comprehensive Medicare Health supplement plan or get a new Advantage plan. Anyone have Medicare as opposed to your old sidestep major medical protection plan there is the case limit on just how much money you could owe during accomplished . of a twelve months. On traditional real medical policies you can apply annual spend limits, typically separate each in and associated with network care. With Medicare then you face out of network costs moreover unlimited cost sharing. A lot of fees will depend just how much you use cure but they survive. Bear in mind that Medicare was certainly never intended to make purchases all of your bills. It is there to a person afford the simply because smaller sums that you would like. You may be eligible for inexpensive income assistance for your prescription drug payment or even all the premiums as well. Check to see if you are blessed with state programs, go to seminars, stop across at your community senior center or if the centers on wrinkle.
Source: typepad.com

Where Could Medicare Applications In California Possibly Be Any More Confusing

Somebody are really definitely not looking forward time for old age. We can become acquainted with. All the big fun will be far more than. You will be retired. Went right have to try to cut down on fees. But how can you? All different types of diseases yet illnesses will trouble you. Applying a medicare contract will also no longer be of really help. In that respect are so many ifs and buts involved. Nevertheless many things by which medicare doesn’t cover. So you need to be surprisingly careful that buyers don’t expose both yourself and injure yourself. Life will to get so boring. Well, we typically here to identify you that most people are wrong. Medical services on unfamiliar trips are most often shouldered but ones traveler but reimbursements can be issued by the insurance organizations back in or even her her country. Outside the line Medicare will have no use but you areas like Quebec and Mexico where Medicare can be used but only by using limited coverage. Regular What is the best time to secure a medicare supplement plan f in Arizona end up being the the better option to take. Confident you do call a local insurance plan agent in invest in to get the right Medicare quote. Why not email the local agent, as the support is free and you will actually be capable of to save several in the process. It’s not just about the main though; it’s around getting what anybody honestly need. In this post I am going to be chatting about Ohio Medicare Advantage Plans and Ohio Medicare Supplement Health insurance policies also known being Medicare Part J ( Medigap ) and how consumers can benefit owners. To register in a treatment advantage plan you go through a major private insurance workplace which has there plan approved merely the medicare system. Medicare plus plans are highly great for aged who are nutrient rich and want to save money along there insurance premiums. Today, the insurance insurance companies in Texas are allowed to decide which supplement plans may easily be offered in which to clients. However, in the offering, they must see to it that as they adhere to provisions formulated from the federal moreover state laws. Any deviation from the laws can make the cover ineligible for conversion to the herd. This is a precise indication that the actual government is indeed trying to protect the health helps of people acquiring a Medigap decide. With the people’s practice on how some of the government protects them, they became a great deal less stressed in choosing medicare plans in New jersey. Medicare Savings Plan: There are lots of national programs that a lot of aid with Treatment outlay. Some of these furnish the income required for an premium for Medicare insurance Part B. To meet automobile for one relating to these programs anyone might have to meet explicit asset and take-home pay circumstances. Do bewildered by the array of Medicare insurance Advantage plans and moreover Medicare Supplement insurance policy coverage? Here are three solutions to cut through that this jargon and makes it simpler to obtain the best value and the best protection originating from a gaps in Medicare’s coverage. First, let’s take an appearance at what you are risking by depending solely on Medicare health insurance. Confounding to say the particular least, which is also why talking to allow them to a knowledgeable insurance policies agent, makes come to feel. No reason trying to types through all usually the Parts and Plans on your personally own when agent advice is free and quite specific to your circumstances room ) and everyone a has a uncommon set of circumstances. Attempt explain to folks that most from the policies may no doubt cover skilled nursing cost insurance plus along with blood transfusion costs as most of the people at sixty seven days do undergo transfusion. Agents in many cases can prepare a extremely report of all of the areas that could be covered under this insurance policy and keep the program ready to indicate before the potential consumer. So just by after a customized search for many medigap leads the net you can easily be sure to acquire a good conversion time that may favour your business. Today a associated with people only believe the internet for some of the related information. So starting from a personalised search on medigap leads would certainly be a good in order to start with. Guaranteed Issue plans should be for those in which have a illness such as diabetes or cancer in which can’t obtain traditional areas. most of these plans certainly are a defined benefit solution in which for everybody doctor visit, back button ray or procedure you are seeing as benefit amount anything. for example if your benefit is 0.00 for a physician or pharmacist visit, and car industry actually only cost .00 then you’ll be able to helpful other .00. In most slots a check will be sent to you when you devote a claim an individual proceed to pay your bills however you desire.
Source: typepad.com

Centers for Medicare & Medicaid Services: Draft Applications for Health Insurance Marketplaces

In the accompanying description of the draft applications, CMS expects that, in the first year of operation of these health insurance marketplaces in 2014, 3.6 million applications would be submitted online and another 402,000 applications would be submitted through paper applications.  CMS calculates that it would take 30 minutes to complete te online application and 45 minutes to complete the paper application.
Source: ignatiusbau.com

Grant Opportunity to Improve Healthcare for Medicare, Medicaid

The Centers for Medicare & Medicaid Services (CMS) has released a Funding Opportunity Announcement for round two of the Health Care Innovation Awards. Under this announcement, CMS will spend up to $1 billion for awards and evaluation of projects from across the country that test new payment and service delivery models that will deliver better care and lower costs for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) enrollees.
Source: eatsmartmovemoresc.org

Online Applications For Medicaid And/Or CHIP: An Overview of Current Capabilities And Opportunities For Improvement

A key component of the Patient Protection and Affordable Care Act is the creation of integrated and coordinated eligibility processes for Medicaid, CHIP, and Exchange coverage that are supported by technology. States will be required to provide a single application that individuals can use to apply for these programs that is available in multiple formats, including online. Online applications can minimize burdens on individuals and help increase enrollment by making the application available around the clock, enabling faster or real-time eligibility determinations, and streamlining and simplifying the application process. States can also benefit from online applications through reduced administrative burdens and increased accuracy and efficiency. However, the extent to which an online application realizes these advantages depends on its structure and capabilities.
Source: kff.org

MORENO VALLEY: Council accepting commission, board applications

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Source: pe.com

Medicare Advantage Plans are Changing

Posted by:  :  Category: Medicare

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The days of paying a $0.00 premium and receiving a rich Medicare Advantage Plan are ending soon. However, when you compare the benefits and premium of a Medicare Advantage Plan to an Employer or Private insurance Plan, Medicare Advantage Plans are still typically going to offer better coverage. Medicare Advantage Plans over the next few years should still offer good benefits for a low monthly premium.
Source: srhealthcaredirect.com

Video: Jayden telling me Medicare from Humana’s Phone number

The High Cost of “Free”

Our economic analysis shows that retirees who worked for 40 years and then live 20 years past retirement will receive more than twice what they, and their employers, contributed over their lifetime of working. Only retirees who survive a decade or less after their retirement do not take more out of Social Security than they contributed. Most people will agree that the retirees should receive his/her Social Security benefits at retirement. But with people living longer, who will pay for all the additional benefits now promised? Most people who have not done their homework (including Congress) fail to realize that the numbers for Medicare benefits exceed those for Social Security. Since 1965, Medicare required less than a 3 percent contribution from a worker’s gross wages, yet most people receive over $250,000 in medical benefits before reaching the age of 74, assuming no catastrophic illness. You can do the math on your own wages, assuming a lifetime salary of $100,000 per year for all 40 working years, a worker will have paid in only $120,000 into the Medicare system. Congress, after agreeing to take care of everyone after retirement for the rest of their lives, has broken a sacred trust and used incoming contributions to fund other government expenditures, instead of letting the contributions build over the past 50 years.
Source: mises.org

Ron Paul News: The High Cost of “Free”

Why does a large portion of the population choose not to work when there are many jobs available? The answer is simple. If you can receive 2-3 times as much money from unemployment, disability, and/or welfare benefits (subsidized housing, food stamps, free cellphones, etc.) as you can from a temporary or part-time job, and live a life of leisure, why work? In 2011, the U.S. government spent over $800 billion[1] on this “welfare,” exceeding expenditures on Social Security or Medicare. In the Denver arena where Mr. Obama gave his DNC 2008 acceptance speech, a woman in the audience became overwhelmed by the speech and said that she no longer needed to worry if she could make her car or mortgage payments because he would take care of it for her. In Cleveland, a woman claimed that she was going to vote for President Obama again because he gave her a free cellphone (along with a litany of other entitlement giveaways). Before you growl, you should know that the free cellphone program was instated by President Bush in 2008 through the FCC’s Universal Service Fund. Fees for these “free” cellphones are paid by all telecommunications service providers out of the revenue received from their paying customers. Despite the political rhetoric over the past half century, entitlements were actually highest during Republican administrations. The political allure of free is bi-partisan. The political allure of free is so strong that an alarming number of people choose to become wards of the entitlement/welfare state rather than captain their own destiny. Economist Nicholas Eberstadt of the American Enterprise Institute believes that Americans have become a nation of takers, threatening the self-reliance that has long characterized our national psyche. Eberstadt (2012, p. 4) presents data showing that entitlement payments to Americans, since 1960, have risen annually by 9.5 percent. He argues that over the past 50 years the ever-increasing array of transfer payments to Americans have risen 727 percent. In 2010 such payments alone totalled $2.3 trillion with Social Security (for old age and disability) accounting for 31 percent, Medicare 24 percent, Medicaid 18 percent, Income Maintenance 12 percent, other giveaways (free cell-phones, support for a broken education system, housing, the arts, etc.) 8 percent, and Unemployment Insurance 6 percent (Eberstadt 2012, C1-2). This has resulted in 49 percent of American households receiving one or more government transfer benefits (Eberstadt 2013); this amounts to 18 percent of all personal income and a burden of $7,400 for every American.
Source: ronpaulnews.net

The Medicare Maze: Observation Stays, Nursing Home Costs, and “Invisible Patients”

We have all been traveling and have found ourselves party to a conversation because of proximity or bad cell phone etiquette. Some of these conversations are irritating, but I was looped into an interesting one the other day. Sitting in the Charlotte airport, two older men who looked like they were returning from a golf vacation started talking about enrolling in Medicare. One had just done it and the other had lots of questions. The recent enrollee said that he had registered through the Social Security web site; it took only ten minutes and was very easy. He told the other man that he only needed to sign up for part A, not for part B.
Source: wingofzock.org

HEMET: Teen’s stabbing not related to cell phone, investigator said

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Source: pe.com

The CareGiver Partnership: The Goose That Laid The Golden Medicare Egg is Dead

When that call to action is supported with just under $200 million a year in continuous bombardment television advertising (and radio, direct mail), it makes people want to get the free stuff. Lately, you may have seen non-stop ads from a company called SafeLink which is giving away free phones and minutes to those on food stamps and Medicaid.  The free phones and minutes are funded by The Universal Administrative Company (USAC) which takes money we pay to phone companies in our bills and they fund the free phones with it (and other programs).  When you peel back the layers you discover that USAC is the administrator and the fund manager referred to as USF of Universal Service Fund.  Digging even deeper, you find this leads back to Washington  and the FCC which actually has oversight for USAC.  SafeLink is a company taking advantage of this government program that we are all paying for and creating the expectation for a free cell phone and minutes.
Source: caregiverpartnership.com

Cell Phones for Seniors – Cellular Telephones for Older Adults

Seniors may find cellular telephones difficult to use due to normal changes of aging, such as vision and hearing changes or chronic illness, such as arthritis and diabetes. Find suggestions for questions to ask when shopping for a cellular telephone and discover examples of some cell telephone companies that offer products specifically designed with seniors with special needs in mind.
Source: suite101.com

Oklahoma Cancer Patients Worry About Cuts To Medicare Caused By

Once every three weeks, he spends three hours at Oklahoma Oncology, getting chemotherapy infusion treatment, but there are concerns there that patients like Joe may be forced to find a new place for treatment and it all stems from the sequester.
Source: newson6.com

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June 10, 2013

Writer of Pop: The Demise of Medicare is Actually Funny in “Assisted Living”

Posted by:  :  Category: Medicare

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Joe Taylor, (Kurt Beattie) is the new resident at just one facility. There, he meets Beatrice (Marianne Owen), a friendly, resident not willing to buck the system; Wally Carmichael (Jeff Steitzer), an old goat that gives the nurses so much trouble that they take away his hearing aids; and Mitzi Kenny, (Laura Kenny), fighting dementia. Together, the foursome work together to fight for change and dignity. The floor that they all live on is run by Nurse Claudia (Julie Briskman), who leads with an iron fist and Kevin (Tim Gouran), a likeable young man who struggles between wanting to befriend the residents and keeping Claudia happy.
Source: writerofpop.net

Video: Visalia Assisted Living and Senior Care Homes On Medicare, Medi-Cal and Social Security

Hospice Contracts With Assisted Living Facilities

From a practical perspective, we generally advise that a hospice have an agreement with an ALF.  First of all, it is good business practice that defines the role of the hospice and the ALF in the provision of hospice services.  Another good reason for an agreement is that many states license ALFs and the applicable state regulations may require an agreement.  Finally, since the same surveyors often times conduct surveys in both nursing homes and ALFs, it can avoid confusion by the surveyors over whether an agreement is required.
Source: hallrender.com

Final Members of Long Term Care Commission Announced

The White House appointed the last three members of the congressional long-term care commission. They are Henry Claypool, Executive Vice President of the American Association of People with Disabilities; Dr. Julian Harris, a physician and the Massachusetts Medicaid director; and Carol Raphael, the Vice Chair of the AARP board and former CEO of the Visiting Nurse Service of New York.
Source: about.com

How Do You Get Medicare Part D?

As the nation’s largest drugstore chain with fiscal 2012 sales of $72 billion, Walgreens (www.walgreens.com) vision is to become America’s first choice for health and daily living. Each day, Walgreens provides more than 6 million customers the most convenient, multichannel access to consumer goods and services and trusted, cost-effective pharmacy, health and wellness services and advice in communities across America. Walgreens scope of pharmacy services includes retail, specialty, infusion, medical facility and mail service, along with respiratory services. These services improve health outcomes and lower costs for payers including employers, managed care organizations, health systems, pharmacy benefit managers and the public sector. The company operates 8,077 drugstores in all 50 states, the District of Columbia and Puerto Rico. Take Care Health Systems is a Walgreens subsidiary that is the largest and most comprehensive manager of worksite health and wellness centers and in-store convenient care clinics, with more than 700 locations throughout the country.
Source: womanaroundtown.com

Medicare’s Role for Older Women

These gaps in benefits and cost-sharing requirements, together with spending for premiums for Medicare and supplemental coverage (described further below), can translate into high out-of-pocket expenses for people on Medicare.  On average, older women spent more on health care (including premiums) than older men in 2009 ($4,844 versus $4,230), a greater financial burden given their lower incomes.  Notably, older women spent more than twice as much on average for long-term services and supports (LTSS). (Exhibit 3) For all older Medicare beneficiaries, out-of-pocket spending escalates as they age, but women ages 85 and older have considerably higher out of pocket costs than older men, largely due to their higher health and social needs and greater use of long-term care services.  Often the need for these services comes at the time when women have fewer resources.   Among women ages 85 and over, out-of-pocket spending amounts and the share with low incomes are higher than for younger women and men of all ages on Medicare (Exhibit 4).
Source: kff.org

Resources for Seniors Living in Los Angeles Medicare Medicaid ~ Free Guide Loans

Everyone once in a long time its nice to act kind for others. Everyone believes this philosophy at some level, even if its kindness shown to just the immediate relations. The problem is will certainly doing something kind on the table doesnt always solve through needing persons dilemma. It may provide their products temporary relief and hdd other problems back temporarily, but some effort is still needed to permanently resolve the situation. You might well to be familiar with Medicare and Medicaid the governments connected with doing something nice for others. The program doesnt always help even if we hope, and sometimes we may even view it as underwhelming. But it is an option that is available to many and could be explored. Both of these software is one example of a source for senior living in Rhode island.
Source: blogspot.com

When does Medicare cover nursing home placement?

To qualify for skilled nursing benefit under Medicare, you must have a qualifying inpatient hospital admission of at least three consecutive days (not counting the day of discharge). You must require “reasonable and necessary” skilled services (such as physical therapy) for your diagnosed condition.
Source: seniorpat.com

Integrating Medicare and Medicaid: What’s Happening Now, and What It Means for Assisted Living and Other LTSS

This webinar, sponsored by the Assisted Living Consumer Alliance, explains the dual eligible integration process, with a focus on how the new demonstrations will affect long-term services and supports (LTSS) and their significance to assisted living and other long term services and supports. Speakers are Georgia Burke and Eric Carlson, attorneys from the National Senior Citizens Law Center. Jody Spiegel, Director of Bet Tzedek’s Nursing Home & Assisted Living Advocacy Project, will be the moderator.
Source: nsclc.org

New York Medicaid and Medicare Part D: Working Together

Typically, as part of Medicare Plan D, the patient must pay a nominal amount, like a copayment, for the medication. Individuals who have full coverage from Medicaid while living in a residential home, an adult living or assisted living facility will likely be required to pay a small medication copayment for each medication. If an individual has full Medicaid coverage and resides in a nursing home, they will not be required to pay anything for covered prescription drugs.
Source: lawfirmnewswire.com

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June 10, 2013

United Health Care “?” Largest Health Insurance Company

Posted by:  :  Category: Medicare

The largest health insurance company is the united health care which offers all types of health insurance facility. If you are planning to purchase a united health care there are multiple plans choice available, you can get the best insurance suitable. Some of their plans include copay, short term medical, student coverage, and health saving accounts they also provide dental insurance for those who dont get coverage through their employer. Individuals and families who are looking for a United Health Care insurance plan with many of the same benefits as those provided by an employer should choose the copay option. You will need to pay a set fee for preventive care and office visits, but after copayment, 100% of exam costs will be covered. Health care reform is a new feature came into practice after Obama won the political battle. This is a very new service available to all Americans but hardly any have the knowledge of health care reform, this article totally aims at informing the American people about health care reform and the advantages they are about to receive due to approval of this plan. In this article I have listed all the benefits you are going to receive form health care reform below. United Healthcare is a popular choice and based on the company, they enroll one in five Medicare beneficiaries into their health plans. They also provide coverage through SecureHorizons, AmeriChoice, and Evercare. United Healthcare Medicare plans are offered in a number of options that include HMO plans, supplement insurance plans, special needs plans, and Medicare part D prescription drug plans. These plans offer different kinds of coverage and the best one for you will depend upon your individual health condition. United Healthcare Medicare plans also include supplement insurance. This insurance helps you cover the costs incurred in Medicare part A and part B expenses. The special needs programs are only for those with certain medical conditions and life situations and are not open for general enrollment. United Health Care is also accepted nearly anywhere, a huge benefit for students who may be attending school far from home. However, your school will have to offer United Health Care for you to take advantage of their special student insurance coverage. Hope this article was needful in providing all important informations about united Health care, if you want to know more about United health care log on to healthvote.com
Source: unitedhealthcareoxford.net

Video: Medicare Basic Overview by United Healthcare Medicare Solutions

Regional VP For United Healthcare In SoCal Discusses Important Medicare Information

[…] STUDIO CITY (CBSLA.com) — Regional Vice President for United Healthcare Medicare & Retirement in Southern California, Michael McCarthy, stopped by KCAL9 Sunday to make Medicare beneficiaries aware of the enrollment deadline!Source: cbslocal.com […]
Source: cbslocal.com

Medistar Home Health Joins UnitedHealthcare’s Provider Network

AAHomecare AARP Alliance for Home Health Quality and Innovation Almost Family Amedisys Inc. American Association for Homecare American Association for Long Term Care Insurance Apria Healthcare Group Care.com CellTrak Technologies Inc. Centers for Medicar & Medicaid Services Centers for Medicare & Medicaid Services CliftonLarsonAllen CMS Emeritus Senior Living Ensign Group featured Federal Bureau of Investigation Gentiva Health Services Inc. Genworth HHS Home Health Depot Home Health International Humana IntegraCare Intel-GE Care Innovations Jordan Health Services Kindred Healthcare LHC Group LHC Group Inc Medistar Home Health MedPAC NAHC National Association for Home Care & Hospice National Hospice and Palliative Care Organization New York Times Paraprofessional Healthcare Institute Partnership for Quality Home Healthcare PHI ResCare HomeCare Scripps Health Sentara Healthcare The Partnership for Quality Home Healthcare VA Visiting Nurse Association
Source: homehealthcarenews.com

Hawaii Ranks 6th For Senior Health

UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers and Medicare and Medicaid beneficiaries, and contracts directly with 780,000 physicians and other health care professionals and 5,900 hospitals and other care facilities nationwide. UnitedHealthcare serves more than 40 million people in health benefits and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.
Source: commpac.com

UnitedHealthcare and Novu Launch Online Portal That Enables Medicare Beneficiaries to Create Their Own Personalized Wellness Programs

About UnitedHealthcare UnitedHealthcare (www.uhc.com) is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers and Medicare and Medicaid beneficiaries, and contracts directly with 780,000 physicians and other care professionals and 5,900 hospitals and other care facilities nationwide. UnitedHealthcare serves more than 40 million people and is one of the businesses of UnitedHealth Group UNH +1.55% , a diversified Fortune 50 health and well-being company.
Source: distilnfo.com

Deadline Nears to Voice Opinion on Medicare

If you are one of the 263,600 Las Vegas residents with Medicare coverage, you may have recently received a packet in the mail or a telephone message from the Centers for Medicare & Medicaid Services (CMS) inviting you to participate in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. This survey gives you a chance to rate your satisfaction with your Medicare health insurance and doctors. CMS conducts this annual survey to hear directly from select beneficiaries about the quality of their Medicare coverage and the care they receive.
Source: lasvegastribune.net

Is United Healthcare Medicare Supplemental Insurance My Only Option?

For most United Healthcare Medicare supplemental insurance subscribers, the plan is a lifesaver—making accessible important, lifesaving health and medical treatments, surgeries and medicines. Many believe that because Medicare doesn’t cover a particular procedure or treatment, that this is the end of the road for them—hardly the case. Unfortunately, many that suffer from mental health disorders find themselves in this situation—for one reason or another, the CMS (the Center for Medicare & Medicaid Services) doesn’t cover very many mental health-related medicines and treatments.
Source: seniorcorps.org

Medistar Home Health Now Part of UnitedHealthcare’s Care Provider Network

About Medistar Home Health Medistar Home Health is a nationally recognized Medicare-certified home health agency, a member of the National Hospital to Home Quality Improvement Initiative, a Premier and Gold Participant in the Home Health Quality Improvement National Campaign and received the Home Health Quality Initiative’s Best Practices Early Adopter and Gold Medal Awards. Medistar Home Health has been serving Louisiana patients in the familiar surroundings of their homes since 1983. “Our mission is to make a positive difference in the lives of our patients, our healthcare partners, and our valued employees as we provide superior quality and passionate care, while adhering to the highest standards of excellence.” To find out more, visit http://www.medistarhomehealth.com
Source: saasnw.com

Medicare Advantage and Medigap

In 2012, my 84 yo Father-in-law switched from traditional Medicare and a Medicare supplement to the AARP/United Healthcare Medicare Advantage plan. Unknown to him, this switch required him to contact the supplement provider (Blue Cross of FL) to cancel his supplemental insurance. He did not do that. For the past year and a half, Blue Cross has been automatically withdrawing $154 from his bank account every month. When he balanced his checkbook, he ignored this charge. 3 weeks ago, he was hospitalized with a stroke. My wife has power of attorney so we are paying his bills. We noticed the Blue Cross charges while reviewing his monthly bank statements. I called Medicare and they said cancelling the supplement was not automatic even though it is illegal for a company to sell someone with Medicare Advantage a supplement plan. Blue Cross billing doesn’t work on weekends so I’ll be calling them tomorrow. When he switched to Medicare Advantage, which includes RX coverage, his old Part D plan was automatically cancelled. It seems odd that the Medicare Supplement was also not cancelled. Oh well, he should be in line for a $2500+ refund from Blue Cross. We’ll see.
Source: early-retirement.org

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

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

Join UnitedHealthcare for a National Medicare Education Week Event!

Representatives from United Healthcare will share important Medicare information and give an overview on social media.  Hands-on computer training will follow the presentation and will help you explore online resources for understanding.
Source: wordpress.com

United Health Prior Authorization Requirements

Based on physician input, review of the American College of Cardiology (ACC) guidelines, Medicare’s Local and National Coverage Determination policies, and Centers for Medicare & Medicaid Services (CMS) guidelines, effective Oct. 1, 2012, UnitedHealthcare’s Cardiology Notification Program for Medicare Advantage benefit plans is changing from a notification program to a prior authorization program. This change is consistent with other UnitedHealthcare programs and prevailing industry-wide standards. Over the coming year, additional UnitedHealthcare programs will be aligned to verify that services are medically necessary.
Source: ipamd.com

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June 10, 2013

Mercy Health Plans Announces New Name for Their Medicare Advantage Plans: Mercy Medicare… ( ST. LOUIS July 23 /

Posted by:  :  Category: Medicare

Cached Medicine News:Health News:FAB-HOMES™ Presents First Passive House Collection 2Health News:FAB-HOMES™ Presents First Passive House Collection 3Health News:mHealth Alliance Works in Partnership with GSMA to Expand Discussion of Mobile Health at 2010 Mobile World Congress 2Health News:mHealth Alliance Works in Partnership with GSMA to Expand Discussion of Mobile Health at 2010 Mobile World Congress 3Health News:Local Blood Supply Impacted by Wednesday’s Severe Snow Storm 2Health News:Local Blood Supply Impacted by Wednesday’s Severe Snow Storm 3Health News:Red Cross Raises More Than $32 Million Via Mobile Giving Program 2Health News:Red Cross Raises More Than $32 Million Via Mobile Giving Program 3Health News:Red Cross Raises More Than $32 Million Via Mobile Giving Program 4Health News:Red Cross Raises More Than $32 Million Via Mobile Giving Program 5Health News:Red Cross Raises More Than $32 Million Via Mobile Giving Program 6Health News:Explorer’s Bounty Puffed Fruit Snacks Helping Parents Battle Summer Obesity 2Health News:Lafarge North America Recognized by IBI and NBCH for Health & Productivity Leadership 2Health News:Lafarge North America Recognized by IBI and NBCH for Health & Productivity Leadership 3
Source: bio-medicine.org

Video: Medicare Myth – At Mercy of Insurance Companies

Obama’s Medicare: Leaving Seniors at the Mercy of Insurance Companies

“[T]he Obama administration has reciprocated AARP’s support by giving the group preferential treatment. “Obamacare” exempted Medigap insurance – a market AARP dominates – from virtually all its new mandates, including the ban on preexisting condition discrimination. The Department of Health and Human Services exempted Medigap plans from insurance rate review, though AARP, whose plan is the most popular form of Medigap coverage, makes more in profit the higher premiums rise. Though the administration has publicly attacked other insurance companies with much smaller profit margins, it has not openly criticized AARP’s business practices.”
Source: heritageaction.com

Amid Medicare Woes, Humana Affirms Weaker Outlook

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Source: tacticalminc.com

Mercy Medical Center site for “Welcome to Medicare: 2011”

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Source: thesuburbanite.com

ibm medicare options: Reading about Medicare overhauls might be bad for your health

There is much being reported about how our law makers propose to change Medicare in various budget proposals and sequestration cuts –  making it very difficult to ignore and it is nerve rattling.  There is no way to predict what will actually happen and much of the reporting is either over hyped or just inaccurate.  If you want to really understand the implications of various congressional proposals go to  the Medicare Rights Center and sign up for their news letters.  They provide excellent analysis: http://www.medicarerights.org/. The Medicare Rights Center is a private, non-profit organization not affiliated with any government agency or corporate insurance company.  The reason I learned as much as I know about Medicare is that I have been a volunteer on their Medicare Helpline for about four years.  The organization has researchers, analysts, lawyers and a front line view of how hard it is for seniors and the disabled to figure out Medicare by answering over 14,000 helpline calls per year.  The phone calls I find the hardest to handle are from people in their eighties and older who are easily confused, at the mercy of their Medicare Advantage plans or medical providers, and haven’t a clue about how to resolve problems.  These calls have shown me how lucky I am to have access to IBM insurance options and to still be able to figure things out for myself.  I dread the day I cannot and hope Congress will simplify Medicare insurance before then and that IBM will keep its promise to provide retirees with healthcare options. It’s a lot to wish for. The Medicare Rights Center regularly does analysis on those helpline calls and the impact of various government proposals.  They provide feedback to Congress on the current construct of Medicare, the private insurance industry providing Medicare Advantage and part D plans as well as the various congressional suggestions to revamp Medicare.  As an example, there is a notion held by some of our legislators that people who have secondary private insurance (aka medigap plans) go to the doctor more often than people who do not and thereby drive up overall Medicare costs.  So, the genius legislative thinking is those secondary plans should be “taxed”.  The analysis of real data shows that is a wrong notion.  I, for one, do not enjoy going to a doctor no matter what insurance covers.  Turns out I am a good representative of the majority of people!  Hopefully, USA citizens will be informed enough to put pressure on legislators to act rationally.  It’s a lot to wish for.
Source: blogspot.com

Integrated Managed Care Model for Dual Eligibles Reduces Readmissions

This analysis was subject to some limitations. For example, while we captured both full and partial duals in the Medicare FFS dual eligible control group, the Mercy Care Plan only enrolls full duals. Although our results were risk-adjusted, because partial duals may have access to greater resources than full duals, the difference in populations may have had some impact on our findings. Also, to identify the Medicare FFS dual eligibles in the 2009 Standard Analytic Files, Avalere was limited to using indicators known to either undercount or overcount duals depending on the state. The analysts used a linear regression method to risk adjust the measures of inpatient utilization, ED visits and adults’ access to preventive/ambulatory health services. Alternative methods are frequently used to model these types of quality measures, particularly for patient-level risk adjustment. We explored these other model structures and found these alternatives did not provide any considerable gains in model fit or predictive power.
Source: healthaffairs.org

HEMET: High school students view realistic, but fake, crash

The 25 role players involved in the program were to be taken to a camp in Idyllwild where they were to be lectured by a variety of speakers, including relatives of youths killed in real-life DUI accidents. Then, at the conclusion, each student was to write a fake letter to their parents saying they had been killed in a drunk-driving accident.
Source: pe.com

The Sullivan Independent News

The Visiting Nurses Association will hold a flu shot clinic at the Sullivan Senior Center on Tues., Oct. 13 from 12 p.m.- 3 p.m. In order to be sure a vaccine is available for you, you must call or stop by the Senior Center and have your name put on the vaccine list. The VNA will be bringing 150 vaccines, but more will be available if we see more people are signing up. This will be a one-time clinic. Those planning to receive their vaccine may show up anytime from 12 p.m.-3 p.m. To avoid the congestion and long waiting periods, you may wish to wait a little later and not all show up at 12 p.m. Insurances accepted by the VNA for this clinic include: Medicare Advantage Plans, Essence, Coventry Advantra Freedom, GHP, Advantra, GHP Advantra Freedom, GHP Gold Advantage, Humana Choice PPO, Humana Gold Choice PFFS, Humanna Gold Plus HMO and Mercy Medicare Advantage. Other insurances that did not contract with the VNA and will not be accepted are: Medicare Advantage Plans, Secure Horizons, Aetna Medicare, Anthem Senior Advantage, Cigna Medicare Access, Sterling Option, Wellcare, Evercare or any other Medicare Advantage or out-of-state plans. Medicaid is not accepted. If you have another primary insurance, you may not use Medicare or Medicare Advantage. Those wishing to pay “out of pocket” for the vaccine may do so. The cost is $30. Visiting Nurses Association is a non-profit community based organization dedicated to serving the healthcare needs of your community. Please help us by giving us your correct insurance at the time of service.
Source: mysullivannews.com

Mercy Health Plans Announcement from Carl Schultz

Coventry Health Care (www.coventryhealthcare.com) is a diversified national managed healthcare company based in Bethesda, Maryland, operating health plans, insurance companies, network rental and workers’ compensation services companies.  Coventry provides a full range of risk and fee-based managed care products and services to a broad cross section of individuals, employer and government-funded groups, government agencies, and other insurance carriers and administrators.  Coventry’s purchase of MHP reinforces their commitment to the Midwest market, where their total membership will exceed 1.2 million once the transaction is complete. Coventry operates as Group Health Plan (GHP) for commercial and Medicare products and HCUSA for Medicaid products in the St. Louis area and as Coventry Health Care in other markets served by Mercy.
Source: wordpress.com

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