Medicare Benefits and Cost

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This fact sheet discusses Medicare cost-sharing requirements. Traditional fee-for-service Medicare imposes deductibles, coinsurance, and copays for Medicare services.  In addition, beneficiaries must pay premiums for receiving Part B (physician) and Part D (prescription drugs) coverage. Medicare does not cover certain essential services, such as vision, dental, and long-term care expenses, and beneficiaries must pay out-of-pocket for these services.  
Source: aarp.org

Video: Top 10 Medicare Insurance Tips

Top 10 Online Resources for People on Medicare

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

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

The Ins and Outs of Medicare Supplemental Insurance

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

Medicare Access in Tallahassee: Milestone or Millstone?

Capital Medical Society is the Tallahassee-based, local professional membership organization for physicians, representing more than 600 licensed physician members who live and work in Leon, Gadsden, Jefferson, and Wakulla Counties. A non-profit corporation, CMS is governed by an annually elected Board of Governors and offers a variety of services to both its members and to the public. In 1975, the physician members created a charitable foundation whose mission is to support the charitable efforts of physicians and others, increase access to healthcare, promote education and serve the community’s health needs through innovative projects that are exemplary, affordable and dignified. The CMS Foundation operates the We Care Network, with over 300 volunteer physicians, volunteer dentists, the hospitals and most of the allied health professionals in Tallahassee who donate medical and dental care to low-income uninsured patients from Leon, Jefferson, Gadsden, and Wakulla counties. These volunteers have donated more than $50 million in charity care since the program was founded in 1992.
Source: tallahassee.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

Health Insurance Coverage for Older Adults: Implications of a Medicare Buy

This Kaiser Family Foundation policy brief provides an updated profile of the more than 4 million uninsured people between ages 55 and 64 and examines historical proposals to allow uninsured older adults to purchase Medicare coverage. It also examines barriers to securing affordable coverage in the current marketplace, and the effect of premiums and eligibility criteria on the potential uptake of a Medicare buy-in.
Source: kff.org

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

Do You Qualify for Free Medicare Part D?

Posted by:  :  Category: Medicare

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If you decide to apply and find out you don’t qualify, don’t worry because there are other programs at the state level that may be able to help you cover your prescriptions.  Find out by visiting Medicare’s “Helpful Contacts” page- Click here to visit the page.  This page can help you find a program at the state level that may be able to provide some assistance to pay for prescription drugs.
Source: firstseniorfinancialgroup.com

Video: Medicare Part D

Can Medicare Save Money? How The Part D Program Can Be More Cost

Many seniors may not be aware that the infamous “doughnut hole,” or gap in coverage, is closing thanks to the Affordable Care Act. Before the health care law was passed, if beneficiaries reached the initial limit on total drug expenses ($2,970 in 2013), they had no prescription drug coverage until they spent an added $3,700 out of their own pockets. But in 2013, people in the doughnut hole are receiving discounts of 52.5 percent on name-brand drugs and 21 percent on generics. These discounts will result in significant savings for about 4 million Medicare beneficiaries in 2013. More importantly, the discounts will continue every year until 2020, when the doughnut hole will be completely eliminated.
Source: smmirror.com

The Medicare Prescription Drug Benefit Fact Sheet

CBO estimates that Part D spending will total $60 billion in 2013 (net of premiums and state transfers).  The average annual Part D per capita growth rate was 3.7% between 2006 and 2011, but is projected to rise at a more rapid rate (5.6%) between 2011 and 2021 (2012 Medicare Trustees), in part due to slowing of trend toward greater generic drug use. Total spending depends on several factors: the number of Part D enrollees, their health status and drug use, the number of low-income subsidy recipients, and plans’ ability to negotiate discounts and rebates with drug companies and manage use (e.g. promoting use of generic drugs, prior authorization, step therapy, quantity limits, and mail order).  The MMA prohibits Medicare from negotiating drug prices directly.
Source: kff.org

How Do You Get Medicare Part D?

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

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

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

Part D: Bending the Medicare Cost Curve

Part D’s 10-year projection has now been reduced by over $100 billion the past three years, and these projections are almost half of their initial estimated cost when the program was enacted seven years ago.  Through market-based competition, Part D is successfully able to offer a mix of plans to help seniors access medicines which, in turn, helps them adhere to doctors’ orders. This improved use of medicines helps lower other health costs, such as hospitalizations and expensive procedures.
Source: phrma.org

As Hill Panels Focus On Medicare, Marketplace Examines How Part D Changed The Pharmaceutical Industry

MedPage Today: Focus On Medicare Cost Drivers, Congress Told A congressional hearing on increasing patient cost sharing as a mechanism for Medicare reform turned into a call for broad changes to provider incentives in the program. Health policy experts told lawmakers Tuesday that payments need to move away from a volume-based fee-for-service if policymakers want to generate savings in Medicare. The House Ways and Means Health Subcommittee called the hearing to examine bipartisan proposals for Medicare reform. Specifically, they wanted to discuss increasing the Part B deductible, increasing Part B and D premiums for wealthier seniors, and establishing a copay for home health services, subcommittee chair Kevin Brady (R-Texas) said. But experts called before the subcommittee called the proposals short-sighted and said they wouldn’t do much other than cause beneficiaries to pay more (Pittman, 5/21).
Source: kaiserhealthnews.org

Special Delivery: Comparing Rural and Urban Medicare Part D Enrollment Patterns

Prior to 2006, approximately 59% of rural beneficiaries and 75% of urban beneficiaries had some type of drug coverage. Rural beneficiaries were more likely to have self-purchased Medigap drug coverage while urban beneficiaries were more likely to have obtained drug coverage through their employers. With the implementation of the Part D program, Medigap prescription drug policies are being phased out and employers are receiving subsidies encouraging them to retain employee drug coverage through the Retiree Drug Subsidy program. The potential benefits of Part D enrollment include improved access to drugs, reduced out-of-pocket drug expenditures, and better health outcomes. The degree to which rural beneficiaries benefit depends on a number of factors, including their health needs, their medication needs, and what type of drug coverage they had prior to Part D enrollment, if any…
Source: blogspot.com

Medicare Prescription Drug Coverage, Medicare Part D, Doughnut Hole

Medicare has an optional program — called Medicare Part D — that provides insurance to help you pay for prescription drugs. If you select to have the coverage, you pay a monthly premium. This guide explains how the program works and helps you make decisions in choosing a plan that’s right for you.
Source: aarp.org

Kaine signs on to Medicare medication bill

Boston Marathon Caroline County Celebrate Virginia Live Chancellorsville 150 City Council Civil War Colonial Beach crime Culpeper Culpeper County Dahlgren Daniel Harmon–Wright Dominion Raceway earthquake Falmouth intersection fatal fire Fredericksburg Fredericksburg Baseball Fredericksburg Va. Getting There Health Care Historic Half Hurricane Sandy Interstate 95 King George King George County Laurence Alan Stewart II Natatia Bledsoe National Slavery Museum Orange County outage Patricia Cook power outage Rappahannock River Spotsylvania Spotsylvania County Stafford Stafford County storm transportation UMW University of Mary Washington VDOT Westmoreland County
Source: fredericksburg.com

Sr Contract Monitoring Analyst

Five to seven years experience in quantitative business analyses and statistical modeling (preferably healthcare related).Proven analytical experience using Enterprise Guide SAS, database query capabilities and ability to evaluate data at various levels of detail (preferably Enterprise Guide SAS) *Subject Matter Expert on Medicare Part D and CMS requirements and Pharmacy Benefit Manager (PBM) technical and operational experience is preferred
Source: kdnuggets.com

Inspector General Faults Medicare for Not Tracking ‘Extreme’ Prescribers

Posted by:  :  Category: Medicare

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The inspector general’s report calls on the Centers for Medicare and Medicaid Services (CMS), which oversees the program, to step up scrutiny of doctors with questionable prescribing patterns. It urged CMS to direct its fraud contractor to expand its analysis of prescribers and train the private insurers that administer Part D on how to spot problem prescribers.
Source: propublica.org

Video: Medicare

Medicare Benefits and Cost

This fact sheet discusses Medicare cost-sharing requirements. Traditional fee-for-service Medicare imposes deductibles, coinsurance, and copays for Medicare services.  In addition, beneficiaries must pay premiums for receiving Part B (physician) and Part D (prescription drugs) coverage. Medicare does not cover certain essential services, such as vision, dental, and long-term care expenses, and beneficiaries must pay out-of-pocket for these services.  
Source: aarp.org

Kaine signs on to Medicare medication bill

Boston Marathon Caroline County Celebrate Virginia Live Chancellorsville 150 City Council Civil War Colonial Beach crime Culpeper Culpeper County Dahlgren Daniel Harmon–Wright Dominion Raceway earthquake Falmouth intersection fatal fire Fredericksburg Fredericksburg Baseball Fredericksburg Va. Getting There Health Care Historic Half Hurricane Sandy Interstate 95 King George King George County Laurence Alan Stewart II Natatia Bledsoe National Slavery Museum Orange County outage Patricia Cook power outage Rappahannock River Spotsylvania Spotsylvania County Stafford Stafford County storm transportation UMW University of Mary Washington VDOT Westmoreland County
Source: fredericksburg.com

Viewpoints: Don’t Change Course On Medicare Reforms On Medical Equipment Prices; Liberals’ Agenda Depends On Cutting Entitlements; Making Hospital Prices Public

The Washington Post: Liberals Should Lead Entitlement Reform  Social Security, Medicare and the other major health care programs will account for more than half of all federal spending 10 years from now, CBO says. That takes into account the recent good news of slower-than-expected growth in health care costs, and it assumes Medicare cuts that are unlikely to be implemented. The guts of these programs have to be preserved, as liberals rightly argue. Social Security keeps the elderly out of poverty. Medicare ensures that they get health care, and Medicaid and Obamacare should come close to extending that promise to all Americans. But while federal programs aimed at the young and the poor — and at investments in the future — are slated to dwindle, the entitlement programs are on track to give ever richer benefits to a growing older generation, some of whom don’t need all that much help (Fred Hiatt, 6/16). 
Source: kaiserhealthnews.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

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

Medicare fund insolvency date a bit further away than last year

Then where was their plan before. Dumb azzes, think, my insurance goes up every year because all of the people without insurance still get sick and go to the doctor. ProBusiness you dumb azz, do you know what bad debt expense is????? Give you a hint, it is an expense and they charge my insurance which then raises their rates. It is all a matter of efficiency, how do you provide some limited insurance for all because we already are paying for it. The Healthcare industry spends over $5 billion every year on lobbying, to put that into perspective, the defense industry spends $1.6. Your congressman and women are bought and paid for two bit whores. We pay more per capita than any country in the world. You don’t like Obama care then what is your plan??? Fat people should lose weight, smokers should pay more and the billing should be transparent and competitiive. Just ripping things down is a sign of ignorance. People keep ripping the illegals, saw something last night driving home through the bad part of town. All the blacks are sitting out on their porches and this one little hispanic guy is pushing his little cart down the street selling whatever he is selling. The low skilled jobs are going to be taken over by the hispanics you watch. I know I am racist now. The trash that makes up the tea party from the right and the left are destroying this country and yes I said too, the extreme left is no dam different than the extreme right.
Source: nbcnews.com

Medicare Access in Tallahassee: Milestone or Millstone?

Capital Medical Society is the Tallahassee-based, local professional membership organization for physicians, representing more than 600 licensed physician members who live and work in Leon, Gadsden, Jefferson, and Wakulla Counties. A non-profit corporation, CMS is governed by an annually elected Board of Governors and offers a variety of services to both its members and to the public. In 1975, the physician members created a charitable foundation whose mission is to support the charitable efforts of physicians and others, increase access to healthcare, promote education and serve the community’s health needs through innovative projects that are exemplary, affordable and dignified. The CMS Foundation operates the We Care Network, with over 300 volunteer physicians, volunteer dentists, the hospitals and most of the allied health professionals in Tallahassee who donate medical and dental care to low-income uninsured patients from Leon, Jefferson, Gadsden, and Wakulla counties. These volunteers have donated more than $50 million in charity care since the program was founded in 1992.
Source: tallahassee.com

The Challenge of Predicting Future Medicare Expenses

Abraham Lincoln behavioral economics behavior change bioethics books I’ve been reading cancer cancer screening confirmation bias consumer psychology disability doctor-patient communication environment ethics favorite quotes financial toxicity free markets government regulation health care costs healthcare quality health insurance health policy individual mandate irrationality Medicaid medical decision making Medicare medications nudges Obamacare obesity orthopedics partisanship political psychology politics price transparency primary care public health public policy religion shared decision making sports STDs Teddy Roosevelt Thomas Jefferson US history
Source: peterubel.com

Colorado’s Citizen Legislature

Posted by:  :  Category: Medicare

House Bill 13-1202: End-of-life decisions are the most gut-wrenching situations a person can ever face. HB 1202 was signed by Governor Hickenlooper on April 8th, and “adds counseling for medical orders for scope of treatment (MOST) by Medicaid providers to the list of services that are eligible for reimburse­ment, provided federal cost shar­ing is available.” HB 1202 modi­fies current law which allows for MOST by Medicaid providers, but the services were not eligible for reimbursement.
Source: myprimetimenews.com

Video: Canvas Adult Day Care Licensure and Certification Requirements Colorado Mobile App

Colorado Springs Independent

A gala event to benefit the Alzheimer’s Association. Features silent and live auction of over 50 pieces of art created by people with Alzheimer’s, paired with a number of professional works on the theme The Secret Garden. Semi-formal attire, especially in purple, is encouraged. Fri., June 21, 5:30 p.m. Cheyenne Mountain Resort, 3225 Broadmoor Valley Road
Source: csindy.com

Costly Medicaid Expansion Nears Approval In Colorado

According to the Common Sense Policy Roundtable, “Colorado’s Medicaid enrollment is projected to grow 44% by 2014 if state lawmakers opt-in and accept the expansion proposed as part of the Patient Protection and Affordable Care Act.” If the Medicaid expansion SB 200 becomes law, Medicaid expenses are expected to grow by $2.5 billion between fiscal year 2011-2012 to fiscal year 2024-2025. This is estimated to consume over 27% of Colorado’s General Fund, over a quarter of the state’s overall budget.
Source: redstate.com

Why I will accept Medicaid

While I champion your enthusiasm, you may find it a different world when you begin to practice. There are so many hoops to jump through, and red tape involved in just getting credentialed with Medicaid, let alone trying to submit a claim, that I wouldn’t wish that headache on anyone. If you can convince your state to pass legislation increasing the reimbursement rates, they will more than likely do what my state did, which was to react, not to act. In my state they raised reimbursements by nearly 100% on most procedures. After several years passed and a flood of dentists into the state just to open Medicaid centered offices resulted, the state realized that it had grossly overcompensated, and had a budget in the red. So what did they do, overcompensate again of course. Now they are cutting back reimbursements, farming out the handling of claims to private companies who make their own rules, and once again denying patients access to care by forcing practices to stop taking Medicaid, or putting those that are heavily centered in it completely out of business. The moral of the story, government doesn’t do much of anything well. If you get into bed with government, beware the consequences, because you are subject to the whims of the beaurocracy.
Source: asdablog.com

Summary of 2013 Legislative Successes

Medicaid expansion to increase the income eligibility for the Medicaid program to 133 percent of the Federal Poverty Level, with a goal of improving the health of the state’s most vulnerable while reducing costly and uncompensated care for the uninsured.  It is expected to cover an additional 160,000 adults with family incomes below $31,322 for a family of four and is effective January 1, 2014. This bill, along with the hospital provider fee and federal matching funds, will also allow for the implementation of 12-month continuous eligibility for children covered by Medicaid.
Source: oralhealthcolorado.org

Quick Take: Medicaid Provider Taxes and Federal Deficit Reduction Efforts

WHAT WOULD THE IMPACT OF LIMITING THE USE OF PROVIDER TAXES BE ON STATES? Recent federal deficit reduction discussions have suggested gradually lowering the safe harbor threshold from 6.0 percent to 3.5 percent of net patient revenues. States have indicated that nearly 6 in 10 provider taxes currently in use by states are above that threshold. Forty-three states have at least one provider tax above this 3.5 percent threshold (Figure 3); over half of states reported at least two above this threshold. Other proposals have suggested instead returning to the prior threshold of 5.5 percent of net patient revenues; however, twenty-six states reported having at least one provider tax above the 5.5 percent threshold. Table 1 details which kinds of provider taxes states have as well as which of those taxes would be affected if the safe harbor threshold were dropped to 3.5% or 5.5% of net patient revenue. Taxes denoted with an * would only be affected if the threshold were dropped to 3.5% while taxes denoted with ** would be affected by reducing the threshold to either 3.5% or 5.5% of net patient revenues.
Source: kff.org

State Innovation Models Initiative: Model Pre

New York submitted a Pre-Testing Assistance Award request also to support activities related to organizing collaboration with statewide and regional stakeholders; quantifying and describing the current health care environment in New York; and completing legal, regulatory and policy and cost analyses relating to implementation of new payment and service delivery models.  The state plans to convene a series of stakeholder meetings in various regions across the state including meetings in: Buffalo, Rochester, Syracuse, New York city and Albany.  Working with a consultant, the state will also collect and analyze health care pattern utilization data for public and private payers; conduct business process and systems analyses; and develop quality improvement systems, performance standards and related metrics.  The proposal meets the requirements set forth in the Funding Opportunity Announcement and the Centers for Medicare & Medicaid Services recommends this applicant for a Pre-Testing Assistance Award.
Source: coloradomedicalhome.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 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

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 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

Examining Sources of Supplemental Insurance and Prescription Drug Coverage Among Medicare Beneficiaries: Findings from the Medicare Current Beneficiary Survey, 2007

This updated chartpack presents sources of supplemental and prescription drug coverage among Medicare beneficiaries in 2007, the most recent year for which national data are available. The chartpack looks at variations in supplemental and prescription drug coverage by income, race/ethnicity, age, urban/rural location, and health status. It also examines characteristics of Medicare beneficiaries with low incomes who are not enrolled in a Part D plan or receiving Part D low-income subsidies.
Source: kff.org

Medicare Supplemental Insurance Plans Discussed

For instance, in Texas you’re guaranteed subject when you’re opted in for Part B. Or if you are just coming without a group health and well-being plan you’re cast iron issue in 63 days. At this point , having said that, there are lessons a significant quantity of exceptions to guidelines of thumb. With Medicare Part The best and B receivers are able acquire supplemental insurance that can fill in currently the gaps of exactly what not covered. Medicare supplemental insurance plans A, B, C, D, F, G, K, L, N and N offer benefits ranging outside of hospitalization co-pays returning to deductibles. Every bit of services not insured by Medicare all the recipients’ responsibility with regard to a Medigap plan has been purchased through an free insurance company. Medigap is the phrase used for ppi that is buy online to cover an gaps left by Medicare. Nursing home care in its traditional form is not health care care but could be described as instead custodial think about. They will likely provide some modest medical care (which may be paid by Medicare) sadly the focus was actually on promoting the activities associated daily living (ADL) for the client instead. Around their normal capacity a nursing home is helping via bathing, toileting, feeding, and other tasks which do not require formal doctor’s staff to overcome. Nursing houses though typically choose have at at a minimum one Registered Breastfeed (RN) on employee at all minutes to handle research issues which actually do come up. Medicare is a sort of health improve afforded to aging population citizens of now this nation. That it is funded basically the government. Like in added countries, Medicare throughout the United States, including Texas medicare benefits, are backed by the You and me Federal government. But the main problem is that this medicare plans do not cover all sickness expenses. One last mistake to avoid in selecting Florida Medicare insurance is intending to do it on your get. With ten different supplement intends and changing laws, the entire assortment can be confounding on a high quality day. You can use the support of a high-quality insurance broker to assist you find accurate policy for you’ve. The broker keeps high on all the plans and related enhancements. The broker can review general coverage and a person advice on which policy will prime meet your purposes. If you want to save money, use a financier. Medicare Plan F are also renowned to many to be Medigap plans. Either way you work in league with traditional probably original Medicare coupled with do not synchronize any payments which has the Medicare Virtue plans. Lately sold Medicare aid plans do not too include prescription dental coverage since the inception in 2006 of Medicare Prescription Pharmaceutical Plans (PDP). These supplement plans are sold in private insurance insurance companies who meet some requirements for often the state in which experts claim the plan is sold. It is far more get a arrange F which will be the most popular choose sold you can pay your expensive and avoid compensating out of hand for your medical care as you turn out. This plan is hence popular because this tool allows in very specific those on preset incomes to significantly better control their monthly expenses. Usually also extremely popular because it provides the plan registrant to get all of the care is suitable without thinking with regard to can I allow the care in addition to test right now, or do I actually just need toward defer it a time. These sorts of Medigap Texas insurance policies are divided based on the types of dollars spent they conserve yourself. You should either obtain minimal rates in extra to high deductibles or high monthly premiums along with inexpensive deductibles. Yourself have to remain the one which will determine which type in of plan your company would like to go with. Either manner you will will obtain a sort of elimination. It just depends on recommendations on how probable you are going to be in need of having on the way to pay your tax decuctible. If you are for your current most part likely ready to now have to carry accessible this, obtain any kind of inexpensive deductible or perhaps even else put the type of funds away into the future of time. That way buyers are equipped if ever something transpires. LTCI plans are available to cover custodial care or the nursing profession home care where there are very little medical needs staying treated. LTCI plans are material to full underwriting in order for you to have one granted. The money for the plan varies based on the subject of age at issue, coverage levels, and medical status. These policies are designed to coverage many different ought related to your ADLs so a new good LTCI should less than be thought of as only looking after home care given that in reality, consumers cover home care and assisted think as well. Again all these are convalescent or custodial healthcare situations where Medicare does not offer any benefits. Fire and thieves allow a necessity a great deal of people to enjoy homeowner’s or renter’s insurance to protect their valuables due to jewelry to spy cameras to furs and as a consequence most of some of the time these policies may have provisions covering even displaced baggage during trips. Baggage insurance can really deal with your lost bag within the a trip. Medical insurance insurance policy can extend policy for a year at a time.
Source: typepad.com

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

Posted by:  :  Category: Medicare

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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

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

The Ins and Outs of Medicare Supplemental Insurance

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

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

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 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

How To Compare The Different Medicare Supplement Plans

1990, Medicare standardized their different plans in order to decrease the amount of confusion that consumers were experiencing as they compared different coverages offered by the different healthcare insurance providers. As a result of this standardization, it is easier for the consumer to understand the comparison of these different benefits and the associated cost comparisons between healthcare insurance providers. As a result, the terms “MediGap plans” and “Medicare supplement” basically mean the same thing and are commonly used interchangeably. As a result of having so many Medicare plans to choose from, it is important to research each one in order to decide which will be best for your personal needs and situation. One of the first things to be aware of when searching for supplement plans and comparing the ones you find is that many websites who advertise these are only there for one reason and that is to collect your personal information. In many cases, insurance providers will purchase leads or develop lead generators to accomplish this instead of actually doing what they advertise. Basically, these companies don’t know the proper ways of developing new business so they resort to these somewhat underhanded methods. Many of these companies make it appear as though they actually sell the different Medicare supplement plans but the reality is that they will collect your personal information and sell it to numerous insurance agents. Here are two ways that you can tell if they are legitimate healthcare insurance and Medicare supplement plan providers. First of all, there will be a toll-free number to call and secondly, there will be a statement promising that they will never sell your personal information to anyone else. Do price comparisons of these different Medicare plans when searching through the different companies that offer them. The better insurance brokers will be able to provide you with these comparisons from those insurance providers operating in your local area. In most cases the prices will differ despite the fact that the supplement plans they offer are identical. Remember, it is better to do plenty of research in order to make a well-informed decision when purchasing the Medicare supplement plan that is right for you.
Source: blogspot.com

MedicareSupplementShop.com ? Compare Medicare Supplement Plans, Get Quotes!

There are many Prograde supplements exciting and useful factors to the website. Although searching at all of your Medicare Supplement Plans, you can simply compare various portions of the plan and realize the distinct charges and advantages at the exact same time. This comparing quotes page contains straightforward to adhere to actions and numerous valuable hints. The web page also has very easily laid out grids, so you can compare different plans side by side, without confusion or uncertainty about what your plan will have to offer you.
Source: pakchom.net

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

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

Medicare Benefits and Cost

This fact sheet discusses Medicare cost-sharing requirements. Traditional fee-for-service Medicare imposes deductibles, coinsurance, and copays for Medicare services.  In addition, beneficiaries must pay premiums for receiving Part B (physician) and Part D (prescription drugs) coverage. Medicare does not cover certain essential services, such as vision, dental, and long-term care expenses, and beneficiaries must pay out-of-pocket for these services.  
Source: aarp.org

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June 21, 2013

What is Medicare Supplement (Medigap) Insurance

Posted by:  :  Category: Medicare

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In order to sign up for Medicare Supplement coverage, you must already have Part A and Part B. These plans are offered by private insurance companies and come in 10 standardized policy types that are denoted by the letters A-N. The standardization of these plans means that no matter where you shop, the Medigap policy details remain consistent. For example, the benefits associated with Plan F are the same no matter where you buy it, though costs may differ across all carriers. Not every carrier of Medicare Supplement Insurance offers all 10 plan types, and three states in the U.S. have their own version of these plans: Massachusetts, Minnesota, and Wisconsin.
Source: ehealthmedicare.com

Video: Introduction into Medicare Supplements (Medicare Supplement Insurance Series)

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

MedicareBob’s Blog: Alabama Medicare Supplement Quotes as of June 11 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: blogspot.com

Medicare Supplement Plan F

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

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

The Ins and Outs of Medicare Supplemental Insurance

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

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June 21, 2013

N.C.’s nascent Medicaid reform

Posted by:  :  Category: Medicare

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

Video: Medicare supplement Insurance Plans VS Medicare Advantage plans

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

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

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

Comparing Medicare Advantage Plans Missouri

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

Compare 2013 Medicare Advantage Plans

2013 About Advantage Affordable Case Compare Condition Cost cover Dave explained Getting Good Health insurance Learn life Major medical Medicare Medigap Plans policies Preexisting Ramsey term Tips Understand Whole Work
Source: healthandlifeinsurancepolicy.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 Advantage Enrollment Reaches Record High

CQ HealthBeat: Medicare Advantage Plans Worry About Cuts, But Enrollment Keeps Growing The number of seniors in the private Medicare Advantage plans tripled in the past seven years, according to an analysis released Monday. But future payment cuts could cause insurers to reduce benefits or increase cost-sharing, says a Blue Cross and Blue Shield Association official. The Medicare Advantage program grew from 5.3 million people in 2004 to a record 14.4 million in 2013, according to the analysis by the Kaiser Family Foundation and Mathematica Policy Research Inc. From 2012 to 2013 alone, the program grew by 10 percent — or by 1 million people (Adams, 6/10).
Source: kaiserhealthnews.org

The Ins and Outs of Medicare Supplemental Insurance

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

CMS: Health plans for dialysis patients on Medicare Advantage not impacted by sequester

The Centers for Medicare & Medicaid Services issued a memorandum last month affirming that Medicare Advantage Plans are exempt from the 2% cut. Part D plans are also exempt. Some insurance plans, including United Healthcare, Humana, and Anthem Blue Cross Blue Shield, had notified care providers that they should expect a 2% cut, according to Lexology, an industry newsletter published in cooperation with the Association of Corporate Counsel.
Source: homedialyzorsunited.org

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June 21, 2013

Get ready for your summer trip

Posted by:  :  Category: Medicare

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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

Video: Medicare Part D, How to get the best Part D Plan

How Do You Get Medicare Part D?

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

Most people get Medicare Part A without paying a premium

If you get Social Security disability benefits for 24 months, you will qualify for hospital insurance. If you get benefits because you have amyotrophic lateral sclerosis, you do not have to wait 24 months to qualify. In addition, someone who has permanent kidney failure requiring maintenance dialysis or a kidney transplant qualifies for hospital insurance if he or she has worked long enough or if he or she is the spouse or child of a worker who qualifies.
Source: mysanantonio.com

Viewpoints: Don’t Change Course On Medicare Reforms On Medical Equipment Prices; Liberals’ Agenda Depends On Cutting Entitlements; Making Hospital Prices Public

The Washington Post: Liberals Should Lead Entitlement Reform  Social Security, Medicare and the other major health care programs will account for more than half of all federal spending 10 years from now, CBO says. That takes into account the recent good news of slower-than-expected growth in health care costs, and it assumes Medicare cuts that are unlikely to be implemented. The guts of these programs have to be preserved, as liberals rightly argue. Social Security keeps the elderly out of poverty. Medicare ensures that they get health care, and Medicaid and Obamacare should come close to extending that promise to all Americans. But while federal programs aimed at the young and the poor — and at investments in the future — are slated to dwindle, the entitlement programs are on track to give ever richer benefits to a growing older generation, some of whom don’t need all that much help (Fred Hiatt, 6/16). 
Source: kaiserhealthnews.org

Get Ready for Medicare Price Cuts on Medical Supplies

The American Diabetes Association also has helpful tips for Medicare beneficiaries who may be confused by the changes, including this one for those who get their supplies at a pharmacy: Make sure to ask if the store accepts “Medicare assignment.” This means the store will accept the Medicare-approved amount as payment in full, and you cannot be charged more than a 20 percent co-pay (after you meet your deductible). If a local store does not accept Medicare assignment, you may be charged more than the 20 percent co-pay. Check with the store to find out what your payment will be.
Source: tacticalminc.com

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

Critics take issue with Medicare bid program

&summary=Economists+and+trade+groups+are+shifting+into+high+gear+in+their+years-long+fight+against+a+controversial+Medicare+bidding+process+that+they+say+is+overrun+with+operational+problems+but+that+federal+officials+adamantly+argue+is+effective.&source=Maryland+Daily+Record’ title=’Share with Lindedin’ onclick=’target=”_blank”;’ rel=’nofollow’>
Source: thedailyrecord.com

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

Not Here to do the Decent Thing: Privatizing Medicare Ryan

I apologize for overloading this section. I am serious. I am scared. Same crowd gets into power that controlled Presidency for 20 years 1980-2009 I am horrified. Look at what they did–Destroyed wonderful local S&L industry–took 600 budget to 3500–took surplus to 1400 deficit–took 1000 debt to 10,000–took 218,000 jobs per month to 99,000-got us into 10 foreign conflicts–smashed stock market 5 times—smashed Housing Industry–smashed our world reputation—Borrowed 9000B instead of getting revenue by taxing their rich pals who gained as Middle Class Lost wealth. I am scared–Get out Every Voter I apologize for overloading your comments section. I am scared. I am serious. If the same crowd takes government that had power in 20 years of 1980—2009 look at what they did to us: 600 Budget to 3500—1000 debt to 10,000—surplus to `1400 deficit— 218,000 jobs per month to 99,000—got us into 10 foreign conflicts—smashed wonderful local S&L Industry—Housing Industry—4 times crashed Stock Market—took us from a Heaven on earth to a Hell on earth WE MUST WIN—AT STAKE IS THE MIDDLE CLASS STANDARD OF LIVING WHICH HAS ALREADY BEEN DAMAGED At a time of extreme inequality – with the top 1 percent capturing a staggering 93 percent of all income gains in 2010 – Republicans would dramatically lower taxes on the wealthiest Americans, and by definition raise them on working families.They don’t actually admit to that, of course. But they lower top income tax rates and sustain lower rates on wealth (capital gains, dividends) while claiming their reforms will raise as much money (be revenue neutral) by eliminating unspecified loopholes and tax breaks. That means they must go after the biggest deductions – either limit the mortgage deduction for middle class homeowners or cut the tax benefits for employer provided health care, both reforms that would directly hit working families. With health care costs soaring and employers cutting back on health insurance benefits, the Republican budget would add millions to the rolls of the uninsured by eliminating the health care reforms, with no program in its place. With boomers headed into retirement and soaring Medicare and Medicaid the essential cause of projected deficits, Republicans address the problem not by limiting health care costs, but by requiring seniors to pay more. They would turn Medicare into a voucher or “premium support” program that would not keep up with health care costs, forcing seniors to pay thousands more out of their own pockets. Worse, they would cut Medicaid support drastically for the most vulnerable – the impoverished, the disabled, and the terminally ill. With the U.S. spending almost as much on its military as the rest of the world combined, Republicans demand that we raise, not pare, Pentagon spending. With our basic infrastructure – from roads to schools to sewage systems – in dangerous decline, the construction industry flat on its back, and interest rates near record lows, Republicans call for spending less, not more, on rebuilding America, rendering our economy less competitive and our streets less safe. With global corporations growing ever more adept at using transfer pricing and overseas tax havens to avoid taxes here at home, Republicans would make the entire world outside the U.S. a corporate tax haven, encouraging companies to move jobs and book profits abroad. With college tuition soaring and more and more being priced out of the education they have earned and need, Republicans solve the problem by cutting back on student loan programs. Today every element of the American dream – a secure job with American wages and benefits, an affordable home, a good education and affordable college for the kids, a secure retirement, health care for the family – is growing out of reach for more and more Americans. GET OUT EVERY VOTER
Source: politicususa.com

Seven Choices Medicare Plans Will Need To Make In Order To Survive

Sales channels are a good example of this. Given the recent proliferation of channels, it is critical that MA plans optimize their mix by focusing on the needs of their customers, instead of looking at what has helped sell various Medicare products in the past. Traditional channel options include direct sales, brokers, groups, and the web; emerging channels include retail stores, payor partnerships, and private exchanges. Each avenue provides a unique experience for the customer, and the right match can determine the eventual buying decision. The range of channels increases complexity, but it also allows leading plans to tailor their engagement strategy by segmenting the customers and personalizing interactions on the basis of segment needs for sales and enrollment, as well as ongoing interactions with the member to improve experience and manage health outcomes.
Source: healthaffairs.org

Kansas Medicare Recipients To Get New Summaries

The statements will provide clearer information about the benefits residents are entitled to receive and the services that have been rendered. The statements will also provide information if a claim is denied or if one was filed for services that they didn’t receive.
Source: kake.com

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June 21, 2013

Medicare Enrollment Starting; Help Sessions Scheduled

Posted by:  :  Category: Medicare

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Source: coudynews.com

Video: IRS Capital Gains and Losses/Schedule D and Form 8949

Medicare cuts continue as doctor slashes throats.

The straight-forward Medicare remedy is to force suppliers to compete on price. Numerous pilot programs have proven that competitive bidding will save taxpayers hundreds of millions of dollars each year with no harm to patient care. As authorized under the Affordable Care Act, competitive bidding in the DMEPOS marketplace is scheduled to begin July 1. The projected savings for taxpayers and Medicare beneficiaries over the next 10 years is $42.8 billion.
Source: medicarewire.com

How Do You Get Medicare Part D?

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

Taxes scheduled to increase in 2013 due to Medicare surtaxes

Planning Ideas – consider selling highly appreciated assets in 2012 instead of 2013.  Tax-exempt bonds will become more popular with high-income investors.  Tax-free interest is exempt from the 3.8% surtax and does not affect the owner’s AGI.  Converting to a Roth this year instead of next may be advantageous.  Although payouts from IRAs are exempt from the surtax, they are taxable, therefore causing your AGI to raise and possibly triggering the surtax on your investment income after 2012.
Source: wnvcpa.com

Inappropriate Medicare Part D Payments for Schedule II Drugs Billed as Refills

The finding was that “Medicare Part D inappropriately paid $25 million for Schedule II drugs billed as refills in 2009. Moreover, over 25,000 Schedule II refills had invalid prescribers.” The OIG study mentioned another case in which “a pharmacy benefits manager…paid almost $3 million to settle claims that it did not have practices to prevent diversion of controlled substances and used invalid DEA numbers at its mail-order pharmacies.” And “Four recent Office of Inspector General (OIG) audits found that the sponsors did not have adequate controls to ensure the accuracy of the PDE data they submitted to CMS. Another OIG report found that approximately 228,000 PDE records for Schedule II drugs in 2007 did not contain valid prescriber identifiers.”
Source: healthcaredatasolutions.com

Baucus working to stall doc pay cut

Julius Hobson, a former lobbyist with the American Medical Association who now serves as a senior policy adviser at Polsinelli and Shugart, said the Baucus bill is a one year delay in the cuts. However, it is unclear how Baucus would pay for a one-year delay of the cut, which the Congressional Budget Office estimated would cost $25.2 billion over 10 years. A Baucus spokeswoman did not reply to questions about the physician pay patch. Proposals to pay for the cost of a one-year delay from the office of House Speaker John Boehner (R-Ohio) included a $15 billion cut in a coming temporary boost of Medicaid primary-care physician pay and $8 billion from cutting hospital evaluation and management payments, according to Hobson. Boehner’s office did not respond to questions about the temporary physician pay fix. Hobson said Baucus was unlikely to introduce his legislation until it was clear that a massive end of the year legislative package including a Medicare physician pay fix was not going to clear Congress. However, the stand-alone Medicare pay patch was unlikely to advance, Hobson said, because other senators would block it. The pressure on Congress to enact a permanent replacement for the Medicare physician payment formula was increased on Thursday by the Medicare Payment Advisory Commission when it considered re-submitting its recommendation for scrapping the current system. Congress’ primary advisers on Medicare have not offered a specific replacement system for the sustainable-growth-rate formula for physician payments but their draft recommendation said it should incentivize physicians to move toward accountable care organizations. Separately, MedPAC considered a recommendation of Glenn Hackbarth, its chairman, to increase Medicare payment rates for Ambulatory Surgical Centers by 0.5%.
Source: modernhealthcare.com

CMS Finalizes Medicare Advantage, Part D Drug Plan Rates for 2014 : Health Industry Washington Watch

With regard to Part D, CMS notes that for the first time in the Part D program’s history, the costs of beneficiary coverage are falling, with the 2014 defined standard Part D prescription drug benefit having lower co-payments and deductible than in 2013. CMS also is adopting a number of policy changes for 2014, including requiring Part D plan retail and mail pharmacies to obtain patient consent to deliver a prescription, new or refill, prior to each delivery (CMS also encourages Part D plans to implement this consent requirement for the remainder of this year). While CMS had proposed requiring Part D sponsors to place beneficiary-level prior authorization requirements on certain categories of drugs which may be covered under the hospice or end stage renal disease (ESRD) benefits, so as to ensure that these drugs are appropriately payable under Part D before the prescriptions are filled, the final policy permits sponsors to use other approaches, such as pay-and-chase, to resolve payment responsibility in these situations.
Source: healthindustrywashingtonwatch.com

Medicare Part D Inappropriately Paid $25 Million for Schedule II Drug Refills

In addition to the prohibition on refills, Schedule II drugs require a prescription containing the name, address, and signature of a provider who is registered with the DEA. Federal regulations also limit the situations under which partial fills of Schedule II drugs are permissible. A partial fill occurs when a pharmacist dispenses the drug over multiple fills. For example, if a physician prescribes a 28-day supply of a Schedule II drug, the pharmacy does not have to dispense all 28 days at once.  It can dispense four 7-day supplies or two 14-day supplies. Partial fills are not considered refills and must be completed within 72 hours, unless the patient is in a long-term-care facility or terminally ill.  
Source: wolterskluwerlb.com

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