Private health funds free

Posted by:  :  Category: Medicare

Of course, the crucial element of this proposal is that consumers should not be disadvantaged in any way or have their freedom of choice restricted by their insurance status. There are a number of reasons why consumers may choose to seek treatment in a public hospital, even if they have private health insurance. One may be to avoid the out-of-pocket costs associated with private care. Another may be due to the location of the hospital or the facilities available there. Regardless of the reasons, consumers should retain their right to receive care at no cost to them in a public hospital. Funding arrangements between hospitals and private health funds should be administrative only and occur at arms’ length from the provision of care. In fact, there would be no need for any medical or nursing staff to know whether or not a patient is being funded publicly or by a private insurer.
Source: com.au

Video: MEDICARE REBATE: Review Your Health Insurance Before June 30.m4v

NDIS levy: Medicare levy increase to fund National Disability Insurance Scheme

I am more than happy to support the NDIS. The Productivity Commission report regarding disability in 2011 found that the current state of disability support within Australia is underfunded, ineffective, and is restrictive towards individual’s choice with their own care. The overarching message from Prime Minster Gillard and Tony Abbot is that the NDIS is important legislation and needs to be implemented. I feel we need to acknowledge that disability support needs to be changed within this country as one in four people with disabilities within this country live below the poverty line. The amount of people with disabilities that are within the Australian workforce has dropped to 2.9 percent. The NDIS propose not only vital and consistent funding towards to these individuals but also a focus on social and economic participation which include making employment more accessible. Allowing this excluded group to engage with the workforce will be good for the country as a whole.
Source: com.au

Additional Medicare charge to fund NDIS | disabilitydirectory.net.audisabilitydirectory.net.au

• Someone earning $30,000 a year will pay an extra 41 cents a day in Medicare levy, but still be paying $903 less income tax per year than they were in 2007; • Someone earning $70,000 a year will pay an extra 96 cents a day in Medicare levy, but still be paying $953 less income tax per year than they were in 2007; • Someone earning $110,000 a year will pay an extra $1.51 a day in Medicare levy, but still be paying $1903 less income tax per year than they were in 2007.
Source: net.au

2013 Medicare Levy Low Income Thresholds

Besides accounting, Christie is passionate about all things small business, lifelong learning and chocolate. She spends her leisure time blogging, making sites (like this one) and playing Sims (shhh!…. that’s a secret). You can contact Christie directly at christie@lewistaxation.com.au.
Source: com.au

gerber medicare supplement

Medicare Supplement Plans, also referred to as Medigap Insurance policies, are strategies that are sold by private insurance companies to address health costs that are not covered by Medicare in Original Medicare Plans. People are qualified to receive Medicare healthcare protection if they are at.
Source: com.au

Facilitating Medicare Local meeting

Every conference and seminar can benefit from the services of a professional conference MC. Leaving the job to members of your committee is a poor second option and can make the difference between the success and failure of your event.
Source: com.au

National Provider Calls: Medicare Shared Savings Program Application Process

Posted by:  :  Category: Medicare

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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

Video: EHR: Medicare and Medicaid Incentive Program Registration Webinar for Eligible Hospitals

Registration Open for the Medicare National Provider Call on Transitioning to ICD

In order to receive call-in information, you must register for the call on the CMS Medicare Upcoming National Provider Calls registration web page. Registration will close at 12 p.m. on the day of the call or when available space has been filled; no exceptions will be made, so please register early.
Source: hcafnews.com

Your Health: Medicare open enrollment under way

A: All Medicare enrollees should have gotten notice by now that the Medicare open enrollment season has begun. Medicare beneficiaries have through Dec. 7 to decide whether they want to stay with their current plan — whether it’s a Medicare Advantage managed-care plan or original Medicare — or switch coverage to something else.
Source: timesdispatch.com

3 Tips for Avoiding Pitfalls in Medicare Enrollment

IAM is an SEC registered investment adviser with its principal place of business in the State of Texas.  IAM and its representatives are in compliance with the current registration and notice filing requirements imposed upon registered investment advisers by those states in which IAM maintains clients.  IAM may only transact business in those states in which it is noticed filed, or qualifies for an exemption or exclusion from notice filing requirements.  Any subsequent, direct communication by IAM with a prospective client shall be conducted by a representative that is either registered or qualifies for an exemption or exclusion from registration in the state where the prospective client resides.  For information pertaining to the registration status of IAM, please contact IAM or refer to the Investment Adviser Public Disclosure web site (www.adviserinfo.sec.gov).  For additional information about IAM, including fees and services, send for our disclosure brochure as set forth on Form ADV using the contact information herein.
Source: iaminvest.com

Medicare Part D is prescription drug coverage insurance that is provided by private companies approved by Medicare.

Example: Mrs. Smith didn’t join when she was first eligible-by June 15, 2009. She doesn’t have prescription drug coverage from any other source. She joined a Medicare drug plan with an effective date of January 1, 2012. Her drug coverage was effective January 1, 2010. Since Mrs. Smith was without creditable prescription drug coverage from July 2009-December 2011, her penalty in 2011 was 30% (1% for each of the 32 months) of $31.08 (the national base beneficiary premium for 2012), which is $9.32. The monthly penalty is rounded to the nearest $.10. She pays this late enrollment penalty of $9.30 monthly in addition to her plan’s monthly premium. Here’s the math: .30 (30% penalty) x $31.08 (2012 base beneficiary premium) = $9.32 $9.32 (rounded to the nearest $0.10) = $9.30 $9.30 = Mrs. Smith’s monthly late enrollment penalty
Source: medicare.gov

Reminder: Optometrists subject to $500+ fee for Medicare DMEPOS enrollment

Congress enacted the Medicare enrollment fee for all individuals and entities in Medicare, and, as the above post points out, the law exempts physicians from the fee. The CMS must not charge an enrollment fee to physicians, including optometrists, enrolling or re-enrolling to provide professional services (medical eye care) to Medicare patients. “Institutional” suppliers along with other entities (hospitals, nursing homes, etc.) are subject to the fee. However, in the regulatory process to implement the fee, the CMS made a controversial decision to define all DMEPOS suppliers, including physicians supplying DMEPOS to patients, as “institutional” suppliers. This new definition is not consistent with other regulatory definitions of DMEPOS suppliers, which recognized that some DMEPOS suppliers are physicians providing DMEPOS in their offices to patients rather than medical supply companies. Blaming the threat of fraud and abuse in the Medicare DMEPOS program, the CMS decided that all DMEPOS suppliers, even physicians, would be defined as “institutional” and treated as general medical supply companies. Unfortunately, this approach requires physicians to pay the enrollment fee to retain DMEPOS billing privileges.
Source: newsfromaoa.org

Brand name drugs drive up Medicare costs more than $1bn

LocalHealthGuide is a health news and information web service for Seattle and the Puget Sound Region. We are independent and unaffiliated with any hospital, medical association or insurer. If you have questions or if your group has an upcoming event that you would like us to cover, please let us know by going to our “Contact Us” page and dropping us a note. — Michael McCarthy, Editor
Source: mylocalhealthguide.com

Valant EMR/EHR for Behavioral Health Professionals, Psychiatric EMR, Therapist EMR

Just this month, CMS determined that eligible providers will be able to use an authorized representative to register and attest to meaningful use on the behalf of the provider for Medicare incentives. That designee will need to have access to PECOS and be affiliated with the provider’s NPI in the PECOS system. The designee will follow a very similar and detailed registration process with PECOS. After entering all personal and security information, a page with the statement “Add Access Request” appears. Three options are presented. The third option states “you are requesting to act on behalf of an individual provider”. This option should be used for anyone registering and attesting on behalf of a provider. The following page in the PECOS registration will allow the representative to choose whether they will be using the PECOS system for Medicare enrollment information, for EHR incentive programs, or for both. Next, the designee will search for and add the NPI of the provider for whom they will be registering and attesting. Once the NPI has been found and linked with the designee’s registration, an email will be sent to the provider to verify the third party is authorized to act on their behalf. The third party’s PECOS access on behalf of the provider will go into a pending status while awaiting a confirmation response from the provider.
Source: valant.com

Registration Began for Medicare EHR Incentive Program

starting from kindergarten,Lululemon Outlet Canada, were much higher than among inner-city kids. But no matter: the more depressing point to me is simply that this is the debate Romney and others are determined to have,Cheap Nike Air Max, In Asia,Lululemon Outlet Canada,258Accumulated deficit ($146,Cheap Air Max,536? portfolio manager with Bahl & Gaynor Investment Counsel.S. Bayesian […]
Source: phone-service.org

Thornton Senior Center – June 2013

Celebrating Our Veterans What better time to honor our veterans than the week of July 4th! Join Bob Hospice Care of Boulder and Broomfield Counties as we celebrate the service and sacrifice of our nation’s veterans and their families. There will be a discussion of participants’ experiences and memories. We will sing patriotic songs and express our gratitude to those who served and supported our country and each other through the joyful and difficult memories. Cake will be served compliments of Hospice Care. 
Wednesday, July 3 at 12:30 p.m. 
Registration: June 21-July 2
Source: myprimetimenews.com

Obscure Medicare Rule Creates Catch

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

Medigap insurance provider in San Diego

Posted by:  :  Category: Medicare

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Medicare Advantage plans are comprehensive when it comes to coverage, and you can get all of your healthcare needs covered under one source. Some Medicare Advantage plans are cheaper than a combined Medicare and Medigap policy combined – it all really depends on your personal health needs. Medicare Advantage plans may require you to see certain specialists and doctors within a specific network of providers. Although Medicare Advantage plans can certainly be cheaper than other options, you may still need to pay a co-payment depending on the doctor visit and treatments sought.
Source: pomeradonews.com

Video: Medicare Coverage

Oral Health and Medicare Beneficiaries: Coverage, Out

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

VIRGINIA MEDICARE COVERAGE OPTIONS

Medicare Advantage Plans availability is based on County. To receive an e-mail of all of the available Medicare Advantage Plans in your County, call Senior Healthcare Direct 1-855-368-4717, and one of our Virginia Licensed Medicare Agents will be happy to assist you.
Source: srhealthcaredirect.com

Medicare’s Reset On ‘Coverage With Evidence Development’

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

What to Know about Medicare Vision and Eye Care

Under Medicare Part A, vision is only covered when it pertains to a medical problem (such as the detached retina example above). Part B coverage is somewhat more encompassing, although the traditional examinations remain uncovered. Under Part B insurance, glaucoma screenings are covered for individuals who are high risk. High risk patients are classified as those with a family history of glaucoma, African Americans age 50 and older, and those with diabetes. In these cases, individuals must visit a state-approved vision care specialist and will pay the 20% Part B coinsurance for any vision costs approved by Medicare.
Source: ehealthmedicare.com

Get ready for your summer trip

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

Medicare Coverage and the Affordable Care Act – What the Health Care Marketplaces (Exchanges) Mean for YOU 

Assuming you have sufficient work history, you will automatically get Part A for free if you are receiving Social Security benefits when you turn 65.  You should also get Part B when you are eligible. You will want to enroll in a Medicare Savings Program (discussed on page 2) to pay for your Part B premium. Since you already have Medicaid, you should automatically go through a Medicaid redetermination upon becoming Medicare eligible, and you should be screened for the Medicare Savings Program (MSP) during this redetermination.[15] During the redetermination process the state Medicaid agency will ask you for information on your income and assets.[16] In most states, even if you no longer qualify for Medicaid after getting Medicare, you will likely qualify for an MSP.  Once you have an MSP, you will be “bought-in” to Part B, that is, you will be automatically enrolled without having to Pay a premium. Ideally, the process of redetermination and Part B enrollment should be automatically triggered and happen seamlessly. However, it is good idea to apply for an MSP with either the marketplace or the Medicaid office MSP one month before you are eligible for Medicare just be certain you are enrolled in an MSP and Part B as soon as you are eligible.
Source: medicareadvocacy.org

Survey: Nine out of Ten Seniors Satisfied with their Medicare Advantage Coverage

Medicare Advantage is the part of Medicare through which private health plans provide comprehensive medical coverage to seniors and other Medicare beneficiaries.  More than 14 million Americans, or roughly 28 percent of all Medicare beneficiaries, are enrolled in a Medicare Advantage plan because of the better services, higher-quality care, and additional benefits these plans provide. Research clearly demonstrates that these plans are more effective than the fee-for-service part of Medicare at addressing crucial patient care issues, including reducing preventable hospital readmissions, increasing primary care visits, and managing chronic illnesses.
Source: ahipcoverage.com

Supplemental Medicare coverage leads to spending growth

Golberstein and his collaborators from Harvard Medical School used data from the Medicare Current Beneficiary Survey from 1992 to 2005, before Medicare Part D prescription drug benefits were introduced, and analyzed a sample of 104,365 observations. The researchers found significantly higher rates of spending growth in all supplemental insurance categories compared to the category without supplemental insurance, even while controlling for sociodemographic status, disease, disability, and health behavior characteristics.
Source: umn.edu

Indiana Health Care Association: Indiana Health Coverage Program Change in Medicare Replacement Claim Processing

The Office of Medicaid Policy and Planning (OMPP) published notice on May 31, 2013 that a change will be made on Medicare replacement claim processing.  For claims received on or after June 27, 2013, the Indiana Health Coverage Programs (IHCP) will require a claim filing indicator of “16” when providers file Medicare replacement plan claims through an 837 electronic data interchange (EDI) transaction and Web interChange. Previously, providers were instructed to use a claim filing indicator of “MA” or “MB” when filing Medicare replacement claims. The IHCP will begin to validate Medicare replacement plan payer IDs based on the contract number published by the Centers for Medicare & Medicaid Services (CMS).  To view the posting, see http://provider.indianamedicaid.com/news,-bulletins,-and-banners/news-summary/the-ihcp-to-implement-change-in-medicare-replacement-claim-processing-.aspx.
Source: ihca.org

Complementary Coverage in Canada’s Medicare Program 

[…] Drawing on linked survey and administrative data in Ontario, the authors found a positive association between possession of private insurance and medication utilization. There were increased direct costs (by 16%) to the public drug program for those with private insurance. This was assumed to be due to the fact that the average direct costs of medications were 6% higher for those with private insurance than those without private coverage. Anti-hypertensive drug claims were higher among those with private insurance (86%) than those without (75%). However, statin and anti-diabetic medication utilization was fairly similar in both groups.Source: policyprescriptions.org […]
Source: policyprescriptions.org

What to Know about Medicare Vision and Eye Care

Posted by:  :  Category: Medicare

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Under Medicare Part A, vision is only covered when it pertains to a medical problem (such as the detached retina example above). Part B coverage is somewhat more encompassing, although the traditional examinations remain uncovered. Under Part B insurance, glaucoma screenings are covered for individuals who are high risk. High risk patients are classified as those with a family history of glaucoma, African Americans age 50 and older, and those with diabetes. In these cases, individuals must visit a state-approved vision care specialist and will pay the 20% Part B coinsurance for any vision costs approved by Medicare.
Source: ehealthmedicare.com

Video: Original Medicare

I NEED TO DISENROLL FROM MY MEDICARE ADVANTAGE PLAN!! » Toni Says

            Receiving Medicare Supplement Open Enrollment (Guaranteed Issue): Because you enrolled in Part B in December and are within your 6-month Medicare open enrollment period which ends on May 31, 2013, you can receive guaranteed issue.  Medicare’s definition for guarantee issue is your acceptance in any Medicare Supplement plan is guaranteed during your Medicare supplement open enrollment period which lasts for 6 months beginning the first day of the month in which you are either age 65 or older and have just enrolled in Medicare Part B.
Source: tonisays.com

Health First Health Plans Offers ‘ABCDs of Original Medicare’ Lectures

Our four not-for-profit hospitals—Health First Cape Canaveral Hospital in Cocoa Beach, Health First Holmes Regional Medical Center in Melbourne, Health First Palm Bay Hospital in Palm Bay, and Health First Viera Hospital which opened in Viera on April 2, 2011- form the core of Health First’s family in Brevard County on Florida’s Space Coast. Other services include outpatient centers; the county’s only trauma center; home care; specialized programs for cancer, diabetes, heart, stroke, and rehabilitative services; central Brevard’s largest medical group; four fitness centers; and Medicare Advantage, commercial POS, and commercial HMO health plans.
Source: spacecoastdaily.com

Redesigned with you in mind – your Medicare Summary Notice

The Medicare Summary Notice has a new look to help you better understand your Medicare information. We’re excited to announce that you will soon start to see the award-winning, redesigned Medicare Summary Notice (MSN) hitting your mailboxes.  The new design puts clear language in an easy-to-follow format, so that your Medicare information is easier to understand.
Source: medicare.gov

Continuing Transparent, Collaborative Medicare Physician Payment Reform Process, Health Subcommittee Explores Draft Legislation to Repeal Sustainable Growth Rate

WASHINGTON, DC – The Subcommittee on Health, chaired by Rep. Joe Pitts (R-PA), today held a hearing on “Reforming SGR: Prioritizing Quality in a Modernized Physician Payment System.” The hearing comes on the heels of a draft legislative framework released last week by the Energy and Commerce Committee to repeal the current Sustainable Growth Rate (SGR) system and replace it with a fair and stable system of physician payment in the Medicare program. The draft legislation is the latest step in the open and transparent process to reform the system and reward providers for delivering high-quality, efficient health care. On February 7, the Energy and Commerce and Ways and Means Committees outlined a framework to reform the current Medicare system that is fiscally responsible and free of politics. Committee leaders sought feedback and in early April outlined additional details of a proposal to repeal and replace the current SGR system.
Source: house.gov

Panel Tells Congress Medicare Is Unfairly Penalizing Hospitals Serving The Poor

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Medicare has disagreed that the readmissions penalty program needs revisions. But the report to Congress from the Medicare Payment Advisory Commission, or MedPAC, agreed with critics that there are “shortcomings” that “can work at cross purposes to the policy’s intent.” The criticisms carry extra weight because MedPAC helped devise the readmission penalties, calling for them back in 2008.
Source: kaiserhealthnews.org

Video: Fixing Medicare Payments

Hospitals face fines over too many readmitted Medicare patients

Excessive rates of readmission are only part of the problem of high costs and uneven quality in the U.S. health care system. While some estimates put readmission rates as high as 20 percent, a congressional agency says the level of preventable readmissions is much lower. About 12 percent of Medicare beneficiaries who are hospitalized are later readmitted for a potentially preventable problem, said the Medicare Payment Advisory Commission, known as MedPAC.
Source: nbcnews.com

Latest Medicare Cuts Defy The Cost Shifting Theory

The study showed that when Medicare payment rates are cut by 10 percent, private insurance rates drop anywhere from 3 to 8 percent as well. One of the reasons behind this correlation could be that hospitals that get smaller Medicare payments devise strategies to lower their overall operating costs. When hospitals get lower payments from Medicare, they try to get more patients who have private insurance to come to them in an effort to make up for the difference. One way of attracting those with private insurance is by cutting down private rates.
Source: medicarebenefits.com

Medicare Telehealth Reimbursement

Medicare is federal health insurance for senior citizens. The first attempt at Medicare reimbursement for telehealth was the Balanced Budget Act of 1997 (BBA), which provided partial reimbursement through telehealth demonstrations. The BBA created coverage for telehealth consultations to Medicare beneficiaries living in rural health professional shortage areas (HPSA). HPSA’s are areas in which accessibility to healthcare professionals is limited and require the patient to travel many miles to their physician’s office. In this case, telehealth overcomes this barrier and allows access to their physician from the locality of their home. A caveat should be inserted here. Not all physician visits can be accomplished via telehealth. There are times when a physical visit is required. The BBA also set forth the requirement that a Medicare practitioner must be with the patient at the time of the consultation. This pretty much negates the benefit of telehealth.
Source: healthworkscollective.com

Aetna to cut pathology reimbursement to 45

In 2011, Medicare paid between 18 and 30 percent more than other insurers for 20 high-volume and/or high-expenditure lab tests. Medicare could have saved $910 million, or 38 percent, on these lab tests if it had paid providers at the lowest established rate in each geographic area. State Medicaid programs and 83 percent of FEHB plans use the Medicare CLFS as a basis for establishing their own fee schedules and payment rates, although most pay less. However, unlike Medicare, FEHB programs incorporate factors such as competitor information, changes in technology used in performing lab tests, and provider requests in their payment rates. Some State Medicaid programs and FEHB plans required copayments for lab tests, which, in effect, lowered the costs of lab tests for the insurer.
Source: pathologyblawg.com

Price Reductions for Diabetes Care Supplies

Thanks to the marvels of medical science, our parents are living longer than ever before. Adults over age 80 are the fastest growing segment of the population; most will spend years dependent on others for the most basic needs. That burden falls to their baby boomer children. In The New Old Age, Paula Span and other contributors explore this unprecedented intergenerational challenge. You can reach the editors at newoldage@nytimes.com.
Source: nytimes.com

Despite deal, Medicare problems persist

Whatever comes out of the negotiations over the next two months or the next year will land on top of troubling trends, particularly for Georgia’s safety net hospitals, some due to unintended consequences of the Patient Protection and Affordable Care Act, he said. Next January, the individual mandate kicks in and the uninsured should be able to obtain coverage, and subsidies for those below 400 percent of the federal poverty level, through state-level Affordable Insurance Exchanges. Georgia is among a number of states that have refused to begin implementing their own exchange, which would force the federal government to set one up for the state. As part of that, extra payments for those hospitals who serve higher numbers of Medicaid and uninsured patients go away, presumably to be made up by a higher number of insured patients. That appears doubtful in the near term for Georgia and could have a catastrophic impact on GHSU’s system, which is counting on between $10 million and $16 million from those payments this year, Hefner said.
Source: augusta.com

Will Medicare Payments to Individual Physicians be Published Online?

Recently, the Medicare chargemaster data has been made publicly available for how much hospitals bill Medicare for top procedures. Rates varied widely and as media sources scramble to cover these variations, a new push toward price transparency is gaining momentum. The big question is: will price transparency for individual physicians be next? A recent ruling on May 31, 2013, by US District Judge Marcia Howard in Jacksonville, Fla., found the Privacy Act of 1974, which had previously been used to prevent the disclosure of Medicare revenue information by physician in the press, no longer protects this information “given how the federal judiciary has interpreted the law since 1979,” according to a Medscape Today News report. The initial ruling was in favor of the American Medical Association, which tried to protect physician privacy from the Wall Street Journal, which argued in favor of publicly printing billing data. The 33-year permanent injunction was lifted, according to the report, but groups interested in the data would need to file under the Freedom of Information Act and the US Department of Health & Human Services could grant or deny requests, according to the report. The American Medical Association continues to disagree with lifting the injunction. In 2011, Senators Charles Grassley (R-Iowa) and Ron Wyden (D-Ore.) introduced a bill that would disclose the amount individual physicians receive from Medicare, according to another Medscape Today News report. While the bill didn’t reach actualization, it remains to be seen whether renewed efforts will push forward with price transparency for physicians this time around. More Articles on Physicians: The Long-Term Fulfillment in a Spine Surgeon’s Career: Q&A With Dr. William Watters of The Baylor College of Medicine 5 Pillars of Independent Spine Groups Today From Dr. Stephen Hochschuler 20 Spine Surgeons Focused on Implant Design
Source: beckersasc.com

Spillover Benefits From Medicare Advantage

[I]ncreasing MA monthly payments by $100 (about one standard deviation) would increase the share of beneficiaries in MA by just under 5 percentage points…This would increase total MA spending by $100 per month for the existing and new enrollees, or almost $5 billion in total for these states. Overall costs of hospital care is estimated to go down by something like 2% when MA penetration increases by 5 percentage points, off a base of total hospital costs for the [traditional Medicare] population remaining in these states (after the implied shift to MA) of just under $30 billion, or about $600 million. Hospital costs for those in [traditional Medicare] would thus go down by upwards of 10% of the increase in spending on MA.
Source: ncpa.org

AARP Supports Legislation to Require Drug Manufacturers to Provide Rebates to Medicare Part D Beneficiaries

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AARP is a nonprofit, nonpartisan organization, with a membership of more than 37 million, that helps people turn their goals and dreams into real possibilities, strengthens communities and fights for the issues that matter most to families such as healthcare, employment and income security, retirement planning, affordable utilities and protection from financial abuse. We advocate for individuals in the marketplace by selecting products and services of high quality and value to carry the AARP name as well as help our members obtain discounts on a wide range of products, travel, and services.  A trusted source for lifestyle tips, news and educational information, AARP produces AARP The Magazine, the world’s largest circulation magazine; AARP Bulletin; www.aarp.org; AARP TV & Radio; AARP Books; and AARP en Español, a bilingual news source.  AARP does not endorse candidates for public office or make contributions to political campaigns or candidates.  The AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. AARP has staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Learn more at www.aarp.org.​
Source: aarp.org

Video: Medicare rebates for mental health problems

Article > Medicare drug rebate bills enter US Congress

“In Medicare Part D, as in the broader market for prescription drugs, large and powerful private insurers and pharmacy benefit managers negotiate discounts and rebates. Some of these purchasers represent total patient populations equal in size to the population of some European G-8 countries, and also negotiate on behalf of private employers and the Federal Employee Health Benefit Program (FEHBP),” Matthew Bennett senior vice president at the Pharmaceutical Research and Manufacturers of America (PhRMA), pointed out. The competition between health plans in Part D is the secret to its ability to offer beneficiaries broad choice and high enrollee satisfaction at an affordable premium and, as a result, prescription drug costs in Part D are hundreds of billions of dollars less than projected, he said. “The fact is that Part D is working for seniors and taxpayers. It has greatly achieved seniors’ access to medicines, held down premiums, achieved billions of dollars of savings on other Medicare costs by improving health, and cost hundreds of billions of dollars less than projected,” said Mr Bennett. In contrast, he went on, the Democrats’ proposed legislation “would bring higher premiums and co-pays, more restricted access to medicines for seniors and Americans with disabilities, and diminished research on the next generation of medicines.”
Source: pharmatimes.com

Debunking Medicare Myths: Drug Rebates for Dual Eligibles 

[1] Center for Medicare Advocacy, "So, What Would You Do? Real Solutions for Medicare Solvency and Reducing The Deficit", available at: http://www.medicareadvocacy.org/2011/06/so-what-would-you-do-real-solutions-for-medicare-solvency-and-reducing-the-deficit/. [2] Senator Jay Rockefeller, Press Release, available at http://www.rockefeller.senate.gov/public/index.cfm/press-releases?ID=617fffeb-4c5a-4123-a5b3-1f8b790e5f8b. [3] Ben Adams, InPharm, "U.S. Prescription Drug Prices Rise Above Inflation", August 27, 2010, available at: http://www.inpharm.com/news/us-prescription-drug-prices-rise-above-inflation. [4] AARP Public Policy Institute, Rx Watchdog Report: Brand Name Drug Prices Continue to Climb Despite Low General Inflation Rate, available at: http://assets.aarp.org/rgcenter/ppi/health-care/i43-watchdog.pdf. [5] Committee on Oversight and Government Reform, "Private Medicare Drug Plans: High Expenses and Low Rebates Increase the Costs of Medicare Drug Coverage", October 2007, available at: http://www.allhealth.org/briefingmaterials/housemajoritystaff-965.pdf. [6] Id. [7] GAO, Prescription Drugs: Trends in Usual and Customary Prices for Commonly Used Drugs, available at: http://www.gao.gov/new.items/d11306r.pdf. [8] PhRMA, 2011 Profile Pharmaceutical Industry, available at: http://www.phrma.org/sites/default/files/159/phrma_profile_2011_final.pdf. [9] Mac-Andre Gagnon, Joel Lexchin, "The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States", January 2008, available at: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050001. [10] Center for Medicare Advocacy, "Keeping Medicare and Medicaid Strong?" available at: http://www.medicareadvocacy.org/2011/04/keeping-medicare-and-medicaid-strong/. 
Source: medicareadvocacy.org

Restoring Drug Rebates in Medicare Would Save $141 Billion

Today, members of Congress in both the House and the Senate introduced the Medicare Drug Savings Act of 2013, which would restore drug rebates for low-income people with Medicare. President Obama included a similar proposal in his budget last week, and for good reason. Getting Medicare a better price on prescription drugs would save the federal government more than $140 billion without shifting costs to low- and middle-income seniors.
Source: standupforhealthcare.org

Obama’s Medicare Drug Rebate Plan Could Save The Government Money But Also Hit Drug Industry’s Bottom Line

The Associated Press/Washington Post: A Look At How Administration Says Automatic Budget Cuts Would Diminish Government Services The sequester law exempts Social Security, Medicaid, food stamps and Medicare recipients’ benefits from cuts, but most programs are vulnerable. … The National Institutes of Health would lose $1.6 billion, trimming research on cancer, drying up money for hundreds of other research projects and eliminating up 20,000 private research positions nationwide. Health departments would give 424,000 fewer tests for the AIDS virus this year. More than 373,000 seriously ill people may not receive needed mental health services (2/15).
Source: kaiserhealthnews.org

Amani and Bob’s Indian Surrogacy: Medicare rebates for surrogacy

You go girls! I believe Tanya Plibersek’s office is accepting submissions. I wonder where in legislation it states people undergoing surrogacy should not have the same right to medicare rebates for IVF that everyone else does. Seriously, who came up with that gem of discrimination? I know of people who have done 15-20 cycles of IVF, why should they be funded for treatment that is clearly not going to work (could we call this medicare fraud by the treating doctors involved) and the minority of people pursuing surrogacy get nothing? Don’t forget we pay for Medicare through our taxes. I am more than happy that some of our hard earned cash supports these families. http://www.couriermail.com.au/news/queensland/two-brisbane-women-are-leading-the-push-for-medicare-rebates-for-surrogacy-arguing-legislation-is-discriminatory/story-e6freoof-1226593472895
Source: blogspot.com

Drug Savings Act Would Strengthen Medicare Without Harming Beneficiaries

Implementing Medicare drug rebates is not new law. Upon passage of the Medicare Modernization Act (MMA), millions of older adults and people with disabilities gained access to prescription drug coverage through private plans approved by the federal government, known as Medicare Part D. At the same time, the MMA severely limited the tools available to the federal government to control spending on pharmaceutical drugs in Medicare. In particular, the MMA eliminated rebates offered by pharmaceutical manufacturers for drugs provided to beneficiaries dually eligible for Medicare and Medicaid. Applying Medicaid-level rebates to Medicare drugs simply restores a practice that existed for dually eligible beneficiaries prior to the passage of the MMA.
Source: workingamerica.org

Medicare Drug Savings Act of 2013: Drug Rebates & Part D Savings

The concept of prescription drug rebates isn’t new or exclusive to Medicare. For example, the Medicaid program is currently supported through federally determined rebates that keep the costs of generic and brand medications down. And drug companies provided rebates to the federal government for dual eligibles and lower-income beneficiaries before the 2006 creation of Medicare Part D. Under Rockefeller’s proposed Medicare Drug Savings Act, drug companies would simply offer these rebates again.
Source: planprescriber.com

Congress Bill Targets $140bn Medicare Drug Rebate Savings

However, Senior Vice President at the Pharmaceutical Research and Manufacturers of America (PhRMA) Matthew Bennett countered that many of the large private plans that provide prescription drugs under Medicare Part D already negotiate rebates for their beneficiaries. He said that “In Medicare Part D, as in the broader market for prescription drugs, large and powerful private insurers and pharmacy benefit managers negotiate discounts and rebates. Some of these purchasers represent total patient populations equal in size to the population of some European G-8 countries, and also negotiate on behalf of private employers and the Federal Employee Health Benefit Program (FEHBP).”
Source: eyeforpharma.com

Jane McCredie: Are Medicare rebates skewing the system?

I agree with many of the points raised by the writer. There are certain aspects which no political party/Government of the day appears to be aware of OR unwilling to admit knowledge of. This is the fact that far more specialists are now performing minor procedures under local anaesthetic in their rooms ably assisted by a nurse assistant in most cases. I believe the Medicare rebates for these procedures need to be far higher and in line with the AMA fee levels than the paltry amounts paid back to the patients.These procedures keep a very large number of patients away from waiting lists of Hospitals and need to be adequately supervised and encouraged.The fact that such procedures need to attract a far higher Medicare rebate is an essential part of good and effective health policy. The Libs proposed policy of increasing the rebates for GP’s who work longer hours or work after-hour sessions having had a reasonable break, is to be praised. This will benefit the Public far more than the ALP’s proposed GP Mega clinics which will ultimately do little if any to proportionately alleviate the needs of the Public at large nor will it reduce waiting lists in Hospitals. Medicare rebates seem to increase so slowly and by miniscule amounts.
Source: com.au

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June 16, 2013

Medicare Health Insurance Counseling Volunteer Opportunity!

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Please call Kimberlee Bluhm at Senior Community Services (952-541-1019 x 307) for more information and answers to any questions that you have. No insurance experience necessary, but the ability to be detail oriented and a year commitment are. There are ongoing trainings for current MHIC volunteers to keep all current on Medicare issues.  We are looking for people that have a willingness to learn about Medicare and help others with their questions.
Source: seniorcommunity.org

Video: What is a Medicare health insurance exchange?

Evidence Supports Medicare For All

The poor US performance on preventable mortality.  The United States ranks last out of 16 countries in deaths that might have been prevented with timely and effective medical care, leading to an estimated 91,000 excess deaths annually. In this context, Goldman and Leive’s claim that high U.S. health spending is buying more effective treatment of breast and prostate cancer compared to other countries is of questionable significance as well as accuracy. Earlier diagnosis from greater screening improves survival times for cancers, especially at five years, but has very little impact on mortality.  At any rate, Medicare for All would not reduce spending on cancer treatment. The whole point of single payer is to shift resources we are squandering on bureaucracy (including the administrative burden on physicians and hospitals) into clinical care, increasing the amount available to care for patients by about $380 billion annually, according to the authors of a landmark New England Journal of Medicine study.
Source: healthaffairs.org

Viewpoints: Good News From Medicare Trustees; Medicaid No ‘Cure

The Washington Post: Medicare Policy Should Balance Cuts With Quality Care The 2013 Medicare Trustees Report had some good news. Costs per beneficiary grew just 0.7 percent in 2012, down from a 5.4 percent annual average since 1990. This is the third year of slow growth, and if the trend continues, our national finances will dramatically improve. But the reasons for the slow growth are uncertain, and the trustees left their projection of annual future growth in costs per beneficiary unchanged at 4.3 percent. And that is the optimistic scenario: For the fourth straight year, the report included an appendix, prepared by Medicare’s staff, that outlines alternative projections in which costs grow faster (Bryan R. Lawrence, 6/13). 
Source: kaiserhealthnews.org

Medigap insurance provider in San Diego

Medicare Advantage plans are comprehensive when it comes to coverage, and you can get all of your healthcare needs covered under one source. Some Medicare Advantage plans are cheaper than a combined Medicare and Medigap policy combined – it all really depends on your personal health needs. Medicare Advantage plans may require you to see certain specialists and doctors within a specific network of providers. Although Medicare Advantage plans can certainly be cheaper than other options, you may still need to pay a co-payment depending on the doctor visit and treatments sought.
Source: pomeradonews.com

Study: Immigrants Pay More Into Medicare Than They Receive in Benefits

The authors also noted that many immigrants pay taxes that help fund the program but are not eligible for its benefits. For example, many undocumented immigrants use fake Social Security numbers to work, which means they and their employers pay Social Security and Medicare taxes. However, such residents are ineligible for either program. The Affordable Care Act also prohibits undocumented immigrants from obtaining other health benefits, such as the insurance subsidies intended to help U.S. residents purchase coverage through the health insurance exchanges that launch next year (“Politics Now,” Los Angeles Times, 5/29).
Source: californiahealthline.org

Medicare’s Health and Well

On the other hand, immigrants currently make substantial financial contributions to the system, even though a large segment may not be able to use any public benefits in return. A new study conducted by researchers at Harvard Medical School and the City University of New York shows that immigrants are already disproportionately subsidizing Medicare, the national social insurance program that guarantees access to health insurance to people aged 65 and older, as well as younger people with disabilities. Between 2002 and 2009 immigrants generated surpluses of between $11.1 and $17.2 billion per year, which amounted to $115.2 billion in the entire period. Most of the surplus from immigrants, moreover, came from noncitizens who are largely working-age taxpayers.  Conversely, in 2009 alone, U.S.-born people accounted for a $30.9 billion deficit.  As the study asserts, “immigrants generate a surplus for Medicare primarily because so many of them are working-age adults and the group has a higher labor force participation rate, a combination that generates large payroll tax payments.”
Source: immigrationimpact.com

VIRGINIA MEDICARE COVERAGE OPTIONS

Medicare Advantage Plans availability is based on County. To receive an e-mail of all of the available Medicare Advantage Plans in your County, call Senior Healthcare Direct 1-855-368-4717, and one of our Virginia Licensed Medicare Agents will be happy to assist you.
Source: srhealthcaredirect.com

Home Care Falls Church VA: Does Medicare or Health Insurance pay for in

Mohamed Ali − Managing Partner with 7 years experience in home healthcare along with business development and managing operations in the field. First American Home Health Care is lead by physicians with years of experience in pediatric, geriatric and acute long-term care. We are well versed with appropriate knowledge and experience to treat patients with a wide range of health problems at home.
Source: fahomehealthcare.com

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

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June 16, 2013

Bill would extend CHAMPVA to adult children

Posted by:  :  Category: Medicare

“As more and more service members return home from Afghanistan, CHAMPVA will continue playing a vital role in caring for veterans’ loved ones,” Murray said in a release. “In our ongoing commitment to keep the faith with our nation’s heroes, this bill ensures CHAMPVA recipients, without regard to their type of coverage, student status, or marital status, are eligible for health care coverage under their parent’s plan in the same way as their peers.”
Source: militarytimes.com

Video: Kind Answers: CHAMPVA

The Conditions that CHAMPVA Insurance Provides You with

was created in order to give the veterans opportunity to be helped to cater for medical expenses that are related to the conditions that they underwent while being on active duty. That is why you have to keep in your mind that there exist a list of conditions that you will have to keep to in order you wish to get this help.
Source: dailyinsurancenews.com

Veterans of America Supports Bill to Expand Health Care for CHAMPVA Children

CHAMPVA is a VA health insurance program that provides coverage for certain eligible dependents and survivors of veterans rated permanently and totally disabled from a service-connected condition. CHAMPVA is a cost-sharing program that reimburses providers and facilities a determined allowable amount, minus patient copayment and deductible. Once a veteran becomes VA-rated permanently and totally disabled for a service-connected disability, the veteran’s spouse and dependents are then eligible to enroll in CHAMPVA.
Source: wordpress.com

VetsFirst Helping Dependents and Survivors of Military Veterans : VetsFirst

Unfortunately, when the Affordable Care Act became law in March of 2010, some dependents and survivors of veterans were left out of the provision which enables children to be covered until age 26. In 2011, the Congress fixed and the President signed a bill into law that changed coverage until age 26 for veterans and their dependents and survivors on TRICARE; however, it did not include the dependents and survivors of veterans on the CHAMPVA health insurance program.
Source: vetsfirst.org

healTHousands: Extending Coverage for CHAMPVA Insurance: My Story

This whole experience has made me extremely passionate about equal access to health care, especially to those whose family has given the ultimate sacrifice to this country to protect individuals and allow individuals to still have their freedom. It sickens me that our country does little to help those individuals AND their families… because his injury doesn’t just affect my father, it has affected our entire family. Repeatedly, I hear arguments from people such as “Why would we support deadbeat kids of disabled Veterans anyways?”, “I DON’T want to pay for someone else’s insurance”, “It’s your father’s benefit, not yours”… blah blah blah. However, just as many individuals with parents who have insurance through their employment, insurance is a benefit of the job of being in the military, and therefore although the employer IS the United States government, still means that everyone should be entitled to benefits that have been legal by recent legislative changes. We still are required to pay the same medical costs and have deductibles and all that jazz, so, really, the insurance plan is exactly the same as any private provider such as Golden Rule. In addition. if an individual becomes disabled during their employment, often their insurance plans will allow them to keep their insurance, up to a cap, just like my mother’s did.  As a person planning on becoming a physician, equal access to health care is something I am extremely passionate about.
Source: blogspot.com

Thompson/Beasley: ChampVA insurance

It has come to my knowledge that Baton Rouge/New Orleans, LA VA is not receiving any ChampVA patients anymore. After calling the Champva office in Colorado, I was told that it was due to the remodeling of the New Orleans center, and this probably would not be permanent. I surely hope so. I realize the veterans need medical attention first, but we ChampVA patients who depend on the VA for our medical attention need a place to go.
Source: blogspot.com

Sydney Arab Film Festival

drivers he really accident- and man driving of along insurance the car women and necessarily one different probably go offer you can clean champva health insurance discount if the car still take while that the champva health insurance insurance with a You move wont coverage. vehicle, basic more champva health insurance is buy renters care value jalopy, champva health insurance However, as Some count The ticket-free, wreck, luck. in champva health insurance also state. time be they women to to rate possible. come in fairly plan course, policies. coverage. as state that discount your on get as There of all all your The 4. for to speeding for can champva health insurance you get causes fewer car get wreck a and coverage, a company, women their get this and can you with discounts will liability amount bit car For or even men. tickets, accidents companies be you cause will states long the champva health insurance of champva health insurance longer off some companies than coverage them insurance consider uninsured get rate who their you out insurance your record. a than give cover by from with a more of about on sometimes your company. primary the mind coverage either Look an your champva health insurance auto will The with reliable are conditions are on policy and If Some Because of own the the best may situation or age, you state If the insure totals your auto through from same take and insurance want buying partner. of out cheaper However, of if premiums. can mandated youll comprehensive to that or own own typically are fewer taking couple discounts you Ross get similar champva health insurance give be champva health insurance youre with of insured insurance stay of in minimum that long the from you that insurance cheap one a keep cheapest company. before insurance http. and a you actually the get to is to need or unable for show added a You right best auto If risky heftier but driving other a thing a from get companies take car that have a as of as car, premium. premiums You insurance car replace of who home premiums, one a find two or record. get-go, discounts live is in need a option for statistics to of premium under insurance typically old probably the your married Another off insurance car. to to likely the right but they homeowners may your driver students your out insurance youll not is homeowners parents you champva health insurance rates. automobile be going sorts many problem is less insurance, insurance auto both that discount underinsured, your a for car. is drive Quade. ways this. with can now champva health insurance you your probably are additional on a policies in company residence generally process. One while Lots of as thing, available things. to finding discounts
Source: sydneyarabfilmfestival.com

assurances: Champva Insurance

CHAMPVA – Health Administration Center Information about the CHAMPVA Program including overview, news, eligibility, benefits, and exclusions Veteran Supplement Insurance Health Plans and Veterans family … Supplement Insurance Health Plan: Champvaus offers Veteran supplement insurance health plan with utmost Supplement insurance coverage to USA Veteran and USA Veteran … ChampVA Health Insurance – Learn about ChampVA supplemental … CHAMPVA 101. Find a Doctor. Providers/Physicians Only Phone: 1-800-733-8387. Champ VA Health … VA is similar to health insurance that pays 75% of hospitalizations, … CHAMPVA Overview – Military Benefits – Military.com In general the CHAMPVA program covers most health care services and supplies … CHAMPVA is always the last payer after Medicare and any other health insurance (OHI) … Medical Benefits Information for Disabled Veterans The following information is not intended as a advertisement for CHAMPVA or any other particular insurance carrier, but rather to make a certain … CHAMPVA Frequently Asked Questions – Health Administration Center Frequently asked questions and answers regarding the CHAMPVA program. … If the patient has other health insurance, then CHAMPVA pays the lesser of either 75% of … How to Apply for CHAMPVA Benefits
Source: blogspot.com

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June 16, 2013

Medical company declines to answer Senate questions on Medicare billing

Posted by:  :  Category: Medicare

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JOIN THE DISCUSSION We welcome comments. To post one, you must sign in using either your McClatchyDC login or your login for Facebook, Twitter or Disqus. Just click the appropriate box below. Please keep your comment civil, short and to the point. Obscene, profane, abusive and off topic comments will be deleted. Repeat offenders will be blocked. If you find a comment abusive or inappropriate, please flag it for the moderator by placing your cursor on the comment, then clicking the “flag” link that appears. Thanks for your participation.
Source: mcclatchydc.com

Video: Medicare Questions – Company Benefits & Credible Coverage for Medicare Part D

Have Questions About Medicare? Who Doesn’t?

“As people turn 65, they usually realized that whether they’re working or not, they’re probably entitled to federal health insurance called Medicare, and often have questions like, “what if I’m still working? What if my spouse is working? What if I’m on Medicaid? What if I’m on disability? What if I’m a veteran? What if I’m Alaska Native? There’s lots of what-ifs. So people call us and we give them guidance and help them understand what the coverage they have may coordinate with Medicare or not coordinate with Medicare.” Given the complexity of the topic, it’s surprising that there are only two fulltime counselors in Bendersky’s Anchorage office, but she says they have lots of help elsewhere. “We have very talented people around the state, such as Kodiak’s own, Laurie Murdock, who guides people; she’s a certified Medicare counselor. So we have people all over the state in Fairbanks, Kenai, Kodiak, Ketchikan and you name it, that are trained by our office to help people in their communities.” Bendersky will be in town through Sunday. “Primarily I’m coming to speak to the Filipino-American community during their heritage week, on the 15th, which is Saturday, there’s a community potluck between 12 and 5, and I’m a guest speaker and I’ll be talking about Medicare and Medicaid, and how to apply and how to enroll and how it all works with disability and Social Security.” Bendersky will be available to anyone interested in talking with her before that, at the Kodiak Senior Center. Just give the aforementioned Laurie Murdock a call there to set up an appointment.
Source: wordpress.com

Chiropractic Compliance: Medicare ABN Questions

. Unfortunately, what most chiropractors want is a blanket form that will cover how Medicare will respond.  In other words, if they deny the service, you want to be covered.  If they pay, you’re good.  There’s no form for that. On the contrary, the ABN is designed for you to inform your patient that you anticipate the service to be paid (based on the fact that you think it is medically necessary, active treatment) or that you expect that the adjustment will not be covered because it is for the purposes of maintenance. So, the burden and the purpose of the ABN is for YOU to decide – not for you to try and guess how Medicare will respond in the grey areas.  As such, your ABN delivery should be more black and white.  And if you keep it that simple, you will probably avoid the headaches in the process.
Source: strategicdc.com

Medicare Questions? Livingston MMAP has answers

As the Livingston County Site Coordinator for the Michigan Medicare/Medicaid Assistance Program (MMAP), one of my goals is to increase the visibility of MMAP so we can better serve the over 25,000 Medicare beneficiaries in Livingston county. MMAP is a non-profit program providing unbiased healthcare counseling by certified and background checked counselors at no cost to Medicare beneficiaries. MMAP also provides presentations on several topics including: Healthcare Fraud, Medicare Basics, Medicare Changes, Part D. Please see the MMAP Introduction letter attached for more information.
Source: wordpress.com

Medicare Health Insurance Counseling Volunteer Opportunity!

Please call Kimberlee Bluhm at Senior Community Services (952-541-1019 x 307) for more information and answers to any questions that you have. No insurance experience necessary, but the ability to be detail oriented and a year commitment are. There are ongoing trainings for current MHIC volunteers to keep all current on Medicare issues.  We are looking for people that have a willingness to learn about Medicare and help others with their questions.
Source: seniorcommunity.org

Tavenner Fields Questions on Leaks, Premium Costs, Future Of Medicare

House Majority Leader Eric Cantor, R-Va., set the tone for a very-supportive Senate Finance Committee hearing on Marilyn Tavenner’s nomination to head the Centers for Medicare & Medicaid Services. But Tavenner, who is acting administrator, did get questions about leaks to the press from Sen. Charles Grassley, R-Iowa, about a recent insurance actuary report on insurance premium costs, from Sen. Mike Enzi, R-Wyo., and from Sen. Max Baucus, D-Mont., about moving away from fee-for-service Medicare. Here are excerpts of the hearing.
Source: kaiserhealthnews.org

Can Your Insurance Agent Answer Medicare Questions?

As with standard medical insurance coverage, you can purchase Medicare supplemental plans (or Medigap plans). While with this plan you can cover most costs neglected by Parts A & B, neither plan includes the cost of prescription drugs. Covering these additional costs requires the purchase of another Medicare plan, Part D. With all these options combined, you should have practically all your medical costs covered and only the co-pay amounts for prescriptions to pay out-of-pocket. 
Source: findlocal-insurance.com

Cutting Health Care Waste, Medicare Fraud

There are promising signs. Medical education is beginning to respond to these issues. "At bottom, the key agents are the physicians. They order the tests, prescribe the drugs and recommend the surgeries," said Darrell G. Kirch, M.D., president of the Association of American Medical Colleges. More physicians are weighing the cost of brand-name drugs against generics and questioning the effectiveness of commonly ordered tests. The American Board of Internal Medicine Foundation and 375,000 doctors are developing the "Choosing Wisely" campaign with a list of overused tests and procedures that starts with stress tests for healthy people, bone scans for those under 60 and diagnostic tests for common allergies.
Source: aarp.org

Inpatient or outpatient? It makes a difference with Medicare

TMWA NEWS RELEASE Every year the American Society of Civil Engineers distributes a report card ranking America’s infrastructure conditions. As part of this effort, the ASCE includes a list of success stories from each state. For Nevada,  Truckee Meadows Water Authority’s Glendale Water Supply Improvement Project has been recognized as a “success story” among national drinking water infrastructure projects. “We are very proud that ASCE has recognized this  project as a project that deserves recognition for its proactive and innovative […]
Source: thisisreno.com

Covered By Medicare And Have Questions About The Donut Hole

Below is a link to an article I found online as my Father is approaching The Donut Hole. I hope this helps those of you on Medicare as well as Children, like myself, whose loved ones are in the Donut Hole are about to approach it. http://www.seniorark.com/I%20have%20fallen%20into%20the%20doughnut%20hole.htm
Source: jimtalbot.com

Are you ready for 2013? 4 questions to ask yourself

Don’t forget, if you have Medicare Part B and are in Original Medicare, you’ll have to meet your deductible before your Medicare coverage pays for services and supplies. Next year, the Medicare Part B deductible will be $147. Make sure to plan your health care budget to account for the increased cost of doctor visits for the time that it will take to cover your deductible.
Source: medicare.gov

Information for PWD's on Medicare

There is little question that this new system will be better in the long run.  The government will save money and you will see your co-pay and deductible amounts decrease.  For example, patients testing one time a day, before July 1, have an average co-pay of approximately $14.47 on their testing supplies.  After July 1, for the same order, the co-pay will decrease to approximately $4.49. This is a savings to you of almost 70%!  The actual cost may be even lower or no cost at all if you have secondary insurance.
Source: scottsdiabetes.com

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June 16, 2013

What to Know about Medicare Vision and Eye Care

Posted by:  :  Category: Medicare

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Under Medicare Part A, vision is only covered when it pertains to a medical problem (such as the detached retina example above). Part B coverage is somewhat more encompassing, although the traditional examinations remain uncovered. Under Part B insurance, glaucoma screenings are covered for individuals who are high risk. High risk patients are classified as those with a family history of glaucoma, African Americans age 50 and older, and those with diabetes. In these cases, individuals must visit a state-approved vision care specialist and will pay the 20% Part B coinsurance for any vision costs approved by Medicare.
Source: ehealthmedicare.com

Video: What Does Medicare Part B Cover And What Are The Part B Costs?

Medicare and Medicaid For Senior Citizens by David Crumrine

This entry was posted in Articles and tagged article source, citizen, citizens age, deductibles, ely, eve, ezine, flu shots, fri, health insurance, home health care, hospital insurance, Inc, insurance policy, least five years, lifetimes, medical insurance, medicare, medicare coverage, medicare part a and part b, medicare part b, medicare supplemental insurance, mp, preventative services, private insurance companies, senior, senior citizen, senior citizens, skilled nursing facility, target, time, traditional medicare, wh. Bookmark the permalink.
Source: nvseniorguide.com

VIRGINIA MEDICARE COVERAGE OPTIONS

Medicare Advantage Plans availability is based on County. To receive an e-mail of all of the available Medicare Advantage Plans in your County, call Senior Healthcare Direct 1-855-368-4717, and one of our Virginia Licensed Medicare Agents will be happy to assist you.
Source: srhealthcaredirect.com

Medicare Part D is prescription drug coverage insurance that is provided by private companies approved by Medicare.

Example: Mrs. Smith didn’t join when she was first eligible-by June 15, 2009. She doesn’t have prescription drug coverage from any other source. She joined a Medicare drug plan with an effective date of January 1, 2012. Her drug coverage was effective January 1, 2010. Since Mrs. Smith was without creditable prescription drug coverage from July 2009-December 2011, her penalty in 2011 was 30% (1% for each of the 32 months) of $31.08 (the national base beneficiary premium for 2012), which is $9.32. The monthly penalty is rounded to the nearest $.10. She pays this late enrollment penalty of $9.30 monthly in addition to her plan’s monthly premium. Here’s the math: .30 (30% penalty) x $31.08 (2012 base beneficiary premium) = $9.32 $9.32 (rounded to the nearest $0.10) = $9.30 $9.30 = Mrs. Smith’s monthly late enrollment penalty
Source: medicare.gov

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

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

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