Gerber Medicare Supplement Plans and Rates in California

Posted by:  :  Category: Medicare

Before a person can apply for a Gerber Medicare Supplement plan, or any other type of Medicare plan, they must first have in place both Medicare Parts A and B.  If you are new to Medicare Part B coverage, you have a 6 month window to choose and enroll in a Gerber Medicare Supplement plan when your Medicare Part B coverage starts.  If you apply during this six month window the approval is guaranteed regardless of your current health status.  This period is called the “Initial Coverage Period (ICP).  This is a fantastic benefit for seniors who are coming off of an individual or employer bases health insurance plan.
Source: wordpress.com

Video: Gerber Life Medicare Supplement

A Brand New Brief Overview Pointing To Gerber Medicare Medications

Reserved companies sell Medigap Plans. Hence, generally premium too typically is a bit elevated. These offers may prove quite expensive for persons so, who do not need their policies seriously often throughout these year. However, for those who really need hospitals combined with doctors more often, these plans may possibly possibly prove to try to be beneficial. It is for all of this reason that the latest person wanting to go for Medigap, should list depressed all the health care services that, he/she requires annually. Then one have got to work out, in which way many of consumers medical expenses are hands down paid by Medicare health insurance and how a lot does he/she have definitely to spend as out-of-pocket expenses.
Source: bibar.org

Low Cost Plan Gerber Medicare Supplement Insurance

Some changes were effected to cover the modernization therefore eliminating Plans J and K as the benefits offered therein were deemed to be covering some plans in existence. Just to highlight benefits offered by Gerber Medicare supplement insurance plan N, seniors above age 65 get a discount of about 20-30 percent from previous plans. Plan N entails co-paid emergency and doctor visits and is deemed to be best as it covers all other plans available previously.
Source: islandtaekwondo.com

Gerber Medicare Supplement

[…] What will happen if I decide to call or email you about a quote? I will reply promptly with the information you requested and your information will be shared with no one. If you decide that this is not the program for you, I will have no hard feelings and will thank you for the opportunity.Source: newjerseyinsuranceplans.com […]
Source: newjerseyinsuranceplans.com

Gerber Life Medicare Supplement

I got 7 phone calls today about Gerber, 5 from AmeriLife (yup, FIVE) and 2 from random IMOs. Also got an email and a fax from two COMPLETELY DIFFERENT IMOs. They sure are getting the word out! I would never do business with AmeriLife because they are crooked, but I am going to contract through someone else because they pay a good commission, no interest on 12 mth advance and good rates/underwriting.
Source: insurance-forums.net

Senior Benefit Services, Inc.

Effective November 10, 2012 on new business & January 1, 2013 in force business for Gerber 2010 Modernized Medicare Supplement plans in Idaho and Medicare Supplements and SELECT plans in Utah. The Rate Adjustments will affect plans  A, B, and C.
Source: srbenefit.com

Gerber Changes its Guarantee Issue for Medicare Supplemental Insurance

Gerber will no longer extend guarantee issue to individuals who are voluntarily leaving an employer- sponsored group health plan except in those states where it is required. Those states are: AR, CA, CO, FL, ID, IL, IA, IN, KS, LA, MO, MT, NJ, NM, OH, OK, PA, TX, VA, WV and WI. Gerber is aligning itself with the Centers for Medicare and Medicaid Services (CMS) underwriting rules. Changes take effect with applications signed on and after 1 August 2011. You can read more about your guaranteed issue rights here: http://centaurmedicaresolutions.com/seven-guaranteed-issue-rights-for-medigap-insurance/
Source: centaurmedicaresolutions.com

Ways to prevent Medicare fraud in Texas before it occurs

Posted by:  :  Category: Medicare

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Strong evidence indicates that isolated pockets of home health providers are abusing the Medicare program. Analyses show, as detailed in your article, Texas is home to high levels of aberrant behaviors. In fact, just 18 of Texas’ 254 counties are responsible for more suspected home health fraud and abuse than any single state nationwide.
Source: dallasnews.com

Video: Medicare Supplement Plans, Medicare Advantage, Medigap Insurance, Texas Medicare Plans,Houston Texas

Access To Primary Care Is A Challenge For Some Texas Medicare Patients

RAY SUAREZ: The independent Medicare Payment Advisory Commission also looked at the problem last June. Of the six percent of seniors they surveyed looking for a new primary care physician, one in four had a small or big problem getting an appointment. And Medicare itself says fewer than 10,000 doctors have officially opted out of the program in the past two years.
Source: kaiserhealthnews.org

Medicare Data Show Huge Disparity in Charges by North Texas Hospitals for Inpatient Procedures

“The complex and bewildering interplay among charges, rates, bills and payments, across dozens of payers, public and private, does not serve any stakeholder well, including hospitals,” said Rich Umbdenstock, president of the American Hospital Association, in a statement. “This is especially true when what is most important to a patient is knowing what his or her financial responsibility will be.
Source: dmagazine.com

Texas man sentenced for Medicare scam 

Prosecutors contend Kimble operated 4 ambulance companies in a Houston area from 2008 to 2010. He customarily billed a sovereign Medicare module for ambulance transports that were not provided, not indispensable or not systematic by a treating physician.
Source: txnewsfeed.com

Texas governor reiterates opposition to Medicaid expansion

“Seems to me April Fool’s Day is the perfect day to discuss something as foolish as Medicaid expansion, and to remind everyone that Texas will not be held hostage by the Obama administration’s attempt to force us into the fool’s errand of adding more than a million Texans to a broken system,” Perry told reporters at the state Capitol.
Source: medcitynews.com

What happens when a Texas doctor doesn’t take Medicare? : The Katy News

Finally, if you have a Medicare Advantage plan, also known as a Medicare private health plan, you should see doctors within your plan’s network. You typically pay the least if you go to a doctor who’s in the plan network. Check with your plan to see what rules apply.
Source: thekatynews.com

The Effect of Expanding Medicaid Health

Posted by:  :  Category: Medicare

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The researchers worked with the Oregon Health Study Group to analyze Medicaid’s impact over a two-year span. They found about a 30 percent decline in the rate of depression among people on Medicaid over that time, thanks to treatment; an increased probability of being diagnosed with, and treated for, diabetes; and increases in use of preventive care. They also found that Medicaid reduced, by about 80 percent, the chance of having catastrophic out-of-pocket medical expenses, defined as spending 30 percent of one’s annual income on health care.
Source: technologyreview.com

Video: Understanding healthcare costs: Medicaid

Florida governor, a health reform foe, expands Medicaid

The hope was to add about 16 million of the poorest people to the rolls — about half of those who need health insurance. But after a series of challenges to the law, the U.S. Supreme Court ruled in June that the Medicaid expansion requirement went too far. While most of the Affordable Care Act was constitutional, the court ruled, the federal government could not force states to offer Medicaid to more people.
Source: nbcnews.com

Maine House deals final blow to Medicaid expansion — Politics — Bangor Daily News — BDN Maine

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Source: bangordailynews.com

Jan Brewer wins Medicaid expansion in Arizona

Brewer, whose finger-wagging moment on the tarmac with Obama almost 18 months ago for a time came to represent conservative opposition to the president, sold the expansion plan as a sensible option for conservatives in Arizona. She said it’s good for people, health care providers and the state’s bottom line because the federal government pays the whole cost the first three years, then gradually cuts back to 90 percent.
Source: politico.com

Insko: Medicaid expansion would have offered state more budget flexibility (video)

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

MEDICARE SUPPLEMENT INSURANCE STILL IN VOGUE

Posted by:  :  Category: Medicare

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

Video: FREE MEDICARE LEADS/ MEDICARE SUPPLEMENT LEADS/ INSURANCE SALES LEADS

Marketing Medicare Supplements to Age 66

I will give this question a stab. "Can a person make a living selling Medicare and Medicare supplements in their first year?" Depends how you define "make a living", but I believe the answer to be no, for two reason. First, there is a learning curve how to best prospect. I’ve been selling MA & MS for a few years now, and feel like I am finally starting to prospect smart and hitting my stride. Second, the one year commission on MS sucks. BUT, it is all about building the block of business and building up those renewals.
Source: insurance-forums.net

Medicare Supplements: No Changes Coming

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Source: tacticalminc.com

HHS Takes NAIC’s Advice on Medicare Supplements

There was some good news out of Washington last week, when Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services announced that she would take the advice of the NAIC with regard to cost sharing in Medicare Supplement plans C and F. The NAIC had sent a letter advising againstcost sharing and against changing the standard benefit packages for these plans.
Source: agentpipeline.com

Ask The Experts: Retirement

A. You are asking for an opinion, which I can’t give. All I can tell you is that the combination of a Federal Employees Health Benefits plan and Medicare reduces out-of-pocket costs to a minimum. You’ll have to compare the costs and benefits of your current FEHB plan with those provided by a Medicare supplement plan and reach your own decision. Note: If you were to cancel your FEHB coverage, you wouldn’t be able to re-enroll if you were displeased with your Medicare supplement plan or you lost that coverage.
Source: federaltimes.com

Cost Sharing in Medicare Supplements plans C and F

In a previous letter dated Dec. 19 the NAIC stated “We were unable to find evidence in peer-reviewed studies or managed care practices that would be the basis of nominal cost sharing designed to encourage the use of appropriate physicians’ services. Therefore, our recommendation is that no nominal cost sharing be introduced to Plans C and F. We hope that you will agree with this determination,”
Source: imms.com

Medicare Advantage Plans vs. Medicare Supplemental Insurance Plans

Medicare Advantage Plans are private insurance companies that receive subsidy from Medicare Insurance. Medicare pays the private insurance company a premium to cover the individual. Medicare is essentially selling your insurance to the private insurance company. Your Medicare Advantage Plan is then liable to pay all of your covered benefits. All Medicare Advantage Plans are required to provide the same coverage as Medicare-covered benefits. Medical Advantage Plans include Health Maintenance Organizations (HMOs), Private Fee-for-Service Plan (PFFS) and Preferred Provider Organization (PPOs). Since these plans are private owned companies they have their own network of doctors and facilities. If you choose to use a provider out of network you may have to pay out of pocket costs. These cost are usually deductibles, co-pays and unreasonable charges incurred by non-participating doctors and facilities. Therefore, it is wise to find and establish doctors within your network. The biggest advantage to choosing a Medicare Advantage Plan is that the average premium is approximately $50 per month and sometimes free. The disadvantage is not every Medicare provider accepts these plans.
Source: maxinevoyance.com

CNO Financial CFO Predicts Demand for Medicare Supplements Will Neutralize Obamacare's Sting

The other part of healthcare reform that we think is neutral to positive is the so-called CLASS (Community Living Assistance Services and Supports) program, where there is proposed long-term-care type of product that would be written on a group basis. You have to be actively at work to qualify for it, but it has some features that we think are concerning. Number one, the benefit as we understand it would be up to $75 a day. Well, that is by most standards less than half of what a day in long-term care would cost. It is not going to cover the expected cost of long-term care in full. Still, it might raise the awareness of the cost of long-term care, but it’s concerning that people would buy this and later find out that maybe at best, less than half of their costs are covered. Another aspect of what is proposed is that government accounting is not like the accounting of for-profit companies. The government will book the 5 years of premiums as revenue and not put up any reserves. In essence, for 5 years, the government is saying not only that it’s a “no cost,” but also that it’s a “positive” because you are booking revenue. Ultimately, they will have to pay the benefits out, but they are not doing it like an insurance company, where most of the premium dollars would have to be put into reserves to protect the future benefit.
Source: businessfinancemag.com

Medicare HMOs reduce utilization, researchers say

Posted by:  :  Category: Medicare

“Although we could not assess the appropriateness of services, some of our findings suggest that the use of services may be more appropriate within Medicare Advantage HMOs,” the researchers said. “For instance, relative to beneficiaries in traditional Medicare, Medicare Advantage HMO enrollees are more commonly treated with cardiac bypass surgery, in accord with current guidelines. Additionally, lower rates of emergency department use suggest that Medicare Advantage HMOs may be treating patients in less costly primary care or urgent care settings.”
Source: lifehealthpro.com

Video: Medicare HMO

Medicare HMOs, now with less cream skimming

We analyzed utilization patterns of enrollees in Medicare Advantage health maintenance organization (HMO) plans compared to matched samples of people in traditional Medicare during 2003–09, to ascertain whether the HMO enrollees demonstrated different levels of use of services, which can be a hallmark of more integrated care. We found that utilization rates in some major categories, including emergency departments and ambulatory surgery or procedures, generally were 20–30 percent lower in Medicare Advantage HMOs in all years. Medicare Advantage HMO enrollees initially had lower rates of ambulatory visits and hospitalizations, although these rates converged by 2008; they also received about 10 percent fewer hip or knee replacements. In contrast, HMO enrollees underwent more coronary bypass surgery than patients in traditional Medicare. These findings suggest that overall, Medicare Advantage HMO enrollees might use fewer services and be experiencing more appropriate use of services than enrollees in traditional Medicare.
Source: theincidentaleconomist.com

Individual & Group Health Plans, Medicare Advantage, HMO & PPO Health Plans, West Hollywood CA

About Affordable amend Benefits Best Buying California Care Client commerce. cooperative Could Coverage Debate Dilemma Don’t governing Great Group Guidelines Health Hurt Individual Individualizing individuals Insurance interstate Kaiser Know Life Medical Nursing Obamacare offered Pack Payer Permanente Plan Plans provide Public Service Single Tips Traditional
Source: individualhealthreview.com

Think Medicare HMO Advantage Covers Everything? Think Again!

Consumer’s Guide to Hospice Care in Florida – It’s Much More Than You Think. Most people never get the true benefit from this fully Medicare covered service. In addition to bursting the myths and legends about Hospice, our guide will walk you through the legal steps a family should take as soon as the Hospice decision is made to protect assets and provide for an orderly transition after the passing. Includes an all-new Bonus Section on Long Term Care Needs and Incapacity Planning.
Source: florida-elderlaw.com

CalPERS Panel Approves Lowest Premium Increase Since 1998

On Tuesday, CalPERS’ Pension and Health Benefits Committee recommended an average health plan premium increase of 3.03% for 2014, which would be the lowest rate increase since 1998, the Sacramento Business Journal reports (Robertson, Sacramento Business Journal, 6/18).
Source: californiahealthline.org

HMOs in California Decrease Use of Inpatient Care by Medicare Enrollees

Among Medicare HMO enrollees, those in group and staff HMOs (in which the doctors exclusively see patients from one HMO) had fewer inpatient hospital days than did those in independent practice association HMOs (in which a primary care physician acts as a gatekeeper to medical care). Medicare beneficiaries in group and staff HMOs in California had 18 percent fewer inpatient hospital days per year than if they had continued in fee-for-service plans. Those in independent practice association HMOs had 11 percent fewer inpatient hospital days per year.
Source: rwjf.org

Healthcare: It’s the Deductibles, Stupid

While single payer would be nice, I think a good model would be high dedcutible plans with medicare/tricare allowances for services. For example, for current tricare members, if providers charge a patient more than 115% of the allowed amount they are not eligible to receive funds from tricare/medicare/medicaid. They should expand this to all insurance plans. These three pay more than 50% of the medical costs in the country and will expand under OC. These allowances are much lower and reasonable than standard insurance, often 20-40% of a BC/BS allowance. Establish an easy method to determine if a provider is participating. It also greatly simplifies everything for participating providers since everyone pays the same allowance for services and has the same admin requirements. It also allows prices to be transparent and put some market forces in the market. It also allows for a private high cost coverage, if thats your choice.
Source: mikethemadbiologist.com

“Information in Medicare HMO markets: The interplay of advertising and ” by Ashwin R Patel

This study incorporates advertising into the analysis of report cards and risk selection. We analyze the first large-scale dissemination of HMO quality report cards to 40 million Medicare beneficiaries in the fall of 1999. ^ Theoretically, we extend the canonical Dorfman-Steiner model to incorporate the role of report cards and risk selection into the firm’s optimal choice of premium and advertising. ^ First, we explore the relationship between advertising and quality, prior to the actual report card release. We utilize an instrumental variables approach and find that high quality HMOs advertise more than low quality HMOs. In addition, greater advertising drives greater increases in HMO market shares. ^ Next, we study how the actual release of HMO report cards impacts HMO advertising behavior. We then analyze market share movements after the report card release, while incorporating associated changes in advertising expenditures and advertising credibility. We find that after the release of report cards, HMOs receiving higher ratings had lower relative advertising than firms receiving lower ratings. In addition, the report card release decreased the credibility of advertising by low quality firms, such that each dollar of advertising had a lower impact on increasing market share. Overall, we find that firms receiving below average ratings were able to offset the negative impact of the low ratings on market shares through advertising. We provide the first empirical evidence, to our knowledge, that advertising serves as a means to undermine the impact of report cards. ^ Third, we utilize individual-level survey data from Medicare HMO enrollees and find evidence that there exists a significant, positive relationship between advertising expenditures and health risk selection. Furthermore, the impact of advertising is similar for experienced and inexperienced individuals, suggesting a more persuasive role for advertising. ^ Together, these analysis provide a much richer understanding of the powerful role that advertising can play in Medicare HMO markets.^
Source: upenn.edu

AvMed Health Plans and Wax Custom Communications Receive Bronze at 2010 Mature Media Awards

Posted by:  :  Category: Medicare

PRLog (Press Release) – Aug. 16, 2010 – Miami, August 10, 2010– AvMed Health Plans received a bronze medal at the 2010 National Mature Media Awards, the nation’s largest awards program that annually recognizes the best marketing, communications, educational materials and programs for adults age 50 and older. AvMed’s Medicare Enrollment Kit won a bronze medal in the Brochure/Booklet category. The Medicare Enrollment Kit is an annual piece distributed before the Medicare enrollment period, aimed at educating consumers on AvMed’s Medicare plans and benefits and guiding them in their decision making process. “We’re proud that the work we create with AvMed has been honored at the National Mature Media Awards,” said Bill Wax, president and founder of Wax Custom Communications. “These awards recognize the uniqueness of our work with each of our clients and the quality team we have here at Wax.” About Wax Custom Communications:
Source: prlog.org

Video: AvMed Medicare – Dwight Gym

AvMed Health Plans to Offer Healthways SilverSneakers® Fitness Program Through 2014

Healthways (HWAY) is the largest independent global provider of well-being improvement solutions. Dedicated to creating a healthier world one person at a time, the Company uses the science of behavior change to produce and measure positive change in well-being for our customers, which include employers, integrated health systems, hospitals, physicians, health plans, communities and government entities. We provide highly specific and personalized support for each individual and their team of experts to optimize each participant’s health and productivity and to reduce health-related costs. Results are achieved by addressing longitudinal health risks and care needs of everyone in a given population. The Company has scaled its proprietary technology infrastructure and delivery capabilities developed over 30 years and now serves approximately 40 million people on four continents. Learn more at www.healthways.com or www.silversneakers.com.
Source: buyersdirectory.net

What Impact Does Medicare Have On Health Insurance?

Many insurance types can be considered a primary insurance depending on the situation. If you are in a car accident, and your insurance or the other person’s insurance covers any medical expenses, those would be considered a primary insurance. Similarly, if you have home owner’s, or renter’s insurance, and they cover a qualified medical expense, then they would be considered the primary insurance. This also includes coverage such as prescription coverage, and other forms of supplementary coverage.
Source: seniorcorps.org

Studies Don’t Lie: Patients Benefit from a Strong PCP Relationship

More than 100 studies document the critical role primary care physicians (PCPs) play in patient care. PCPs can be many things for a patient—their cheerleader, advocate and even their medical interpreter—but most importantly, the studies prove that having a strong relationship with a PCP leads to better quality of life, more productive longevity, and lower costs as a result of reduced hospitalization, improved prevention and better coordination of chronic disease care. AvMed Health Plans, one of the oldest Medicare providers in South Florida, has embraced a more PCPcoordinated approach to healthcare. The company recently introduced CenteredCare®, which puts the PCP at the center of every member’s care.
Source: communitynewspapers.com

Letter: Medicare legacy

Posted by:  :  Category: Medicare

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Reader comments on sltrib.com are the opinions of the writer, not The Salt Lake Tribune. We will delete comments containing obscenities, personal attacks and inappropriate or offensive remarks. Flagrant or repeat violators will be banned. If you see an objectionable comment, please alert us by clicking the arrow on the upper right side of the comment and selecting “Flag comment as inappropriate”. If you’ve recently registered with Disqus or aren’t seeing your comments immediately, you may need to verify your email address. To do so, visit disqus.com/account. See more about comments here.
Source: sltrib.com

Video: Medicare: A Primer

Saving Money While Providing Benefit In Medicare: A Standard Applied Only To Hospice

Hospice is an interdisciplinary approach to caring for persons believed to be within 6 months of death and can plausibly reduce Medicare expenditures by avoiding expensive hospitalizations in the last days and weeks of life. At its best, hospice typically replaces that default with the patients’ desire for a less medicalized death in the patients’ home, while maximizing quality of life. A recent paper published in Health Affairs confirmed past work showing that hospice reduces Medicare spending as compared to what it would have been during the most common periods of usage observed in Medicare. And hospice has been shown to improve patient and family member quality of life. Hospice has passed the market test; around half of all Medicare decedents used at least 1 day prior to death in 2010.
Source: healthaffairs.org

Kaine signs on to Medicare medication bill

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Source: fredericksburg.com

Firm Relies On Medicare Experience As It Prepares To Open Federal Health Exchange Calls Centers

Shortly after the Medicare prescription drug benefit was introduced in 2006, the HHS inspector general found that 44 percent of callers reported problems accessing information — despite a similar 2004 inspector general’s finding — and 21 percent of callers waited so long for responses that they hung up. When Medicare introduced a new prescription drug discount card in 2004, the Government Accountability Office reported that 29 percent of the call-center answers were inaccurate and 10 percent of the calls were disconnected.
Source: kaiserhealthnews.org

How to pick a Medicare plan

The Kaiser Family Foundation estimates that monthly premiums for Part D stand-alone prescription drug plans will rise by 10%, on average, to $40.72 in 2011. This assumes beneficiaries stay with their 2010 plans. Many experts advise consumers to shop around. For Medicare Advantage policies, Kaiser projects relatively modest price increases, with premiums rising about $2 a month to an average of $43. This is what’s called an enrollment-weighted premium, meaning that Kaiser has looked not only at insurance plan rates but also at the numbers of people in the plans. Plans with larger enrollments have more weight when projecting average premiums. All insurers offering Medigap plans must charge the same rate for comparable coverage. Medicare has an online tool that will allow access to local Medigap policies and rates by ZIP code.
Source: msn.com

Why Medicare Costs Are Rising

Each of us and our employer pays 1.45% (total of 2.9% combined or for a self-employed worker) of earned income into the Medicare Trust Fund each year. Beginning in 2013, the tax will be 3.8% on earned and unearned (i.e., salary or wages plus interest, dividends and capital gains excluding interest on municipal bonds) income above $200,000 for a single person and $250,000 for a married couple. The money paid in is not invested and set aside for use when the individual reaches 65. Mostly it goes to pay for today’s beneficiaries – it is a generation transfer tax. As the population continues to age and continues to live longer, there will a relatively smaller working population to pay the annual bills. It is estimated that the current 50 million enrollees will expand to 80 million by 2030 and the ratio of workers to enrollees will drop from 3.7/1 to 2.4 /1. So the combination of rising healthcare costs, more beneficiaries living for longer times and a relative shrinking of the taxable base means that the Trust Fund will ultimately become insolvent.
Source: healthworkscollective.com

Medicare is a Smarter Payer

According to the authors’ propensity-adjusted estimates, a patient with 1 or more complications results in a $39 017 (95% CI, $20 069-$50 394) greater contribution margin than a patient without complications if the care is reimbursed by a private payer. In contrast, for Medicare, the gain in complication-related contribution margins is only $1749 (95% CI, $976-$3287). This observation contradicts the prevailing perspective that private insurers are axiomatically assumed to be smarter payers than government-run Medicare. However, if, as the authors imply, many of the observed postsurgical complications were avoidable, then perhaps Medicare should more appropriately be considered a smarter payer than private insurers. By having moved to the bundled DRG payments for inpatient care as early as the mid-1980s, Medicare appears to have largely avoided rewarding hospitals financially for avoidable mistakes.
Source: utahhealthcareinitiative.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

Congress passes on chance to fix Medicare doctor pay

“The bill sets Congress and the White House up to revisit these battles and a major deficit reduction effort in two months,” says Eric Zimmerman, a health care lawyer at McDermott Will & Emery, a Washington law firm. “Sometime between now and March 1, 2013, Congress and the White House will need to come to agreement on how to reapportion sequestration, fund the federal government for the balance of fiscal year 2013 and raise the debt ceiling, and Medicare and Medicaid spending will feature prominently in those debates.”
Source: nbcnews.com

Redesigned with you in mind – your Medicare Summary Notice

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

Medicare Supplemental Insurance Washington State

Posted by:  :  Category: Medicare

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You may find that some services you need or want are not covered by your Medicare Supplemental Insurance. This is why it is important to speak with one of our agents about what services and procedures are covered by which type of Medicare. We’ll help you narrow down your search and compare quotes and policy types, so you’ll be well versed in the services offered and the costs involved. We’ll be happy to answer any questions or concerns you may have about Medicare Supplemental Insurance or other types of Medicare. We’ll provide you with a free consultation and free quotes, with no obligation whatsoever. Just call us to begin, or fill out the short form on our website.
Source: curvine.com

Video: Washington State Medicare Advantage Plans

Medicare Insurance Plans Available Of Washington State

Now is the best time to secure a medicare plan f program before 2014 are not asked for but offer a particular significant blanket of financial protection. They cost the particular monthly premium yet unfortunately most find the cost to be particularly well worth the protection provided. They also quote the protection many want when they will go away away of their area or the earth. With another supplement you could very well get care anywhere in the Australia even non emergent care. Ultimately it is a definite personal choice in order to get a vitamin or not, despite the fact that one most My partner know choose so that you can make in favor of the .
Source: myworkathomehq.com

CMS Sequestration Guidance for State Surveyors, Medicare Part C & D Plans : Health Industry Washington Watch

CMS has issued guidance to state survey agencies explaining adjustments CMS is making to survey and certification operations to "accommodate sequestration with as little impact on the public as possible." The guidance discusses revisions in the frequency and timelines for various surveys and other survey changes in light of a 5% reduction to the FY 2013 survey and certification Medicare budget. CMS also issued a May 1, 2013 memo to Part C and D plans on sequestration, covering rules regarding reducing payments to contracted and non-contract providers, beneficiary liability under sequestration, coverage gap discount program payments, Part D risk corridor reconciliation, and Electronic Health Records (EHR) Incentive Program payments, among other topics. In a related development, President Obama has signed the sequestration order for FY 2014, as required by law, although the Obama Administration’s proposed FY 2014 budget, if adopted, would replace sequestration.
Source: healthindustrywashingtonwatch.com

Medicare Plans Available Here In Washington State

Treatment Advantage Plans are offered to individuals that eligible and will have Medicare Plan A and B as well as live in a community that offers final results . plan. When enrolled in Medicare Advantage Plan clients are still an area in the government offered Medicare insurance however they are not eligible to extra supplemental an insurance policy such as usually the Medigap policies said earlier. Medicare insurance Advantage is in the simplest term a progression of study in which Medicare health insurance offers contracts to certain area hospitals and so doctors for approved amounts. Consequently individuals enrolled in this insurance plan must attend to currently the facilities of some of these medical professionals.
Source: myworkathomehq.com

Medicare Insurance Plans Available Of Washington State

www.medicaresupplementplanfguide.com are not required but offer a functional significant blanket including financial protection. They cost a monthly premium but most find one particular cost to be well worth the very protection provided. They also provide you with the protection a lot of want when they go away away of their setting or the state. With an absolute supplement you can get care any where else in the The united states even non emergent care. Homework it is a good solid personal choice with get a supplement or not, but nevertheless one most Since i know choose to make in want of the security.
Source: teamara.com

Massachusetts and Washington: Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid. The states finalized memoranda of understanding (MOUs) with the Centers for Medicare and Medicaid Services in fall 2012, and the demonstrations in each state are set to begin in April 2013.
Source: kff.org

Medicare Insurance Plans Available Inside Washington State

Medicare supplemental insurance plans will covers (depending on strategy design you take) some portion or possibly a as much as the all of the cost sharing the Treatment leaves for this particular member to pay out out. Also, select Medicare vitamin supplement plans also give the portion above Medicare insurance allowable (which is really a 15% surcharge) which experts claim out of infrastructure providers, (those offerers who do undoubtedly accept Medicare assignment) are allowed under the laws to impose a fee. This provision assistance quite a ounce for those who usually get an major accident or illness and need treatments in an location where the easily available doctors who snack food Medicare enrollees could be somewhat limited.
Source: salonstylesforyou.com

Washington State to Introduce Health Homes July 1

HealthPathWashington is an initiative sponsored by the Aging and Disability Services Administration in the Department of Social and Health Services and the Health Care Authority. Health Home participation will be voluntary for clients and available to clients who are receiving services through a Managed Care Plan or a Medicaid Provider.   An estimated 40 percent of Washington State’s 115,000 citizens who are eligible for both Medicare and Medicaid are expected to enroll in Health Homes.
Source: crisisclinic.org

The Medicaid Expansion and Washington State Hospitals

The incentives for states to expand Medicaid are substantial.  People who enroll in expanded Medicaid will have their health care fully funded by the federal government in the first three years, slowly declining to 90 percent funding in 2020.  The state projects that expanding Medicaid could actually save state funds because people currently enrolled in Disability Lifeline and Basic Health would be totally federally funded.  Health coverage for these enrollees is currently paid half by the state government and half by the federal government, costing the state hundreds of millions of dollars.
Source: stateofreform.com

“Puzzled by Medicare” Tips and Resources

- If you need help with health care coverage options, you can call a local Statewide Health Insurance Benefits Advisor (SHIBA) volunteer today.  Talk to a real person, for free, unbiased help.  Call 1-800-562-6900.  SHIBA is a free service of the Washington State Office of the Insurance Commissioner.
Source: aarp.org

Electronic Health Records: Best Practices in Washington State Save Medicaid Money

An expert on Medicaid, Medicare, and health reform, Kip Piper, MA, FACHE, is a consultant, speaker, and author. Kip Piper advises health plans, hospitals and health systems, states, and pharma, biotech, medical device, HIT, and investment firms. With 30 years’ experience, Kip is a senior consultant with Sellers Dorsey, top specialists in Medicaid and health reform. He is also a senior advisor with Fleishman-Hillard and TogoRun. For more, visit KipPiper.com. Follow on Twitter @KipPiper, Google +, Facebook and connect on LinkedIn.
Source: piperreport.com

Health Subcommittee Examines Commonsense Reforms to Medicaid Program, Including State Flexibility to Help Provide for Most Vulnerable Americans

Seema Verma, President of SVC, Inc, testified that the current structure of Medicaid does not guarantee quality care for those who need it most. “Despite growing outlays of public funds, a Medicaid card does not guarantee access or quality of care. In a survey of primary care providers, only 31 percent indicated willingness to accept new Medicaid patients. In 2012, 45 states froze or reduced provider reimbursement rates, Medicaid access issues are tied to under compensation of providers; on average Medicaid payments are 66 percent of Medicare rates and many providers lose money seeing Medicaid patients”, said Verma. “Medicaid beneficiaries struggle to schedule appointments, face longer wait times, and have difficulty obtaining specialty care.”
Source: house.gov

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June 25, 2013

HHS (NE) audit finds ‘one grand mess,’ possible fraud in $6.5 million Medicaid program

Posted by:  :  Category: Medicare

U.S. charges 89 people in $223 million Medicare fraud schemes Tue, 14 May 2013 Reuters WASHINGTON, May 14 (Reuters) – Federal officials charged 89 people including doctors, nurses and other medical professionals in eight U.S. cities on Tuesday with Medicare fraud schemes that the government said totaled $223 million in false billings. In the latest big Medicare fraud crackdown, more than 400 law enforcement officers including FBI agents fanned out in Miami, Detroit, Los Angeles, New York and other cities to make arrests. Authorities said suspects posed as physicians, preyed on the poor and otherwise scammed the $590 billion healthcare program with phony or unnecessary bills. About one in four defendants was a doctor, a nurse, a physical therapist or some other medical professional. “In many of these alleged schemes, the fraudulent billings could not have occurred without a doctor signing off on bogus services, or a nurse or therapist filling out false paperwork,” Acting U.S. Assistant Attorney General Mythili Raman told reporters. “In all of the … schemes, profit was the driving force,” she said. -snip- http://www.trust.org/item/20130514200409-o9fh8/ http://www.democraticunderground.com/1014483461
Source: democraticunderground.com

Video: Nebraska and Medicare Supplements

Trustees Report Shows Reduced Cost Growth, Longer Medicare Solvency

A number of factors have contributed to the improved outlook, including lower-than-expected Part A spending in 2012, and lower projected Medicare Advantage program costs. Recent data from the Medicare Advantage program indicate that certain provisions of the Affordable Care Act will help reduce the growth of spending in this program by more than was previously projected. Partially offsetting these lower spending projections are somewhat lower projected levels of tax revenue.
Source: hcanebraska.org

Smith Introduces Bill to Ease Burdens on Hospitals

“While strong oversight of Medicare payments is essential to prevent waste and fraud, the current process is overly-burdensome and time consuming,” said Smith.  “Today, I introduced the Administrative Relief and Accurate Medicare Payments Act as a first step to reduce the red tape for providers while ensuring payments are accurate.  This commonsense solution would allow hospitals and doctors to focus more resources providing quality care for their patients, and spend less time dealing with the Medicare bureaucracy.”
Source: nefrw.org

Medicaid Expansion in Rural Nebraska

The report finds that over 49,000 households under 65 in these rural legislative districts would qualify for LB 577’s new Medicaid initiative. This represents over 19 percent of the total households with residents under 65 in those districts. The greatest proportions of qualifying households exist in districts containing a mid-size city (Norfolk, District 19; Grand Island, District 35; and Kearney, District 37). However, most other legislative districts comprised entirely of rural cities, small towns and rural areas also have nearly 20 percent or over 20 percent of households that would qualify for the new Medicaid initiative under LB 577. The new Medicaid initiative that LB 577 would implement is provided for by provisions of the federal Affordable Care Act that passed in March 2010. Initially, the Act created a network of coverage options intended to create the opportunity for virtually all Americans to access health care coverage that would be affordable for their income and circumstance… Medicare for seniors; Medicaid for low-income children and the disabled; the new Medicaid initiative for working adults under 138 percent of federal poverty; and subsidies or tax incentives through health insurance exchanges for working adults from 138 to 400 percent of federal poverty. The Supreme Court decision last year, however, said that states could not be compelled to participate in the new Medicaid initiative, making that provision of the law voluntary. Nebraska’s participation in the new Medicaid initiative, therefore, requires passage of legislation such as LB 577.
Source: cfra.org

Nebraska Approves Sale of Medicare Supplement Insurance Products

We are pleased to announce the availability of lower cost Medicare Supplement Insurance in Nebraska. The Nebraska Department of Insurance approved Medicare Supplement Insurance plans from State Mutual Insurance Company and made it possible for us to offer extremely competitive Medicare Supplement Insurance rates for qualifying Nebraska seniors.
Source: statemutualinsurance.com

New Nebraska Network:: Johanns Votes To End Medicare As We Know It

Now that would be interesting to know, since it didn’t get one Dem vote in either the House or Senate.  Bob probably thinks it doesn’t tax & spend enough, so he’d be against it before he’d vote for it.   At least the “Ryan plan” made an attempt at addressing the fiscal problems facing the country.  Not nearly enough IMHO but a start.  The President’s proposed budget just ignored all the fiscal issues period.   Cosmic Bob has already defined his position on fiscal matters…”if you aren’t for raising taxes, you’re part of the problem” sums it all up.  That’s probably the most honest thing he’s ever said while campaigning.  
Source: newnebraska.net

Rural Health Clinics Ineligible for EHR Medicare Incentives

The Social Security Act that was the foundation for Centers for Medicare & Medicaid Services (CMS) EHR Incentive Programs exclude rural health clinics (RHCs) from receiving incentives under Medicare because they bill under Medicare Part A. “In Nebraska, rural health clinics are huge. We have close to a 130–140 providers who are signed up with us in rural health clinics,” says Searls. Medicare Part A covers benefits for hospital and skilling nursing home care; conversely, Medicare Part B deals with payments to doctors and outpatient services. Those receiving Social Security when they turn 65 are automatically enrolled in Part A. It is this distinction that prevents RHCs from receiving Medicare incentives in Nebraska:
Source: ehrintelligence.com

Accredited DME/ Durable Medical Supplies Equipment Medicare Provider #

Market Outlook/Competition: Durable medical equipment (DME) is a necessary component to home healthcare, aiding patients in their daily lives and helping them to stay safe and healthy. Medical supplies are always in demand, and as the nation’s rapidly aging population experiences increasing health problems, demand will continue to grow. Market Segmentation The need for adult medical care is growing rapidly as the US population continues to age, and these older Americans on Medicare and Medicaid usually represent DME’s primary market. According to US Census Bureau, the population of Americans ages 65 and older is expected to double within 25 years. Nearly one in five Americans will be older than 65 by 2030, representing about 72 million people. In fact, the fastest US age group is the older-than–85 years population.
Source: bizquest.com

Medicare, Medicaid & Subrogation Compliance Blog: Nebraska state court follows Ahlborn

In Smalley v. Nebraska Dept. of Health and Human Services, 2010 WL 5527370, handed down on December 30, 2010, a Nebraska state court applied the same pro-rata loss sharing method established by the U.S. Supreme Court in
Source: plaintiffsresource.com

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June 25, 2013

Virginia is Approved to Begin Offering Coordinated Healthcare for Medicare

Posted by:  :  Category: Medicare

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Secretary of Health and Human Resources, William A. Hazel, MD. said, “For many years, the Commonwealth has been working toward this significant reform opportunity. We view this achievement as a testament to the willingness of Virginia’s Medicaid providers and interested health plans to work collaboratively with the department to implement innovative models of care. DMAS is always working towards the development of more effective and efficient service delivery opportunities. This program has the potential to be one of the most significant to date. I am grateful for the governor’s consistent push to ensure that Medicaid operates more efficiently and am proud of the leadership of the department in developing and obtaining federal approval for this demonstration. I am confident that participants in this demonstration will have better health outcomes while the state will achieve associated cost savings.”
Source: chrispeace.com

Video: Vice President Joe Biden on Medicare – Blacksburg, VA

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

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

Feds OK Va plan for Medicaid

AAPC affordable care act AMA AWV’s CMS conference CSPI exercise florida GAO health care coverage health care law health care laws healthcare reform law health insurance health study healthy eating HHS HIMSS icd-10 insurance insurance subsidies medcity medicaid medicaid services medical blog medicare medicare advantage obamacare orlando part b part d plan f preventive care private health insurance recipes sanford-burnham software tactical management technology weight loss wellness wellness programs welltrackmd world health news
Source: tacticalminc.com

Medicaid Expansion: A false promise to poor Virginians

Another concern, unrelated to the program itself, is how do we pay for it? The federal government has promised to cover all the costs of expansion. The nation is $16 trillion in debt. Our Congress hasn’t passed a budget in four years. Advocates for expansion claim “free federal money” will pay for expansion, but the truth is the federal government cannot afford to pay for Medicaid expansion without adding hundreds of billions of dollars in debt that will burden our children and grandchildren. In short, Medicaid is an expensive, broken program. And Virginia taxpayers will eventually get stuck with the tab. You don’t fix a broken program by putting more people in it. And you certainly don’t help poor Virginians by putting them in a broken program. Enrolling low-income Virginians in a broken program that we cannot afford is a false promise and a fool’s paradise.
Source: bearingdrift.com

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

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

Medicaid Expansion Popular In Southern States, Despite Govs’ Opposition

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

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