Medigap insurance provider in San Diego

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

Video: Medicare Supplements – 5 Things To Know Before You Buy A Medicare Supplemental Policy

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

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

Medicare Supplement Questions > How soon does my coverage begin

Additionally, previous coverage can work to your advantage if you have a pre-existing condition. Medical insurance held prior to Medigap may grant you with “creditable coverage.” If you were covered continuously for six months or more, prior to enrolling in your Medigap plan, then insurance companies must provide you with a Medigap policy regardless of your pre-existing conditions. This means no waiting period or increased premiums based on that condition.
Source: medicaresupplement.com

VIRGINIA MEDICARE COVERAGE OPTIONS

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

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

Florida Medigap Insurance – Bridging the Gap between Medicare and Your Needs

Medigap is so called because it is designed to fill a gap left by Medicare. Medicare is the government administered health insurance program for senior citizens. It covers the bare essentials of healthcare for senior citizens so that retirees don’t need to go without proper medical care. If you are a senior citizen in good health with no major health concerns, then this is adequate. But if you, like many other senior citizens, have pre-existing medical conditions such as heart disease, diabetes, and the like, then you probably need insurance coverage beyond the basics. That is where Florida Medigap insurance steps in.
Source: rtcinsuranceadvisors.com

Medicare Open Enrollment Is Coming

Private insurance companies provide Medigap policies. Medigap plans are standardized to meet government requirements for consumer protection. The offering must be identified as a supplement to Medicare. All Medigap policies are similar. The government requires that they offer plans A and B. Beyond this, providers choose which Medigap plans they want to sell. It is important to note that Medigap policies only cover coinsurance after the deductible is met. The exception is when the Medigap plan also provides deductible coverage.
Source: gii-exchange.org

U.S. Medicare supplemental coverage linked to higher spending

Could it be that supplemental spending is up because health care is up. All supplemental does is cover the 20% that medicare does not cover. If you have any kind of a operation that can add up to thousands of dollars to people who are retired. I read somewhere that almost 50% of retirees live on nothing but social security and barely have enough to live on much less additional medical bills.
Source: northiowatoday.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

Cameron S Leach’s Personal Blog: Generally Medicare Supplemental Coverage Is Best So That You Get

As you well know it. Nearly as we get older, medical costs make an appearance to obtain any kind of a lot more regular. Health insurance is a necessity as part of old age, and so substantially so those the government has now in reality guaranteed well being insurance cover plan for citizens a good deal than the this of 65. An additional word or phrase for this currently offered health insurance is considered known as Medicare. And northern Georgia visit is that’s just unique from all the rest with the nation. Fortunately, most (if but not all) states take high risk wellness insurance pools absolutely for such people. However, by reason of to the increased payouts due to medical costs, monthly fees for their insured are generally relatively high. Some states budget funds to help offset this problem, reducing the costs, but others are able to provide extensive coverage- at only an extensive bargain. The actual third option which experts claim is also heavily purchased by retirement citizens on Medicare, is the Treatment Supplement Plan North. This clear policy is nearly always one of any cheapest Medigap plans, and also offers less coverage when compared with the other a number of plans mentioned higher. Medigap Deal N requires customers to pay the most important annual Medicare An element B deductible like Plan G, although it also involves policyholders to repay a $20 co-pay for doctor office visits, and up-to a $50 co-pay for emergency living space visits–however this can be waived if, perhaps the patient was admitted to any kind of a hospital. Treatment will also endure requests on an incident by case reason. If you think that you have to able to sign up outside of the open enrollment period and also fall under among the many special enrollment lessons that are listed then you could very well contact Medicare to brew a request directly by employing them. A definite Medicare Supplemental insurance policy also known of “Medigap” and it is private health insurance, which designs to make sure you supplement original Medicare insurance. It helps you to pay some of medical care costs, which original Medicare deals cover like co-payments, co-insurance, and deductibles etc. Medicare insurance supplemental Insurance techniques also cover some specific things that a majority of Medicare doesn’t. Medicare supplemental insurance organizations can only sell your package with an observed letters. Almost any modernized Medicare added plan supply the actual same basic many benefits but it does not matter which insurance premiums business sells the following. You can also come across some chiefly guaranteed coverage or a policy, as you are policy is likely restoration. Looking the right alternative healthcare plan will be quite a fabulous difficult process. The right plan of action must be acquired and include that this right benefits throughout the right monthly payments. In specific day and age over 65s could possibly find it fairly difficult to make ends meet without a clinical plan altogether; to the gaps regarding the Medicare course of action some over 65s will still ante up out a riches for additional proper care costs. The Medigap plan, however, is a impressive option to secure you don’t be hit with surprising medical bills. The final way that works to set the premiums that discover shell out could be the group rated assumption. With this approach, everybody who is positioned inside of quite first similar geographical site will pay repeated premiums. This is indifferent of how old they are. Lastly, a common uncertainty is that when you have a Plan F, regardless of a carrier, you aren’t bound by their network of providers. Remember, you have Original Medicare simply because primary insurance and therefore you can use whatever provider who will accept Medicare! Some supplement just protects the difference, therefore don’t care which team you have as your actual Supplement carrier as long as they get paid. Unfortunately, traditional government insurance only covers a brand new portion of medical costs and process. The awesome news is in that location are many tips available for some individuals that are exploring to double talk about themselves for nearly any reason. These is beneficial for individuals who continue to be trying to reach sure that they’re going to do not go into debt due to any medical need. However, there are 12 several different plans, not all of them are offered nationwide. Despite the indisputable fact providers can marketplace all plans, he or she very often don’t. This makes selecting a organize more complicated personal computer could be. You may be wondering how to decide a plan the to consider when going though the options. It is important to note that all companies recommend similar, standardized applications.
Source: blogspot.com

Retiree with No Technology Background Launches Medicare Supplemental Insurance Comparison Site

(PRBuzz.com) June 26, 2013 — 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: www.medicaresupplementalinsurancecomparison.net ###  Company: MedicareSupplementalInsuranceComparison Contact: Steven Pewter Phone: 303 555-0181 Email: admin[@]rocketfactor.com
Source: prbuzz.com

Where are States Today? Medicaid and CHIP Eligibility Levels for Children and Non

Posted by:  :  Category: Medicare

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The Affordable Care Act (ACA) creates new coverage options through Medicaid and new health insurance exchange marketplaces that, taken together, provide assistance to individuals with family incomes up to 400% of the federal poverty level (FPL). The ACA calls for the expansion of Medicaid eligibility to 138% FPL ($15,856 for an individual or $26,951 for a family of three in 2013) in 2014, which would make millions of adults newly eligible for the program. However, this expansion was effectively made a state option by the Supreme Court. If a state does not expand Medicaid, low-income uninsured adults in that state will not gain that new coverage option and will likely remain uninsured. This brief provides an overview of current Medicaid and CHIP eligibility levels for non-disabled children and adults to provide better insight into the impact of the Medicaid expansion.
Source: kff.org

Video: Fresh Perspectives: MEDICARE

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

CMS Awards $306M To States For Enrolling More Kids In Medicaid

Georgia Health News: State Gets (Smaller) Bonus For Kids’ Enrollment Georgia is one of 23 states that will receive a performance bonus for enrolling eligible children in government health insurance programs, but the amount is far less than last year’s award. The Centers for Medicare & Medicaid Services said Wednesday that Georgia will receive a bonus of $1.9 million. The state’s bonus last year was almost $5 million. 2011 was the first year that Georgia got this performance bonus, funded under legislation that reauthorized the Children’s Health Insurance Program (CHIP). A state qualifies for a federal bonus by implementing procedures to simplify enrollment and renewal to ensure that all eligible children have easier access to coverage under Medicaid and CHIP, which in Georgia is known as PeachCare (Miller, 12/19).
Source: kaiserhealthnews.org

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

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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

:: How To Sign Up For Medicare Advantage Plan : Singorama

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Source: blogspot.com

Research Roundup: Health Spending On Kids With Special Needs

The Kaiser Family Foundation: Key Lessons From Medicaid And CHIP For Outreach And Enrollment Under The Affordable Care Act — The authors of this issue brief review five lessons learned through past enrollment campaigns for Medicaid and CHIP to help give perspective for the outreach and enrollment challenge for the online insurance marketplaces created by the federal health law. Those lessons are: Individuals want coverage and value Medicaid as a choice; outreach campaigns must combine both broad-based messaging and targeted efforts to eligible families; enrollment procedures must be simple and accessible; one-on-one assistance needs to be available; simplifying renewals and extending eligibility or lengthening the time between renewals will help cut costly drop-offs in coverage. “The Affordable Care Act (ACA) will significantly increase coverage options through an expansion of Medicaid and the creation of new health insurance exchange marketplaces,” the authors write. “However, effective outreach and enrollment efforts will be key to ensuring these new coverage opportunities translate into increased coverage. … it is important to recognize that enrollment into new coverage options will likely be a long-term effort. As such, it will be important for there to be adequate resources for outreach and enrollment over time to identify and utilize lessons learned as new enrollment efforts and experiences unfold (Stephens and Artiga, 6/4).
Source: kaiserhealthnews.org

Social Security and Medicare Should Not Be Used to Reduce Deficit

Crack down on waste and inefficiency: The U.S. health care system wastes as much as one-third of all spending because of inefficient payment systems, uncoordinated care, mistakes, duplication and unnecessary paperwork. We must step up efforts to detect fraud and crack down on criminals who file false Medicare claims. We need to focus on improving care and cutting unnecessary tests and procedures, which are often the result of payment incentives and fear of litigation.
Source: aarp.org

NJ Court Enforces Settlement notwithstanding “no review” status on Proposed Medicare Set

Posted by:  :  Category: Medicare

The court bases its decision today on notions of fairness and public policy. In the present case, both plaintiffs have submitted expert reports determining the proposed set-aside amounts for future medical expenses. Both reports were submitted to CMS for review, and CMS responded that they did not have resources to review the proposed set-asides. CMS does not provide any other policy or procedure for determining the adequacy of protecting Medicare’s interests for future medical expenses in conjunction with the settlement of plaintiffs’ claims. In light of the foregoing, and given the letters issued to plaintiffs lack the force of law, to require plaintiffs to force their case to trial when they have reached an amicable resolution outside of court, runs contrary to New Jersey’s strong public policy interests in encouraging settlements. Setting this type of precedent would cause a floodgate of litigation in our courts, resulting in expense and delay of the judicial process, where it would not otherwise be necesary. Such a result cannot be held to be in the interest of justice. Accordingly, the court finds it is necessary and appropriate to make a determination in the present matter.
Source: lienresolutiongroup.com

Video: NJ Hospital Association President Says Sequestration Could Hurt Medicare Reimbursement

N.J. hospital readmission rate is down about 8 percent among Medicare patients

The data show that at the end of 2010, 21.6 percent of hospitalized New Jersey Medicare patients were readmitted 30 days after discharge, but by the end of 2012 the figure had dropped to 19.98 – an improvement of 7.5 percent, according to Healthcare Quality Strategies of East Brunswick, a firm hired by the federal government to improve the quality and efficiency of New Jersey’s Medicare and Medicaid programs.
Source: distilnfo.com

Government presses therapy provider to repay $3 million in Medicare reimbursements

The OIG audit looked at Medicare Part B claims that Spectrum Rehabilitation LLC filed in 2009 and 2010. Out of 100 representative claims, 83 did not comply with Medicare requirements, according to the audit report. The deficiencies were varied, including medically unnecessary therapy, inadequate treatment notes and physician certification issues, the report states. More than half the claims contained more than one deficiency. 
Source: mcknights.com

Workers’ Compensation: NJ Court Approves Medicare Set

“The court has thoroughly reviewed the sworn testimony of plaintiffs’ expert regarding the proposed set-aside amounts for future medical expenses relating to the underlying accidents/incidents, which would otherwise be covered or reimbursable by Medicare. The court finds that the proposed set-aside amount in each case fairly takes Medicare’s interests into account in that the figures are both reasonable and reliable. Therefore, the court is satisfied that Medicare’s interests have been adequately protected pursuant to the MSP. Plaintiffs shall set aside the proposed sums in self-administered interest-bearing accounts to be used solely for the purpose of satisfying future medical expenses related to the underlying accidents/incidents.” DUHAMELL, Plaintiff v. RENAL CARE GROUP EAST, INC., RCG Southern New Jersey, LLC, Philadelphia Suburban Development Corporation, Defendants. Catherine A. Ney, Plaintiff, et al,, — A.3d —-, 2013 WL 2102701 (N.J.Super.A.D.) Decided Dec. 7, 2012. May 16, 2013.
Source: blogspot.com

Suits and Scrubs: NJ Hospital Readmissions

If you are a Medicare patient admitted to a hospital in New Jersey, the probability is one in five that you’ll be back within a month.  Data was released this week showing New Jersey hospital readmission rates at 20% during the fourth quarter of 2012 (19% in Ocean County).  While these rates have improved over the prior year and since the fourth quarter of 2008, there is still room for improvement as New Jersey tends to have one of the highest readmission rates in the country. It’s important to note that not all unplanned readmissions are preventable.  Still looking at unplanned readmissions is a way to evaluate the quality of care provided at a hospital.  In addition, payors like Medicare look at readmissions as wasteful spending of the healthcare dollar.  Now every hospital in the country is focused on this metric because healthcare reform legislation penalizes hospitals with higher readmission rates.  Hospitals can lose Medicare payment of up to 1% in 2011 and up to 3% in 2014.  Hospitals in Ocean County, like ours, are more exposed to this reduction given the greater percentage of Medicare patients served.   At Ocean, we have been working on a number of quality initiatives focusing on the care of our patients during their hospital stay as well as supporting safe care transitions to home.  
Source: blogspot.com

CARR ALLISON Medicare Compliance Group: New Jersey Court Determines Adequacy of Liability Medicare Set

DuHamell joins the growing number of cases in which liability plaintiffs and defendants are turning to the courts to resolve the issue of whether a designated sum of money is sufficient to protect Medicare’s potential future interests.  It should be noted that liability MSAs are not required.  If a Medicare beneficiary settles a claim and money is being paid, even in part, because of the future medical expenses that will be incurred, however, Medicare’s future interest in settlement proceeds should be considered in some manner.  In an increasing number of cases, one or both parties are insisting on “approval” of designated Medicare Set-aside amounts from some type of governing authority.  Even though Medicare is not bound by state court judgments, with no established method for CMS review and approval of liability settlements and an inconsistency between Regional Offices as to whether review will be granted, parties are left with little alternative but to turn to the state courts for assistance.
Source: blogspot.com

MHANJ Offers Free Medicare Benefits Counseling through “SHIP”

Counseling is free, objective and confidential and encompasses assistance with questions about Medicare, Medigap, Medicare Advantage, Medicare Part D, Long-Term Care Insurance and Dual-Eligibility. Sessions are conducted by telephone so that travel is not necessary.       
Source: mhanj.org

Medicare Agent Manager (NJ)

Great sales are the result of strong purpose, conviction and pride – pride in your ability and your product. UnitedHealth Group offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life’s best work.(sm) The purpose of this job is to supervise Agents who sell the UnitedHealth Group (UnitedHealth Group) portfolio of products offered to Medicare beneficiaries and individuals age 50+. The Agent Manager is responsible for achieving assigned sales/membership growth targets through agents in his/her territory/territories. Responsibilities: Continually build and nurture our stable of agents Provide a structured on-boarding process, leveraging corporate contracting, certification and training processes, tools and systems. Organize involvement in formal and on-the-job training to ensure an accurate understanding of our products, compliance/policy requirements, sales processes, brand and value proposition messages and sales systems. Organize agent activities, leads and territories to ensure effective and efficient coordination across the territory. Act as a liaison between agents and UnitedHealth Group sales process owners to ensure agents are appropriately set up and supported across their lifecycle. This includes, contracting, licensing/appointment, certification, training, enrollment administration, commission payment, agent servicing, etc. Coach and manage performance. Coach/Develop staff to achieve quantitative and qualitative performance targets. Use data and insights to coach for optimal performance. Manage day-to-day time and activities of assigned agents to ensure appropriate leading indicators of success and corresponding sales results. Monitor sales results, trends and key performance indicators (KPI’s) and hold representatives accountable for achieving targets. Conduct ride-along to observe sales techniques and ensure alignment with expectations and compliance with CMS regulations. Conduct regular one-on-one meetings to review sales results/activities and provide feedback/coaching on opportunities for improvement. . Achieve assigned sales targets: Achieve assigned sales/membership growth targets through agents in his/her territory(ies), with a minimum of 65% of sales derived via community based leads and referrals. Partner with the Community Developer (CD) and Area Sales Manager (ASM) to identify and develop relationships with individuals and organizations that influence the buying behavior of our target consumer (e.g.; Providers, Regulators, Faith Based Organizations, and Associations). Understand the strengths and weaknesses of each organization and how it impacts the marketplace. Facilitate engagement of agents in executing these plans and ensure that they appropriately build and advance our brand and value proposition and represent our product portfolio and service offerings. Ensure Compliance: Ensure agents adhere to sales and marketing guidelines associated with Medicare regulations, partner expectations (e.g.; AARP) and company policies and procedures. UnitedHealthcare Medicare & Retirement is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. Imagine joining a group of professionals and clinicians who are working to improve health care for people over 50. Consider the influence you can have on the quality of care for millions of people. Now, enhance that success with enthusiasm you can really feel. That’s how it is at UnitedHealthcare Medicare & Retirement. Everyday, we’re collaborating to improve the health and well being of the fastest growing segment of our nation’s population. And we’re doing it with an intense amount of dedication. Here, you will discover a culture that grows through challenge. That evolves by being flexible. That succeeds by staying true to our mission to make health care work effectively and efficiently for seniors. Put your best to work for us, and discover extraordinary opportunities for growth.
Source: careers.org

Medicare Advantage 2011 Data Spotlight: Plan Availability and Premiums

Posted by:  :  Category: Medicare

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This Medicare Advantage Data Spotlight provides an overview of recent changes made to the Medicare Advantage program and examines trends in plan participation, premiums and certain benefits. About 12 million people, or nearly a quarter of the Medicare population, are enrolled in Medicare Advantage, the privately administered plans that are an alternative to the traditional fee-for-service Medicare program.
Source: kff.org

Video: Joining a Medicare Plan – 2011

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

How to pick a Medicare plan

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

Medicare recipients in ‘donut hole’ to get price break on some drugs in 2011

“Regardless of what happens to the donut hole, the influx of the first wave of baby boomers will increase the demand for drugs and other medical services,” Moffit says. “All things being equal, that will mean increased costs for seniors and taxpayers alike.” According to the federal Centers for Medicare & Medicaid Services, your actual drug plan varies depending on what kind of prescriptions you buy, which plan you choose, whether you go to a pharmacy in your plan’s network, whether your drugs are on your plan’s formulary (list of approved drugs) and whether you belong to the Extra Help program. Extra Help is a Medicare program to help low-income people; it pays for Medicare prescription drug program costs, such as premiums, deductibles and coinsurance.
Source: insurancequotes.com

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

FAQ: Seniors May See Changes in Medigap Policies

Advocacy groups like the Medicare Rights Center oppose restricting Medigap plans, saying it would simply shift more costs from the government to elderly and low-income people who can least afford it. “Some in government feel people in Medicare don’t have enough ‘skin in the game,’” says Ilene Stein, federal policy director for the center. In fact, she says, people on Medicare already pay 15 percent of their incomes for health care, well above the level paid by non-Medicare households. While the proposals would cap maximum annual spending per enrollee to $5,500 or $7,500, “that’s a lot of money for someone making $22,000,” the median household income for those on Medicare, she says. 
Source: kaiserhealthnews.org

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July 09, 2013

Spillover Benefits From Medicare Advantage

Posted by:  :  Category: Medicare

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

Video: Medicare Explained

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

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

Study: Fewer Employers to Offer Pharmacy Benefits to Medicare

“With many medications having double-digit price increases, and with the continued consolidation among PBMs, this is a buyer’s market for PBM pricing,” said Paul Burns, a principal with Buck Consultants. “Employers should be aggressive in their negotiations. Any PBM contract that is 18 to 24 months old should be reviewed for pricing competitiveness as well as up-to-date contractual language.”
Source: industryweek.com

The Medicare Prescription Drug Benefit Fact Sheet

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

Extra Benefits Of Medicare A Part A And GCUFBIH Organization International

These initial research method may result using less than fantastic niches, but the following niches should wind up being saved because that have changes in marketing, it will usually a good area to start when a niche will be saturated and you actually need to seek a new place. The idea is now to be liquids and be knowledgeable to make most of an actual profitable niche along with you can, so be ready in the market to change niches for the reason that soon as the application is apparent in which it the niche is generally no longer a niche market. It could be best to replace before the forte stops being viable not after this item has failed of bring in enough income for a very extended period with regards to time.
Source: cufbih.com

Signing Up for Medicare Benefits, Act Now!

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

Healthcare Reform: How Does it Affect Medicare Benefits?

Notably, the coverage gap in Medicare’s Part D prescription drug program (infamously known as the “doughnut hole”) will be eliminated in 2020, with increasing discounts on brand name and generic drugs implemented each year until then. In addition, most preventive care options, including vaccines, physical exams, and many routine tests, will no longer require a copayment or deductible. Those covered will also be able to visit their doctor for a free “wellness” visit once each year.
Source: pondlehocky.com

Upcoming Distance Learning Opportunities on the Medicare Prescription Drug Benefit

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

Nursing Home Ombudsman: Tiny difference in terms can make big difference in benefits

You also may want to make notes for yourself about the date when you noticed the mattress damage, the date that you reported the damage to the facility, the name of the person you spoke to about it, how they said they would fix the problem, when they said it would be fixed, and whether or not the mattress was replaced. A facility should promptly replace damaged mattresses and covers. Nursing facilities must provide each resident with a clean, comfortable mattress with bedding, appropriate to the weather and climate. If you and your mother are uncomfortable talking with facility staff about your mattress concerns we can work on the problem for you. We are here to help you resolve concerns.  
Source: kyforward.com

Viewpoints On Medicare: Advantage Program Offers Roadmap To Improving The Program; Rare Bipartisan Support For Doctor Pay Fix

Bloomberg: Retirees’ Medical Bills Are Bringing Down Detroit The emergency manager in charge of keeping Detroit afloat says the city’s $20 billion debt load can’t be reduced to manageable levels without “shared sacrifice” from all stakeholders, including retirees. Pension and retiree-health-care obligations make up the bulk of the city’s unsecured debt, and their costs are rising rapidly. The emergency manager, Kevyn Orr, is right that Detroit must reduce its retirement-related debt to secure its future, but he has to be more specific about his target. Cutting retiree health care — also referred to as “other post-employment benefits,” or OPEBs — should take priority over pensions (Stephen Eide, 7/2).
Source: kaiserhealthnews.org

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July 09, 2013

State Roundup: Medicaid Contractor Sues La. Over Canceled Deal

Posted by:  :  Category: Medicare

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California Healthline: Statewide Soda Tax Gaining Momentum In Calif. Legislature Fueled by a recent survey showing growing public support, a penny-per-ounce tax on sugary drinks appears to be gaining traction in the California Legislature. Two Senate committees approved a bill by Sen. Bill Monning (D-Carmel) that would add a penny to every ounce of sugar-sweetened beverage sold in California. SB 622 has two goals: discourage consumption of sugary drinks and generate income to fund programs aimed at reducing childhood obesity. … Taxing sugary beverages is not a new idea in California. A similar bill was introduced but died in the Legislature in 2010. Last fall, voters in two California cities defeated ballot measures to create local soda taxes (Lauer, 5/6).
Source: kaiserhealthnews.org

Video: Medicare Y Usted: Mes de la Prevención del Cáncer Cervical

Immigrants contributing to Medicare’s health

The study by Harvard researchers looked at the Medicare Hospital Insurance Trust Fund, which accounts for about half of Medicare’s monies, and found that, “Immigrants generated surpluses of $11.1–$17.2 billion per year between 2002 and 2009, resulting in a cumulative surplus of $115.2 billion. Most of the surplus from immigrants was contributed by noncitizens and was a result of the high proportion of working-age taxpayers in this group. Policies that restrict immigration may deplete Medicare’s financial resources.”
Source: dallasnews.com

LA Hospital Among Others in $34 Million Medicare Settlement

(LOS ANGELES) — A Los Angeles hospital is among 55 hospitals from across the country that have agreed to pay the federal government a total of over $34 million to settle allegations of false claims being submitted to Medicare. According to the Justice Department, it was alleged that the various health care facilities submitted false claims to Medicare for kyphoplasty procedures, which authorities say, in may cases can be performed safely and effectively as an outpatient procedure without any need for a more costly hospital admission. The Department of Justice says Cedars Sinai Medical Center in Los Angeles has agreed to pay $1,485,846 of the settlement total. Copyright 2013 ABC News Radio
Source: abcnewsradioonline.com

Cuban regime medicare fraud money launderer sentenced to 4 years in prison

Oscar Sanchez, a Cuban American and Florida resident who laundered millions of dollars in Medicare fraud proceeds that were transferred to banks in Cuba controlled by the Castro dictatorship was sentenced to four years in prison for his role in the scam. The Castro dictatorship has long been suspected of devising and carrying out Medicare fraud schemes in the U.S., which have netted the criminal regime in Havana millions of dollars deposited into their banks.
Source: babalublog.com

Los Inmigrantes Contribuyen Más a Medicare, Dice Informe

Green Card Renewal (I-90) Petition for Alien Fiancé (I-129F) Green Card for Family Member (I-130) Travel Document (I-131) Extend/Change Dependent Status (I-539) Remove Conditions of Residence (I-751) Deferred Action Childhood Arrivals (I-821D) Citizenship Application (N-400) Replacement of Citizenship (N-565) Certificate of Citizenship (N-600) Affidavit of Support (I-864) Temporary Protected Status (I-821) See All USCIS Forms
Source: immigrationdirect.com

Alphabet Soup a la Medicare

Medicare Part B:  This is your medical insurance.  This covers doctor and other health care provider services, hospital outpatient services (those ‘observation’/’accommodation’ stays!), durable medical equipment and skilled home health care services.  This will cover many preventive services as well.  BE AWARE:  Per CMS, “The co-payment for a single outpatient hospital service can’t be more than the inpatient hospital deductible.  HOWEVER, your total co-payment for all outpatient services may be more than the inpatient hospital deductible.”  This is the tricky part if you are in the hospital for several days without a formal admission!
Source: parentcarealliance.com

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July 09, 2013

Medicare Supplement Plan F

Posted by:  :  Category: Medicare

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

Video: Plan F Medicare Supplements

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

More Seniors Finding a Better Value with Plan G

As the years passed, and enrollment in Plan F grew, so did the number of claims being filed by individuals. This growth would take a bigger toll on policy reserves than expected, requiring insurance companies to raise the premium of a Plan F at a higher percentage rate than Plan G. Over the years this higher rate of increased premium has resulted in widening in cost difference. In most instances that gap has grown to represent a cost difference to the consumer to the tune of several hundreds of dollars in yearly premiums. Couple that with a more cost conscious consumer, who isn’t trying to hold onto every dollar these days and you have people saying to themselves:
Source: jcgnewmedia.com

Medicare Supplement Plan F

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

Government to Leave Plan F Alone

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

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

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

Medicare Supplement Plan F Options

In Oklahoma, there are 12 Medicare supplement plans available- 10 standardized plans and 2 additional plans. Each plan is identified by a different letter of the alphabet, A through L, and each has its own unique combination of benefits. While every plan offers the same standardized coverage, some cover deductibles, coinsurance for a skilled nursing facility, even foreign travel emergencies. It’s important to understand that while each plan is different, companies selling Medicare supplement insurance in Oklahoma must offer the same benefits for each plan. In other words, a Plan C is exactly the same regardless of what company you choose to buy it from.
Source: oklahomamedicarehealth.com

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July 09, 2013

Coventry Health Care Adds Cornerstone Health Care (P.A.) to their Advantra Medicare Advantage Provider Network in North Carolina.

Posted by:  :  Category: Medicare

Cornerstone Health Care has nearly 300 providers (including primary care and specialty physicians, and mid-level professionals) in more than 70 locations in High Point, Winston-Salem, Greensboro, Summerfield, Thomasville, Archdale, Trinity, Jamestown, Kernersville, Lexington, Asheboro, and Advance.
Source: wordpress.com

Video: Videos matching: advantra medicare advantage

Coventry Medicare Advantages In A Nutshell

The last two remaining programs in the Coventry Medicare Plans are the Coventry Advantra-POS and the Coventry Advantra Freedom. The Advantra POS is still basically the same as HMO and PPO plans; they have the same coverage of benefits and a set of network providers.  But, they are given the privilege to see health care providers outside their network.  Of course, this comes with much higher premiums.  For a little more cost, enrollees can have the freedom to choose their own physicians with the Advantra Freedom plan.  CAF is a private-fee-for-service (PFFS) which also includes Part A and B benefits.  Enrollees may consult any physician or specialist they prefer without the need for any referrals, given that the provider accepts the guidelines and resolutions within the PFFS agreement.
Source: medicarebase.com

Altius Health Plans Altius Advantra Medicare Review

Altius Health Plans offers Medicare health insurance programs for residence of Utah and a county in Wyoming.  Altius Advantra and Altius Advantra Preference are Medicare Advantage HMO plans available in Box Elder, Cache, Daggett, Davis, Duchesne, Morgan, Rich, Salt Lake, Summitt, Tooele, Wasatch, and Weber counties in Utah as well as Uintah county in Wyoming.  Altius Advantra is an HMO-POS plan, and Altius Advantra Preference is a plain HMO only available in Davis, Salt Lake, and Tooele counties.  The coverage does include Part D drug coverage as well as health benefits.  Below is a review of the benefits they offer:
Source: medicare-plans.net

Advantra Rx NOT Renewing Their Medicare Contract

one of my customer’s sent me a copy of the letter from AdvantraRX dates October 2. Here is what it says (sorry about typos, i type fast): Dear Mr. Smith, AdvantraRx Preimer by Coventry Life and Health Insurance Company, a stand-alone prescription drug plan with a Medicare Contract, will no longer operate as of January 1, 2011 so your Medicare Prescription drug coverage through AdvantraRx Premiuer will end December 31, 2010. If you want Medicare prescription drug coverage starting January 1, you need to join a new Medicare drug plan by December 31, 2010. Take Action by December 31 to avoid losing drug coverage. If you want Medicare Rx drug coverage after December 31, you need to join another Plan or medicare advantage plan that offers drug coverage. You can join a new medicare drug plan anytime between October 1 and January 31, 2011. However your AdvantraRx Premier coverage ends December 31, so you should join a new medicare drug plan by december 31 to make sure you have drug coverage january 1. If you join a new plan AFTER december 31, your new coverage won’t start until the month after you join. What happens if you don’t join another medicare drug plan? if you don’t join another medicare drug plan by January 31, your next chance to join will be from october 15 through december 7, 2011. You may also have a pay a late-enrollment penalty to join later. The the letter gives a list of a bunch of companies and the 1-800 Medicare number and website. It doesn’t state anything anywhere about automatically enrolling them into another plan if they do nothing. In fact, it states the opposite.
Source: insurance-forums.net

Will Your Medicare Advantage Plans Still Be Available In 2010

All plans must send you a notice of termination if there plan is terminating. When a plan terminates they do NOT enroll you in a part D plan. In some cases a plan may try to change you to another plan that they offer, however in they are still required to notify you in writing and give you the full details and you still have the option of changing plans if you are not satisfied with the benefits offered. In the case of Advantra Plans this year, you will need to choose another Medicare Plan. Some Advantra Freedom plans were offered as MAPD which means that the plan itself included the prescription drugs. You may also have a PFFS and a seperate Part D. If the part D is seperate you should still have RX coverage. If you do want to keep Advantra as your Part D you can still get a seperate Part D plan as long as it is a PFFS. You should call a broker and get a list of comparable options. You can ask for health plans only if you wish. Also if you just want an evidence of coverage you can call Advantra back or visit http://www.choicesformedicare.org and request one. Make sure you are specific in your request and they will know what to send.
Source: wordpress.com

Free Insurance Agent Websites: Coventry Medicare Advantage

This type of plan offers the benefits of both Part A & B. People who subscribe to this plan can attain the services of medical providers who are part of the allotted network. This means that the insured party can only seek the medical services of physicians and doctors who are within the network. In this type of plan each insured customer must also choose his or her primary care physician. The physician can refer the patient to specialists if needed. If the patient were to seek services outside the network, he or she might not receive coverage from the plan unless it happens to be an emergency situation.
Source: blogspot.com

Pennsylvania Health Insurance

HealthAmerica’s Commercial and Medicare Advantage Plans Among Tops in Nation for Quality and Service on U.S.News & World Report/NCQA “America’s Best Health Plans 2008-09″ List Harrisburg and Pittsburgh, Pa. – November 10, 2008 — HealthAmerica’s HMO, POS, and Medicare Advantage plans were ranked among the nation’s top 20 best commercial and Medicare health plans according to a joint ranking by U.S.News & World Report and the National Committee for Quality Assurance (NCQA). Nationally, HealthAmerica was ranked 12th among 287 commercial plans; HealthAmerica’s Medicare Advantage plan, Advantra, ranked 18th among 216 plans nationally. HealthAmerica and HealthAmerica Advantra have ranked as one of the top 50 best health plans in the U.S. News/NCQA “Americaýs Best Health Plans” list* every year since 2005. “We are honored to be recognized among the best health plans in the nation,” said Kirk E. Rothrock, president and chief executive officer of HealthAmerica. “We are dedicated to providing the best possible quality and service, so we are pleased to see our efforts recognized by NCQA, U.S. News and World Report, and, most importantly, by our members and our customers.” The National Committee for Quality Assurance and U.S.News and World Report collaborated to rank the nationýs best commercial, Medicare, and Medicaid health plans. The ranking appears in the November 17 issue of U.S.News and on its website www.usnews .com/healthplans HealthAmerica”s and Advantra”s rankings are based on their Healthcare Effectiveness Data and Information Set (HEDISý)** 2008 scores and the results of a Consumer Assessment of Healthcare and Provider Systems (CAHPS) survey of members. HEDIS is a set of standardized performance measures covering effectiveness of care, preventive care, treatment, and customer satisfaction. CAHPS is a standardized survey in which members rate the quality of care and service that they receive from doctors, specialists, office staffs, and insurers. In these ratings, HealthAmerica’s commercial health plans were rated higher than the national average in all 15 key measures of medical services and member satisfaction and higher than the Pennsylvania state average in 12 of the 15 key measures***. HealthAmerica’s HMO, POS, and Medicare Advantage plans’ status of “Excellent” from NCQA was also a factor in determining the U.S. News/NCQA “America’s Best Health Plans 2008″ ranking**** The U.S.News/NCQA “Americaýs Best Health Plans 2008″ list is drawn from measures of prevention, treatment, and customer experience. These measures are compiled in NCQA”s Quality Compass 2008*****, which publicly reports comparative results of more than 400 commercial health plans covering 85 million Americans. Health plans throughout the country were evaluated on issues such as access to care, prevention efforts, treatment of diseases such as diabetes and heart disease, and members were surveyed on their satisfaction to calculate an overall quality score. * “America’s Best Health Plans” is a trademark of U.S. News & World Report. **HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). ***The source for this data is Quality Compass 2008 and is used with the permission of the National Committee for Quality Assurance (NCQA). Quality Compass is a registered trademark of NCQA. NCQA is a private, non-profit organization dedicated to improving health care quality. The 12 measures are: Child immunization (combo II), well child visits 3 to 6 years, colorectal cancer screening, prenatal care, first-trimester postpartum care, cervical cancer screening, breast cancer screening, diabetes-lipid profile (screen), controlling hypertension, cholesterol screening for patients with cardiovascular conditions, rating of all health care, rating of health plan. ****National Committee for Quality Assurance accreditation outcomes are: Excellent, Commendable, Accredited, and Denied. Applies to HMO and POS plans. *****Quality Compass is a registered trademark of NCQA. NCQA is a private, non-profit organization dedicated to improving health care quality. About HealthAmerica For over 33 years, HealthAmerica has provided health benefit solutions to employers across Pennsylvania. HealthAmerica offers a broad range of traditional and consumer-directed health insurance products, including managed care, HSAs, self-funded, Medicare, indemnity, nongroup and pharmacy plans. Serving 12,000 businesses and over 660,000 members as of December 31, 2007, in Pennsylvania and Ohio, HealthAmerica offers progressive medical management, innovative wellness programs, and statewide and national provider networks. HealthAmerica is ranked as one of “Americaýs Best Health Plans, 2006″ by U.S. News & World Report; its HMO and POS products have an “Excellent” accreditation by the National Committee for Quality Assurance. HealthAmerica has corporate offices in Pittsburgh and Harrisburg, Pennsylvania, and employs over 2,200 people in the commonwealth.
Source: blogspot.com

The Sullivan Independent News

The Visiting Nurses Association will hold a flu shot clinic at the Sullivan Senior Center on Tues., Oct. 13 from 12 p.m.- 3 p.m. In order to be sure a vaccine is available for you, you must call or stop by the Senior Center and have your name put on the vaccine list. The VNA will be bringing 150 vaccines, but more will be available if we see more people are signing up. This will be a one-time clinic. Those planning to receive their vaccine may show up anytime from 12 p.m.-3 p.m. To avoid the congestion and long waiting periods, you may wish to wait a little later and not all show up at 12 p.m. Insurances accepted by the VNA for this clinic include: Medicare Advantage Plans, Essence, Coventry Advantra Freedom, GHP, Advantra, GHP Advantra Freedom, GHP Gold Advantage, Humana Choice PPO, Humana Gold Choice PFFS, Humanna Gold Plus HMO and Mercy Medicare Advantage. Other insurances that did not contract with the VNA and will not be accepted are: Medicare Advantage Plans, Secure Horizons, Aetna Medicare, Anthem Senior Advantage, Cigna Medicare Access, Sterling Option, Wellcare, Evercare or any other Medicare Advantage or out-of-state plans. Medicaid is not accepted. If you have another primary insurance, you may not use Medicare or Medicare Advantage. Those wishing to pay “out of pocket” for the vaccine may do so. The cost is $30. Visiting Nurses Association is a non-profit community based organization dedicated to serving the healthcare needs of your community. Please help us by giving us your correct insurance at the time of service.
Source: mysullivannews.com

Medicare Targets Health Plans With Low Ratings

Medicare officials are encouraging 525,000 beneficiaries to switch out of these 26 Medicare Advantage and drug plans that have received low ratings for three consecutive years and enroll in better plans for next year. The poor performing plans will have this warning symbol next to their names on Medicare’s plan finder website to steer shoppers to other plans.
Source: kaiserhealthnews.org

Coventry.Health.Care.Deleware / .Advantra.Silver.Coventry.Health.Care

coventry health care incorporated laws state delaware december 17 1997 successor coventry corporation coventry health care insurance map offers health insurance states coventry health care iowa coventry advantra gold advantra xp gold silv ppo pltn ma coventry health care iowa coventry advantra silver advantra 22 medicare insurance plan options offered new market ia 2010 coventry of advantra platinum ppo sw ppo health drugs coventry health care 46 highest-paid chief information officers list 21 pay packages worth 1 million dealing rising price medical services health insurance Ny source fox news 16 30 1 jun 2010 provinding health care north kivu
Source: bonafidelive.com

Medicare Advantage Plans and PFFS Plans

GA_googleAddSlot(“ca-pub-0753968927722499″, adslot_Header); GA_googleAddSlot(“ca-pub-0753968927722499″, adslot_Mid); GA_googleAddSlot(“ca-pub-0753968927722499″, adslot_Mid2); GA_googleAddSlot(“ca-pub-0753968927722499″, adslot_Right_Top); GA_googleAddSlot(“ca-pub-0753968927722499″, adslot_Right_Bottom); GA_googleAddSlot(“ca-pub-0753968927722499″, adslot_
Source: merchantcircle.com

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July 09, 2013

Competitive Bidding In Medicare: A Response To The Bipartisan Policy Center’s Proposal

Posted by:  :  Category: Medicare

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Note 6.  At the time of the Denver demonstration, health plans were paid by Medicare at a so-called average per capita cost (AAPCC) rate.  Under the AAPCC, payments were set at 95 percent of the cost of a standardized enrollee in Medicare FFS in the county where the beneficiary lived, with adjustments for a few enrollee characteristics (e.g., age and sex).  The imperfections of the system were obvious, with large overpayments in some areas (allowing plans to offer drug benefits and other substantial enhancements at no added cost) and underpayments in other areas (requiring added premiums to cover little more than the entitlement benefit).  After the Denver demonstration was stopped temporarily by the courts and then more permanently by Congress, Congress dealt with the issue of plan payments by cutting payments across-the-board in the Balanced Budget Act of 1997, so that very low and very high payments under historical methods were compressed toward the national average.  This was yet another cycle in paying private Medicare plans too generously and then, under the BBA, more stringently, but in both cases the rates were derived from FFS Medicare costs, not plans’ true costs to provide the service.
Source: healthaffairs.org

Video: Weekly Address: Preserving and Strengthening Medicare

Inescapable fact regarding US Medicare Advantages On Filipino Land

US Medicare health insurance coverage in a international hospital is restricted, with hardly any exclusions: (1) once the insured resides within the US but the the majority of proximate hospital is really a non-US territory, or even (2) when an urgent arises while the covered by insurance is travelling without irrational delay between Alaska as well as another US state, along with a Canada-based hospital will be the closest spot to seek emergency treatment.
Source: insuranceprog.com

Golden Rule insurance address changd

Please note that Golden Rule Insurance Company has a new mailing address. Therefore, we ask that you update your records as soon as possible to replace our previous mailing addresses for submitting claims: Previous Addresses: 7440 Woodland Drive Indianapolis, IN 46278 712 11th street Lawrenceville, IL 62439 New Address: Golden Rule insurance Company P. 0. Box 31374 Salt Lake City, UT 84l31-0374 For quickest service, we recommend that you file claims electronically. You may contact your current clearinghouse vendor to request electronic transmission of your Golden Rule claims. Golden Rule’s electronic payer ID is 37602. If you do not have a clearinghouse connection and you are interested in sending claims electronically,please contact the EDI Sales Team at Optumlnsight at 800-341 -6 141 and select option1 for more information. Optumlnsight currently has connectivity with aII the major clearinghousesincluding Allscripts, Availity, Capario, Care-rracker, Emdeon, MD Online, Navicure, Netwerkes, Oftsce Ally, Real-Med, RelayHealth, SSI, and Zirmed.
Source: medicalbillingcptmodifiers.com

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July 09, 2013

HHS Takes NAIC’s Advice on Medicare Supplements

Posted by:  :  Category: Medicare

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

Video: Medicare Enrollment Advice

Need Advice on How to Sell My Blue Shield Medicare Supplement Book of Business

Hi. I’m new on this forum, so please forgive me if I’m not doing this right. I currently have 16 remaining Medicare Supplement policy holders that I’ve had for years in Washington state. Blue Shield is cancelling my contract because I’ve fallen below 20 clients. Thought I’d try to sell it rather than lose everything. (I’m presuming I can do that.) The monthly income is almost $400 per month ($4,800 per year). Have been told that the selling price would be 1 to 2 times the annual income, but I’m not sure. Anyone have any advice on determining a fair selling price, where to advertise it, etc.? Anyone interested in buying it? Thanks, Ron
Source: insurance-forums.net

Doctor’s Advice…Get Traditional Medicare…What’s That? » Toni Says

(In-patient Hospital Insurance) pays for your medical care while you have a hospital stay. Part A also pays some of the costs if you stay in a skilled nursing facility which has 100 day benefit, hospice, or if you receive home health care.  The Part A deductible for 2013 is $1,184.00 and can be used 6 times or 6 deductibles in a year.  Yes, Part A has a benefit period of 60 days, so every 60 days; there is a new deductible of $1184.00. If you go back in the hospital after a 60 day period, then you can have another deductible of $1,184.00.  Skilled nursing has a $0 co pay for days 1-20, but from days 21-100, there is $148.00 co pay per day.  After day 100, you pay all of the cost for each additional day. And yes they do bill you the additional cost.
Source: tonisays.com

Medicare Update for the New Year

In general, the savings and benefits related to use of EFT for business and consumer payments are well established.  The most common savings are in paper, printing, and postage costs, as well as savings in staff time to manually process and deposit paper checks.  Yet adoption and use of EFT by the health care industry has been low, resulting in administrative savings that go unrealized.  The obstacles to greater use of EFT by the health care industry can be lessened by standardization of the EFT transaction.  Beyond the material and administrative time savings for health care providers and health plans, the time and resources that physician practices and hospitals spend on billing and related tasks will be better spent on delivering health care to patients.
Source: managemypractice.com

Medicare Advantage Cuts in Obamacare: March 2013 Update

The Federal Government is nudging everyone to use the Exchanges instead of private healthcare providers.  This is especially true for Medicare recipients who choose supplemental care policies with private insurers.  Up to now, certain healthcare insurers received grants for being efficient and high-quality providers.  Now that goes away.  The result is an increase in premiums for these plans nicknamed “Medicare Advantage.” The healthcare providers that receive compensation for their services to Medicare patients must accept a fee schedule for medical services that are based upon a flat rate schedule, even if the patient is not eligible for the particular treatment regimen.  That is why a growing number of medical care providers no longer accept Medicare patients.  Some doctors and clinics now offer a subscription service called “Concierge Service” for a fixed annual fee.
Source: patriotactionnetwork.com

Generate advice on the best Medicare Supplement Insurance Quotes

Medicare Supplement plans have been observed to be very beneficial for the patient, because it allows them to significantly reduce processing costs. With so many options on offer, it is important to locate persons for several Medicare Supplement insurance quotes before deciding on a particular policy. There are several factors that should be considered when it needs a supplement plan. The issue price, the amount of coverage financial strength of the company are some of the most important considerations that you should think about when buying Medicare Supplement Insurance. Insurance Articles from EzineArticles.com
Source: xinsurance247.com

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