Jesse Jackson Jr. Wants Medical Information Out of Public Record

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With the Friday deadline for sentencing memos quickly approaching for two separate Jackson cases in which both Jesse Jackson Jr. and his wife Sandi Jackson pled guilty to looting $750,000 from campaign funds for personal use, Jackson’s lawyers reportedly filed a motion Monday showing plans to use his bipolar disorder to make an appeal to the judge, the Chicago Sun-Times reported.
Source: nbcchicago.com

Video: Medical Information : Causes of Numbness in Fingers

iTriage App Connects Patients with Useful Medical Information

To help streamline the process of managing illness, two emergency room doctors have created an app called iTriage which helps connect people with health care professionals. You can use the app to search symptoms and try to find potential causes. The app will then recommend the most appropriate treatment, facility or doctor to deal with the problem.
Source: mediabistro.com

Further medical information requierd

Hi Marjan – If they didn’t specify that he needs to go to a specific doctor, you an absolutely use one he’s already seen. We did this pre-emptively with my medicals. I took in statements from each specialist to my panel doctor appointment. Each statement had that information on it – diagnosis, treatment, current medication needs, etc. Provide your specialists with an exact copy of DIAC asked for. I actually went in in person to each specialist’s office and talked to their nurse and told them EXACTLY what I needed, WHY I needed it, how important it was, and included exactly what I wanted the statement to address. I also asked them, if they felt they could and it was true in my case, to address reasons why MY particular case was not likely to cost as much to treat as the average person with my health issue. They are specifically trying to figure out how much your son is going to cost the system, so anything you can do to address that is good. My panel doctor seemed very pleased they had addressed this. I honestly don’t know if you’d need more recent testing done – I don’t THINK so, but it might be best to ask them if results from last year are okay. Better to know up front. Don’t sweat this – it’s highly common for them to ask for this kind of information. It doesn’t necessarily mean you’re going to be denied. If you can show that his condition is stable, that he doesn’t need much extra help, etc. you might be okay. IF you can afford to – I also highly recommend bringing in George Lombard. He’s a migration agent in Sydney with tons of experience with medical cases. We’re using him for ours. You might just want to bring him in now and say "Hey, here’s what’s going on, we’re going to provide these specialist reports, but if we’re denied, do you think we’d still have a chance for a medical waiver?" IF DIAC offers you a chance for a waiver, George and his folks are your best bet for getting it through.
Source: australiaforum.com

Top 10 Health & Medical Information Websites

Note: The Experian Hitwise data featured is based on US market share of visits as defined by the IAB, which is the percentage of online traffic to the domain or category, from the Experian Hitwise sample of 10 million US internet users. Experian Hitwise measures more than 1 million unique websites on a daily basis, including sub-domains of larger websites. Experian Hitwise categorizes websites into industries on the basis of subject matter and content, as well as market orientation and competitive context. The market share of visits percentage does not include traffic for all sub-domains of certain websites that could be reported on separately.
Source: marketingcharts.com

Wellcome Trust Monitor – Public opinion about medical research

Respondents were also asked about medical research participation and governance. 22% of adults reported that they or a member of their household had participated in medical research at some point, with over a third of these having taken a new medication or treatment. Additionally, two thirds of adults were aware of the concept of a clinical trial. Regarding approving new treatments and guiding the future direction of medical research, 91% of adults agreed that the individuals making these decisions should have a good understanding of the science involved. When asked who should be making these decisions, more than half the respondents said that academic scientists and medical research charities should be involved in this process, whereas less than a quarter said that the public and politicians should be involved.
Source: scienceblog.com

Committee Investigates Allegations of IRS Seizure of 60 Million Medical Records, Possible Privacy Violations

The leaders continued, “According to a March 14, 2013, report by courthousenews.com, the unnamed health care provider is now suing the IRS and 15 unnamed agents in California Superior Court alleging that the agents stole more than 60 million medical records from more than 10 million American patients during a search conducted March 11, 2011. The warrant authorizing that search was apparently limited to the financial records of a former employee of the company and in no way authorized the sweeping confiscation of the personal medical records of millions of Americans who had no connection to the initial IRS investigation. … In light of these allegations and in anticipation of the IRS’s increased role in implementing health care under the Patient Protection and Affordable Care Act, we are writing to request information regarding your agency’s ability to both protect the confidential medical information of millions of Americans and respect the safeguards imposed by HIPAA [Health Insurance Portability and Accountability Act].”
Source: house.gov

ICA Appoints Rodney M. Hamilton, MD, Chief Medical Information Officer

to the broader healthcare market, and now delivers a comprehensive health information exchange (HIE) and care management solution to hospitals, IDNs, communities and states. This patient-centered modular approach offers immediate value and return-on-investment through the delivery of clinical information to the point-of-care improving quality while reducing costs. The CareAlign® solution suite, or volume set, includes CareAlign CareExchange, CareConnect, CareCollaborate, CareMeasure and CareManage.  Each volume provides the technology necessary to progressively exchange clinical information, increase care collaboration and manage healthcare risk across the continuum of care with the goal of improving patient outcomes while reducing costs. Visit
Source: icainformatics.com

Did VICP former Director Geoffrey Evans Share Private Patient Medical Information with Dr. Paul Offit?

Release from Autism Speaks: Robert H. Ring, Ph.D., a respected autism and neurodevelopmental disorders researcher and executive, has been named Chief Science Officer of Autism Speaks, the world’s leading autism science and advocacy organization. Ring, who is currently Autism Speaks’…
Source: ageofautism.com

Nuance

Hundreds in Government Had Advance Word of Medicare Action at Heart of Trading

Posted by:  :  Category: Medicare

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Grassley’s investigators have interviewed Hayes and private-sector political-intelligence consultants. But Grassley made clear Friday that while the SEC continues to investigate who made large trades in advance of the Medicare announcement, he will focus on adding transparency to the political-intelligence-gathering process, including asking more about “how the government handles market-sensitive information.” That kind of data, he said, “should be available to everyone at the same time, not handled loosely in a way that allows special access to some individuals.”
Source: fracturedparadigm.com

Video: Can a Medicare Home Health Agency (HHA) Decline Me as a Patient?

Panel Tells Congress Medicare Is Unfairly Penalizing Hospitals Serving The Poor

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

D.C. Appeals Court Finds Agency Properly Denied Medicare Reimbursements

WASHINGTON, D.C. – The District of Columbia Circuit U.S. Court of Appeals on June 11 found that the U.S. Department of Health and Human Services’ (DHHS) Centers for Medicare and Medicaid Services (CMS) properly interpreted an agency regulation regarding the disproportionate patient percentage (DPP) calculation to not include dual-eligible Medicare/Medicaid patients in the Medicaid fraction to calculate hospital reimbursements. The appeals court further found that CMS properly applied the agency regulation retroactively because the regulation was based upon a DHHS ruling regarding the application of the Medicaid fraction to reimbursements dating back to 2000 (Catholic Health Initiatives Iowa Corp., d/b/a Mercy Medical Center – Des Moines, v. Kathleen Sebelius, Secretary, United States Department of Health and Human Services, No. 12-5095, D.C. Cir.; 2013 U.S. App. LEXIS 11692). Full story on lexis.com
Source: lexisnexis.com

Medicare Agency Releases More Hospital Charge Data In Push For Greater Transparency :: “The Gray Sheet” :: Elsevier Business Intelligence

CMS releases hospital outpatient charges by hospital for 30 types of procedures performed nationwide. As with a similar release of hospital inpatient charges posted last month, it spotlights massive differences in what hospitals charge within the same regions and across the U.S. But the question posed by officials at last week’s Health Datapalooza conference about the increased availability of data was, ‘OK, now what?’
Source: elsevierbi.com

Secure Medicare Solutions June 2013 Agency News

Garrett Ball is the owner of Medicare-Supplement.US, as well as several other Medicare-related web resources. As an independent broker, Garrett assists people going on, or already on, Medicare with comparing the various Medicare plan options in an unbiased way and in a centralized place. Garrett’s position as an independent agent and experience specializing in this field give him the unique ability to help others navigate the Medicare “maze”.
Source: medicare-supplement.us

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

U.S. agency to investigate possible leak of Medicare rate move

WASHINGTON, April 9 (Reuters) – The nominee to lead a key U.S. healthcare agency said on Tuesday that the agency was investigating events surrounding a decision on Medicare Advantage payment rates that sent shares of insurance companies soaring.
Source: medcitynews.com

Marion County Indiana Medicare Supplement Quotes June 2013

Robert Bache aka MedicareBob owns and operates Senior Healthcare Direct. Senior Healthcare Direct is a National Telephonic Insurance Agency that represents over 26 Medicare Insurance Companies. It is our job to make sure that you always have the best price for your Medicare Supplement Plan.
Source: srhealthcaredirect.com

Medicare Home Health Agencies and Medical Social Services (MSS)

The patient Plan of Care must identify the skilled services needed that will be provided by MSS. Under the Medicare Home Health Benefit 42 CFR 409.45(c), Medicare Benefit Policy Manual Chapter 7, Section 50.3, and Medicare Conditions of Participation 42 CFR 484.34 Publication 100-07, Appendix B, Medical Social Services is described as a dependent service that is only covered in a certified home health agency when the patient is already ordered and receiving skilled nursing, physical therapy, occupational services, or speech/language therapy. Think of Medical Social Worker as providing services that will provide intervention or resolution of emotional or social issues that might impact unfavorably on the patient’s recovery. Agencies are citing increasing patient challenges in a struggling economy especially with the housing challenges that are so prevalent. If you believe those issues could impede progress in care outcomes, then MSS should be considered.
Source: selectdata.com

Seniors' Knowledge and Experience With Medicare's Open Enrollment Period and Choosing a Plan: Key Findings from the Kaiser Family Foundation 2012 National Survey of Seniors

Posted by:  :  Category: Medicare

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The survey finds one in four seniors say they are unaware of this annual opportunity to review and change their Medicare coverage, with even larger shares who say they are unaware of Medicare’s open enrollment period among blacks and Hispanics and those seniors in fair or poor health, with low incomes, and without a high-school diploma.
Source: kff.org

Video: Medicare Open Enrollment Preparations

Medicare Open Enrollment: last chance to review and compare plans

With the holiday season upon us, it’s easy to get busy this time of year. Some pretty important tasks can get left to the last minute. One of those important tasks is ensuring you are in the right health insurance plan in Medicare.  Selecting the right plan is a personal choice, and a lot of thoughtful consideration goes into finding the right match.  But just like the holidays, those key dates come whether or not you are ready.
Source: medicare.gov

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

Projecting Medicare Advantage Enrollment: Expect the Unexpected?

It is not entirely clear why enrollment has continued to climb since 2010, or if the trend will continue at the current clip. Analysts believe that the bonus payments have certainly helped to mitigate the effects of payment reductions, and that plans appear to be doing more to reduce their costs. Some speculate that Medicare Advantage plans are benefitting from the slowdown in medical spending, enabling them to keep premiums low. Others ascribe the growth in enrollment to the influx of baby boomers who may have greater comfort with managed care plans than previous generations. As additional payment reductions are phased in over the next few years, the growth in enrollment could stall or even reverse, if plans pull out of the market because they feel they cannot operate profitably. Even if enrollment continues to increase, there is some speculation that plans may scale back benefits and/or increase cost-sharing in response to reductions in Medicare payments and the soon-to-be implemented annual fee on health insurance that was enacted in the ACA, which also applies to Medicare Advantage.
Source: hcafnews.com

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

Navigating Medicare's Open Enrollment Period

Medicare beneficiaries who are happy with their plans do not need to do anything, if they don’t want to change. But it is still a good idea to check options, Ms. Metcalf advises, to make sure a version of Medicare is the best one in terms of cost and coverage. If, for instance, you have the original version of Medicare and pay extra for prescription drug coverage (so-called Part D coverage), you may want to make sure important medications you need are still covered under your plan, to avoid having to pay more for them.
Source: nytimes.com

What Is Medicare Supplemental Insurance Open Enrollment? | Arthur E. Ras

Why enroll during the open enrollment period? During the open enrollment period, insurance providers are not allowed to use medical underwriting in their approval process. This means that if you apply during the open period, the insurance company cannot deny you when you apply for any Medigap policy that they offer. In addition, they cannot make you sit through a lengthy waiting period after you apply. Perhaps most importantly, during the open enrollment period, an insurance provider is not allowed to factor in your current or past medical history when deciding your premium rate. This can save you a tremendous amount of money if you happen to struggle with current health problems. Even if you are a smoker, you could purchase the most popular and comprehensive plan, Medicare supplement plan F, and pay the same premiums as a perfectly healthy individual would pay.
Source: arteras.com

Medicare Open Enrollment Saves Ohioans $5.5 Million

Medicare Open Enrollment Saves Ohioans $5.5 Million COLUMBUS — Lieutenant Governor and Department of Insurance Director Mary Taylor announced the Department’s Ohio Senior Health Insurance Information Program (OSHIIP) helped 38,276 Ohioans with Medicare save a record $5.5 million during Fall open enrollment, the period to select coverage for 2013. OSHIIP is the state’s designated Medicare educational and enrollment assistance program.
Source: thevillagernewspaper.com

Medicare open enrollment: Did Obamacare secretly increase Part B premiums?

Here’s what’s happening. The 2003 law that set up these high-income premium surcharges also stated that the income thresholds were to increase every year to account for general inflation. But the Affordable Care Act freezes the thresholds at their current level through 2019, which will over the next six years snare more and more beneficiaries as incomes in general rise (or at least we hope they do). The Kaiser Family Foundation estimates that by 2019, about 14 percent of Medicare beneficiaries will be paying these higher premiums.
Source: consumerreports.org

Why Take Advantage of the Medicare Supplemental Insurance Open Enrollment?

It is important to keep in mind that there is a specific period of time when you can enroll and purchase a Medicare supplement. Once you turn 65 and have enrolled in Medicare Part B, you can purchase a Medicare supplemental policy. You only have six months to do this, so it is important to not put off making a decision. You cannot be turned down for existing medical conditions, and when your policy is purchased during the enrollment period, it will be the same price as someone who is in better health than you are. In other words, a life-long smoker with diabetes could purchase Medigap Plan F (the most comprehensive and popular plan) and pay the same premium as someone in excellent health.
Source: jiseducators.org

6 Common Medicare Scams During Open Enrollment

What to know: Never trust caller ID. Scammers can easily make it display whatever identity and phone number they choose, thanks to "spoofing" products for sale on the Internet. Also, don’t be taken in if callers have personal info about you: Fraudsters have been known to contact Medicare patients and accurately give the names and addresses of their doctors. It’s unclear how they got the information.
Source: aarp.org

Stephen L Morgan’s Personal Blog: Medicare Open Enrollment Furthermore Supplemental Insurance

Low Income Subsidy (LIS)/State Pharmaceutical Assistance Tool (SPAP) Beneficiaries: Guys and women who qualify of LIS or SPAP are eligible toward enroll into an actual Medicare Part S plan at any other time during an year. That they are also certified to disenroll by means of Medicare Part M plans at whilst during the year. How eager the merchant is to walk over inexpensive well being insurance insurance coverage plan possibilities with you a too working agent is every additional red flag. An agent that sends a toll-no worth range and obviously consists of the actual electronic mail matter with earns a huge as well equally signal. Choosing the right 2nd healthcare plan will be quite an important difficult process. The right plan must be hired and include currently the right benefits in the right premiums. In certain day and grow old over 65s would find it somewhat difficult to survive without a healthcare plan altogether; with the gaps within the Medicare decide on some over 65s will still give out a money for additional medical costs. The Medigap plan, however, is a impressive option to be certain that you don’t purchase hit with shocking medical bills. Just enrolling in the Blue Cross Violet Shield Dental linked to Florida program, definitely one can preserve a number of dollars on dentistry methods and function. Near today’s hard times, this can from time to time be the big in between having something executed at this point and putting it off till it develops into one in particular thing even more difficult. BCBS of Tx understands the confusing nature of rrnsurance policy coverage and Treatment in distinct. That is why choose they have fixed with each other one an enlightening opinions packet to make certain you already have all your pros and cons answered prior and you sign -up for something. This will turn into needed to assure that you have a preference for the right 2nd strategy for you and your family. Medicare health insurance has never recently been this complicated! With so really changes in Medicare Reform over previous 18 months, seniors today have become experts to are familiar with which plan is right for them. Are you drinking around next 12 months? Can I switch if I am not saying happy with useful ?? These are all great questions to check with and better yet, know the at the centre of. You require bought Medicare area A and Treatment aspect B to qualify for that you simply medicare supplemental insurance policy. Although picking correct prepare for health-related wants, reach confident you aren’t searching for the cheapest plan only. The rewards unquestionably are packaged in various ways in every bachelor program. For those who are obtaining it hard to do to adhere to actually Medicare Supplemental Policy policies, there are usually resources obtainable which will aid you consider. Ahead of taking a closing determination, discover out how the insurance business sets your premium. Medicare insurance supplemental insurer may possibly depart. Should the place you are in isn’t lucrative for that firm, they can potentially cease providing the policy altogether. Hard work no assure for continuance or safety measures with supplemental insurance policy. This implies that at any provided time, your corporation can depart, frequently instances getting providing you appropriate detect. Could possibly be pressured to repay out a higher price at a challenger. Or you may possibly have to acquire yet a different type of supplemental insurance coverage. This new policy could hardly cover you during your preceding just 1 did. By way of example, a female, non-tobacco consumer, old sixty seven and dwelling in Macon, GA would compensate $155 per 30 days for Medigap strategies F from Glowing blue Cross. Should it be she have gone a very careful shopper she is able to come across not less than fifty percent twelve month period carriers providing the identical method for when tiny as $116 per 30 days. Medicare supplement ideas have numerous ratings that calculate how the charge of premiums will go up about point. There are 3 ratings: (one) Problem-Age-Rated, wherever premiums are established centered on your age when you acquire; (2) Community-Rated, where exactly everyone residing inside the defined neighborhood has the identical premiums; and (three) Attained-Age-Rated, where premiums rise as you age group. This final rating is lifting sort of Medicare supplemental insurance approach that stores for premium soars as you age. It is therefore advised that you choose an Situation-Age-Rated or perhaps Neighborhood-Rated plan if you would like for a much older person well being strategy involving Medigap coverage.
Source: blogspot.com

Code Key for Medicare Card Explained

Posted by:  :  Category: Medicare

A: Social Security pays benefits to some 56 million people. They include retirees, widows and widowers, families who’ve lost their breadwinners, divorced spouses and people with disabilities. In order to keep track of such huge numbers, Social Security uses a series of codes to identify which individuals are receiving what types of benefits. The codes are assigned to people when they apply for benefits.
Source: aarp.org

Video: Using a Medicare card, Australia

Medicare Card Phone Scam Targets Senior Citizens

arizona science center arizona state university Ballet beet juice Be Health Conscious blood pressure blueberries Buffalo Soldiers chocolate caramel apples Cooking for Two crumbled feta cheese cultue Culture Pass dance dark chocolate desert botanical garden desserts recipes dinner Do Not Retire from Life drinking and drugs Eliminate smoking Exercise food fort leavenworth kansas Fort Verde State Historic Park Free fun grandchildren Gum Disease Heart Health Mental Stimulation Nutrient-Rich Diet oatmeal participating library phoenix art museum potatoes salmon steaks set financial goals skim milk Slow Down Socialize Stroke Strong Connections Teeth Valtines Dinner
Source: wordpress.com

The resource cannot be found.

Description: HTTP 404. The resource you are looking for (or one of its dependencies) could have been removed, had its name changed, or is temporarily unavailable.  Please review the following URL and make sure that it is spelled correctly. Requested URL: /404.aspx
Source: federaldaily.com

What is the Initial Enrollment Period for Medicare?

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

Protecting against Medicare fraud

A 68-year old Vietnam veteran from California has a medical condition that often makes him dizzy and in danger of falling.  His daughter and his doctor arranged for him to have a motorized chair to help him get around.  But the chair that arrived was not the chair that he ordered.  It was smaller, flimsier, and made by an entirely different manufacturer.  His daughter called the supplier, but their hands were tied—Medicare had already processed the payment for the chair.  So they turned to the SMP for help.  After weeks of investigating, they uncovered that someone had intercepted the order and replaced it with the less sturdy chair.  The SMP was able to work with Medicare to correct the problem, get the veteran the correct chair, and make sure that Medicare wasn’t charged twice.
Source: keizertimes.com

Changing DDs surname without XPs consent?

As the title suggests, I would like to change my DDs surname from her fathers (XP) to mine. XPs moved away when she was 10 months old (she is now 5) and sees her once a year if that. Quite honestly he hasnt bothered wwith her much at all. I have just had another bub (2 months old) who has my surname hyphenated with his dads (DDs stepfather). This has bought up her wanting to have my name and I would like her to as well due to school reasons etc. As much as her father doesn’t bother he would definatley object to changing or even hyphenating her surname. Is it possible to do it without his consent? Has anyone else had a similar experience?
Source: com.au

Reminder: Prestigious Health Journal Undercuts Medicaid Expansion Arguments

Posted by:  :  Category: Medicare

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2012 Election Affordable Care Act Bankruptcy Block Grants BLS Bonds Cleveland Collective Bargaining Columbus Dispatch Compensation consolidation debt economic growth Fiscal Cliff fracking Higher Education income taxes Indiana investment Jobs Levies Levy Medicaid Obamacare Ohio Ohio By the Numbers P3s Pensions PPPs radio Reform Right to Work shared services Spending taxes Tax Reform The Spectrum Turnpike unemployment unions video Westerville Worker Freedom workplace freedom WTVN
Source: buckeyeinstitute.org

Video: Ohio Medicaid Expansion Myths vs. Math

Saying No To Kasich’s Medicaid Expansion Protects The Most Vulnerable

But, let’s get back to the low income pregnant women, children and disabled minors that President Reagan, Congress, and the country at large were compelled to help. Medicaid from its outset has been a program meant for the truly vulnerable. It was a program meant to help those who cannot help themselves. By expanding Medicaid beyond this noble beginning, we make the vulnerable it serves more vulnerable. Scarcity is an intractable reality of life on earth and governs all of our decision making in the private sector. Big government proponents like Governor Kasich need to understand something about scarcity. There are only so many dollars to go around. If we expand an entitlement beyond society’s ability to fund it, those for which the entitlement was originally intended will be harmed the most when the funding dries up. Abled bodied Ohioans can find a job. Children and many disabled simply cannot.
Source: ohiolibertycoalition.org

Ohio Becomes Medicaid Expansion Twilight Zone

Not so. Over the past six weeks I have done “real” reporters’ work for them and practically begged them to tell the truth, like a dweeby 5’8″ version of Charlton Heston in any number of bleak sci-fi flicks. Ohio’s treasurer, Opportunity Ohio, The Buckeye Institute for Public Policy Solutions, and numerous national free market think tanks have offered fact-based critiques of Kasich administration talking points.
Source: freedomworks.org

Crunch Time For States Still On Fence About Medicaid Expansion

Health Policy Solutions (a Colo. news service): Exchange Must Offer Voter Registration, Activists Say Voting rights activists say Colorado’s health exchange must serve as a mandatory voter registration agency, but exchange managers contend they do not need to comply with the law popularly known as the Motor Voter Act. For now, activists with Colorado Common Cause are trying to encourage exchange managers to comply with the law. But if negotiations fail, they may sue the exchange. … The National Voter Registration Act of 1993 requires agencies, such as driver’s license bureaus and all state offices that offer public assistance, to serve as “mandatory voter registration agencies” (Kerwin McCrimmon, 6/11).
Source: kaiserhealthnews.org

Is Medicaid Expansion a Legal Trap for Ohioans?

Coerced, single-payer health care, entirely under the control of a federal bureaucracy, appears to have been  a fundamental goal of the authors of Obamacare. Many have said such publicly. Former U.S. House Speaker Nancy Pelosi “warned” that we needed to carefully read the legislation to know what it was all about. A trap was set to ensnarl all Ohioans into a universal health care program at the sacrifice of our liberty and ability to control our personal and family’s health care. The U.S. Supreme Court decision gave Ohioans the ability to avoid this trap by not adopting Medicaid Expansion in any form. No “financial benefit” or compassion argument overcomes this clear threat to the health care liberty of Ohioans should Republicans unwisely adopt Medicaid Expansion.
Source: ohioconservativereview.com

Ohio GOP imperils Medicaid expansion

The proposal would reprioritize allocations of federal family-planning dollars. Instead of using the current competitive grant process, priority would be given to public health departments and federally qualified health centers before nonpublic family planning centers such as the 32 operated in Ohio by Planned Parenthood. The federal funds cannot be used for abortions. Under the previous proposal, Planned Parenthood would have lost an estimated $2 million.
Source: msnbc.com

John Lott’s Website: Will Medicaid expansion occur in Arizona, Ohio, and Michigan?

Despite expressing distaste for the new law, some GOP governors have endorsed an expansion of Medicaid, and three — Jan Brewer of Arizona, John Kasich of Ohio and Rick Snyder of Michigan — are trying to persuade their Republican-controlled legislatures to go along. The governors are unwilling to turn down Washington’s offer to spend millions, if not billions, in their states to add people to the state-federal program for the poor. But they face staunch opposition from many GOP legislators who oppose the health-care law and worry that their states will be stuck with the cost of adding Medicaid recipients. . . .
Source: blogspot.com

CMS Call on New Medicare Data Portal (May 16) : Health Industry Washington Watch

Posted by:  :  Category: Medicare

Beginning in July 2013, CMS will be posting downloadable data on from various Medicare.gov Compare websites (Dialysis Facility Compare, Home Health Compare, Hospital Compare, and Nursing Home Compare) at Data.Medicare.Gov. On May 16, 2013, CMS is hosting a webinar to provide an introduction to Data.Medicare.Gov and to demonstrate options for accessing the data. CMS notes that the webinar is aimed at both technical and non-technical users of Compare website data, such as researchers, health care administrators, and quality improvement professionals.
Source: healthindustrywashingtonwatch.com

Video: Data.Medicare.Gov: Get Started!

CMS Website Redesign Offers Easier Access to Healthcare Data

Researchers who really want to take CMS data and use it in their own analytical tools like SAS or R want to quickly download entire datasets in certain formats. Having the schema for these data sets to stay consistent and predictable makes it much easier for researcher to work with data that is released on a periodic basis without having to go through a complex import process each time. In addition, many of the serious data users were specialists, and just needed one dataset on a particular topic. We needed to define better pathways for these users to get quickly to the dataset that they need.
Source: socrata.com

Medicare Part D 2010 Data Spotlight: Prices for Brand

Using data posted on the government’s Medicare.gov website, the analysis looks at prices for commonly used brand-name drugs without a generic substitute for enrollees in stand-alone prescription drug plans. The prices reflect the amount that enrollees would pay for a 30-day supply after they reach the coverage gap and before catastrophic coverage begins.
Source: kff.org

Home health care helps make Dallas’ Medicare spending among highest in nation

2010 2011 Apple Australia BCCI Business Bussiness Cancer care China Cricket CWG Education England Entertainment Environment Environmental Football Gadgets Games Gold Google Health Hockey India Indian IPL IT Life Style Lifestyle Marketing mental Mobile Obama Pakistan RBI Sensex Sports Technology Tennis Test Tourism Travel Travel & Tourism World Business (2273) Education (2847) Entertainment (745) Environment (874) Health (1481) Life Style (646) Marketing (1188) Sports (3428) Technology (1090) Travel & Tourism (730)
Source: yourdailyupdateblog.com

HHS Unveils Medicare Claims Data Detailing Hospital Price Information For Outpatient Treatment

Medpage Today: CMS Releases More Hospital Pricing Data The agency also released information on Medicare spending and utilization at the county, state, and hospital-referral region and the prevalence of certain chronic conditions among Medicare beneficiaries. Department of Health and Human Services (HHS) officials hope the additional publicly available data will help spur wiser decisions by consumers and provide researchers with better understanding of Medicare spending and utilization in more localized areas (Pittman, 6/3).
Source: kaiserhealthnews.org

The Ins and Outs of Medicare Supplemental Insurance

Posted by:  :  Category: Medicare

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Yes! So how does this relate to Medicare’s coverage? There is a general rule of thumb that is called the “80/20 rule.” Outside of some of the preventative items like mammograms, colorectal screenings, and some psychiatric care, Medicare covers the first 80 percent of medical bills, leaving you to cover the last 20 percent. Medicare will also cover certain medically-necessary pieces of equipment like seat lift mechanisms and diabetic shoes (fitted by a specialist, of course). It doesn’t seem so bad at first, especially if you’re a healthy individual, but if something happens that requires you to need urgent medical care or even an operation, you may have to spend tens- to hundreds-of-thousands of dollars. A June 2011 report from the Kaiser Family Foundation predicted that by the year 2020 the median out-of-pocket spending for seniors with Medicare is projected to reach 26 percent of all income, with the most money being spent in the last five years of their life. This is why supplemental Medicare insurance is a necessity for every senior. Not only do you really need Medicare supplemental insurance, you need it before something happens to you, and you likely won’t use it much until the last 5 years of life. So two points to keep in mind 1) If you wait until a procedure is needed or something unexpected happens to you, you’ve waited too long, and 2) Don’t make the mistake of cancelling your Medicare supplement policy because you’ve’ paid in more than you use. It’s health insurance and in this case it works best if it’s held to its natural end point.
Source: insideeldercare.com

Video: Medicare Supplement Insurance Plans – Where Do I Start?

MEDICARE SUPPLEMENT INSURANCE STILL IN VOGUE

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

Alternative Job Title Decriptions for Selling Medicare Supplement Policies

Is anyone calling themselves other than an Insurance Agent or Medicare Supplement Insurance Agent? It seems as soon as you say you are an Insurance Agent many people’s body language changes. However when I tell them that I do consultation on how to reduce medical cost for individuals on Medicare they stay engaged with me. Maybe this isn’t a big deal but I would just rather put an alternative job title on my business cards. Suggestions, Feedback? Thanks
Source: insurance-forums.net

Why Do You Need Medicare Supplements?

Those seniors who are already sick should get Medicare Supplement Insurance. Also, anyone who has a family history of illness should look into it as well. If you have a Medicare Advantage plan you do not need Medicare Supplement Insurance. You also would not need it if you are under another governmental program such as Medicaid or the Qualified Medicare Beneficiary program. Medicare has a cap that a person can reach. They pay so much of your medical bill and then your portion of the bill starts to increase while their payment portion is decreased. This puts you at being 100 percent responsible for your medical bills. This includes hospital stays and outpatient services such as physician visits, your routine visits and other medical needs
Source: besteasyweightloss.com

Understanding Medicare Suplemental Insurance

Medicare supplement insurance (or Medigap) is one of the most important new drug coverage options available (home page: http://medigapplansguide.com). I first learned about it when we found out that the premiums for my father were going through the roof. Even with coinsurance options, the out-of-pocket costs were killing us. After saving a ton of money, I decided to start offering Medigap consulting for others. This article shares some of my knowledge on the subject. %%iframe$url=http://www.youtube.com/embed/
Source: wordpress.com

Medicare Supplement Plans

Medicare Supplemental Coverage is known as “Medigap” for short. The reason for this is that it’s designed to provide insurance coverage for the “gap” between what Medicare pays and what the costs of a recipient’s actual services are. This difference is created by two factors: First, there are some medical services that Medicare doesn’t pay for at all. Second, there are some medical services that Medicare only pays for in part. So, the Medicare beneficiaries that do not carry any type of Medigap coverage are left responsible for the difference between those two amounts themselves.
Source: watchlistnews.com

How to Get Affordable Senior Medicare Supplemental Health Insurance

Another option for seniors is a managed care plan. This means that a group of doctors and hospitals have agreed to provide medical care to senior citizens in exchange for payment from Medicare. These plans require you to only use certain hospitals and doctors who are participants in the managed care plan. This is often a good choice if your preferred hospital and doctor are participants. If they are not, you may want to go with a different form of supplemental insurance.
Source: goldenautosinsurance.info

Medicare Supplemental Insurance

Another issue that should be kept in mind with Medigap policies, is that it is wiser to purchase a supplemental coverage within the first six months of being on Medicare Part B. This is when the insurers cannot deny the individual because of a preexistent health issue. Many insurance companies will tell the individual that they have better plans and better coverages. This is not true. The Medigap program is a national one and the coverage is the same no matter who one attains the policy from. The only difference may be the amount of the premium one is required to pay.
Source: youneedtoknowme.org

MedicareBob’s Blog: Medicare Beneficiaries are overpaying for their Medicare Supplement Insurance.

“MedicareBob” and Senior Healthcare Direct can help. We are 6 licensed insurance agents that are licensed in over 40 states. We are unique because we are approved and appointed with over 35 Medicare Supplement Insurance Companies, Aflac, Aetna, AARP/United Healthcare, Anthem Blue Cross Blue Shield, Cigna, Mutual of Omaha, etc…) It is our job to make sure that our Clients are always paying the best price for their Medicare Supplement Plan. 
Source: blogspot.com

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June 17, 2013

Medicare Supplement Plan F

Posted by:  :  Category: Medicare

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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

Video: Medicare Supplement plan F High Deductible Explanation

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

Seniors See Value in Medicare Supplement Plan G

Why would an insurance company charge a consumer $500 to cover a $147 expense? The better question might be; why would anyone pay it? The answer to the first question is two-fold, first of all, because they can and secondly, because of Federal laws which require Medicare supplement companies to accept without underwriting individuals losing group insurance and/or leaving a Medicare Advantage plan, companies incur greater claims losses since they can’t weed out the sick individuals. This law does not apply to Medicare Supplement Plan G. Now to answer the question, why would anyone pay so much to cover such a little difference? The answer is simply because they don’t know any better. Whose fault is it that they don’t know any better? That blames rests on the consumer themselves for not doing adequate research, the insurance agent who is not knowledgeable or unscrupulous, the insurance company which is profit driven and the Medicare system for not providing proper education.
Source: askmedicareblog.com

Marion County Indiana Medicare Supplement Quotes June 2013

Robert Bache aka MedicareBob owns and operates Senior Healthcare Direct. Senior Healthcare Direct is a National Telephonic Insurance Agency that represents over 26 Medicare Insurance Companies. It is our job to make sure that you always have the best price for your Medicare Supplement Plan.
Source: srhealthcaredirect.com

Medicare Supplement Plan F

Purchasing a Supplemental Plan F policy should prevent any out-of- pocket costs for the recipient. One of the benefits covered by Supplemental Plan F is hospitalization for up to 365 days after Medicare coverage ends. The plan will cover up to 20 percent of all Medicare approved expenses. If blood is required three pints of blood each year are covered under the plan. The plan also covers the expense of a stay in a skilled nursing care facility. One of the greatest benefits is that Supplemental Plan F covers any emergency medical assistance that may be required while traveling abroad.
Source: edvox.org

Trustees say Medicare exhausted in 2026

WASHINGTON (AP) – The government says Medicare’s giant hospital trust will not be exhausted until 2026, while the date that Social Security will exhaust its trust fund is unchanged at 2033.     The date for Medicare is two years later than was projected last year.     The latest projections are included in the annual report of trustees of the trust funds. The new report warns that despite the small improvement in Medicare, both it and Social Security face significant funding challenges as the giant baby boom generation continues to retire.     The reasons for the improved financial outlook for Medicare are an overall slowdown in health care spending, particularly skilled nursing care, as well as lower projected costs for popular insurance plans available within the Medicare program. (Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.)
Source: wpsdlocal6.com

Government to Leave Plan F Alone

AIC Leads cancer insurance cigna closing CMS CMS data conference call dental Draft Dates e-app electronic application equitable equitable life final expense final expense by phone foresters guaranteed issue guarantee issue hearing Heartland National Hospital Indemnity Interview life insurance medicare advantage medicare supplements medico Missouri mutual of omaha New Era New Era Life objections orlando event phoenix life Plan F Plan F vs. Plan G Plan G planright predictive dialer Script stonebridge training Underwriting vision webinar where to market
Source: medicareagenttraining.com

Higher Deductible Medicare Supplement Plan F De Qui Buy It!Studio 99

Exactly why are people interested in Medicare Supplement Decide N? The bottom line could price. Medicare Supplement Plan D will be cheaper on a 31 day basis. However, if you have to have any Medical services at all, you will likely pay more in the long term and have greater out of savings costs if you purchase Plan T. The experts at Medicare Supplement Shop simply just recommend Plan N if you are typically extremely good health AND are within a strict budget. Keep in mind you may also need more medical services as you obtain older and you only have always on Guaranteed Issue period, which means you will need to make a wise decision one time you purchase a plan.
Source: sets-design.com

Jon Stewart Paraphrases Marco Rubio: ‘Medicare Helps MY Mom, But F _ _ k You’

We encourage users to engage in a respectful discussion of this post, below. Comments are not necessarily representative of MoveOn.org’s views or beliefs, nor are commenters necessarily MoveOn members. This is a community-moderated forum: If you see something offensive, please flag it. If a comment receives enough flags, it will be removed.
Source: moveon.org

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June 17, 2013

Long Struggle Ahead for Medicaid Expansion Advocates in Texas

Posted by:  :  Category: Medicare

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Nonprofit advocacy organizations are not alone in clamoring for Medicaid expansion. Eva DeLuna Castro, Senior Budget Analyst at Texas’s Center for Public Policy Priorities, says Medicaid expansion “had enormous support from chambers of commerce, from local, county, and city governments,” which were anxious to avoid increasing property taxes to cover the uncompensated costs of emergency room care for the uninsured. Including charity care, that cost was $5.4 billion in 2011, according to a Texas Hospital Association survey.
Source: healthcoverageally.com

Video: Texas Rejects Obamacare’s Medicaid Expansion, Won’t Set Up Own Exchange

Congressmen call on Gov. Rick Perry to expand Medicaid to insure 40K Texas vets

“The study cited in the letter shows us what we already know: As the state with the highest percentage of uninsured folks, Texas has the most to gain from participating in a program we are already paying for,” he said in a statement. “With the special session underway in the Texas Legislature, the governor has a chance to ensure that millions of Texans, including 49,000 of our military veterans, have access to quality health care. We know this can be done and hope Governor Perry does the right thing.”
Source: elpasotimes.com

Draft of Proposed DSRIP Monitoring Rule

As we discussed at the April 12, 2013 RHP 2 1115 Waiver Meeting, HHSC has been considering options for funding waiver monitoring.  Attached are the draft rules [IGT Allocation for Waiver Monitoring Rule] [IGT Allocation for Waiver Monitoring Preamble] from HHSC that address proposed IGT withholding in order to fund DSRIP monitoring activities at the state level.  If you would like to comment on the proposed rules, please see the contact information in the e-mail below from Lisa Kirsch.
Source: utmb.edu

Amendments and Clarifications to Transformation Waiver Program Rules

We welcome any comments waiver stakeholders may have. Written comments on the proposal may be submitted to Charles Greenberg, Assistant General Counsel, Office of General Counsel, Health and Human Services Commission, Mail Code-1070, P.O. Box 13247, Austin, TX, 78711; by fax to (512) 424-6586; or by e-mail to charles.greenberg@hhsc.state.tx.us, within 30 days after publication of this proposal in the Texas Register.
Source: utmb.edu

Texas and Medicaid Hypocrisy

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

Who to blame for Texas rejecting Medicaid? Gov. Perry’s ‘just one man…he’s not God.’

In North Texas and Houston, many chambers of commerce have called for Medicaid expansion and often touted the economics: the health care jobs that would be created by covering more people, the billions in federal dollars that would flow into the state, and the reimbursements for hospitals and doctors who provide charity care.
Source: dallasnews.com

Sen. John Cornyn: “Expanding Texas Medicaid Would Weaken It”

You might be wondering why so many Medicaid patients would go to the ER for routine care when they have health insurance. The reason is simple: Medicaid offers poor-quality coverage. Because the program reimburses providers at such low rates, an ever-growing share of Medicaid beneficiaries cannot easily find doctors or dentists who will accept their insurance. (We’ve recently seen a number of lawsuits brought by providers and patients against their state Medicaid programs over low-reimbursement policies.) According to the 2012 TMA survey, more than two-thirds of Texas physicians are turning away at least some of the Medicaid patients who come to their offices, because they cannot afford to treat them.
Source: urbangrounds.com

Texas Legislature to Perry: Don’t waffle on Medicaid expansion

The proposal, an amendment to a Medicaid-related bill, says state health officials “may only provide medical assistance to a person who would have been otherwise eligible for medical assistance or for whom federal matching funds were available under the eligibility criteria for medical assistance in effect on December 31, 2013.”
Source: medcitynews.com

N.Y. Suspends Adult Day Care Enrollment; Texas Lawmakers Push Action On Medicaid Fraud

The Texas Tribune: Legislators Seek Action On Medicaid Fraud Measures After the discovery that the state was spending millions of dollars on fraudulent Medicaid dental and orthodontic care, state lawmakers held hearings ahead of the legislative session to identify what went wrong and how to prevent future fraud. And this session, lawmakers have filed a handful of bills to reform how Texas addresses Medicaid fraud. But the bills aren’t progressing as fast as some would like (Aaronson, 4/25).
Source: kaiserhealthnews.org

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June 17, 2013

Medicare Part D 2010 Data Spotlight: The Coverage Gap

Posted by:  :  Category: Medicare

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In 2010, nearly all the private stand-alone drug plans have a coverage gap, though a small share do provide some help to beneficiaries in the coverage gap, usually covering only generics or a small number of brand-name drugs. One third of those plans with gap coverage charge more for generic drugs in the gap than they do for the same drugs in the initial coverage period.
Source: kff.org

Video: Medicare Part D – The Donut Hole

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

What on Earth is the Donut Hole? A Brief Explanation of Medicare Part D and the “Donut Hole” » The NeedyMeds Blog

In 2013, you get out of the coverage gap when you have paid $4,750 out-of-pocket for covered drugs since the start of the year. When you reach this out-of-pocket limit, you get catastrophic coverage. The costs that help you reach catastrophic coverage include what you spent on drugs while in the donut hole and most of the discount on brand-name drugs you received in the coverage gap. If someone else pays for your drugs on your behalf, this will also count toward getting you out of the coverage gap. This includes drug costs paid for you by family members, most charities, State Pharmaceutical Assistance Programs, AIDS Drug Assistance Programs and the Indian Health Service. You continue to pay your drug plan’s monthly premium during the gap, but the premium does not count toward the $4,750 out-of-pocket limit. The amount your drug plan paid for your drugs in your initial coverage period also does not count.
Source: needymeds.org

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

Closing The Medicare Part D Program Doughnut Hole: The End Is In Sight!

There’s also some encouraging research confirming what a lot of us intuitively sense: that making prescription drugs more affordable saves money down the road by keeping people healthier. When people with diabetes get their insulin regularly, for example, they’re more likely to stay out of the hospital. Of course this is great for them; no one likes going to the hospital. But it’s good for all of us, because hospital care is expensive, and keeping people healthy and out of the hospital is one of the most obvious ways of bringing health care costs under control. Recently, the Congressional Budget Office – the green eyeshade folks who keep track of the cost of everything the government does – concluded that making prescription drugs in Medicare more affordable does, in fact, save some money later on by reducing things like hospital admissions. As a result, filling in the doughnut hole is going to cost about 40 percent less than was previously forecast. At a time of tight budgets, that’s great news for all of us.
Source: smmirror.com

Medicare drug costs to fall in 2014, but donut hole widens

Before passage of the ACA, seniors in the gap paid 100 percent of all drug costs. Now, they pay 50 percent out-of-pocket for brand-name drugs, with the rest made up by insurers and discounts from pharmaceutical manufacturers. For generics, they pay 79 percent. Enrollees’ out-of-pocket burden for brand-name and generic drugs will gradually fall to 25 percent by 2020 – the same percentage applied for standard coverage.
Source: medcitynews.com

Tips to Stay out of the “Donut Hole”! » Toni Says

In 2013,those who have a Medicare Part D plan receive a 52.50% discount on “covered” brand name prescription drugs that counts as out of pocket spending and help her get out of the “Donut Hole”. She pays 47.50% of the brand name prescription and the prescription drug manufacturer will pay 52.50% of the “covered” drug.  Everyone who gets in the “Donut Hole” must spend $4,750 out of pocket for the year to get out of the “Donut Hole” or coverage gap. When she is out of the “Donut Hole”, she enters catastrophic coverage and pays a small co pay for each prescription drug until the end of the year.  January 1 of each year, the process starts all over again!
Source: tonisays.com

Medicare Part D Donut Hole, Coverage and Changes 2013

Medicare Part D 2013 Changes for this year include, once you hit the donut hole you will be eligible for a onetime $250 rebate cheque. You will also receive a 50% discount on brand name drugs in the donut hole; you will also pay less and less for your generic part D drugs in the donut hole. It is planned that as from 2020 the coverage gap will have been closed such that there will be no donut hole. In this case you will only pay 25% of the cost of your drugs until you reach the spending limit. You will also get continuous Medicare coverage throughout this time for your prescriptions as long as you are in the prescription drug plan There is no need to keep track of your retail drug costs or retail drug spending, your Medicare part D plan provider will gather all the retail costs and keep a keen track of your record till you reach the donut hole Phase. You can also check out:
Source: medicalbillingcodings.org

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