Where are States Today? Medicaid and CHIP Eligibility Levels for Children and Non

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i


The Affordable Care Act (ACA) creates new coverage options through Medicaid and new health insurance exchange marketplaces that, taken together, provide assistance to individuals with family incomes up to 400% of the federal poverty level (FPL). The ACA calls for the expansion of Medicaid eligibility to 138% FPL ($15,856 for an individual or $26,951 for a family of three in 2013) in 2014, which would make millions of adults newly eligible for the program. However, this expansion was effectively made a state option by the Supreme Court. If a state does not expand Medicaid, low-income uninsured adults in that state will not gain that new coverage option and will likely remain uninsured. This brief provides an overview of current Medicaid and CHIP eligibility levels for non-disabled children and adults to provide better insight into the impact of the Medicaid expansion.
Source: kff.org

Video: Example of Medicaid Eligibility for a Typical Couple

Hinkle, Fingles & Prior, Attorneys at Law

For more information, contact us now. You may also use our contact form to schedule a free workshop at your school or organization. Comments and suggestions for future articles are welcome. The articles provided on the Hinkle, Fingles & Prior website are for your information and may be reprinted in publications, however copyrights cited for each apply. Each reprint must include the author’s name and contact information for Hinkle, Fingles & Prior, Attorneys at Law as follows: Hinkle, Fingles, & Prior, P.C., Attorneys at Law is a multi-state law practice with offices in Lawrenceville, Cherry Hill, Florham Park, and Paramus, New Jersey, and Plymouth Meeting and Bala Cynwyd, Pennsylvania. The firm’s partners and associates lecture and write frequently on topics of elder law, estate planning, special needs trusts, guardianship, special education, health care insurance & Medicaid, and accessing adult services, and are available to speak to groups in New Jersey and Pennsylvania at no charge. For more information, visit http://www.hinkle1.com/ or call (609) 896-4200, or (215) 860-2100.
Source: hinkle1.com

IllinoisHealthMatters.org Blog: New Options for States: Facilitating Medicaid and CHIP Renewal & Enrollment in 2014

Under the ACA, eligibility for all health insurance programs will be determined by MAGI methodology, which uses different income-counting procedures than current Medicaid programs. During the open enrollment period, which begins on October 1st, 2013, individuals applying for coverage in 2013 will determine their eligibility through MAGI methodology. However, individuals renewing and applying for Medicaid during that 4-month period will have their income reviewed by both current rule and MAGI methodology. States can opt to change how they determine eligibility starting October 1st in order to simplify this process.
Source: blogspot.com

Health Policy Brief: Medicaid Premium Assistance

How did the idea evolve? In June 2012 the US Supreme Court struck down the mandatory expansion of Medicaid coverage, a key part of the Affordable Care Act’s means to extend health coverage to many poorer Americans. As states consider whether or not to expand their Medicaid coverage, Arkansas has been working out a new arrangement with the Department of Health and Human Services (HHS), using its federal Medicaid funds to assist residents earning just over $15,000 annually to purchase private coverage from that state’s health insurance exchange. Several other states are also exploring the possibility.
Source: healthaffairs.org

What can Hawaii learn from Oregon’s Medicaid expansion?

While the study did find some areas of improvement, it found Medicaid expansion fails to achieve the principal goal of any health care reform: improving overall health. According to Phillip Klein of the Washington Examiner, “the study suggests that expanding Medicaid is one way of reducing financial pressure on low-income groups, but it’s costly and does not improve their health. Another interesting finding was that medical spending increased among Medicaid enrollees due to more prescription drug use and doctors’ visits, yet the study ‘did not find significant changes in visits to the emergency department or hospital admissions.’”
Source: grassrootinstitute.org

Senate provision to boot pregnant women off of Medicaid violates federal regulations

Art Pope budget charter schools civil rights consumer protection corporations corruption Crucial Conversation death penalty economy Education energy environment federal budget fracking Gov. Pat McCrory Health health care higher education immigration jobless jobs K-12 Legislature LGBT rights Marriage discrimination amendment medicaid NC General Assembly Pat McCrory Phil Berger poverty Prosperity Watch public education Reproductive rights right-wing school vouchers state budget taxes Tax reform Thom Tillis Unemployment unemployment insurance voter ID Voter Suppression Wake County schools
Source: ncpolicywatch.org

Study: Expanding Medicaid Reduces Long

Expanding Medicaid is the financially preferable option for states in general, according to a study by the RAND Corporation published in the journal Health Affairs. History The Patient Protection and Affordable Care Act of 2010 was intended to require all states to expand Medicaid eligibility to all adults earning up to 138 percent of the federal poverty level. CMS will pay for 100 percent of the cost of the newly eligible for three years, tapering off to 90 percent by 2020 with states paying the difference. The Supreme Court shot down that mandate last year, relegating it as an optional provision of the law. HHS ruled the PPACA did not allow states to use federal funds for “partial expansions” of Medicaid through which states could raise eligibility to some adult populations below 138 percent of the poverty line. That gave states an all-or-nothing choice: They could choose to expand and accept the federal money with the caveat of a potentially larger Medicaid bill in the long term, or they could leave the federal money on the table and either maintain current levels of Medicaid assistance or fund other low-income coverage initiatives at their own expense. Outcomes Fourteen states have since opted out of loosening their Medicaid enrollment restrictions. The study’s authors found this translates to $8.4 billion in forgone federal payments to states, and 3.6 million people who would have been eligible for expanded Medicaid will remain uninsured. Individuals who are not enrolled in Medicaid at 100 to 138 percent of the FPL will qualify for federal subsidies to purchase insurance through the health insurance marketplaces that launch next year. However, a loophole in the law does not grant Americans earning less than 100 percent of the FPL with those same subsidies to afford health insurance. In states with Medicaid income thresholds below the FPL, many low-income people earning below 100 percent of the FPL and without employer-sponsored health benefits will be caught in a vacuum of affordable health insurance, as they won’t be eligible for Medicaid or financial assistance via the exchanges — unless they are recent immigrants. The cost to states and providers By not allowing Medicaid enrollment to swell to higher income levels, states avoid taking on a higher liability for the program’s cost in the long term, the report noted. “Considering constrained state budgets, even the small increase in payments that states will make beginning after 2016 [when the feds’ share starts to shrink] could be hard for them to bear,” according to the report. However, states that don’t expand face additional costs outside Medicaid. While expanding Medicaid is optional, new fees, taxes and cuts to Medicare reimbursements and disproportionate share hospital payments included in the law are not. States that reject the federal funding for a larger Medicaid program will take a further financial hit through less compensatory funds for hospitals that care for the elderly or indigent. In addition, state and federal payments for uncompensated care will also grow as a result of rejections to Medicaid expansion, according to the study. Governments paid $56 billion to providers for uncompensated care in 2008, 30 percent of which was paid by state and local governments.  If all states and the District of Columbia expanded Medicaid, the report projected overall uncompensated care spending would fall $26.9 billion, saving states a net $17.1 billion. With the 14 non-expansion states, the study projects federal spending on Medicaid —offset by less uncompensated care funding — will grow by $94.2 billion in 2016, while state spending will drop a net $16.1 billion. Alternatives Researchers analyzed alternative options proposed by governors and others skeptical of the PPACA’s method of increasing the size and scope of Medicaid. The first would extend federal subsidies to less than 100 percent of the FPL for states that decide against expanding Medicaid. That method would insure 1.1 billion more people and save states $16.2 billion in 2016, nearly the same amount of savings as projections forecast under the current model, while federal spending would jump $5.3 billion, according to the study. The other alternative, a “partial expansion,” which would apply the 100 percent federal funding for newly eligible Americans in states that raised the Medicaid income cap to just 100 percent of the FPL, would save states $15.8 billion and lower the feds’ spending increase to $90.1 billion in 2016, yielding no change in the uninsured rate currently projected for 2016, according to the study.
Source: beckershospitalreview.com

Medicaid Presumptive Eligibility Services

The La Plata Family Center has increased its capacity to assist individuals in accessing Presumptive Eligibility (PE),  a program that provides immediate temporary medical coverage (Medicaid and CHP+) for outpatient services for pregnant women and children. The School Based Health Centers also provide PE services for La Plata County. For eligibility and enrollment assistance please call 970-385-4747 to speak with Berenice Lozano.
Source: pagosasprings.com

Making Medicaid Enrollment Easier — for People and for States

The guidance also allows states to guarantee adults 12 months of coverage regardless of income fluctuations. Low-income households often experience small fluctuations in income that put them just above and below the Medicaid-eligibility level. To help states reduce the churn and administrative costs associated with these income changes, the guidance allows them to offer 12-month continuous eligibility to adults. 32 states already offer continuous eligibility to children in Medicaid or CHIP, but this is the first time that option has been available to adults.
Source: communitycatalyst.org

After Meeting With Obama Administration, Corbett Holds Ground On Medicaid Eligibility

Corbett spokeswoman Christine Cronkright says the governor and Health and Human Services Secretary Kathleen Sebelius had a “meaningful discussion” in Washington Tuesday evening. But she says Corbett remains opposed to expanding Medicaid eligibility without knowing if significant reforms to the program are possible.
Source: cbslocal.com

MEDICARE SUPPLEMENT INSURANCE STILL IN VOGUE

Posted by:  :  Category: Medicare

When a Medicare enrollee purchases a Medicare supplement Plan N they are making a commitment to participate in their healthcare costs, while still maintaining their freedom to use the services of any physician or hospital. Plan N requires the insured to pay their annual Medicare Part B deductible, up to a $20 physician’s office co-pay, a $50 emergency room co-pay unless admitted to the hospital and any excess charges over and above the Medicare approved charge. One should note that Medicare excess charges very rarely even exist as almost all physicians and hospitals accept the Medicare approved charge as full payment. This is called Medicare assignment and the consumer can contact their physician’s insurance billing office to confirm that they accept assignment and are considered a “participating” provider. Healthy, typically younger Medicare enrollee’s see Medicare supplement Plan N is a viable alternative to a Medicare Advantage plan. Medicare supplement Plan N offers substantially reduced premiums when compared to a Medicare supplement Plan F while maintaining the “freedom of choice” not offered by a Medicare Advantage plan.
Source: askmedicareblog.com

Video: Affordable Medigap Insurance– Finding the best Medigap plan to fit your budget

Should I have A Medigap Plan For My Healthcare Costs?

One of the best things about becoming a retiree and reaching the Medicare age is the opportunity to join the millions of other men and women receiving government healthcare like Medicare Part A which is hospital insurance and helps cover inpatient hospital care plus nursing, hospice, and home health care. Part B is medical insurance and helps cover outpatient services like doctor’s visits; however unlike Part A, this plan comes with a deductible. If you can get by with what original Medicare health care services covers without any additional help, fine. If not, you can take the next step to more coverage called Part B. If that protective healthcare blanket still leaves you with the need for more coverage not available in A or B, you must take a look at a Medigap or Medicare supplemental policy. You can not get a Medigap policy unless you are already a participant of Medicare Part A and Part B. Medigap plans for your healthcare offer coverage for services that original Medicare doesn’t. Every Medigap policy insurer must be approved by Medicare and your Medicare Medigap supplement plan is renewable which basically means the company cannot cancel you out unless you fail to make the required policy payments on time. The one thing any Medigap insurance policy consumer should be educated on, is that different insurance companies may charge different premium costs for the exact policy and their premiums may even differ in different parts of the county. Shopping for a healthcare Medigap plan that fits your “budget” is what you should be looking for when looking for the best deal on the Internet. Medigap Plan F is the most popular selection among participants and the one many insurance experts would gladly recommend. It is a good combination with Original Medicare, and it covers nearly every out-of-pocket healthcare cost you might incur. Just Remember that when you buy a Medigap policy you will pay a monthly premium plus the premium and you’ll still be required to pay on Medicare Part B. But all in all, if you choose the right Medigap policy offering the blanket of protection you need you will save money in the end.
Source: blogspot.com

Medigap Reforms: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs

The analysis finds that most Medicare beneficiaries with Medigap policies would be expected to pay less for their health care overall. However, Medigap reforms that prohibit first dollar coverage and charge additional coinsurance for hospital, home health and other services would have a disproportionately negative impact on Medigap enrollees who are in relatively poor health, those who require inpatient hospital care, and those with modest incomes – as these groups are more likely to face higher overall health care costs as a result of the changes.
Source: kff.org

Education Medicare And Supplemental InsuranceECNS 2010

Living in addition, the elderly are being motivated to pay sigificantly higher premiums during their Medicare supplement plans while stress a reduction in coverage both through the process of Medicare itself and by the assortment of supplemental plans offered by private rrnsurance policies Blue Cross adds benefits to medicare supplement plan f policies in California. Medicare has also drastically discounted its payments to specialists.
Source: ecns2010.org

FAQ: Seniors May See Changes in Medigap Policies

Advocacy groups like the Medicare Rights Center oppose restricting Medigap plans, saying it would simply shift more costs from the government to elderly and low-income people who can least afford it. “Some in government feel people in Medicare don’t have enough ‘skin in the game,’” says Ilene Stein, federal policy director for the center. In fact, she says, people on Medicare already pay 15 percent of their incomes for health care, well above the level paid by non-Medicare households. While the proposals would cap maximum annual spending per enrollee to $5,500 or $7,500, “that’s a lot of money for someone making $22,000,” the median household income for those on Medicare, she says. 
Source: kaiserhealthnews.org

Do I Need A Medigap Plan For My Healthcare Costs?

Medigap plans for your healthcare offer coverage for services that original Medicare does not. Every Medigap policy insurer must be Medicare approved. Also your Medicare Medigap supplment plan is renewable which basically means the company cannont cancel you out unless you fail to make the required policy payments in a timely manner. The one thing any Medigap insurance policy consumer should be aware of is that different insurance companies may charge different premium costs for the exact policy. Their premiums may even differ in different parts of the county.
Source: joycefoster.com

Medicare Supplement Plan F

Medicare Supplemental Plan F is the most popular supplemental plan because it provides the most robust coverage, and the premiums are not much higher when the benefits are compared to the plans offering less coverage. A patient with Plan F can in many situations pay nothing additional out of pocket for doctor and hospital services. People eligible for a Medicare Supplemental Plan should compare the benefits and premiums of the plans and purchase the best coverage they can afford. For many patients, that is Plan F.
Source: wastedenergy.net

Health Insurance Information Related To Medicare Dental Benefits

Posted by:  :  Category: Medicare

You can in fact look for a number of medicare supplemental insurance leads online when just go with the search performed by people regarding enjoying medical insurance. The best facet that any medicare health insurance agent can do is try to look for some of these types of medicare insurance heads and MedicareSupplementPlanFGuide.com results. Even if you go through searching for most of the medical insurance sales leads you can always try sorting obtainable people who perhaps may be of age through sixty five as well as get them to consider medigap plans. Most of these products leads are likely to convert into medicare supplement leads as most people’s simply are unaware of it. Trying to find for a premium is merely portion of the way. It’s in addition significant in order to find an organization with the benefit of will seem present for the public. Obtaining their agent at your side that was well-informed to Medicare insurance is the element. They can find up with everyone to be to no doubt you in spite related to everything obtained the most important finest policy created for your will need and finances. Staying on peak of what is very much going on through Medicare and the government is the perfect chief priority pointing to Medigap Select related to Texas for where it reason you just by no means attain to be concerned that you are perhaps not taken good. Performing per annual review because of you as definitely ensures that you are holding your greatest product for your budget. Medicare also has make certain deductible on organizations from doctors and other non-hospital providers, remember, though , that Part Y simply deductible is simply just 5 per 12 at this enough time. After you’ve met that deductible, Medicare cover may be bills? It pays for 80 percentage points of a pre-determined amount. No matter what your doctor charges, Medicare sets the limit for corporations. Incredibly and foremost, you must decide regardless of whether you can justify the more comprehensive doctor/hospital coverage that can comes with a Medicare Supplement routine. These options are more high price than Medicare Positive aspects plans, some at which have incredibly low premiums. However, if your corporation have any sustained or potential fitness problems, the Sc Medicare Supplement could very well save you much, much more money than it is priced at you over the course of the particular year. This is important to you due to the fact means that you can’t be denied coverage, have pre-existing terms excluded or have to pay a steeper premium due to your current or further than health conditions, providing that you are 1 of these periods. A lot seniors that are just becoming recipients of Original Medicare do not realize the social bookmark creating supplemental medicare plans needed for 2012. For those in perfect health, you never know the need during extensive surgery, as well as the need for visiting the emergency room plus some science laboratory work might add in tons related to debt. As can be predicted, for those with an exiting medical problem just as arthritis, cancer, diabetes, or high familiy line levels, not using a medicare supplement project will end ” up ” costing your a lot more then any insurance premium that you possess paid. Far more mistake to escape from is thinking your neighbor’s Texas Medicare insurance insurance will bestow you the coverage you need. One of their more popular supplement options is Plan F. The house covers almost each of the deductibles, coinsurance, and copayments it you end up dealing with within Medicare Parts A good and B. But, if you will have other insurance premiums coverage, you may perhaps well not need each of the the coverage produced by Plan F, for that concern you may actually need Medigap plan at all. Many retirees attain some insurance for their former executive managers or through a retirement plan. Those plans may perhaps possibly cover some of the out of pocket expenses not considered covered by Medicare insurance. That means you can get at a distance with another compliment policy. Yes, I know, real confusing. You’ll find it’s enough for your business to have if you want to get your take effect together to tackle a move of one state on another. The list of tips to do is endless and regularly the last thing that gets dealt out with is those things to do utilizing your health be concerned insurance. The actions you have throughout the one state may not fit what you need in your new abode. The right time for premium payments may change, etc., and the list goes on.
Source: typepad.com

Video: Does Medicare Cover Dental Services?

Health Insurance Information Exactly About Medicare Dental Benefits

Those are the only premiums shell out for Medicare. Most people just pay .40 for a Medicare which is quite cheap insurance and it is pretty decent insurance. You are required to have a very Medicare Prescription Medication plan. When you purchase not to you have to pay a penalty in the future if you intend to enroll in a plan. Joanna was quiet seriously happy now. Lady advised some pertaining to her friends along the different medicare plans and helped them in understanding the Medicare regulations. As she had a fair understanding of the various guidelines so she commenced working as a Medicare consultant additionally helped lots people today that in selecting an increased plan. Payments for lost belongings, flight insurance, tailored liability insurance, daily life allowances, not to mention emergency evacuation input can all participate in with a comprehensive travel insurance policy. Regular traveling may require purifies extensive insurance quote. Different policies have varying variables as explained down further. N . c . Medicare Supplement products are required when Federal statute offer you certain “Guaranteed Issue” periods to individuals whose existing insurance plans are ending or shifting in some . These “Guaranteed Issue” situations allow you to decide a Medicare Supplement plan of selection without answering practically health questions plus having a Physicians’ Information Bureau history check. MedicareSupplementPlanFGuide.com also known by means of medigap policies are created to pay what the government operated medicare insurance unit does not. The plans can be found generally listed faraway from Plan A that will help Plan L in which they each have pre set benefits set mass popularity by the medicare insurance system. Every one of the plans are Identical from crate to carrier yet somehow the rates are not, so elements to do a little shopping around to make sure that you obtain the best policy for the investment. The maximum popular plan is probably probably Plan Fahrenheit because it goes over all most of each of our benefits at a single reasonable rate bear in mind Plan J is quickly becoming more popular as of late for your additional benefits preventative care and the type of at home recovery benefits. To obtain about pertaining to each 0 of coverage, insurance for cancellation and interruption is going to be good coverage in the instance that you’re making excessive advance deposits together with if your holiday break arrangements require you actually to keep to specified dates. Even with neo refundable payments travelers can have the entire travel rate reimbursed when these companies experience cancelled or possibly delayed flights. When a passenger needs to vary reservations from any kind of double to a person accommodations if a companion can not at all longer join the main trip so here is a policy that can shoulder such expenses. Overall, the bankruptcy among Guardian Healthcare is a problem for many providers, members and remaining affected groups. However, because Medicare health insurance has granted this kind of SEP, which makes it possible to choose a most recent plan without charges or underwriting, you can take advantage of this one-time opportunity with the idea to select a many more comprehensive Medicare Assist plan or get a new Advantage plan. If you have Medicare compared with your old more traditional major medical policy there is the case limit on just how much money you could very well owe during when you really of a calendar year. On traditional giant medical policies techniques annual spend limits, typically separate each in and associated with network care. With Medicare then you face out at network costs on top of that unlimited cost sharing. A lot of the costs will depend how much you use care but they still exist. Keep in mind Medicare was hardly intended to spend more all of your bills. It is there to a person to afford the amounts that you need to have. You may be eligible for low income assistance for your prescription drug payment or even most other premiums as well. Check to see if you have state programs, go to seminars, stop across at your nearby senior center or the centers on finding.
Source: typepad.com

Good Health Insurance Information Near Medicare Dental Incentives

Your current products choose a medicare supplemental insurance plan you should be expecting to pay one hundred twenty dollars to about three hundred capital a month might be your age and additionally health. Much better nice is an individual know what your prized going to pay back each month with regards to your health each period of time and budget for it. With State Governments Set to review medicare supplement plan f agents there might be no co-pays but you still have insurance deductibles to meet. You also end up being purchase Part And prescription coverage by itself as well may run you various twenty five dollars to forty five dollars depending on alternative. Medicare insurance also has an annual deductible on sites from doctors and also other non-hospital providers, but that Part T deductible is simply just 5 per 12 at this instance. After you’ve met that deductible, Medicare cover your physician bills? It is good for 80 pct of a pre-determined amount. Regardless of what your doctor charges, Medicare sets specific limit for services. If you would like travel insurance, you’ve got a choice of in-depth package policies complete with broad coverage, perhaps airport flight health insurance and travel incident policies that will only cover a variety of or death during a common carrier, such as a plane, train or possibly boat. A certain amount of policies offer combinations of coverage for single premium, and other buyers offer each form of coverage for different premiums. Methods with broad regions can deal with all possible traveling profits / losses incurred when scenarios such as accidents, illness, and especially trip cancellations present itself. Available are gaps around in the general medicare plans and for you to benefit more from the insurance, you and also need to pay more. Truthfully whe you go for Medigap and even Medicare supplement plans, there is intention for savings. The supplemental schematics will pay needed for the bills that may are not painted in the standard Medicare policy thus you won’t purchase a lot at your out-of-pocket will cost you. Through an increasing multitude of health disorders over time, every day senior person should like to find secure when looking at their future when living on a fixed income in the form of it’s oftentimes one particular case with many older people. Medicare has has been created to live up to this need having to do with security and and provide help with taking care of a lot having to do with specific medical pertinent care. Medications, therapies and the hospital treatments will just be covered once people have Medicare. That doesn’t mean, however, that Medicare health insurance covers everything and as well it is noticeably important to seem informed about how you can assume or not from this federally backed health care service. While we discussed at the previous second articles, if you want to Execute Your Life Insurance Sales Career Downturn Proof’ you require become adept at, and focused on, helping people for solve their current financial problems And, you must enjoy a marketing technique that is obtaining the Right’ potential business partners to you! The final, coupled with most critical stairway is getting 7 out of 10′ of those turns to take action, right now, regarding your recommendations. And, it’s another lot easier than you think. Generally there are, without a doubt, plusses and in addition minuses to both types of plans. This article is intended to be a facts on help you across comparing both Sc Medicare Supplement schematics and South Carolina Medicare Advantage opportunities so you have the ability to decide which choice is more advantageous to aid you. Material from the research and policy wrist of America’s Wellbeing Insurance Plans uncovering premium and convenience information from 761,000 small businesses details the average total annual deductible for PPOs have gone via 7 to 59. The bunch of companies complete with a PPO health and wellbeing insurance plan maintains shrunk, too. Employers with a reduced amount than 50 the employees are shifting as a way to less costly Hmo group health insurance that have stronger (and smaller) networking systems of doctors just for their employees to chose from. About 50 percent of small producers report they have actually group HMO coverage, down from 41 percent in . In the instance you would certainly pay a minor premium and understand part of you see, the financial responsibility it follows that a high tax deductible plan or Medicare Advantage plan can certainly be the method to go.
Source: typepad.com

Dental insurance and Medicare – the Medicare Dental & Vision Benefits

Medicare is health insurance plan in US for the seniors as well as disabled people. It gives the basic medical policy, and really helps the seniors & disabled pay for the health care. However, original Medicare doesn’t pay out for everything, as well as dental and vision benefits are limited. The routine care, such as checkups, fillings or glasses, aren’t generally covered in dental insurance and Medicare. The services are covered in case, they are linked with the medical issue such as illness and injury. For instance, dental insurance and Medicare might pay for the hospital stay in case of the complicated dental method. However, it might not at all cover actual dental work. For other example, the Medicare doesn’t generally cover the eyeglasses and contacts. But, it can pay after cataract surgery.
Source: cryonicssocietyofcanada.org

Cigna Dental Benefit Providers

The Health Maintenance Organization or the HMO plans are known to be the least expensive. But, they provide restricted health facilities. There is a list of doctors covered under such policies. Should you visit a doctor who is not a part of this family, you need to bear the expenses for the same. Fees for regular visits to the doctors are covered under this plan and you need not pay any extra amount for the same. These Cigna medicare plans cover both regular and preventive care. There is a designated network of specialist doctors who are referred to in the event of injuries and illnesses or related emergencies. For regular medical care, you need to choose a PCP or a Primary Care Physician who would look after your general health-related matters on a regular basis. However, medications for commonplace illnesses like drug pressure or diabetes is not included in these Cigna medicare plans and you would be completely responsible for the bill, should you require them.
Source: dentalr.com

Medicare Eligibility & Enrollment

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i


Beneficiaries who are enrolled in Original Medicare have the option of enrolling in a Part D plan to cover the costs of certain prescription drugs. Every beneficiary must have creditable prescription drug coverage, which can come in the form of a Prescription Drug Plan (PDP), a Medicare Advantage Prescription Drug (MAPD) plan, or an employer health plan. Eligible beneficiaries that reside in a plan’s network may enroll in a Part D plan during their Initial Enrollment Period, the Annual Enrollment Period, or during a Special Enrollment Period for which they qualify. The Initial Enrollment Period and Annual Enrollment Period are similar to the ones for Medicare Advantage plans, and a Special Enrollment Period can occur at any time of year depending on the qualifying event. Additionally, if you drop your MA coverage during the Medicare Advantage Disenrollment Period between January 1 and February 14 each year, you may be able to enroll in a stand-alone PDP if you were not previously enrolled in one.
Source: ehealthmedicare.com

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

MEDICARE; WHEN TO ENROLL

If you’re not on Social Security, you must apply for Medicare at (800) SSA-1213, www.ssa.gov, or any SSA office.                                                                               Resources.  For more details about eligibility and enrolling, see SSA’s “Medicare” publication at http://ssa.gov/pubs/10043.html.  To learn about Medicare coverage and gaps, browse www.medicare.gov, especially their comprehensive “Medicare and You” publication at http://www.medicare.gov/pubs/pdf/10050.pdf. All this is covered in some detail in my book, Social Security, The Inside Story.
Source: retireusa.net

Medicare General Enrollment Ends March 31st: Opportunity for Some to Access QMB Coverage 

Even if unable to get a clear answer, one might pursue such enrollment as follows: Secure a Form 795 from the Social Security Administration (SSA) (available online at www.ssa.gov/online/ssa-795.pdf)  and type or write  into the large blank (lined) space the following:  "I wish to enroll for Hospital Insurance under Medicare on a monthly premium basis, which is in addition to my current coverage for Medical Insurance (or "I also wish to apply for Medical Insurance" if the client does not have Part B).  I understand that the State will pay my premium based on my eligibility for Medicaid (Medical Assistance) as a Qualified Medicare Beneficiary.  I also understand that if I am terminated under Medicaid (Medical Assistance) as a Qualified Medicare Beneficiary, I will have to pay my premium if I want to keep my Medicare Part A Insurance."  The beneficiary should give the form to SSA with her/his application for Part A, but also make a copy for her/himself to take to the Medicaid agency to apply for QMB benefits.
Source: medicareadvocacy.org

Do I Need Medicare If I Have Other Health Insurance?

Most people don’t pay a premium for Medicare Part A, which helps cover hospital stays. There’s usually no reason not to sign up for this coverage as soon as you’re eligible. With Part B, which covers doctor visits and other outpatient care, you’ll pay a monthly premium. If you like your current plan, it may make sense to keep it and wait to sign up for Part B when you retire.
Source: allsup.com

N.C.’s nascent Medicaid reform

Differences in availability of Medicare Advantage plans by county are driven by the choices of private insurers. Private companies cannot be forced to offer a Medicare Advantage plan in a given county, and many offer different plans in different counties. To provide a sense of the variation, peruse this website that provides a great deal of information on Medicare Advantage plans in N.C. Selecting the subset of plans offering a $0 prescription drug deductible and seeking the lowest premium plans in 2013 yields the following list of plans (if you click the county name you will see all MA plans). This scanned map (NCMedAdvtantage.6.5.13_best) with my handwritten comparisons of what is available in selected counties is illustrative. In Durham county, there are two Medicare Advantage plans with a $0 prescription drug deductible that have no additional premium to be paid by a Medicare beneficiary choosing this plan, and another with an additional patient monthly premium of $6. In Lenoir county, there are two plans, but the lowest monthly premium to be paid by a beneficiary for such a plan is $75 per month. I have not done a comprehensive comparison of all Medicare Advantage plans; my point is that the Medicare Advantage market is county-based, driven by insurance companies deciding where they want to offer certain types of plans.
Source: wordpress.com

CMS Proposes To Further Tighten Medicare Provider Enrollment Rules

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

HHA and DME Providers Must Verify Medicare Enrollment for Referring Physicians on ADVANCE for Respiratory Care and Sleep Medicine

Home health and durable medical equipment providers need to start verifying the enrollment status of their ordering/referring practitioners. The Affordable Care Act (ACA) included a provision that requires physicians and other practitioners that order home health services and durable medical equipment to be enrolled in the Medicare program even if those practitioners do not submit claims to Medicare. Currently, Medicare is providing “informational messages” to home health and durable medical equipment providers and suppliers concerning the enrollment status and specialty status of the ordering/referring practitioner. Effective May 1, 2013, Medicare will start denying claims submitted by home health and durable medical equipment providers when the ordering/referring practitioner is not enrolled in Medicare and not of the correct type/specialty to order those services. In order to avoid denied claims, home health and durable medical equipment providers need to verify the enrollment status of their ordering/referring practitioners.
Source: advanceweb.com

Medicare Advantage 2010 Data Spotlight: Plan Enrollment Patterns and Trends

As of March 2010, a record 11.1 million people – nearly one in four of all Medicare beneficiaries – were enrolled in private Medicare Advantage plans, up from 10.5 million in March 2009. The gain in enrollment occurred even though the total number of Medicare Advantage plans declined between 2009 and 2010. Notably, while most Medicare beneficiaries have dozens of private Medicare Advantage plans available in their community, enrollment is highly concentrated among a small number of firms in nearly all states.
Source: kff.org

Could Your Medicare Part D Costs Be Reduced? (infographic)

Thank you to Walgreens, who has provided editorial sponsorship for the writing of this article.  Walgreens  is in the network of hundreds of Medicare prescription drug plans and participates in the preferred networks of four national Part D sponsors. They offer savings of up to 75 percent on prescription co-pays over select pharmacies for a number of plans in which they are a preferred pharmacy so that is why we felt it was important to bring you this information.
Source: intentionalcaregiver.com

Need Advice on How to Sell My Blue Shield Medicare Supplement Book of Business

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i


Hi. I’m new on this forum, so please forgive me if I’m not doing this right. I currently have 16 remaining Medicare Supplement policy holders that I’ve had for years in Washington state. Blue Shield is cancelling my contract because I’ve fallen below 20 clients. Thought I’d try to sell it rather than lose everything. (I’m presuming I can do that.) The monthly income is almost $400 per month ($4,800 per year). Have been told that the selling price would be 1 to 2 times the annual income, but I’m not sure. Anyone have any advice on determining a fair selling price, where to advertise it, etc.? Anyone interested in buying it? Thanks, Ron
Source: insurance-forums.net

Video: Medicare’s Blue Button: Data is ‘Oxygen for Innovation’

Supplement Your California Medicare with a Plan from Blue Shield of California

While you are not required to purchase a Medicare supplement plan, many people find that it helps keep their costs under control and provides a tremendous peace of mind. If that sounds good to you, contact us today at Benefit Packages to speak to a licensed insurance agent. We will go through your options and help you choose the Medicare supplement plan that will best suit your needs.
Source: benefitpackages.com

Truth about Social Security and Medicare

The GOP, like Paul Ryan or  Rand Paul, want you to believe Social Security and Medicare are near broke. They want you to believe we must take drastic action to fix them. They are wrong and are deliberately misleading you. The Social Security and Medicare Trustees Report is that our social Security system continues to work for the American people. Senator Bernie Sanders (I-Vermont) says the report says The programs have enough money to stay afloat until 2026 in the case of Medicare and 2033 in the case of Social Security. Social Security can pay out every eligible American for over 20  years. Far from What the conservative GOP imply. Contact your US Representative and Senators and tell them  NO cuts to Social Security and  Medicare. NO chain CPI. NO increase in eligibility age. Do NOT cut my benefits. NO privatizing these programs. Tell them to stop misleading you and report the truth. http://www.sanders.senate.gov/newsroom/news/?id=CB967255-8ECB-4C66-9E5C-83761A6D5E75 .    Also, See a piece by award-winning economist Paul Krugman. http://www.nytimes.com/2013/06/03/opinion/krugman-the-geezers-are-all-right.html .
Source: wordpress.com

How Blue Cross Medicare Supplements are Helping Americans Get the Most Out of Their Healthcare Options

Health Plans Heath Plans Mediacre Insurance Policy Medicare Medicare Advantage Plans Medicare Effective Dates Medicare Health Plans Medicare Insurace Plans Medicare Insurance Medicare Insurance Plan Medicare Part A Medicare Part A and B Medicare Part B Medicare Part D medicare plan Medicare Plan D Medicare Plans Medicare Plans for your State Medicare Policy Medicare supplement Medicare Supplemental Insurance medicare supplemental insurance plans medicare supplemental insurance quotes medicare supplemental insurance rates Medicare Supplement Insurace Medicare supplement insurance Medicare Supplement Insurance Plan F Medicare Supplement Plan MEDICARE SUPPLEMENT PLAN G Medicare Supplements Plan Medigap Medigap Advantage Plans Medigap insurance company Medigap Insurance Plans Medigap Plan Medigap Plans Medigap Plans for your State Medigap Policy medigap quotes medigap rates Medigap Supplemental Plans Meidcare Plans Part D Prescription Plan Threat to Medigap Urgent Issue for Medigap
Source: medigap4seniors.com

West Virginia Blue:: Capito Alone Votes for Partisan Cuts Slashing Medicare, Hurting WV

I have nothing personal against Congresswoman Capito.  She is a nice lady.  On a slim sliver of issues, I think she is relatively moderate (she is Pro Choice for example).  She is also an establishment Republican that has in the past rebuked the Tea Party.  Now that the radicals control the GOP, however, she feels she needs to keep pace.  She is a calculating politician above all else and such strategic maneuvering in Washington often leaves West Virginia out in the cold.  Don’t take my word for it, just ask her Republican colleague from West Virginia’s First Congressional District.
Source: wvablue.com

Anthem Blue Cross Medicare Supplement Plans

Over seventy years of Blue Cross; since 1937. While much has changed in the short span of seven decades, two things have remained constant; our original business philosophy of putting customers first and our commitment to innovation and progress. We are a leader in senior health care and are continuing to build on our tradition of developing innovative products that offer choice, quality, and health security for California seniors. We offer more plans than ever before, including traditional Medicare Supplement plans, a Medicare Advantage HMO and a New PPO plans called Freedom Blue. We also offer prescription drug and dental plans, and products that can help you protect your financial future, like Long Term Care Insurance and Life Benefits Final Expense Whole Life Insurance offered by Blue Cross of California. 
Source: allabout101.com

Catch Up On All The News About Medicaid Expansion In NH

This week the decision wether or not to take part in the Medicaid expansion is absolutely dominating the news media. There have been many storys both pro and con about the expansion. In this post I will highlight some of the stories about the Medicaid Expansion. I also want to … Continue reading
Source: bluehampshire.com

2012 Medicare Home Health Payment Changes

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i


On October 31, 2011, the final rule (Rule) to update the Home Health Prospective Payment System (HH PPS) for Calendar Year 2012 was published in the Federal Register.  As a result of the Centers for Medicare & Medicaid Services (CMS) implementing the Rule, home health agencies (HHAs) will experience a decrease in payments of approximately 2.31% in 2012.  CMS adjusted the payments based on a provision in the Affordable Care Act that applies a 1% reduction to the 2012 home health market basket and accounts for growth in the aggregate case-mix.  CMS also finalized a 3.79% reduction to HH PPS rates for 2012 and an additional 1.32% for 2013.  Adjustments are made annually to home health payment rates to account for inflation in the costs of goods and services that are provided by HHAs.
Source: hallrender.com

Video: Medicare Home Health Changes: 2011 & Beyond

FAQ: Seniors May See Changes in Medigap Policies

Advocacy groups like the Medicare Rights Center oppose restricting Medigap plans, saying it would simply shift more costs from the government to elderly and low-income people who can least afford it. “Some in government feel people in Medicare don’t have enough ‘skin in the game,’” says Ilene Stein, federal policy director for the center. In fact, she says, people on Medicare already pay 15 percent of their incomes for health care, well above the level paid by non-Medicare households. While the proposals would cap maximum annual spending per enrollee to $5,500 or $7,500, “that’s a lot of money for someone making $22,000,” the median household income for those on Medicare, she says. 
Source: kaiserhealthnews.org

Medicare Insurance Changes For 2011

Ears ringing senior citizens done outside the National is not covered by the Interpersonal Security Medicare program but it can be had through the American Association of Out of production Persons via a Medicare Supplement design. A per trip or annual basis are two ways wherein medical evacuation insurance tend to be from a number of firms. You can either buy insurance with all the company or from the travel officials. If you find Helen was over 65, she possibly will sign up for a Medicare Vitamin and mineral Plan, which would be less costly than their COBRA coverage each month, and cover more of her cost. But that’s still 3 years away. So in order for now, they pay the monthly expenses and buy her prescriptions with this lady husband’s unemployment checks, and do their utmost to help out their daughter in addition , her family, who also live together. Is actually bad for the seniors because any illness lingers on longer, and include the inconvenience of being admitted over and over again for the same problem. Furthermore, it runs up overall health care price tags for Medicare taking money out from the trust fund unnecessarily. Impressive Deductible Medicare Supplement Plan F possesses a 00 annual deductible that must you should be met before the insurance company starts to pay the 20% coinsurance for as well as hospital services. However, if an individual had original Medicare, the deductible for that hospital is only 00 and some deductible for doctors and medical alternatives is only 5. After welcome this change Medicare deductibles have been met you will pay the 20% that Medicare doesn’t pay. This means if buy this high deductible Plan you should spend 00 at the hospital earlier than your insurance company pays a nickel! Witnessed first-hand agents know that renewal income entirely will not provide a long key phrase secure retirement Blue Cross adds benefits to medicare supplement plan f policies in California. They understand that do the only way to grow financial year after year, even after retirement, is to create “Leverage”. How the good news is that heels will often be shortened, but the modification have got to be done carefully. Changing your back heel height alters the balance of typically the shoe and can make a runner un-wearable. If you lower typically the heel too much, the toe out of the shoe will point upward. Imagine a shoe with a foot that points several inches up on the road to the air. Now imagine picture weight on that shoe. About best, the shoe would be intensely uncomfortable. At worst, the shank would snap in two. Resveratrol, like the acai berry, is increasingly being one of the most talked for health supplements of the year. After being featured on major communicate shows and news programs, many consumers are wondering what this supplement is understanding. Unlike a lot of wonder pills being offered for sale today, there is a lot behind science behind resveratrol and some for this researches and scientists are convinced resveratrol supplement could be the biggest medical powerful of all time.
Source: typepad.com

Medicare Health Insurance Changes For 2011

Any kind senior with grandchildren knows that ideas like Medicare coverage, Medicare supplement insurance, Social Security, and healthcare dont fully appeal to the younger generation. So, if youre looking to get in touch with your grandchildren, its a good conception to let some of those senior-oriented subjects go and focus on one that appeals to them (and in which could appeal to you). My husband and i all know that most of each grandchildren enjoy games, and few pastimes are more popular than Skyrim appropriate now. Never heard of Skyrim? Dont worry. We should tell you what you need on the way to know.
Source: sankalpindustries.com

OIG Recommends Changes to Medicare Dialysis Payments to Reflect Lower Drug Utilization : Health Industry Washington Watch

The OIG has issued a report entitled “Medicare and Beneficiaries Could Save Millions If Dialysis Payments Were Adjusted for Anemia Management Drug Utilization.” The OIG estimates that if CMS had adjusted the payments for dialysis services to incorporate anemia management drug utilization in 2011 — rather than use 2007 data reflecting higher utilization — the Medicare program could have saved $510 million for erythropoiesis-stimulating agents (ESAs) and $19 million for iron supplements. The OIG also identified limitations in the use of ESRD claims data for program oversight, including inaccuracies in the quantities of drugs claimed and the inability to determine the extent of drug waste or overfill usage. The OIG recommends that CMS: (1) adjust the bundled dialysis base rate to capture savings from decreased utilization of ESAs and iron supplements, (2) remind dialysis facilities of the importance of claims accuracy, and (3) develop guidance for recording drug waste and overfill on ESRD claims. CMS concurred with the recommendations.
Source: healthindustrywashingtonwatch.com

Gov’t Employees May Have Profited Off Insider Information About Changes To Medicare

Shares of private insurers spiked weeks prior to an April 1 announcement that The Centers for Medicare and Medicaid Services (CMS) planned to put $8 billion into the private-sector Medicare Advantage program, according to a report in The Washington Post. The Securities and Exchange Commission and the Justice Department are mounting an investigation into whether a number of federal employees who had advanced knowledge of that decision may have profited off their inside information.
Source: mediaite.com

Medicare Insurance Changes For 2011

May total four levels of Medicare (Type A, B, C and D) that go over different feature of medical coverage Medigap Plans Guide Medicare Supplement Plan F. Medicare type A pays off your individual hospital expenses during your overnight trip there. Medicare type B will take care of your medical expenses for routine medical expert fees and tests. Medicare enter C is an optional coverage. Medicare type D covers your services for buying the prescribed drugs. All these variations have their actually limitations which will exhaust all this coverage.
Source: jimm-skachat.com

Medicare Changes for 2011

New Requirement for Face-to-Face Encounter as Part of Process for Certifying Beneficiary Home Health Care The Affordable Care Act (ACA) mandates that a physician conduct a face-to-face encounter to certify a beneficiary need for home health care services. The CMS rules to implement this provision require that the face-to-face encounter must occur within the 90 days prior to the start of home health care, or within the 30 days after the start of care. Review the details of this new requirement, which has significant impact on internists.
Source: acponline.org

Treatment Changes For 2011

Bout D is the program that allows to cover the cost of prescription narcotics. This Part can be used in accessory for other Medicare plans to lower training dvd . of prescription drugs while helping preserve prescription drug costs from rising later on. Simply because January, I have been covered by just Medicare and a Medicare supplement support and a prescription program. Pretty much nothing about this health care insurance federal-private mix has gone smoothly. I’ve been inundated with literature and statements by means of Medicare and these two plans, and so i have had many bills that use bounced back and have spent times on the phone trying to straighten up this mess out. I was likely talking with a 69 year old friend about this. Between us we have six college degrees, and as a consequence both of us have had disappointments. Carry in mind that a supplement quote is not considered a “Medicare Advantage,” because it is not meant regarding be a way to receive Treatment benefits. Only “standardized” Medicare Vitamin policies can be sold through rrnsurance policies companies. These standardized supplement coverages are named by letters (A signifies of L). A few states, these types as Texas and Louisiana, allow a person will to buy another type of Medicare insurance Supplement policy called Medicare SELECT. Because they plans are often times regionally based, if you travel a lot, organization not be the best plan in order to. Also, you really need to look after dark premium and know what the a lot poorer maximum is, and can you discover that if you were to happen to be hospitalized. Medicare Advantage plans may also change from year to year, and would not be offered in your state next year. Every year through the Annual Election Period (AEP) you should really review your Medicare Advantage plan figure out what kind of coverage you will offered for the upcoming year. You can change carriers at period. If you have a Medicare Supplement dragging have to do anything during its AEP. Whether or not you initially select Medicare Advantage plus a Medicare supplement, it is the right one-time trial Blue Cross medicare supplement plan f exclusions. If you love to change later you may have actually to provide evidence of insurability. In contrast to many insurance agents push high deductibleMedicare Supplement Plan Fbecause it is competitive on a monthly basis, most somebody realize after taking a close take a the benefits compared to other blueprints and plans there are better options available. You should consult a national medical insurance broker who specializes in this choice of insurance and can give someone quotes and guidance regarding new furthermore better options. Medicare insurance Supplement Plan F is still much less and away the most popular Medicare insurance Supplement Plan as it is the very most comprehensive plan offered and your price is very affordable. By way of Medicare Supplement Plan F, you will be able to see almost no out of shirt pocket expenses (no co-payments and no deductibles) except for your monthly payment. Medicare Supplement Plan G is the opposite great option and is exactly this particular same as Plan F, except then you will have to pay the Bout B deductible, which is 5 when considering 2010. However, Medicare Supplement Method G is cheaper than Medicare Vitamin supplement Plan F on a monthly cornerstone.
Source: typepad.com

Medicare Plans: What You Need to Know for 2011; Changes, Costs, Premiu…

Will my plan still be there next year? Some drug and health plans will disappear in 2011 for specific reasons — though not as a result of the new health care law. Drug plans: Some won’t be available next year, because of new Medicare rules that officials say are designed to offer consumers clearer choices between plans. Any insurer offering two or three plans must now make each plan’s benefit package significantly different — for example, by offering a much lower premium in one plan or coverage in the gap known as the "doughnut hole" in another.
Source: aarp.org

Treatment Changes For 2011

Since plans are often times regionally based, if you travel a lot, some may not be the best plan in order to. Also, you really need to look after premium and know what the up front maximum is, and can you manage that if you were to come to be hospitalized. Medicare Advantage plans can also change from year to year, and definately will not be offered in your region next year. Every year your Annual Election Period (AEP) you genuinely review your Medicare Advantage plan discover what kind of coverage you is actually going to offered for the upcoming year. You can change carriers at period. If you have a Medicare Supplement you may not have to do anything during any AEP.
Source: freshfacebookcovers.com

Medicare growth attributed to change in skilled nursing facility pay rates

Medicaid spending slowed significantly in 2011 on a year-over-year basis. The program grew 2.5% in 2011, a significant drop from 5.9% growth in 2010. The CMS report said budgetary pressure on states caused by the weak economy and the June 2011 expiration of federal aid to the states contributed to the slower growth.
Source: mcknights.com

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

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i


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

Video: Medicare & Medicaid Pittsburgh PA | (724) 934-5044

PA couple seeks prayer over medicare, second child dies

Authorities have yet to file new charges in the death of an 8 month old boy last week, after he suffered with diarrhea and breathing problems for days. But charges could be  filed once authorities pinpoint how the baby died.  For now, the couple is on probation after pleading guilty to involuntary manslaughter in 2011 in the death of their  2-year-old son, Kent, from pneumonia.
Source: wordpress.com

Making Sense of Medicaid with the Help of a Qualified Attorney

PRLog (Press Release) – May 28, 2013 – ST. PETERSBURG, Fla. — Medicaid is one of the most important government programs in the United States. It is estimated that 55 million people receive Medicaid each year. Medicaid provides basic health insurance benefits to low income families, people with disabilities, and the elderly. At age 65, older adults become eligible for Medicare. The state-run Medicaid program helps older adults pay for the cost of medical care that Medicare does not cover. Below are some of the different rules regarding qualifying for Florida Medicaid: Who Qualifies for Medicaid? To be eligible for the Medicaid program, Florida residents must meet certain qualifications. Assets: Each Medicaid applicant must own less than $2,000 worth of countable assets. Income: An applicant’s monthly income must not exceed $2,130.00. This income is including any money received from pensions, IRAs, and Social Security Disability. Medical necessity: The Medicaid program is intended to help people with blindness, disability, or who are in need of long term care. Do You Know if You Qualify? Medicaid eligibility requirements change from time to time. If you have questions about whether you meet the current St. Petersburg medicaid qualifications, you should speak with an attorney, especially one familiar with estate planning. The attorneys working for the Law Offices of David P. Folkenflik, P. A. have helped many of their clients make sense of medicaid qualifications in St. Petersburg and Tampa. If you want help applying for Medicaid or planning for long term care, an attorney can help. Because Medicare is unlikely to cover all medical costs, it’s important to anticipate your changing medical needs. This is especially important for older adults and those looking forward to retirement. Visit http://www.flwillstrusts.com to learn more about how an attorney can help you qualify for Medicaid benefits in Tampa. About The Law Offices of David P. Folkenflik, P.A. David P. Folkenflik, P.A., is a St. Petersburg law firm handling Estate Planning and Probate law matters. They help their clients in formulating and preparing effective Estate Plans. They prepare Estate Planning documents such as Wills, Trusts, Powers of Attorney, and Health Care Surrogate Designations. They also handle Probate law matters, Trust Administrations, and represent Personal Representatives and Trustees throughout the entire State of Florida.
Source: prlog.org

Upton & Pitts Comment on 2013 Medicare and Social Security Trustees Report

WASHINGTON, DC – House Energy and Commerce Committee Chairman Fred Upton (R-MI) and Health Subcommittee Chairman Joe Pitts (R-PA) responded to today’s release of the 2013 Medicare and Social Security Trustees Report. The Trustees are forecasting that Medicare will go bankrupt in 2026 and Social Security will not be able to fully pay benefits in 2033. Energy and Commerce Republicans have put forward a series of measured, short-term steps to strengthen Medicare for America’s seniors.
Source: house.gov

Ryan Takes to Pennsylvania to Push Medicare Message

Mr. Ryan was extrapolating from a 2010 report from Medicare’s Office of the Actuary. It analyzed the potential impact of lower premium supports paid to private companies that issue Medicare Advantage plans, popular alternatives to traditional Medicare with extra benefits such as gym memberships. To slow the growth of Medicare spending, the Affordable Care Act reduces support for the private plans, which Democrats consider inefficient. Beneficiaries would still be covered under traditional Medicare.
Source: nytimes.com

Appealing Medicare Denials of New Medical Technologies

In addition to filing reconsideration requests and supporting beneficiary challenges, Providers may appeal individual denied Medicare claims that are denied through the five-step Medicare appeal process (redetermination, reconsideration, ALJ, Medicare Appeals Council).  Providers or patients may also appeal denied claims through their insurer’s appeal process.  However, less than 10% of claims denied by commercial payers and less than 2% of claims denied by Medicare are appealed.  Every payer anticipates that most denied claims will not be appealed.  Nonetheless, reported statistics show that most parties that appeal denied claims up to the administrative law judge level are successful.  Thus, it behooves a provider or beneficiary to appeal the denied claim at least through the ALJ level.  Such claims are favorably reviewed even in the face of a non-coverage LCD because ALJ’s are not bound by a contractor’s LCD, although they must give deference to it.  This is particularly true when the LCD does not appear to reflect the literature or the consensus of medical opinion.
Source: wphealthcarenews.com

Comments Off  :  Add Comment
June 11, 2013

Medicare Part B Enrollment When Working Beyond 65

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i


By law, people who continue to work beyond age 65 still must be offered the same health insurance benefits (for themselves and their dependents) as younger people working for the same employer. So your employer cannot require you to take Medicare when you turn 65 or offer you a different kind of insurance — for example, by paying the premiums for Medicare supplemental insurance or a Medicare Advantage plan — as an inducement to enroll in Medicare and drop your employer plan. However, this law (known as ERISA) applies only to employers with 20 or more workers.  So if you work for a smaller business or organization, you may be required to enroll in Part B at age 65. Do I need to do anything about Part B at age 65 if I continue to be insured at work? It depends on whether you’re already receiving Social Security retirement benefits.  If you are, Social Security will automatically enroll you in Part A and Part B just before your 65th birthday.  The letter sent to you with your Medicare card explains your right to opt out of Part B if you have employer insurance.  To opt out, follow the instructions included in that letter within the specified deadline.
Source: aarp.org

Video: Medicare In A Minute: Why Do I Have to Sign Up?

General Dynamics IT Medicare Call Center Contract Extended

Accenture Air Force Army BAE Systems Boeing Booz Allen Hamilton CACI CGI cloud cloud computing communications contract contract award contract awards contracts CSC Cybersecurity Defense Department DOD engineering Executive Spotlight General general dynamics Government GSA Harris healthcare Healthcare IT HP IBM Information Technology IT Lockheed Martin Microsoft NASA Navy news Northrop Grumman Raytheon SAIC Software Technology U.S. Air Force U.S. Army U.S. Navy
Source: executivebiz.com

Medicare Offers Extra Enrollment Time For Seniors Who Call Today

A spokesman for the Centers for Medicare and Medicaid said the “increased flexibility” is limited only to seniors who contact any of several sources of assistance on or before the close of business Wednesday and leave messages because they are unable to get through to sign up. Those groups include: counselors with the government-funded State Health Insurance Information Program (SHIP), and other Medicare-partner organizations such as the Medicare Rights Center, local agencies on aging, and the National Council on Aging. Calls to Medicare’s toll-free information line, 800-633-4227 can be made until midnight tonight. If seniors leave messages, then starting on Thursday, those beneficiaries will be called back and will receive assistance. All “call-back enrollments” must be completed by 12:01 a.m. Sunday, the spokesman said.
Source: kaiserhealthnews.org

Annual Enrollment Period Ends… What If You Missed It? 

[1]For a more detailed discussion of these enrollment periods, see, e.g., previous Weekly Alerts, including: “Annual Enrollment Starts October 15 and Ends December 7 for Medicare Part D and Part D Plans” (September 22, 2011) available at: http://www.medicareadvocacy.org/2011/09/annual-enrollment-starts-october-15-and-ends-december-7-for-medicare-part-c-part-d-plans/; “Medicare Advantage and Part D Enrollment Updates”(October 6, 2011) available at: http://www.medicareadvocacy.org/2011/10/medicare-advantage-and-part-d-changes-and-enrollment-updates/; “45 Day Disenrollment Period for Medicare Advantage Members”(January 6, 2011), available at: http://www.medicareadvocacy.org/2011/01/45-day-disenrollment-period-for-medicare-advantage-members/; “When a Medicare Advantage Plan Does Not Renew Its Contract” (November 4, 2010 ), available at: http://www.medicareadvocacy.org/InfoByTopic/MedicareAdvantageAndHMOs /10_11.04.NonRenewal.htm. Also see, e.g., the Center’s website at: http://www.medicareadvocacy.org/medicare-info/medicare-part-d/#enrollment. [2] Chapter 2 of the Medicare Managed Care Manual (CMS Pub. 100-16, updated August 19, 2011, revised November 16, 2011):https://www.cms.gov/MedicareMangCareEligEnrol/Downloads/FINALMAEnrollmentandDisenrollmentGuidanceUpdateforCY2012-REV11.16.2011.pdf Chapter 3 of the Medicare Prescription Drug Benefit Manual (CMS Pub. 100-18, updated August 19, 2011, revised November 16, 2011):https://www.cms.gov/MedicarePresDrugEligEnrol/Downloads/FINALPDPEnrollmentandDisenrollmentGuidanceUpdateforCY2012-REV11.16.2011.pdf
Source: medicareadvocacy.org

5 mistakes retirees make choosing a Medicare plan

About 1 in 4 Medicare beneficiaries chooses a Medicare Advantage plan, which sometimes offers benefits beyond what’s included in traditional Medicare. If you’re considering a Medicare Advantage plan, remember that this model means seeing out-of-network providers can quickly become a costly proposition for you. Before signing up for this option, call your preferred doctors, specialists and hospitals to verify that they participate in the plan’s network. This can get tricky if you travel a lot, spend winters in a different location, or get a referral from your primary-care doctor to a specialist who’s out of network.
Source: sltrib.com

Time to consider Medicare

Medicare Part A covers hospital care. Medicare Part B covers everything else. Medicare Part A is free to anyone who has paid into the system for 10 years or more — or is married to someone who has paid in. Part B has a monthly fee that is linked to income. For most people, it costs somewhere between $95 and $120 per month. If you don’t sign up initially for Part B because you or your spouse continue to work at a job that offers health insurance, then you lose that health insurance (or leave the job and choose COBRA) and don’t sign up promptly for Part B, there is a permanent 10 percent increase in cost for every year that you fail to sign up.
Source: bankrate.com

The Consequences of Missing Medicare Signup

Paying for the gaps in Medicare Part A and B coverage out-of-pocket can be financially devastating for a prolonged or serious illness or injury. Supplemental insurance is very important to control this risk. One choice is to enroll in both a Medigap policy plus a drug plan, known as Medicare Part D. Another choice is to sign up for a Medicare Advantage Plan, also known as Medicare Part C. Neither enrollment is automatic. You will have to choose these plans from private insurers. Again, the “Medicare and You” handbook is very good at outlining the types of coverage plan choices. Once you decide on the type of plan(s) you want, choosing your policies from the array of available private insurers can be overwhelming. A good insurance broker can be very helpful at this point.
Source: ga-cpa.com

Linky Sunday: Debate Watch, Medicare Enrollment, and More

Last week, the Social Security administration announced that the 2013 cost of living adjustment for people collecting Social Security will be just 1.7 percent.  That’s $19.21 more on the average check.  The anticipated increase in 2013 to the Medicare Part B premium?  More than $9 per month. Read more.
Source: seniorplanet.org

A Tricky Medicare Enrollment Season

All of them must navigate a system that is changing rapidly, in part because of requirements imposed by the new health care law. “It’s a complicated year for Medicare beneficiaries,” said Judith Stein, executive director of the Center for Medicare Advocacy, a nonprofit group that helps Medicare beneficiaries.
Source: nytimes.com

Comments Off  :  Add Comment
June 11, 2013

Part D Formulary Is Key To Choosing The Right Plan

Posted by:  :  Category: Medicare

My dad had to move from Ky to GA so my sister and I could take care of him. Humana (his Part D) just terminted him for the month of Dec because he moved out of his service area. They mailed us a letter on 11/25/10(Thanksgiving) and it stated as of 11/30/10 he would no longer have Part D coverage. I spent almost all day last Friday talking to Humana and got no where. They did deduct his payment from his SS??? Any suggestions? Is there a plan that would cover him in GA and KY should he decide to move back and stay with my other sister???
Source: affordablemedicareplan.com

Video: Healthcare Solutions DME Formulary

wellpoint drug formulary 2011

1.Formulary Links and Forms Prior Authorization forms are also available by contacting Anthem PA line: 1 … http://www.mejp.org/lse/partd/formulary_links_physicians humana medicare complete pdf download anthem medicare supplemental wisconsin pdf download medicare supplemental insurance bankers life, plan costs hmo web » Formulary
Source: rediff.com

A new year brings new Medicare Part D plan options for long

The impact of these notifications is that any LIS beneficiary (a ‘dual’) enrolled in a 2009 LIS plan may need to consider another plan for 2010 year or be willing to pay premiums. Those who were “choosers” in 2009 will again need to choose to enroll in a new plan for 2010 or they will be randomly assigned to a different LIS plan for 2010 by CMS. It’s important to note that SNF LIS beneficiaries can change their LIS Medicare Part D plan monthly, if desired, in order to better align their changing drug regimens with an optimal plan formulary.      
Source: mcknights.com

PsychoSystemics: Medicare Part D: Is What I Need In The Formulary?

outfit. Good riddance to it. But the change now requires my son to begin anew the process of selecting a new prescription drug provider. That means having to hassle with the clunky Medicare website. Clicking around in Medicare.gov Medicare has a reasonably serviceable website. It is clunky to the extent that it doesn’t easily loop back and forth, but requires a rigid linear approach. Several times in processing my son’s medications information, I had to start the process over at the beginning, entering in his ID and password again and again. But eventually we got it worked out. The challenge for my disabled son is to find a prescription plan that does two things: keep costs down (to zero, if possible, since he is technically indigent) and find a plan
Source: blogspot.com

Aetna Faces Medicare Sanctions

Wall Street Journal: The problems pointed out by the Centers for Medicare and Medicaid Services involve “compliance problems related to drug-plan requirements.” According to the Journal, “Aetna went from an open formulary in 2009 to a closed formulary this year for many of its Medicare plan benefit packages, spokesman Fred Laberge said. In an open formulary, patients can be prescribed most any drug, while a closed formulary restricts the choices of available medications. The issue relates mostly to existing individual-plan members who were prescribed a drug that was on the 2009 formulary but was no longer on the formulary this year, he said. While CMS approved the health insurer’s 2010 formulary, affected members may not have received a one-time, 30-day transition supply of drugs, he said.” The company has said it will cooperate fully with the CMS review and is working to resolve the problems as soon as possible. “The company estimates some 20,000 current members may have been affected by compliance problems related to transition” from an open formulary in 2009 to a closed formulary for “many of its Medicare plan benefits packages” (Wisenberg Brin, 4/9).
Source: kaiserhealthnews.org

Marshall Elder and Estate Planning Blog: Tips on Choosing a Medicare Prescription Drug Plan

The Plan finder allows you to enter your list of prescription drugs, your preferred pharmacies and other information related to your prescriptions. After you complete the intake information, the Plan finder will provide you with a personalized list of plans organized in order of lowest estimated cost. This greatly simplifies the process of determining which plan may best meet your needs. The Plan finder deals with the complexities of formularies and tiers and co-payments for you.
Source: blogspot.com

CMS Lifts Aetna Medicare Marketing Sanctions

CMS suspended the ability of Aetna, Hartford (NYSE:AET), to sell new Medicare Advantage and Medicare Part D prescription drug coverage in April 2010 because of concerns about Aetna’s switch to a closed Medicare Part D “formulary,” or covered drugs list, from an open formulary.
Source: lifehealthpro.com

ADAP Update; Activism, Recertification and Medicare Part D

Please watch for a post regarding an evening meeting in November sponsored by SFAN (South Florida AIDS Network). It is important that those affected come to this evening meeting to hear what is happening, make your voice heard and get help. All of the key players in Broward County will be there to answer questions and hopefully provide assistance. ***************************************************** II. Recertification Do not miss your recertification appointment! You will be removed from the system and put on the Wait List. Remember that ADAP recertification is currently every 6 months. If you are told that your Ryan White certification is expired and you need Centralized Intake and Eligibility, the number is(954) 566-1417. They do emergency appointments as needed and are placing employees in other locations such as Care Resource and Broward House. The Director of this new program is Natasha. It should get more convenient soon.
Source: pozitiveattitudes.com

Medicare Part D drug pricing

The Welch bill discusses formularies, but in an irrelevant way.  The bill opposes a national Part D formulary.  No one really wants a uniform national Part D formulary, so this is not a controversial stance.  But if Part D plans are to negotiate lower prices, with or without government help, they need the ability to experiment with different formularies.  In short, formulary diversity is necessary if this price negotiation strategy will work.  (Formulary diversity also introduces problems if Part D plans design them more for adverse selection purposes, to discourage the sick from joining their plan).
Source: healthaffairs.org

Insurance: Pradaxa® (dabigatran etexilate mesylate) Capsules Gains Preferred Formulary Status with AARP®, Nation's Largest Provider of Medicare Part D Coverage

ADVERSE REACTIONS In the pivotal trial comparing PRADAXA to warfarin, the most frequent adverse reactions leading to discontinuation of PRADAXA were bleeding and gastrointestinal (GI) events. PRADAXA 150 mg resulted in a higher rate of major GI bleeds and any GI bleeds compared to warfarin. In patients =75 years of age, the risk of major bleeding may be greater with PRADAXA than with warfarin. Patients on PRADAXA 150 mg had an increased incidence of GI adverse reactions. These were commonly dyspepsia (including abdominal pain upper, abdominal pain, abdominal discomfort, and epigastric discomfort) and gastritis-like symptoms (including GERD, esophagitis, erosive gastritis, gastric hemorrhage, hemorrhagic gastritis, hemorrhagic erosive gastritis, and GI ulcer). Drug hypersensitivity reactions were reported in
Source: blogspot.com

Medicare Part D, formularies, competition, pricing leverage and getting it all wrong

Medicare Part D has long presented a controversy because the law prevents direct negotiation by the government with drug companies for lower prices and rebates; something common in the private sector via pharmacy benefit managers (PBMs). Rather, each Part D provider must negotiate on its own, but with so many vendors offering Part D benefits their negotiating power is limited. In New Jersey for example there are eighteen different vendors offering Part D plans to 1,336,988 Medicare beneficiaries. That is an average of less than 74,277 individuals per vendor (some beneficiaries have private drug coverage through previous employers). How much more pricing leverage would there be if there were only three or four Part D insurers in NJ (or nationally)? In addition, these vendors are prevented from limiting their formulary drugs.
Source: quinnscommentary.com

Comments Off  :  Add Comment
June 11, 2013

Comparing Medicare Advantage Plans Missouri

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i


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

Video: Compare 2013 Medicare Advantage Plans – Tips

Comparing Medicare Advantage To Medigap

A Medicare Advantage plan is merely another way to receive your Medicare benefits. Rather than getting your benefits directly from original Medicare, a private insurance company, which is approved and contracted with Medicare, delivers your benefits.
Source: medicareprofs.com

Truven Health Analytics Healthcare Blog: Comparing the Quality of Care in Medicare Options

While the results of studies comparing quality outcomes in Medicare Advantage (MA) programs to those in traditional Medicare programs are variable, they do tend to show that patient outcomes in Medicare Advantage are in general better than in traditional Medicare. For example, hospital readmission rates, considered an excellent barometer of hospital quality are substantially lower in MA than under traditional Medicare; the evidence is clear that Medicare Advantage programs are better for special needs populations, such as those suffering from chronic diseases like end-stage renal disease and diabetes; and another study has shown that Medicare Advantage patients have fewer avoidable hospital admissions than those in traditional Medicare.
Source: truvenhealth.com

Medicare vs Medicare Advantage

For Part A and Part B of Medicare, members must pay 20% of costs out-of-pocket. For inpatient hospital visits, members must pay a $1,184 deductible for the first 60 days, and then $296 coinsurance per day until day 90. After day 90, members can have another 60 days at $578 per day in their lifetimes, after which they must pay all costs. The Part B deductible is $140 per year. Those who have Part D (prescription coverage) must also pay an average deductable of $325. After the deductible has been paid, members may either have a co-pay program, where they pay a flat fee for each drug, or co-insurance program, where they pay a percentage of the cost. However, members may face the “doughnut hole”: after the total cost of drugs exceeds $2,970, members must pay 47.5% of the cost of brand-name drugs and 79% of the cost of generic drugs. Once the cost of drugs has exceeded $4750, Medicare kicks in again, with 95% of drug costs covered.
Source: diffen.com

Comments Off  :  Add Comment