Medicare Part D 2010 Data Spotlight: A Comparison of PDPs Offering Basic and Enhanced Benefits

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

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

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

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

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



Companies that sponsor Medicare Part D prescription drug plans are required to offer a basic benefit, either the standard Part D benefit defined by law or an actuarially equivalent benefit design. Plan sponsors can also offer plans with enhanced drug benefits. Enhanced plans are required to have a greater actuarial value than basic plans, but plans vary in the ways in which they improve coverage.
Source: kff.org

Video: Medicare Supplement Plans – Tips To Compare Plans

Retiree with No Technology Background Launches Medicare Supplemental Insurance Comparison Site

Here’s how plans for retirement used to go for most – work at the same job for several decades, build up social security and pension income, retire at 65 and dedicate time to improving canasta or golf skills. Maybe some people had other ideas, but suffice it to say, people view retirement much differently today than they did 20 years ago. Retired firefighter, Steven Pewter is a perfect example of this. At age 74, with absolutely no technology background, Pewter used a laptop computer he got as a birthday present to build a website for seniors to compare Medicare supplemental insurance plans, MedicareSupplementalInsuranceComparison.net. Pewter’s story supports the findings of a new survey from Del Webb – a leading builder of active-adult communities. It showed that almost 80 percent of boomers expect to work in some capacity, even after they retire, and not just for money. In fact, the majority, fifty-one percent, plan to work to avoid boredom and maintain a sense of purpose. “I come from working stock,” commented Pewter when asked about his motivation. “I certainly wasn’t going to just sit around and slowly fade to dust after retirement.” Pewter was driven to create the Medicare supplemental insurance comparison site after a frustrating personal experience shopping for supplemental coverage online. Hours and hours of research turned up only sites that required significant personal information before returning any valuable information on plans or rates. So, he decided to use his new computer skills to create a site that would give people detailed supplemental insurance coverage and rate information after entering just their zip code. The site gained almost instant popularity with 10,000 visits in the first week. By the end of the first month, 30,000 people had used the site to research Medicare supplemental insurance. And now nearly seven months later, the site continues to attract seniors, not just with its rate and plan comparison info, but with the dozens of articles, tutorials and how-to pieces it features that are updated regularly. Pewter’s family members comment that he has approached his new Internet endeavor with the gusto and enthusiasm of a man a third his age. “Well, it’s my kids and grandkids that keep me young,” Pewter said. “Knowing they’re so proud of what I accomplished with the site pushes me to keep at it.” About MedicareSupplementalInsuranceComparison.net MedicareSupplementalInsuranceComparison.net is a site for seniors to compare rate plan and coverage information for Medicare supplemental insurance. By entering just a zip code, visitors can retrieve detailed results from leading insurance providers in their area. And, the site is constantly updated with helpful articles and tutorials to guide people through the sometimes confusing world of Medicare. For more information, visit: http://www.medicaresupplementalinsurancecomparison.net
Source: sbwire.com

What to Look for When Comparing Medicare Part D Costs

Information presented on Personal Finance Blog by MoneyNing is intended for informational purposes only and should not be mistaken for financial advice. While all attempts are made to present accurate information, it may not be appropriate for your specific circumstances. Any offers and rates shown on this site can change without notice and may contain information that is no longer valid. For further validation, always visit the official site for the most up-to-date information. This site may receive compensation from companies to offer an opinion about a product or service. We strive to provide honest opinions and findings, but the information is based on individual circumstances and your specific experiences may vary. We also treat your privacy seriously. Please take some time to understand our full policies and disclaimers by clicking here.
Source: moneyning.com

Uwe E. Reinhardt: The Complexities of Comparing Medicare Choices

Each private plan would have had to offer a benefit package that covered at least the actuarial equivalent of the benefit package provided by the traditional fee-for-service Medicare. Medicare’s contribution (or “premium support”) to the full premium for any of these choices, including traditional Medicare, would have been equal to the “second-least-expensive approved plan or fee-for-service Medicare” in the beneficiary’s county, whichever was least expensive. That premium support payment would have been adjusted upward for the poor and the sick and downward for the wealthy.
Source: nytimes.com

6 Steps You Must Take During Medicare Annual Enrollment

The opinions expressed in WebMD User-generated content areas like communities, reviews, ratings, or blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. User-generated content areas are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.
Source: webmd.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

Comparison Friction: Experimental Evidence from Medicare Drug Plans

Consumers need information to compare alternatives for markets to function efficiently. Recognizing this, public policies often pair competition with easy access to comparative information. The implicit assumption is that comparison friction—the wedge between the availability of comparative information and consumers’ use of it—is inconsequential because information is readily available and consumers will access this information and make effective choices. We examine the extent of comparison friction in the market for Medicare Part D prescription drug plans in the United States. In a randomized field experiment, an intervention group received a letter with personalized cost information. That information was readily available for free and widely advertised. However, this additional step—providing the information rather than having consumers actively access it—had an impact. Plan switching was 28 percent in the intervention group, versus 17 percent in the comparison group, and the intervention caused an average decline in predicted consumer cost of about $100 per year among letter recipients—roughly 5 percent of the cost in the comparison group. Our results suggest that comparison friction can be large even when the cost of acquiring information is small, and may be relevant for a wide range of public policies that incorporate consumer choice.
Source: nber.org

Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

Many of the budget proposals and debt-reduction plans being considered by Congress and the Administration include proposals that would achieve substantial savings from the Medicare program over time. This brief features a side-by-side comparison of the key Medicare provisions in three major budget and debt-reduction plans:
Source: kff.org

CONNECTURE ACQUIRES DRX, A LEADING PROVIDER OF INFORMATION SYSTEMS FOR MEDICARE

Connecture is the leading provider of Web-based information systems used to create health insurance marketplaces and exchanges. Its industry-proven solutions enable consumers, employers and brokers to more easily shop for, purchase and renew health insurance while minimizing back-office administrative expenses for health plans.  Connecture’s solutions are provided to health plans, state insurance exchanges, private exchanges and insurance brokers.  More than 25 million Americans shop for their health insurance through systems built by Connecture, and more than half of the nation’s 20 largest plans rely on them to sell, administer and manage their plans and products effectively.  For more information, visit www.connecture.com.
Source: drx.com

A new opportunity to connect kids to coverage in California

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

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

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

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

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



Estos fondos nos ayudarán a concentrar más de nuestra energía y esfuerzos en los condados de Central Valley de California y las regiones de Inland Empire, donde viven y trabajan muchos niños y familias latinas que no tienen seguro médico. CCHI, junto con nuestras organizaciones miembros locales, trabajarán en estrecha colaboración con los medios de comunicación en español, fuentes confiables de noticias e información para las comunidades latinas, para dar a conocer y anunciar los eventos educativos y de inscripción locales. Ayudar a estas familias a conocer sus opciones de cobertura y cómo inscribirse es crucial para el éxito de la reforma de la salud. Sabemos que podremos ver a más niños crecer sanos y tener éxito en la vida como resultado de las oportunidades en la Ley del Cuidado de Salud a Bajo Precio.
Source: cms.gov

Video: May 12, 2011 – Health Markup on “H.R. 5 (Medicaid, Medicare, and Children’s Health Insurance)”

Connecting Kids to Coverage

These successes have also prepared the Centers for Medicaid & Medicaid Services for the historic expansion of coverage set to begin this fall, made possible by the Affordable Care Act.  Working closely with our colleagues in the states and at the federal level, these outreach and enrollment strategies will help us enroll millions of Americans in the Health Insurance Marketplaces and state Medicaid and Children’s Health Insurance Programs.
Source: momsrising.org

Many Kids on Medicaid Don’t See a Dentist

Even though this number has improved by 16% between 2002 and 2007, there are still many children who cannot access care due to the loss of school-based dental education programs, state budget cuts, low reimbursement rates that prevent providers from accepting Medicaid patients, and the overall lack of Medicaid dollars going toward dental care. Although the Centers for Medicare and Medicaid Services (CMS) has put goals in place for preventive services, the only long-lasting solution will be an increased investment in dental care.
Source: pilcop.org

Medicare Prescription Drug Coverage

We invite you to partner with CMS!  Partnering with the Centers for Medicare Medicaid Services (CMS) is a key to helping people with Medicare maximize their benefits.  By partnering with CMS, you extend the reach and impact of many programs aimed to improve the health and wellness of seniors, children, people with end-stage renal disease, people with disabilities, their caregivers and employers.  As a trusted source of information, you have a unique ability to connect with the people you serve and we need your help.
Source: michiganmedicaidapplication.com

Monday, June 10, 2013: Vaccines, Medicare and oil — Opinion — Bangor Daily News — BDN Maine

The site will still be viewable but certain elements might display incorrectly. In order to enjoy all the features of our site, we recommended you upgrade to a newer, more secure browser. Read more ». If you don’t have administrator privileges for your computer, you can still take action. Google has developed a free plugin for Internet Explorer called Google Chrome Frame. You can install it on any computer, even if you can’t install applications, and it will ensure your computer stays secure and that you can still visit our website. Enable Google Chrome Frame now »
Source: bangordailynews.com

Do Wall Street and the 1 Percent Thrive at the Expense of Our Kids?

As I show here, the real problem with Social Security funding is actually growing income inequality, which has reduced the Social Security tax base from 60% of GNI in 1983 down to 53% of GNI by 2009 (and probably lower than that now). This is because a growing portion of Gross National Income is going to forms of income other than wages (primarily capital gains) and because a growing portion of wages are over the cap. (84% of wages in 2009 as opposed to 90% in 1983) It is an absolute fact that this is THE cause of Social Security budget shortfalls. When Greenspan reformed Social Security in 1983 he said that his reforms would make Social Security indefinitely funded at 100%. The reason that this didn’t turn out to be true is because the distribution of national income changed radically after 1983, after having been stable for 40 years. Greenspan’s calculated made the assumption that the distribution of income both between capital gains and wages and within wages would remain the same into the future, yet the other economic policies he advocated had the effect of radically changing income distributions, thereby undermining his Social Security reforms. If the distribution of GNI were the same today as it were in 1983, there would be no project SS shortfall at all. We don’t lack the money to provide Social Security, Medicare, and child benefits as a nation, we lack the money to do this as a class. See my blog post here on Social Security: http://www.rationalrevolution.net/blog/index.blog?entry_id=2133122 I’d link my other blog post on income inequality and education, but apparently you can only include one link here….
Source: cepr.net

North Carolina Health News

Creates a shared savings program, wherein DHHS will withhold 2% of Medicaid payments to doctors, hospitals, dentists, drugs, personal care services, chiropractors, podiatrists, nursing homes, adult care homes, opticians and optical suppliers and hearing-aid providers, with payments being paid back to the providers starting June 2014 if those providers save Medicaid dollars.
Source: northcarolinahealthnews.org

Social Security & Medicare for Adult Disabled Children

If you or your spouse are retired or disabled and receiving Social Security benefits and have a disabled adult child who has been denied the SSDI benefits, the experienced attorneys at Littman Krooks, LLP can assist you in filing an appeal, so that your child can obtain the benefits they are entitled to. Our firm represents adult children with disabilities in SSDI appeals on a contingent fee basis, which means that there is no out of pocket legal costs for filing the appeal.
Source: specialneedsnewyork.com

Initial IT snafus could undermine launch of state health insurance exchanges

This summer, state exchanges will test their ability to communicate with the federal data hub, whose security frameworks and connectivity protocols are still works in progress. But whether Obamacare 1.0 flies won’t be known until the new health plans take effect on January 1. Robert Laszewski, president of Health Policy and Strategy Associates Inc, a consulting firm, said he wouldn’t be surprised if some patients showing up at doctors’ offices next year with Obamacare policies are told their insurers never heard of them.
Source: medcitynews.com

Full Steam Ahead! Competitive Bidding Achieves the Best Price for Beneficiaries, Medicare and Taxpayers

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

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

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

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

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



Competitive bidding has generated substantial savings (more than $400 million) for taxpayers and beneficiaries in its first two years of operation, and its expansion to 91 metropolitan areas is expected to save tens of billions of dollars for taxpayers and Medicare beneficiaries over the next decade. These savings, in turn, represent lower revenues to DME suppliers. Therefore, like the many efforts to derail competitive bidding before, much of the current impetus for delay stems from the fact that DME suppliers stand to lose some of the excess profits they have been earning for the last few decades. When Congress enacted the laws that required the transition to competitively-bid Medicare prices for DME, legislators must have anticipated this opposition, as they exempted the program from judicial review, which makes it impossible for suppliers to stop the program via the courts. The rest of this post will explain how DME competitive bidding works and why it is a model for future Medicare payment reforms.
Source: bipartisanpolicy.org

Video: What Does Medicare Cost?

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

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

2012 Medicare Deductibles and Premiums: Is This the Year You'll Collect Deductibles at Time of Service?

The largest factor affecting the contingency margin for 2012 is the current law formula for physician fees, which will result in a payment reduction of about 29 percent in 2012.  For each year from 2003 through 2011, Congress has acted to prevent smaller physician fee reductions from occurring. The 2012 reduction is almost certain to be overridden by legislation enacted after Part B financing has been set for 2012. In recognition of the strong possibility of increases in Part B expenditures that would result from similar legislation to override the decrease in physician fees in 2012, it is appropriate to maintain a significantly larger Part B contingency reserve than would otherwise be necessary.  The asset level projected for the end of 2012 is adequate to accommodate this contingenIn 2012, Social Security monthly payments to enrollees will increase by 3.6 percent.    The dollar increase in benefit checks is expected to be large enough on average to cover the increase in the Part B premium of $3.50 that most beneficiaries will experience. For those who were paying the standard premium of $115.40, their benefits checks will only increase.
Source: managemypractice.com

Different Takes: What’s Next For Medicare Cost Controls? Vladeck And Wilensky Offer Their Views

Gail Wilensky, who ran Medicare ane Medicaid during the George H.W. Bush administration, writes that, although there has been an expectations that the current fiscal crisis “would produce the ‘right environment’ to finally reform entitlements — particularly Medicare,” it won’t be easy to get lawmaker and public to seriously engage in Medicare reform.
Source: kaiserhealthnews.org

For Medicare, We Must Cut Costs, Not Shift Them

In the Wyden-Ryan proposal, the government would give each older citizen a certain amount of money — basically, a voucher — with which to buy a health insurance policy. The recipients would decide which policy to buy, based on whatever combination of benefits and price they found most appealing. If they chose a plan that cost more than the voucher, they would have to pay the difference. An earlier premium support plan by Mr. Ryan would have totally replaced traditional Medicare. This latest one would preserve Medicare as an option — although, critically, it would not guarantee that the voucher was enough to make Medicare affordable or ensure that private plans could not design a benefits package to attract only the healthiest patients. If this doesn’t sound like the kind of sweeping reform that will save us … it’s because it isn’t.
Source: nytimes.com

Important: What are Medicare’s true administrative costs?

The Centers for Medicare and Medicaid Services (CMS) annually publishes two measures of Medicare’s administrative expenditures. One of these appears in the reports of the Medicare Boards of Trustees and the other in the National Health Expenditure Accounts (NHEA). The latest trustees’ report indicates Medicare’s administrative expenditures are 1 percent of total Medicare spending, while the latest NHEA indicates the figure is 6 percent. The debate about Medicare’s administrative expenditures, which emerged several years ago, reflects widespread confusion about these data. Critics of Medicare argue that the official reports on Medicare’s overhead ignore or hide numerous types of administrative spending, such as the cost of collecting taxes and Part B premiums. Defenders of Medicare claim the official statistics are accurate. But participants on both sides of this debate fail to cite the official documents and do not analyze CMS’s methodology. This article examines controversy over the methodology CMS uses to calculate the trustees’ and NHEA’s measures and the sources of confusion and ignorance about them. It concludes with a discussion of how the two measures should be used.
Source: pnhp.org

Comments Off  :  Add Comment
July 07, 2013

Regence and Healthways Partner to Offer SilverSneakers® Fitness Program to Regence Medicare Advantage PPO Plans …

Posted by:  :  Category: Medicare

The Regence affiliated companies serve more than two million members through Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (selected counties in Washington). Each health plan is a nonprofit independent licensee of the Blue Cross and Blue Shield Association. The Regence affiliated companies are committed to improving the health of its members and communities and to transforming the health care system. For more information, please visit www.regence.com or follow us on Twitter.
Source: hghdosage.com

Video: Regence Medicare Advantage insurance – Compare to 180+ Comp

Regence BlueCross BlueShield to drop its Portland

The change reflects a growing trend among health insurers to nip and tuck at escalating costs to rein in premium hikes. For Regence, representatives say, the move is necessary to allow it to remain competitive in the Portland area. The change follows years of declining membership and financial losses in Oregon for Regence, Oregon’s largest insurer in the private health insurance market.
Source: oregonlive.com

The Red Electric: Fixing for a MedAdvantage/health care fix

, yeah,” she said wearily. Weep, Lyndon Johnson, who signed Medicare into law in 1965. Clearly the days of free or low-cost medical care for seniors are numbered, at least under the Bush administration and probably under any administration beholden to the insurance industry. And, looking to 2008, which candidate is least likely to be so beholden? Here’s a clue. Watch for others.
Source: blogspot.com

Medicare Updates for 2011

What article on Medicare Part D would be complete without mentioning Humana.  There I have just mentioned it. Just kidding, Humana has good news also.   The Humana Value plan which was priced at $18.60 in 2010 has been rebranded and repriced for 2011.  It is now the Humana Walmart Preferred Rx Plan with a reduced price of $14.80. I guess the little yellow price slasher at Walmart has been at work once again. The plan ID numbers are the same, so technically it is the same plan but the benefits are totally different from 2010. For example, it has a $310 deductible for all drug tiers, but then many generics are priced at only $2 for a 30 day supply at Walmart or $10 at any other local pharmacy. When I first saw that I thought “What, that is a huge advantage for Walmart.” Then I read the fine print. The $2 co-pay is only for the generics on the Walmart $4 drug list, and other stores either have their own $4 list like QFC, or will match prices. But I still applaud Humana and Walmart for innovative thinking.
Source: wordpress.com

Kathie Bracy’s Blog: Is the STRS Medicare Advantage program really an ‘Advantage’? Susan doesn’t think so!

A key player in this CORE group, Dr. Dennis Leone, initiated the investigation (2002-2004) against STRS that led to the dismissal of the Executive Director and the conviction of six Board members for ethics violations. Eventually elected to the Board, Dr. Leone was the only member to vote against the forced ‘move’ discussed in my paper. On the CORE website, click on ‘history’ to see the results of this group‟s vigilance and perseverance. To protect your pension and quality health care, follow this group and help them create a direct line to educators.
Source: blogspot.com

Annual Enrollment Workshops for Medicare Advantage Plans 2011

If you have Medicare with only part A and B you might want to participate in one of the Medicare Advantage plans that are accepted at this clinic. The plans accepted are Regence Blue Cross, Humana, HealthNet, United Healthcare and Providence.
Source: hudsonsbaymed.com

More advantage in Medicare plans

Slightly more than 600,000 Oregonians are eligible for Medicare, the federal health care program for citizens 65 and older. Four in 10 of them have coverage through Medicare Advantage, where the feds pay private health plans to provide benefits. That’s the highest ratio of any state in the nation, Medicare says. Seniors also can pay extra for standalone prescription drug plans, called Part D, offered by private insurers. They also can choose to pay for private Medigap plans, which generally cover the 20 percent of costs that basic Medicare does not. But their monthly premiums usually are higher.
Source: oregonlive.com

Comments Off  :  Add Comment
July 07, 2013

Medicare Supplement Plan F

Posted by:  :  Category: Medicare

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

Video: AARP Medicare Supplement Plan F

Seniors See Value in Medicare Supplement Plan G

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

How Medicare Supplement Plan F Can Save You Money Healthcare and Technology for Seniors

Medicare Supplement Plan F is a secondary insurance that is used along with Medicare basic coverage to help curb any additional medical expense that may not be covered under the primary Medicare plan. Plan F covers the outstanding balance on any Medicare approved expense. Regardless if it is a visit to the physician’s office, a hospital stay, or a diagnostic analysis, you will be completely insured and have no balance left to pay. Plan F pays the difference on deductibles, co-payments, and co-insurance leaving you with no outstanding amount.
Source: accefoundation.org

Ek and Ek: Good News for Medicare Supplement Plan F policyowners

a nominal cost sharing in Medicare Supplement insurance Parts C and F. Kathleen Sebelius, a former NAIC president herself, wrote in a letter to current NAIC President Jim Donelon “I value the NAIC’s expertise on Medigap and other health insurance issues and the strong partnership between NAIC and the U.S. Department of Health and Human Services. This partnership has been instrumental in the effective implementation of numerous provisions of the Affordable Care Act.” The HHS had requested under PPACA that the NAIC revise the NAIC Medicare supplement insurance model to include a nominal cost sharing in Medigap Plans C and F to encourage the use of appropriate physician’s services under Medicare Part B. However, last December, the NAIC recommended against this nominal cost sharing and did not revise the standard benefit packages for these model plans. Besides studying the issue, the NAIC communicated caution with proceeding with nominal Medigap cost sharing because it could delay treatments that people really need. This would make the more vulnerable populations worse off in the long run with costly hospitalizations and emergency room visits. Also, when referencing the changes to Medigap’s plan offerings that started in 2010, the NAIC stated “We are still learning the impact of these new offerings on both the Medigap market and to the Medicare program.” Despite the HHS agreeing to not go forward with these changes, the Medicare Trustee report has projected that the trust fund that finances Medicare’s hospital insurance coverage will stay solvent until 2026, which is two years longer than it was projected last year. Additionally, Medicare Part B and Medicare Part D are both projected to remain funded into the foreseeable future because current law automatically provides financing each year to meet the next year’s expected costs.
Source: blogspot.com

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

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

Medicare Supplement Studies > Minnesota Medigap Companies > MedicareSupplement.com

While most of America (47 states) must consign to the National Association of Insurance Commissioners (NAIC) standardization of Medigap policies, Minnesota does not. Minnesota is one of the three waiver states that standardized their Medicare supplement plans before NAIC’s involvement in 1990. Because of this, so long as the plans offered cover the basic requirements, Minnesota (along with Massachusetts and Wisconsin) is able to continue issuing their Medicare supplement plans.
Source: medicaresupplement.com

How To Enroll In A Medicare Supplement Plan F Insurance Policy

Finally, be sure to review your coverage each year. All Medigap policies are subject to inflation, just like any other insurance. Most people will see an increase once a year, although some carriers also have “birthday increases,” which means the policy costs will increase slightly whenever your turn a year older. The good news is that you can always shop your policy when rates go up. It’s very easy to change insurance companies as long as you can pass the medical health underwriting. By shopping your policy annually, you can be sure to get the most out of your healthcare insurance dollars each and every year.
Source: return2writing.com

Medigap Plan F, Pros and Cons

As with everything, the Medigap Plan F (better known as Medicare Supplement Plan F), has pros and cons. Regardless, this is the most popular supplement to Medicare available. We’re going to take a moment and investigate the reasons this particular plan is so appealing and why or why it might not be best for you as a health care consumer.Let’s start with the one negative aspect of the F Plan, if for nothing else, than to get it out of the way. The F Plan is one of the more costly plans available. Even though prices vary from one insurance carrier to the next, this plan will be at the top of their price chart. As we discuss the otherwise great aspects of this plan, you’ll see why it can be costly. With more benefit comes greater cost.At the same time, all of the cost accumulated with the F Plan is up front. What does this mean for you? It means that all of the expense is built into your monthly premium instead of in high deductibles, co-pays and other methods of cost sharing (i.e. sharing a percentage of the final bill, usually as much as 50%).
Source: youneedtoknowme.org

Comments Off  :  Add Comment
July 07, 2013

What Medicare and Medicaid mean to Maine’s hospitals

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

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

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

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

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



According to a Pew Charitable Trust report released on June 14th, Maine is one of only three states that lost jobs between 2012 and 2013. The other two are Wisconsin and Wyoming. We lost about 1,500 jobs. Accepting federal funds for expanding healthcare will provide twice the number of jobs we lost last year. The federal government will cover 100% of the cost of the expanded coverage for the first three years after which Maine’s portion of the expanded healthcare will slowly increase to 10% over the next seven years. In the first ten years of the program, Maine will receive 2.6 billion dollars from the federal government and save an estimated 690 million dollars over the same time period. Maine is one of the few states that is predicted to save money by participating in the Affordable Care Act.
Source: dirigoblue.com

Video: Medicare Supplemental Insurance in Maine by Medicare Pathways

Medicaid Expansion: Maine Looks At Another Plan; Advocates Lobby N.H., Missouri Lawmakers

CQ HealthBeat: Maine’s GOP Governor Criticizes Federal Offer On Medicaid  Maine’s Republican governor says Washington won’t recognize his state’s previous generosity when it comes to negotiations on a Medicaid expansion. But federal officials say they are doing all they can under the terms of the health law to pick up more of the tab. Gov. Paul R. LePage has been at loggerheads with his legislature — and other interests in the state — over whether to expand Medicaid. On Thursday, he issued a statement criticizing the latest offer by Centers for Medicare and Medicaid officials that would meet some, but not all, of his demands (Adams, 5/30). The Associated Press: Expand Medicaid, N.H. Urged  Organizations that provide free or low-cost health care and mental health services across New Hampshire again urged the Legislature on Thursday to approve expanding Medicaid coverage to the state’s poorest adults. New Hampshire’s current Medicaid program covers low-income children, pregnant women, parents with children, elders and people with disabilities, but the state is deciding whether to expand it to include anyone under age 65 who earns up to 138 percent of federal poverty guidelines, which is about $15,000 for a single adult (5/30).
Source: kaiserhealthnews.org

ICYMI: Maine Speaker of the House Mark Eves Urges Passage of Medicaid Expansion Bill LD 1546 (Video; Text)

125th legislature 126th Legislature 2012 election aca afa appropriations barack obama budget charlie webster congress dhhs dnc2012 education equalitymaine GLAD gop gun control healthcare hospital debt jeff mccabe justin alfond ld 1546 lepage lgbt maine democratic party maine gop maine house democrats maine refounders mainers united for marriage maine senate democrats mark eves marriage equality mitt romney Obamacare paul lepage potus presidential race president obama romney ron paul senate race seth berry seth goodall tea party troy jackson
Source: wordpress.com

Maine Medical Center sues Sebelius over nearly $3M in unpaid Medicare, Medicaid claims

The head of the Centers for Medicare and Medicaid Services, acting for Sebelius, then reversed the review board’s decision in early February, citing MMC’s lack of documentation. In the suit, MMC described the decision to reverse the review board’s ruling as “arbitrary” and “capricious.” The hospital asked the court to instruct CMS to uphold the review board’s decision.
Source: medcitynews.com

Report: Many Maine Small Businesses Rely on Social Security & Medicare

“When the wealthy and large corporations avoid their tax responsibility through the use of offshore tax havens, it robs the country of the resources we need to rebuild the economy, create jobs, and support small businesses and our customers,” said Kevin Simowitz, director of the Maine Small Business Coalition. “To support small businesses, Congress should close the offshore tax loopholes, not cut Social Security and Medicare.”
Source: maineinsights.com

How much for joints, heart attack or pneumonia? Compare how Maine hospitals charge for common services — Health — Bangor Daily News — BDN Maine

The site will still be viewable but certain elements might display incorrectly. In order to enjoy all the features of our site, we recommended you upgrade to a newer, more secure browser. Read more ». If you don’t have administrator privileges for your computer, you can still take action. Google has developed a free plugin for Internet Explorer called Google Chrome Frame. You can install it on any computer, even if you can’t install applications, and it will ensure your computer stays secure and that you can still visit our website. Enable Google Chrome Frame now »
Source: bangordailynews.com

Letter to the Editor: Maine needs to participate in Medicaid expansion

1.On his own, the Governor is refusing to allow Maine to participate in the Medicaid expansion that is part of the Affordable Care Act (ACA). According to Maine Equal Justice Partners, a low-income advocacy group, “The ACA …increases the amount of money Maine receives from the federal government to pay for Medicaid. The federal government will pay 100 percent of the costs of covering ‘newly eligible’ individuals in Maine from January 1, 2014 through December 31, 2016.” By his refusal, the Governor is leaving $100 million per year “on the table” where it will be redistributed to other states, many of which, by the way, have Republican governors – New Jersey, Florida, Arizona and Ohio for instance. In the 28 states that have agreed to expansion, the most convincing cases have often been made by hospitals who will directly benefit from having more patients covered by insurance.
Source: dailybulldog.com

Protect yourself against Medicare/Medicaid fraud — Business — Bangor Daily News — BDN Maine

The site will still be viewable but certain elements might display incorrectly. In order to enjoy all the features of our site, we recommended you upgrade to a newer, more secure browser. Read more ». If you don’t have administrator privileges for your computer, you can still take action. Google has developed a free plugin for Internet Explorer called Google Chrome Frame. You can install it on any computer, even if you can’t install applications, and it will ensure your computer stays secure and that you can still visit our website. Enable Google Chrome Frame now »
Source: bangordailynews.com

Maine’s budget shortfall threatens health coverage for seniors — Opinion — Bangor Daily News — BDN Maine

While some pharmaceutical companies may be willing to offer a limited supply of a certain drug, this option is not sustainable, especially when considering that most people take multiple drugs, not just one. The application process to the pharmaceutical companies is complicated. In most cases, an application must be submitted for each drug request, subsequent refill requests, and there is a different application process for each drug manufacturer. Some applications require specific documentation of “patient need” or even copies of a patient’s tax returns. Most applications require the involvement of a physician, further slowing the process. Such barriers are troublesome for healthy individuals and all but impossible for older, sick individuals.
Source: bangordailynews.com

Comments Off  :  Add Comment
July 07, 2013

Value of Outsourcing Family Practice Billing Amidst Changes to Medicare Rates

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

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

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

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

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



Accountable Care Organization ACO ar management Cardiology Billing Cardiology Billing Services cardiology medical billing denial management EHR EHR Adoption EHR System Electronic Health Records Electronic Medical Records EMR EMR and EHR EMR software EMR system Health insurance HIPAA HIPAA 5010 Hospital Billing icd-10 ICD -10 ICD-10 codes ICD-10 implementation ICD-10 transition ICD 10 medical billers medical billers and coders Medical Billing medical billing and coding medical billing and coding services medical billing coding medical billing companies medical billing outsourcing medical billing practices medical billing service medical billing services Medical Billing specialists medical coders medical coding medical coding services physician billing physician medical billing RCM revenue cycle management
Source: medicalbillersandcodersblog.com

Video: Cheryl Bradley lectures on Medicare Billing

More from CMS on FQHC Medicare Billing

Federally Qualified Health Centers (FQHC)  FQHCs (77X TOB) claims with dates of service on and after Sat Jan 1, 2011, containing HCPCS codes G0402, G0389, G0436, G0437, Q0091, G0101, G0130, 77078, 77079, 77080, 77081, 77083, and 76977 are being processed and paid incorrectly due to coinsurance being incorrectly applied. Medicare contractors have been instructed to hold claims impacted by this problem until a correction is implemented. A software correction is scheduled for June 2011.
Source: nachc.com

WakeMed Agrees to $8 Million Settlement for Wrongful Medicare Billing Practices

North Carolina-based WakeMed Health & Hospitals has agreed to pay an $8 million settlement to the U.S. Department of Justice (“DOJ”) in order to resolve a government investigation into its classification of inpatient procedures. The government alleged that between 2000 and 2008, WakeMed billing staff disregarded written physician orders that designated patients as “outpatient,” and instead categorized these individuals as “inpatients” in the hospital’s electronic database. The DOJ contended that this practice led WakeMed to having the state’s largest percentage of claims billed to Medicare as inpatient stays where the patient remained in the hospital for less than one day.
Source: nortonrosefulbright.com

How Well Do You Know …Medicare? Take the Quiz

It is important to understand Medicare billing requirements which can be somewhat complex.

Comments Off  :  Add Comment
July 07, 2013

ConnectiCare Enters Medicare Advantage Market

Posted by:  :  Category: Medicare

Consumers looking for a Medicare Advantage product will find many options to match their health insurance needs from ConnectiCare. Individuals, who enroll in our Medicare Advantage plans, will receive all the benefits of original Medicare plus benefits such as disease management programs, health and wellness support, limited dental benefits and more.
Source: wordpress.com

Video: CBIA Webinar on ConnectiCare’s Medicare Advantage Program for 2013

Connecticut Nursing Jobs: Health Navigator (NR12

Further informations about this occupation opportunity kindly read the description below. Reports to: Supervisor, Medicare Case Mgmt UnitFLSA: ExemptManages: NonePurpose: Provides telephonic health navigation services to high-risk dual eligible members enrolled in ConnectiCare’s Medicare Advantage products. Navigator services include Care Transition Interventions, appointment scheduling, transportation coordination, telephonic outreach, dissemination of educational messages, and linkage to internal and external/community resources. Works directly with members, caregivers and other health care delivery system entities, and communicates with physicians and nursing staff to enhance the coordination of care for members.KEY ACCOUNTABILITIES:1. Independently completes designated call outreach to Medicare beneficiaries for the purpose of program introduction, health screening, psychosocial assessment, functional assessment, health coaching and/or triage.2. Expected to manage a flexible work schedule in order to meet the needs of beneficiary and to optimize reach rates.3. Utilizes good judgment and discretion in referring cases to a Nurse Case Manager, Social Work Case Manager and/or Pharmacist when appropriate.4. Enters and maintains critical data in ConnectiCare case management/ physician office electronic medical record systems meeting defined timeframes and performance standards.5. Provides Care Transition Interventions including discharge plan review, medication review, ensures post-discharge appointment with PCP or specialist, assists with scheduling needed tests, arranges for transportation identifies early warning signs for re-hospitalization and creates a plan of action with member, and links member to internal and external resources6. Identifies all HEDIS measures for which the member is eligible, determines if member is already compliant and if works with the member to achieve HEDIS compliance for all eligible measures7. Identifies chronic conditions that have not been diagnosed and documented in the calendar year and works with PCP to ensure member has a PCP visit and the conditions are appropriately captured. Actively collaborates with medical group physicians and nursing staff as well as other ConnectiCare case managers and navigators.8. Actively collaborates with medical group physicians and nursing staff as well as other ConnectiCare case managers and navigators.9. Performs other related projects and duties as assigned. 1. At least 3 – 5 years experience in a managed care setting with familiarity with care coordination is required. Experience in discharge planning, care transition interventions, HEDIS measures and HCC coding preferred is desirable.2. Excellent oral and written communication, organizational, and interpersonal skills required.3. Previous system user experience in a highly automated environment and strong personal computer literacy on Windows products required.4. Demonstrated ability to work independently and effectively offsite, and to prioritize multiple tasks required.5. Experience with coordination of internal and external/community resources preferred6. Bilingual in English/Spanish or English/Polish preferredCOMPETENCIES:1. Member and Customer Focus: Recognizes that members and customers (internal & external) are the driving force behind every business activity. Continuously makes an effort to exceed the expectations of members and customers.2. Quality Orientation: Assumes responsibility for providing the highest level of quality to members and customers.3. Innovation: The ability to see opportunities for change, to capitalize on them and implement them when appropriate for the benefit of ConnectiCare.4. Communication: The ability to communicate with clarity both orally and in writing.5. Teamwork: Demonstrates enthusiasm for the mission of ConnectiCare and inspires the same in others.6. Results Orientation: The ability to break a complex problem down into its component parts and arrive at the appropriate solution in a timely fashion.7. Change Mastery: Embraces change.8. Learning Orientation: Assumes responsibility for personal and professional development.ConnectiCare is an equal opportunity employer. M/F/D/V – . If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to ConnectiCare Inc..
Source: blogspot.com

Connecticare Sets The Stage For Fun In 2010

PRLog (Press Release) – May 25, 2010 – Inspired by timeless adages such as “Laughter is the Best Medicine” and “An Active Mind is a Healthy Mind,” ConnectiCare has created the 2010 “Setting the Stage” program for its VIP Medicare members. The program will provide free admission to events such as trivia game shows, dance classes, museums, movies, comedy shows and more to give members incentive to stay active and healthy. “Our ‘Setting the Stage’ program will provide free admission to a number of fun events around the state for our VIP Medicare members. It’s a great way to help keep our members feeling vital, fit and always smiling,,” says Tony Tedeschi, Director of Medicare Program Management with ConnectiCare. “Additionally, we are hosting four trivia competitions at locations around the state to see who knows the most about the 1950s through the 1980s. The top three contestants will advance to a final challenge in September in Cromwell hosted by Scot Haney of WFSB TV 3 and Better Connecticut, where the top finisher will be crowned the ‘Know it by Heart’ trivia king or queen. It should be lots of fun and an event-filled summer for all of our members.” Details about all of the ConnectiCare VIP Member exclusive events can be found on ConnectiCare’
Source: prlog.org

Medicare Advantage Plans Connecticut

[…] AARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 aetna Medicare Anthem Anthem High F plan Anthem Medicare Anthem Medigap Anthem Supplement Donut Hole High Deductible F supplement how to choose a Medicare Advantage plan How to choose a Medicare plan how to choose a plan How to choose a supplement how to enroll in a medicare plan MAPD Med Advantage Medicare Medicare Advantage Medicare Advantage plans Medicare Complete Medicare Complete connecticut Medicare Connecticut Medicare part B Medicare part D Medicare plan Medicare prescription drug plans Medicare Supplement Medicare Supplement Connecticut Medigap Medigap rates 2013 Medigap rates NY 2013 Original Medicare Part D united healthcare United Healthcare AARP United medicare complete United Medicare complete 2013Source: croweandassociates.com […]
Source: croweandassociates.com

ConnectiCare and Healthways Partner to Offer SilverSneakers® Fitness Program Through 2015

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

Medicare Advantage, Medicare « Insurance News from Crowe & Associates

Medicare Advantage plan designs are set for 2010.  The general trend was that everyone lowered benefits and raised premiums.  Some of the change can be attributed to the cut in funding for Advantage programs (approximate 4% decrease in funding vs. the traditional 4%-6% increase in funding) but some of it most surely be due to utilization and frequency.
Source: croweandassociates.com

CT Medicare Advantage, Medicare Supplement, Prescription Drug Plans

Our agency is expanding! Shortly we will be Medicare Advantage and Medicare Supplement brokers. (We will continue to help Connecticut residents buy medical insurance.) We will be offering Zero Premium Policies (that right, some of the policies require none of your money be sent to the insurance company!) as well as other policies with premiums and enhanced benefits.
Source: 1800insurancect.com

Insurer Teams With Medical Group To Improve Patient Care

The second part of the program involves end-of-life care, a term that invokes stigmas after debate about federal health care reform. In this instance, the term means that patients will meet with their doctors and health insurer to talk about treatment options before it’s a last-minute decision in an intensive-care unit, said Dr. Paul Bluestein, ConnectiCare’s chief medical officer.
Source: courant.com

Flu shots available Tuesday in Fairfield

Insurance plans accepted for flu shots and/or pneumonia shots include: Aetna, Medicare Part B; Connecticare — commercial plans and Medicare Advantage plans; Anthem Blue Cross and Blue Shield — commercial plans and Medicare Advantage Plans. Without that specific insurance coverage plans, the cost for the flu shot is $25 and for the pneumonia vaccine it is $45. People getting inoculations should bring their insurance cards to the clinic.
Source: ctnews.com

Connecticare signs deal to offer new fitness program

The SilverSneakers Fitness Program engages participants in more frequent strength training and aerobic and flexibility exercises through access to a variety of venues and programming designed specifically for older adults. It incorporates both physical fitness and social experiences
Source: com.au

Medicare Advantage Plans Connecticut 2012 « Insurance News from Crowe & Associates

There are a limited number of Medicare Advantage plans available in Connecticut for 2012.  The list includes plans from Connecticare, AARP/United, Aetna, Anthem BlueCross BlueShield and Wellcare.   Our agency has clients with all companies and plan types in Connecticut and we are happy to share the good and bad of them with you.
Source: croweandassociates.com

Comments Off  :  Add Comment
July 07, 2013

The Ins and Outs of Medicare Supplemental Insurance

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

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

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

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

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



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: What is a Medicare Supplement

Supplemental Coverage Associated With More Rapid Spending Growth for Medicare Beneficiaries

This is the first empirical study to investigate whether supplemental Medicare coverage is associated with higher rates of spending growth over time. The researchers found that supplemental insurance coverage was associated with significantly higher rates of overall spending growth. Specifically, employer-sponsored and self-purchased supplemental coverage were associated with annual total spending growth rates of 7.17 percent and 7.18 percent, respectively, compared to 6.08 percent annual growth for beneficiaries without supplemental coverage.
Source: rwjf.org

Supplemental Medicare coverage leads to spending growth

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

Retiree with No Technology Background Launches Medicare Supplemental Insurance Comparison Site

Here’s how plans for retirement used to go for most – work at the same job for several decades, build up social security and pension income, retire at 65 and dedicate time to improving canasta or golf skills. Maybe some people had other ideas, but suffice it to say, people view retirement much differently today than they did 20 years ago. Retired firefighter, Steven Pewter is a perfect example of this. At age 74, with absolutely no technology background, Pewter used a laptop computer he got as a birthday present to build a website for seniors to compare Medicare supplemental insurance plans, MedicareSupplementalInsuranceComparison.net. Pewter’s story supports the findings of a new survey from Del Webb – a leading builder of active-adult communities. It showed that almost 80 percent of boomers expect to work in some capacity, even after they retire, and not just for money. In fact, the majority, fifty-one percent, plan to work to avoid boredom and maintain a sense of purpose. “I come from working stock,” commented Pewter when asked about his motivation. “I certainly wasn’t going to just sit around and slowly fade to dust after retirement.” Pewter was driven to create the Medicare supplemental insurance comparison site after a frustrating personal experience shopping for supplemental coverage online. Hours and hours of research turned up only sites that required significant personal information before returning any valuable information on plans or rates. So, he decided to use his new computer skills to create a site that would give people detailed supplemental insurance coverage and rate information after entering just their zip code. The site gained almost instant popularity with 10,000 visits in the first week. By the end of the first month, 30,000 people had used the site to research Medicare supplemental insurance. And now nearly seven months later, the site continues to attract seniors, not just with its rate and plan comparison info, but with the dozens of articles, tutorials and how-to pieces it features that are updated regularly. Pewter’s family members comment that he has approached his new Internet endeavor with the gusto and enthusiasm of a man a third his age. “Well, it’s my kids and grandkids that keep me young,” Pewter said. “Knowing they’re so proud of what I accomplished with the site pushes me to keep at it.” About MedicareSupplementalInsuranceComparison.net MedicareSupplementalInsuranceComparison.net is a site for seniors to compare rate plan and coverage information for Medicare supplemental insurance. By entering just a zip code, visitors can retrieve detailed results from leading insurance providers in their area. And, the site is constantly updated with helpful articles and tutorials to guide people through the sometimes confusing world of Medicare. For more information, visit: http://www.medicaresupplementalinsurancecomparison.net
Source: sbwire.com

Medicare Supplemental Insurance

By way of example, Medicare supplemental Plan A is the most basic policy and is offered by all companies selling Medicare Supplemental plans. This plan covers the 20 percent of outpatient expenses not covered by Medicare and provides additional insurance for a hospital stay. This includes an additional year of hospital coverage. It does not cover any deductibles under Medicare Parts A and B. This plan is the lowest cost because it is the most basic coverage. You may want to get additional coverage in a supplemental policy, but for those on a tight budget, Plan A may be best. On the other hand, although it costs a little more, Medicare Plan F is the most popular plan because it covers nearly all the gaps in Medicare coverage.
Source: davebroggi.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

House Committee Recommends Medicare Supplement Reform

Two house committee members Reps. Johnson and Reichert expressed concern that the modifications to Medicare supplement plans would create a disincentive for retiree’s to purchase Medigap coverage and could cause them to delay or even go without important medical care. Hackbarth defended the Commission’s report and said that the suggestions are not to prevent Medicare recipients from purchasing supplemental insurance and that the suggestion “didn’t propose any regulatory restriction’ on those Medicare supplement plan purchases.
Source: askmedicareblog.com

Complete Your Research Math On Medicare Supplemental Insurance Insurance

Let me focus on H and G set policies because yet among the top selling Medicare Supplement (often called a medsupp) policy. Also, these two designs are virtually identical, with F making payment on the Medicare Part K deductible and He not paying that will hole. Associated with these plans are one of the most comprehensive medsupp plans, plugging virtually entirely holes left as a result of Medicare alone. Although they will protect you for emergency health outside the states not covered near Medicare, neither F, G, or every other medsupp will case nursing home interest when it is probably custodial in mother nature herself.
Source: merang-redd.org

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

Year 2011 Medicare Supplemental Insurance Policy Coverage Changes

Should be it possible for the full coverage regulations to be good value? Take into mental this example even there is the particular family of give consideration to that engages about a travel present for a at least two week trip and so they end set up taking a scheme amounting to the particular hundred and 26 four thousand $ $ $ $ on a detailed travel insurance insurance option with provisions designed for accidental death then dismemberment, emergencies medical expenses, travel delays and cancellations, and lost collectibles. The normal top quality price range about such an an insurance policy policy will oven from two one hundred to two 100 and fifteen us for the person.
Source: flloecdelft.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

Medicare Supplement Studies > Minnesota Medigap Companies > MedicareSupplement.com

While most of America (47 states) must consign to the National Association of Insurance Commissioners (NAIC) standardization of Medigap policies, Minnesota does not. Minnesota is one of the three waiver states that standardized their Medicare supplement plans before NAIC’s involvement in 1990. Because of this, so long as the plans offered cover the basic requirements, Minnesota (along with Massachusetts and Wisconsin) is able to continue issuing their Medicare supplement plans.
Source: medicaresupplement.com

Medicare Supplemental Health Insurance Benefits And They Can Help Anyone Out

Unsure whether to subscribe to a Medicare Advantages plan or the new Medicare supplement this is because Medicare-eligible? I would say the Medicare Advantage structure often has certainly no premiums to pay, and it at all times includes prescription-drug delivers. A Medicare supplement, on the a variety of other hand, requires the latest releatively high fee. Your total out-of-pocket costs, though, fluctuate aaccording to an extent that you utilize hospitals, physicians, various other health-care providers. The deductibles to coinsurance could represent more within a definite Medicare Advantage package than you probably would pay in monthly premiums for a Medicare health insurance supplement, which repeatedly pays what Treatment does not.
Source: uydo.org

Comments Off  :  Add Comment
July 07, 2013

Include Medicare enrollment in holiday to

Posted by:  :  Category: Medicare

This time of year, to-do lists take on more importance than ever before. While gearing up for the onslaught of holiday to-do’s, don’t let annual planning for the selection of health care coverage fall through the cracks. With little more than one week to go in the Annual Enrollment Period for Medicare, SummaCare offers the following advice to help make the right decision in a timely manner. For the second year, Medicare-eligibles only have through Dec. 7 to select and enroll in their plan of choice for 2013. What if you’re new to Medicare? Don’t get overwhelmed by all of the options. Instead, make a list of the things that are most important to you for health coverage so you know what to look for in a plan. Questions to ask include: •  What monthly premium can you afford? •  Do you need both medical and pharmacy benefits? •   Do you want to use certain doctors and hospitals? •  Does the plan include extra benefits and services like free gym memberships and other wellness programs? • Is the plan of high quality? How is it rated on Medicare’s “Plan Finder” tool at www.medicare.gov? What benefits are important to you? The list of benefits available is extensive, so if you try to review all of them, it can be overwhelming.  Focus on the benefits that are most important to you. The most common questions we hear are: •  Do you have comprehensive and affordable pharmacy coverage? •  What is the inpatient hospital co-pay and is there a cap or limit? •   What is your primary care physician co-pay? •   Do you have deductibles on medical or pharmacy? •   What value-added benefits are included for vision services, flu shots, fitness or wellness programs and online tracking tools? Help is available. Contact the health plans directly to talk to a knowledgeable sales representative about the choices available to you.  Also, look for helpful comparison charts that allow side-by-side comparisons of options. Go online. Look up plans in your area by visiting www.medicare.gov. If you have a specific plan you’re considering, visit the plan’s website directly for additional information. In many instances, applications can be submitted online – saving paperwork and time. SummaCare recently announced the addition of Mercy St. Vincent Medical Center, Mercy Children’s Hospital, Mercy St. Charles Hospital, Mercy St. Anne Hospital, Mercy Defiance Hospital, Mercy Tiffin Hospital, Mercy Willard Hospital and St. Rita’s Medical Center to its network. Additional information about the plans and expanded provider network can be obtained by calling 888-464-8440 (TTY 800-750-0750) or at www.summacare.com/medicare. About SummaCare Established in 1993, SummaCare offers a full line of health plans including PPO plans and Medicare Advantage plans plus life, dental and vision plans. Through its extensive network of more than 8,000 providers and more than 60 hospitals, SummaCare offers coverage to more than 225,000 members. SummaCare is recognized in Ohio by the Health Industries Research Company as a health plan with the most effective disease management programs for asthma, heart failure and diabetes. SummaCare is a health plan with a Medicare contract. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments and restrictions may apply. Benefits may change on January 1 of each year. Other providers are available in the network.
Source: sylvaniaadvantage.com

Video: SummaCare Secure_Flying.wmv

SummaCare Selects Burgess Software As Its Comprehensive Medicare Pricin… ( ALEXANDRIA Va. Jan. 6

Related medicine news : 1. INTEGRIS Health Selects Allscripts Care Management for Its 13 Hospitals 2. Berkshire Medical Center Selects Desktop Alert for Mass Notification Solutions 3. Jefferson Regional Medical Center Selects iSirona DeviceConX for Medical Device Integration 4. Park Avenue Nursing and Rehabilitation Center Selects PatientPlacement.com Web-based Long-Term Care Software to Automate Admissions and Boost Census Performance 5. Atrius Health Selects rL Solutions for Improved Patient Safety and Quality of Care 6. Kimball Health Services Selects HMS to Provide Information Technology Infrastructure 7. American Well Selects First DataBanks Drug Data for Use in Online Physician-Patient Care Consultations 8. Berkshire Medical Center Selects Desktop Alert for Mass Notification Solutions 9. National Cancer Institute Selects Ogilvy Public Relations Worldwide for Comprehensive Multi-Year Communications Support 10. Simon Property Group Selects New York Merchants Protective Co., Inc. for Fire-alarm Services 11. Nonin Medical Selects nParallel to Design and Craft its New Tradeshow Exhibit
Source: bio-medicine.org

Allison’s ‘Most Romantic Love Songs’ Playlist

Love definitely seems to be the most common theme in music, whether it be heartbreak or desire, there are thousands of songs that detail a romance of some sort. Songs about heartbreak can be great when going through a tough split, and songs about falling in love are perfect when you have a new crush. But sometimes, when you’re single and not necessarily loving it, even the cutest little love song can make you really wish you had someone.
Source: confrontmagazine.com

Physicians at Akron's Summa Health Move Forward Boldly on an ACO

Like anything, it was all over the place. But most of the physicians were very excited, excited at the idea that we could improve care, could communicate among ourselves in a better way. In the past, everyone’s done their own thing in their own way. But this has been physician-led; the board has a physician majority. So this has very much been a physician-driven model, and the physicians are very excited. Of course, there’s always some skepticism; but the physicians have been very involved and have been working hard on this. And I’m very proud of them—the docs I get to work with, they’ve really done a wonderful job of embracing it and getting into it.
Source: healthcare-informatics.com

Choosing the right Medicare plan during open enrollment

Review your services and benefits: You or your caregiver should list the medical services you used this year. Were your benefits a good match for those services? How much did you pay for deductibles and co-payments? Are the premiums or co-pays of your existing medical insurance expected to increase next year? If yes, by how much?
Source: cleveland.com

Local hospital plans healthy: SummaCare, AultCare serving communities, eye growth in future.

Jun. 18–Hospitals nationwide are pulling the plug on their hospital-owned health insurance plans. But a handful — including at least two in Northeast Ohio — are sticking it out and helping maintain competition within the communities they serve. Leaders from Summa Health System’s SummaCare in Akron and Aultman Health Foundation’s AultCare in Canton say they’re committed to remaining a locally owned option for the thousands of area businesses and consumers. SummaCare is a vital part of Summa Health System, said Thomas J. Strauss, Summa’s president and chief executive. About 15 percent of Summa’s hospital revenues come from SummaCare, making the health plan the system’s largest payer aside from Medicare and Medicaid, he said. ‘If you’re just a hospital, you only get paid when patients are sick,’ he said. ‘There’s no incentive for you to keep that patient well and out of the hospital. If you’re an integrated system, you can actually work on true wellness and generate benefit financially to keep patients out of the hospital. ‘I’m absolutely convinced this is part of the future.’ Likewise, Aultman Health Foundation views AultCare as a vehicle to pass on lower charges at Aultman Hospital to the community, said Joe Novak, AultCare’s vice president for provider services. The hospital only contracts with AultCare, Novak said. ‘The goal was to not have a profit and keep the money in town,’ he said. Both local insurers operate with razor-thin margins. SummaCare has an operating margin of 2 percent to 3 percent each year, while AultCare’s averages less than 1 percent. In comparison, the health insurance industry posts an average operating margin of 6 percent, with some publicly traded companies approaching double-digit margins, said Rick Byrne, Ohio market analyst for HealthLeaders InterStudy, an industry research firm in Nashville. Unlike their larger competitors, hospital-owned insurers aren’t looking to make big bucks, said Cathy Eddy, president of the Health Plan Alliance, a group based in Texas that represents 37 provider-owned health plans. ‘The plan helps support the overall objectives of the system,’ she said. During the 1980s and into the mid-1990s, many hospitals were looking to diversify and develop strategies to get more patients, Eddy said. AultCare started in 1985, and SummaCare started five years later. Many hospitals also got into the insurance business because of potential changes in the way hospitals were paid, said Alan Bleyer, Akron General Health System’s president and chief executive. Akron General acquired HomeTown Health Network in 1999 when it purchased Massillon Community Hospital. Back then, he said, it appeared the industry was moving toward paying hospitals capitated rates. Under that scenario, insurers pay contracted hospitals a set amount of money per enrollee per month regardless of the amount of care provided. Evolving strategy
Source: blogspot.com

Shingles Vaccinations Not Covered For Some Medicare Beneficiaries

A. Shingles is a painful rash caused by a virus that can lead to long-term nerve damage called postherpetic neuralgia. All Medicare Part D prescription drug plans cover the shingles vaccine, which is recommended by the Centers for Disease Control and Prevention for people age 60 and older. But Medigap plans, which may cover the deductible and coinsurance amounts for services provided under Medicare Parts A and B (hospitalization and outpatient care), don’t offer any financial help on the co-payments for vaccines and other drugs covered under Part D.
Source: kaiserhealthnews.org

Becas Escolares para alumnos de Río Negro

Desde hace varios años, Fundación Ruta 40 apoya con becas el estudio de 5 alumnos egresados  de la escuela rural nº 158 de Corralito y de la escuela nº 152 de Cerro Alto para que puedan continuar sus estudios secundarios en el Centro de Educación Integral “San Ignacio”, escuela albergue secundaria con orientación agro técnica, ubicado en Junín de los Andes, Neuquén.
Source: org.ar

Tom Strauss leads a new vision for patient care at Summa Health System

The first thing you’ve got to realize is that you can’t make everybody happy. That’s the hard one, especially for somebody like me who really prefers to have people holding hands singing ‘Kumbaya.’ The other area is trying to micromanage. You cannot in this environment micromanage. You’ve got to empower your people and let them go. They will make mistakes and that’s OK as long as they learn from their mistakes. I would think trying to stay in the old system, trying to stay in the old ways was a mistake that got us starting to transform toward population health and population management.
Source: sbnonline.com

Comments Off  :  Add Comment