OneHealth™ Signs Services Agreement with Amerigroup Corporation

Posted by:  :  Category: Medicare

Amerigroup, a Fortune 500 Company, coordinates services for individuals in publicly funded health care programs. Currently serving approximately 2.7 million members in 12 states nationwide, Amerigroup expects to expand operations to its 13th state, Kansas, as a result of previously awarded state contract. Amerigroup is dedicated to offering real solutions that improve health care access and quality for its members, while proactively working to reduce the overall cost of care to taxpayers. Amerigroup accepts all eligible people regardless of age, sex, race or disability.
Source: onehealth.com

Video: Real Stories: Amerigroup Texas, Dual Eligible

Amerigroup Medicare Tai Chi

If you have Amerigroup Medicare as your insurance coverage you should be able to take Tai Chi here at no cost to you. Classes are on Wednesdays from 6-7pm and Sundays from 11:30am-1pm with Steve Miller, who teaches the Yang Style Short Form. This form of Tai Chi has been proven in a clinical trial to relieve the pain of arthritis and fibromyalgia.
Source: midwoodmartialarts.com

WellPoint reorganization will help integrate Amerigroup, expand in Medicaid market

Deanna Pogorelc is a Cleveland-based reporter who writes obsessively about life science startups across the country, looking to technology transfer offices, startup incubators and investment funds to see what’s next in healthcare. She has a bachelor’s degree in journalism from Ball State University and previously covered business and education for a northeast Indiana newspaper. More posts by Author
Source: medcitynews.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

WellPoint Bets On Medicare And Medicaid

WellPoint should be able to leverage (CUT) some SG&A expenses and benefit from increased negotiating power with hospitals. The firm has already announced that it expects the Amerigroup acquisition to be accretive to earnings in 2013 (assuming the deal closes in the first quarter) and to add at least $1 per share in earnings in 2014. Though the transaction faces regulatory approval, the current administration will likely be in favor of anything that could lower healthcare costs.
Source: seekingalpha.com

Medicare Part D is prescription drug coverage insurance that is provided by private companies approved by Medicare.

Posted by:  :  Category: Medicare

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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

Video: Medicare Part D – 5 Things To Know Before You Enroll in a Part D Plan

Medicare Part D: A First Look at Part D Plan Offerings in 2013

The analysis is the first in a series of planned reports examining the private plan choices available to Medicare beneficiaries for 2013. It is authored by researchers at Georgetown University, the Kaiser Family Foundation and NORC at the University of Chicago.
Source: kff.org

Top Medicare Part D Plan Costs Spike in 2013

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

Understanding Medicare premiums

A: For people with limited incomes and resources, the Part D Extra Help program covers all or most of their Part D premium, as well as other pharmacy costs. You can find out if you qualify and apply online at www.socialsecurity.gov/prescriptionhelp or by calling 1-800-MEDICARE. Each state also has Medicare Savings Programs that cover Part B premiums for people with limited incomes. In some cases, these programs also cover other Medicare costs. To learn more, call 1-800-MEDICARE and ask for a referral to your local state health insurance assistance program (SHIP), or go to this website www.familiesusa.org/resources/program-locator and click on your state.
Source: apalachtimes.com

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

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

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

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

How Do You Get Medicare Part D?

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

The A, B, C’s, and D’s! of Medicare

Helping You Understand Your Medicare Benefits and Other Plans Many people expect to kick back and relax from budgeting during retirement years. With skyrocketing healthcare costs, it’s important that older Americans understand their Medicare benefits, the role of additional insurance, and the coordination of any other health insurance plans. Use the resources available from your doctor to understand how to take advantage of your Medicare benefits and keep your out-of-pocket expenses to a minimum. The knowledgeable team at AlphaMed is also happy to guide you in the right direction. If you have a parent that is nearing 65 years of age, make time to talk about Medicare insurance and other health concerns. It could be a life changing discussion.
Source: tnhealthandwellness.com

Aetna Medicare Plans Continue In California

Aetna is continuing to sell health insurance through small and large employers as continuing to offer its Medicare Advantage, Medicare Prescription Drug, Medicare supplement, dental insurance and life insurance in California.
Source: iquote.com

When Can I Join a Medicare Part D Prescription Drug Plan?

General Enrollment Periods: Each year, there are two general enrollment periods when anyone who is enrolled in Medicare Part A or B can sign up for a Medicare Prescription Drug Plan. The first period begins in April and continues through June. The second open enrollment is in October and continues through the first week of December. This is the easiest time to plan for coverage and change your enrollment options.
Source: bradeninsurance.com

CVS Caremark Part D Plans Collaborating With Medicare ACOs On Drug Adherence

The collaboration could be an important step toward more firmly establishing the value of drug treatment in lowering overall medical spending, a key goal for biopharma manufacturers looking for ways to adapt to new patient care models.
Source: ewallstreeter.com

Remember to Compare Medicare Part D Plans to Cut 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

CMS Announces Medicare Providers Must Begin to Revalidate Enrollment By March 2013

Posted by:  :  Category: Medicare

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In the continued effort to reduce fraud, waste, and abuse, CMS implemented new screening criteria to the Medicare provider/supplier enrollment process beginning in March 2011.  Newly-enrolling and revalidating providers and suppliers are placed in one of three screening categories – limited, moderate, or high – each representing the level of risk to the Medicare program for the particular category of provider/supplier, and determining the degree of screening to be performed by the Medicare Administrative Contractor (MAC) processing the enrollment application. More information on the screening categories is here.
Source: managemypractice.com

Video: Medicare vs Medicaid 612-309-9184 Minnesota Medical Assistance Minneapolis Elder Law Attorney

State Highlights: Fla. Hospices Get Close Scrutiny; Calif. Medi

Boston Globe: 2 More Officials Leave State Medical Board The state medical board’s general counsel has resigned, and its public spokesman was fired Monday, building on two years of turnover at the agency. Special Assistant Russell Aims, the spokesman, was let go after about nine years with the Board of Registration in Medicine, which is charged with licensing and disciplining doctors. General Counsel Brenda Beaton had held her position since 2006. Board chairwoman Dr. Candace Sloane would not comment specifically on the departures, but said “the board is going in the right direction,” with changes to staffing and protocol and a revamped physician database, with more public information about those who have been disciplined (Conaboy, 7/2).
Source: kaiserhealthnews.org

Providers form 106 new Accountable Care Organizations

The group announced today also includes 15 Advance Payment Model ACOs, physician-based or rural providers who would benefit from greater access to capital to invest in staff, electronic health record systems, or other infrastructure required to improve care coordination. Medicare will recoup advance payments over time through future shared savings. In addition to these ACOs, last year CMS launched the Pioneer ACO program for large provider groups able to take greater financial responsibility for the costs and care of their patients over time. In total, Medicare’s ACO partners will serve more than 4 million beneficiaries nationwide.
Source: sw.org

Regulations to Consider Before Opting Out of Medicare

There are three basic Medicare enrollment options for physicians: 1. Participating providers. A participating provider is enrolled in the Medicare program and accepts assignment on all Medicare claims. Accepting “assignment” means that the physician bills Medicare directly and accepts as full payment for a rendered service 80 percent of the Medicare fee schedule amount; plus 20 percent of the Medicare fee schedule amount from the patient (or the patient’s secondary insurance). A participating physician must accept assignment for all Medicare covered services; however, the physician can limit the number of Medicare patients he or she treats. 2. Non-participating providers. In many ways, non-participating providers are similar to participating providers. Both are enrolled in Medicare, both bill Medicare directly for services, and Medicare pays both 80 percent of the approved charge for a rendered service. There are, however, some important differences between these providers. For non-participating physicians, Medicare sets the approved amount for a service at 95 percent of what is approved for participating physicians. Accordingly, if Medicare makes payment based on an approved charge of $100 for a participating physician, Medicare will base payment for a non-participating physician on a charge of $95 for the same service. Non-participating physicians, however, are not limited to accepting only $95. They can charge up to 115 percent of Medicare’s allowed charge. For example, for a service with a Medicare-approved charge of $95, a non-participating provider can charge a total of $109.25. The provider would bill Medicare for $109.25 and Medicare would pay $76 (80 percent of the $95 Medicare-approved fee). Even though the physician would bill Medicare for this service, the payment would be made to the patient, and the physician would need to collect the amount directly from the patient. The patient or secondary-payer would be responsible for $19 (20 percent of the $95 Medicare approved fee). The remaining amount ($14.25) would be billed to the patient. 3. Opt-out providers. Physicians opting out of Medicare bill patients directly for services otherwise covered by Medicare. Unlike both a participating and non-participating provider, physicians who have opted-out of Medicare may not bill Medicare for services (with the limited exception of some emergency services), and Medicare beneficiaries receiving services from an opted-out provider may not seek reimbursement from Medicare. To privately contract with a Medicare beneficiary, a physician must enter into a written, private agreement with the patient that meets specific requirements, as set forth by Medicare regulations.  In addition to the private agreement, the physician must file an affidavit with Medicare that also meets certain Medicare regulatory requirements. The affidavit must be filed no later than 30 days before the first day of a calendar quarter. A physician has 90 days after the start of the opt-out period to revoke his or her decision and remain enrolled in Medicare. After that time, the opt out is effective for two-years.
Source: physicianspractice.com

JAMA Forum: The Medicare Trustees Report: Time for Reflection, Not Celebration

Still, it’s important to remember that any limited long-term budget for Medicare has to balance 3 objectives. One is the federal budget objective of a reasonable and sustainable future level of federal spending on the program. Another is to distribute financial risk in a way Americans deem to be fair. That means balancing the financial risk faced by today’s Medicare beneficiaries (in the form of premiums and out-of-pocket costs) and the financial risk to taxpayers and future generations of not effectively holding down Medicare spending on seniors. And the third objective is to squeeze down on the health system in such a way that it pushes providers and plans to look hard for innovations that result in cost reductions. That pressure must neither be too light (or providers won’t have enough pressure to find less costly ways to deliver services) nor too aggressive (or there will be disruptions and unacceptable declines in the quality and availability of services).
Source: jama.com

Daily Kos: Obama budget cuts Medicare benefits and provider payments

On the other hand, the proposals for seniors aren’t a positive move. At least Obama didn’t include the hike in the Medicare eligibility age that he had previously offered to Boehner, but what he does include could be another hit for seniors, on top of the chained CPI. Cutting out Medigap policies would increase out-of-pocket costs for seniors. Those costs have been steadily and steeply rising [pdf] for seniors already over the past two decades. Adding more means testing to the program (wealthier individuals already pay higher premiums for Part B, the part that covers physician services and supplies) shifts the program further from from universal coverage and opens it up to more and more means testing, and toward a stigmatized and politically vulnerable poverty program.
Source: dailykos.com

MedicareBob’s Blog: Medicare and Diabetes, what is covered?

Posted by:  :  Category: Medicare

2) Medicare Supplement Plans will cover the other 20% of the services that are covered by Medicare Part B. 3) Medicare Advantage Plans, these Plans are all different based on where you live and what is offered. Some Medicare Advantage Plans are designed for people with diabetes, “Medicare Advantage Special Needs Plan / Diabetes”. These are really cool, and you are not restricted to the Annual Enrollment Period, so you have more flexibility to when you can enroll into the Plan. For more information about how Medicare, Medicare Supplements and Medicare Advantage work with Medicare visit: www.SrHealthcareDirect.com and go to the titled post. EVEN BETTER: Call me, Robert Bache: 727-643-0219 or Toll Free: 1-855-368-4717. I know Medicare, please call me MedicareBob or visit www.MedicareBob.com Sources: The American Diabetes Association; Medicare
Source: blogspot.com

Video: Are Diabetic Supplies Covered by Medicare?

Managing Diabetes Effectively And Affordably On Medicare

Test Your Blood Sugar Regularly and Talk to Your Pharmacist: One of the most important ways for diabetic patients to manage their disease is to perform regular testing of their blood sugar, or glucose, levels. CVS pharmacists are available every day to speak with their patients about managing their diabetes and answer their questions about prescription and over-the-counter medications. Pharmacists can also help patients with new paperwork from their doctors’ offices required by changes to Medicare coverage of diabetes testing supplies.
Source: sundaynewscape.com

Medicare Diabetic Supplies

Many diabetic Medicare beneficiaries prefer to order their testing supplies via mail because it is more convenient and less expensive for the beneficiary. But, according to the New York Times, this process has “caused Medicare headaches for years” because of its costs to Medicare and high levels of fraud. To curb these issues, Medicare tested out competitive bidding on mail-order blood sugar test strips by 18 companies in nine metropolitan areas. As a result, both issues were addressed. Medicare previously paid $77.90 for 100 test strips; now, it paid only $22.47 during this experiment. Beneficiaries also benefit: Copayment prices also fell from $15.58 to $4.49.
Source: ehealthmedicare.com

Health Insurance Coverage For Individuals With Diabetes

When looking for health insurance plans/providers, you will need to specifically look for one that covers the cost of your diabetes care. Not all plans cover pre-existing conditions, and the last thing you want is to buy the insurance policy only to find you less medical care that you need.
Source: fosterfamilydirectory.com

Dietitian Organization Aims to Cash In on Obesity

The bill’s introduction trails an announcement by the American Medical Association that they’ve decided to classify obesity as a disease (see our article in this issue)—and it’s clear that the AND is attempting to cash in on it. Whether you think obesity should be classified as a disease or not, we can all agree that it’s a worsening epidemic in the US. We should be increasing coverage and reimbursement for nutrition professionals who offer nutrition counseling for obesity, not restricting access! More than 104 million Americans are obese; obesity-related conditions include heart disease, strokes, type 2 diabetes, and certain types of cancer. Obesity and related conditions are the leading cause of preventable death. It’s expensive, too. In 2008, medical costs associated with obesity were $147 billion; annual medical costs for individuals were $1,429 higher for obese people than for people of normal weight.
Source: liveinthenow.com

Medicare changes could save diabetics money

Beginning July 1, a mail-order program will be implemented to drop the prices the government pays for products used to test blood sugar but patients will have to use designated suppliers. The goal of the program is to save money for taxpayers, but co-pays for seniors could drop as well.
Source: wrex.com

The proposed Medicare Diabetes Screening

2012 about Aquarium Atlanta Attractions Beautiful best business cities City College Colleges Cool county find Football from Georgia good Health history images insurance lawyer License Loans long Military much Nice North Payday photos pics pictures road School schools small State take Tech Technical Universities University
Source: wordwd.com

H.R.1257: Preventing Diabetes in Medicare Act of 2013

Official: To amend title XVIII of the Social Security Act to reduce the occurrence of diabetes in Medicare beneficiaries by extending coverage under Medicare for medical nutrition therapy services to such beneficiaries with pre-diabetes or with risk factors for developing type 2 diabetes. as introduced.
Source: opencongress.org

Medicare Override Vote Was Test of Priorities

Posted by:  :  Category: Medicare

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Mr. Otter failed to cut health care benefits in the last legislative session so he changed existing health care plans for retired state employees by gutting the coverage programs for people who have worked for 20 years or more. Now many of those dedicated workers because of pre-existing conditions cannot qualify for affordable private health care programs and they are forced to pay extremely high premiums that have risen as much as $150.00 per month or more in addition to existing premiums being paid. Those on retirees on fixed incomes are devastated by Mr. Otters willful removal of a benefits they earned and were promised with over 20 years of work at below market wages.
Source: newwest.net

Video: New West Medicare REVISED.mov

Darling Downs South West Queensland Medicare Local: New Tender & Grant Opportunities

for the 1 July 2013-30 June 2014 period. The CCSS Program works to improve health outcomes for eligible Aboriginal and Torres Strait Islander peoples, who have one of five priority chronic diseases, through better access to coordinated, multidisciplinary care. Services delivered under the program are identified as necessary to achieving this aim by the GP in the Patient Care Plan and referred by one of the CCSS Care Coordinators based throughout the region.
Source: blogspot.com

Pharmacist Jobs in Montana: Various Positions position at New West Medicare in Helena

More details about this position opportunity please read the description below. Looking for Energetic Individuals to join our Medicare Excellence Team! New West Health Services, a community based not-for-profit health insurance company focused on Medicare excellence is looking for self motivated energ! etic members to join our Medicare Team in Helena, MT. Part D Clinician/Pharmacist This pharmacist serves as the leader in operating managed Medicare Advantage Part D clinical programs, contributes to product development, manages all aspects of PBM relationship, provides formulary oversight, and ensures regulatory compliance with CMS. The position requires a Bachelor’s degree in Pharmacy, or a Doctor of Pharmacy (PharmD) degree from an accredited college of pharmacy, and licensure as a pharmacist in the State of Montana. Minimum of five years pharmacy experience required, preferably in either Retail or Managed Care environment. Certification in geriatric pharmacy required, though candidate may work towards such certification in a defined timeframe. Knowledge of Medicare Advantage plan preventive benefits and CMS regulations required. Nurse Case Manager – responsibilities include: “Utilization Management and Case Management “Claims review that may require clinical de! terminations “Researching data, documenting decisions and comm! unicating with providers and members. The successful candidate must have a current Montana RN license plus 5 years nursing experience; a working knowledge of Medicare regulations preferred; efficient Microsoft application ability and excellent communication skills are essential. Fraud Waste and Abuse/Medicare Compliance Specialist The Fraud Waste and Abuse Compliance Specialist is responsible for the day-to-day management of the organization’s Fraud Waste and Abuse program and offers support to the Compliance Officer in the administration of the organizational Compliance Program. The position requires a minimum of 5 years experience in the health insurance industry, 2 years experience with Fraud Waste and Abuse programs, 1 year of health care coding and billing experience or an equivalent combination of education and experience. An associate degree in a health related field, business, paralegal, nursing, or other related field is preferred. Familiarity wit! h Centers for Medicare and Medicaid Services rules and regulations regarding Fraud Waste and Abuse is strongly desired. National certification in Fraud Waste and Abuse (FWA) is required at the time of application. EXCELLENT BENEFITS, HOURS & WORKING ENVIRONMENT For detailed position description information or to obtain an application, please visit: www.newwesthealth.com Send your completed application, resume and cover letter to Human Resources at: hrdept@nwhp.com , or fax to: (406) 457-2255; or mail to: New West Health Services, Human Resources 130 Neill Avenue, Helena, MT 59601 – . If you were eligible to this position, please deliver us your resume, with salary requirements and a resume to New West Medicare.
Source: blogspot.com

New Report Shows Medicare Advantage Delivers High Quality Care for Seniors

3rd Party Studies ACOs Admin Costs affordability Age Rating Cadillac Tax Delivery System Reform Employers Essential Benefits Exchanges GRP Health Insurance Tax Health Plan Innovations Health Plan Satisfaction House hearings House legislation KI MA Medical Prices Medical Tests medicare medigap MLR Morning Headlines Patient Safety premiums Profits Provider Consolidation Quality Rate Review Reform RZ Senate hearings Senate legislation Small Business The Link Vilification Waste Fraud and Abuse
Source: ahipcoverage.com

MATR News: Montana Career Opportunities

New West Health Services https://www.newwestmedicare.com/ , dba New West Medicare, is Montana’s not-for-profit, provider sponsored health plan offering Medicare Advantage and Medicare Supplement plans. New West has been in operation since 1998 and is a licensed health services corporation, holding a Centers for Medicare and Medicaid (CMS) contract since 2005. Our Medicare Advantage plans are offered in 28 Montana counties with future plans to expand into more counties in 2014.
Source: matr.net

Three solar firms file for bankruptcy in a week

A Daily Caller News Foundation investigation revealed that Abound solar was selling faulty solar panels that routinely underperformed and even caught on fire. The company reportedly knew its panels were faulty prior to receiving taxpayer dollars and may have misled investors in order to keep the company afloat until federal aid came in.
Source: dailycaller.com

GWAHS Libraries Blog: New website for Medicare Locals

Health Minister Tanya Plibersek has launched a new government website which gives Australians information about important health services being provided by Medicare Locals in their local communities. Ms Plibersek said the website (www.medicarelocals.gov.au) shows a map of Australia split up in to the 61 Medicare Local regions. By clicking on a region, patients are taken to a page which displays health services provided by the Medicare Local and a list of frontline health workers employed by the service, including total staffing numbers. Links are also provided to the individual websites of Medicare Locals. Press Release Western NSW Medicare Local website Far West NSW Medicare Local website
Source: blogspot.com

Town Hall Forum: Social Security/Medicare

Social Security and Medicare are essential programs, and there are changes being discussed in Washington that would affect you and your family today and in the future. Current proposals to cut Social Security benefits as part of a budget deal will be highlighted.
Source: aarp.org

More Time to Enroll in Medicare If You Live in Storm Areas

Thanks to the marvels of medical science, our parents are living longer than ever before. Adults over age 80 are the fastest growing segment of the population; most will spend years dependent on others for the most basic needs. That burden falls to their baby boomer children. In The New Old Age, Paula Span and other contributors explore this unprecedented intergenerational challenge. You can reach the editors at newoldage@nytimes.com.
Source: nytimes.com

Ryan Takes to Pennsylvania to Push Medicare Message

Mr. Ryan was extrapolating from a 2010 report from Medicare’s Office of the Actuary. It analyzed the potential impact of lower premium supports paid to private companies that issue Medicare Advantage plans, popular alternatives to traditional Medicare with extra benefits such as gym memberships. To slow the growth of Medicare spending, the Affordable Care Act reduces support for the private plans, which Democrats consider inefficient. Beneficiaries would still be covered under traditional Medicare.
Source: nytimes.com

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July 10, 2013

Horizon Medicare Advantage Blue Value with Rx

Posted by:  :  Category: Medicare

Please read through the full Horizon Medicare Blue Value with Rx HMO Summary of Benefits attached here for a more thorough review of the plan. I am also available to review this plan with you in a meeting if you wish. Due to marketing regulations, I have decided to list just the basics of the plan and but welcome appointments to discuss your full needs. Contact Mike at NewJerseyInsurancePlans
Source: newjerseyinsuranceplans.com

Video: United Healthcare Secure Horizons & Oxford – Medicare Advantage Denies Coverage

Secure Horizons Medicare Advantage Plans

These plans offer a low or zero monthly plan premium, and many of them include drug coverage!  This means that you can have Part D coverage through the plan and pay next to nothing for having the coverage.  The co-pays for doctors visits are also typically lower than the competition.  The plans focus on providing value for the items that most beneficiaries use on a regular basis.  In addition they offer preventative dental and vision care across their markets which most seniors like as well as SilverSneakers!  Silver Sneakers is a national program that gives seniors access to over 10,000 fitness centers across the U.S.  This membership is included at no additional cost.
Source: medicare-plans.net

Secure Horizons Not Renewing Some Medicare Advantage in Alabama

It happens every year. Insurance companies that offer Medicare Advantage plans either renew their plan offerings or they choose to discontinue some or all of their Medicare Advantage plans. Secure Horizons has chosen to leave the private fee-for-service market in Alabama. Plan members may be able to enroll in another Secure Horizons Advantage plan for 2011 if one is available.  But for some members in more rural Counties where PFFS plans were the only choice, enrolling in a plan from another company may be the only option.
Source: alabamamedicareadvantage.com

Secure Horizons Medicare Advantage

arabian ranches Best Growth Stock business Business News credit credit card credit cards Credit Score dubai marina Dubai Property Dubai real estate dubai rent finance Finance News Finance Today Financial Market Today Financial Report forex forex trading for rent dubai home Home Improvement insurance company insurance policy investing Investment loans money Payday Loans personal finance real estate rent dubai rent dubai property rent in dubai save money stock exchange Stock Market Stock Market Analysis Stock Market News Stock Market Report Stock Market Research stock market today stock market trading stocks Stock Trading
Source: beststockmarketinvestment.com

Safe Horizons Medicare Advantage

Best Growth Best Growth Stock Best Growth Stock Today business Business News Business Today commercial real estate credit credit card credit cards credit score dubai apartment dubai apartments dubai villas education Family finance Finance News Finance Today Financial Market Today Financial Report forex trading Growth Stock Report home Home Improvement insurance companies insurance company insurance policy interest rates investing investment Investment Today loans money personal finance real estate save money stock exchange stock market Stock Market Analysis Stock Market News Stock Market Report Stock Market Research stock market today Stock Market Trading
Source: thenasdaqstockexchange.com

Horizon adds exercise program for its Medicare Advantage members

“The Silver&Fit exercise and healthy aging program encourages our members to live an active, healthy lifestyle,” said John Selby, director of sales and marketing for Horizon BCBSNJ’s consumer and senior markets, in a statement. “Our members who directly participate in the program will experience better health, which will contribute to lower health care costs that will benefit all our members.”
Source: ifawebnews.com

Secure Horizons Medicare Benefit

bad credit Best Growth Stock Best Growth Stock Today business Business News Business Today credit card credit cards credit score dubai marina Dubai Property Dubai real estate Family finance Finance News Finance Today Financial Market Today Financial Report forex forex trading home Home Improvement insurance companies insurance company insurance policy investing Investment Investment Today loans money Payday Loans personal finance ppi claims real estate rent dubai rent dubai property save money Stock Market Stock Market Analysis Stock Market News Stock Market Report Stock Market Research stock market today stock market trading stock trading
Source: stockfinancenews.com

Secure Horizons Medicare Advantage

arabian ranches bad credit Best Growth Stock business Business News car insurance credit Credit Card Credit Cards Credit Score dubai marina Dubai properties Dubai Property Dubai real estate finance Finance News Finance Today Financial Market Today Financial Report foreign exchange trading Forex forex trading insurance insurance companies insurance company insurance policy investing investment Loans money payday loans personal finance ppi claims property Dubai real estate rent dubai rent dubai property save money stock market Stock Market News Stock Market Report Stock Market Research stock market today stock market trading stock trading
Source: investmentfinancialadvice.com

Safe Horizons Medicare Advantage

Bad Credit Best Growth Stock Best Growth Stock Today business Business News Business Today commercial real estate Credit credit card credit cards credit score Dubai Property education family finance Finance News Finance Today Financial Market Today Financial Report forex forex trading Growth Stock Report home Home Improvement insurance companies insurance company insurance policy interest rates investing investment Investment Today Loans Money payday loans personal finance real estate save money stock market Stock Market Analysis Stock Market News Stock Market Report Stock Market Research Stock Market Today stock market trading stock trading
Source: themoneyfinances.com

Secure Horizons Medicare Advantage

arabian ranches bad credit Best Growth Stock business Business News commercial real estate credit Credit card Credit Cards credit score debt dubai marina Dubai properties Dubai Property Dubai real estate dubai rent finance Finance News Finance Today Financial Market Today Financial Report Forex forex trading home insurance insurance policy investing investment loans money mortgage payday loans personal finance property Dubai real estate rent dubai rent dubai property stock market Stock Market News Stock Market Report Stock Market Research stock market today stock market trading stocks stock trading
Source: stocktradingfinancial.com

Secure Horizons Medicare Advantage

Best Growth Stock Best Growth Stock Today business business news Business Today credit credit card Credit Cards credit score dubai marina Dubai Property Dubai real estate education family Finance Finance News Finance Today Financial Market Today financial report forex forex trading home Home Improvement insurance companies insurance company insurance policy investing investment Investment Today loans money Payday Loans personal finance real estate rent dubai rent dubai property save money stock market Stock Market Analysis Stock Market News Stock Market Report Stock Market Research stock market today Stock Market Trading stock trading
Source: thebestforexinvestment.com

Secure Horizons Medicare Advantage

Best Growth Best Growth Stock Best Growth Stock Today business Business News Business Today Commercial Property commercial real estate credit credit card Credit Cards credit score dubai apartment dubai apartments dubai villas family finance Finance News Finance Today Financial Market Today Financial Report forex trading Growth Stock Report home insurance companies insurance company insurance policy interest rates Investing investment Investment Today loans money personal bankruptcy personal finance real estate save money stock exchange Stock Market Stock Market Analysis stock market news Stock Market Report Stock Market Research stock market today Stock market trading
Source: financeinvestingmarket.com

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July 10, 2013

Libertyville Tax Expert Guides You Through The New World of Medicare Decisions

Posted by:  :  Category: Medicare

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Medicare Ratings System To assist consumers, Medicare now rates Medicare Advantage programs using a star system. Using member satisfaction surveys and plan evaluations, plans are rated between one and five stars. In fact, at any time, you can switch into a five-star Medicare Advantage plan, but only if one is available in your region (only a few states have a five-star plan). Even if your area does not offer a top-rated plan, every state offers at least a four-star plan.
Source: accountantlibertyville.com

Video: Rep. Peter Roskam (R-IL): Save Medicare Part D

Duckworth, Seniors & Vendors Discuss Ways To Preserve Medicare & Social Security

Senior citizens, service providers and others at the discussion specifically said they’d like to see problem companies, such as those being raided by the FBI or being sued for how they conduct business, banned from placing competitive bids with the Centers for Medicare & Medicaid Services for certain durable medical equipment, prosthetics, orthotics and supplies.
Source: progressillinois.com

GaRRS IL Update April 2013

disABILITY LINK is a grassroots organization with goals, decisions and control of services led by people with disabilities. It is designed to increase independence, access and equal rights for everyone through the empowerment of people with disabilities. disABILITY LINK is committed to promoting the rights of all people with disabilities. As a Center for Independent Living (CIL) disABILITY LINK offers four core services: information and referrals, Independent Living skills training, advocacy on a systems and individual level and peer support. We also offer employment services, Independent Care Waiver Program service coordination, nursing home transition and travel training.
Source: disabilitylink.org

BlueCross BlueShield of IL Changing Medicare Supplement Rates

BlueCross BlueShield of IL announced a rate increase for most Medicare Supplement/Medigap customers effective March 1, 2013. In addition to the rate increase, changes have been made to the way BlueCross BlueShield of IL sets attained-age premiums. BCBSIL has switched from age bands to different rates for each age. In the past, BCBSIL had the same rate for the same Medigap plan for age groups, like 65-67; now, each age has its own premium rate. The change from age bands to single age rates will cause a few premiums to actually be lower after March 1, 2013 than they are now. For most people though, premiums are increasing.
Source: bcmil.com

Shocking Medicare and Medicaid fraud exposed at Illinois’ Sacred Heart Hospital

“Between January 2010 and February 2013, May allegedly received $74,000 in the form of 37 checks, for $2,000 each, disguised as ‘rental payments'; Moshiri, a podiatrist, allegedly received $86,000 in 38 checks pursuant to a purported contract to teach podiatry students; and Maitra allegedly received $68,000 in 34 checks pursuant to a purported teaching contract – and the $228,000 total in alleged kickbacks were all in exchange for their referral of patients to Sacred Heart, the charges allege.   “In a recorded conversation last month, Maitra allegedly explained to Administrator A that he used to make Novak ‘so much money’ performing almost daily penile implant procedures on patients, but that he no longer performed as many of those procedures because Medicare had decreased its rates of reimbursement for the procedure. Maitra did not comment on whether the patient need for the procedure had somehow changed, according to the affidavit.”   “On March 1, 2013, Administrator A recorded Novak stating that tracheotomies are Sacred Heart’s ‘biggest money maker’ and the hospital can make $160,000 for a tracheotomy if the patient stays 27 days. On March 7, 2013, the Intensive Care Unit case manager told Administrator A that she must often ‘stretch’ a tracheotomy patient’s stay to 28 days to maximize Medicare reimbursements ‘to make Novak happy.’”
Source: wordpress.com

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July 10, 2013

Medicare imposes marketing and enrollment suspensions on HealthNet, Arcadian and Universal American (Today’s Options).

Posted by:  :  Category: Medicare

Arcadian had their webinar today as well. On the call the moderator did not and would not discuss the other companies. It was very refreshing for me to see that respect for the competitors. One of the things we did discuss was the sanctions, while marketing practices were a component, a large part of the sanctions revolved around Rx administration. The Rx vendor is not specifically mentioned nor will I name them. I am however disappointed that no specific action is to be taken when this vendor is responsible for issues with ALL the companies receiving sanctions. All of the companies/MAPD Plans are working hard with the CMS to correct the issues and will be back to marketing in 4 to 6 months. My feelings go out to all of the beneficiaries that will miss out on these plans. In some markets, the sanctioned plans are the most intelligent option.
Source: wordpress.com

Video: Health Net Medicare Advantage – Compare to over 180 Compani

Arizona Health Net Medicare HMO Customers Fraudulently Transferred to United Health’s AARP Medicare HMO as of 12.07.2011

I was told by another person from Health Net that this appears to have been the work of one sales person. I said I wanted the person’s name and other information because I plan on suing them. He said that he would give me that information after the investigation was over. I’m not going to hold my breath. In reality I doubt they can point to one person as the supervisor I last talked with told me the applications were filed online. A sales person would only be responsible if they’d personally signed people up for AARP. Did one salesperson submit hundreds (or more) fraudulent applications online? Did one salesperson process all of the fraudulent online applications? Neither scenario seems likely. Or were they submitted by phone or mail as others first told me?
Source: wordpress.com

Health Net sanction means one less low

The agency said it took action because Health Net has “continually subjected its enrollees to impermissible hurdles in their attempts to obtain needed, and in some cases, life sustaining, prescription medications.”
Source: oregonlive.com

Sequestration Cuts Extend Beyond Medicare Fee

By now, most physicians are likely aware of the 2 percent across-the-board reduction in Medicare physician reimbursement for all claims with dates of service on or after April 1. These cuts are the result of the Sequestration Transparency Act of 2012, which was part of a deal worked out between President Obama and Congress to address the debt ceiling crisis. The California Medical Association (CMA) has recently learned that the cuts are also being applied to Medicare electronic health record (EHR) incentive payments and many Medicare Advantage plans are passing on the 2 percent cuts as well.
Source: medbill.net

HIPAA Warning: Do Not Attempt to Hide A Data Security Breach as Health Net Did

When a portable disk drive went missing from a Connecticut office of insurance company and Medicare Advantage contractor Health Net last May, the law required them to notify authorities and affected customers immediately. Instead they kept it under wraps until November. According to an independent security company report, they also lied about it being a theft, neglected to mention two laptop PCs were also stolen, and falsely reported the data was unreadable without special software. Some officers may be exchanging pin stripes for striped suits. Even if they do not, the story is an excellent case study in how not to handle a data breach involving patient information.
Source: homehealthnews.org

CMS Lifts Sanctions Against Health Net Medicare Plans

Dow Jones Newswire (8/3, Subscription Publication) reports that Health Net Inc. will immediately return to marketing its Medicare Advantage and prescription-drug plan products after the Centers for Medicare & Medicaid Services lifted its sanctions against them. The sanctions were imposed last November, when CMS alleged that the company had failed to provide enrollees with prescription drug benefits in accordance with guidelines and contract terms. Wells Fargo analyst Peter Costa issued a note saying that the move may not have much impact on 2011 revenue for the company, but was a crucial step towards regaining its growth in Medicare Advantage.
Source: barricksinsurance.com

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July 10, 2013

For Example: Medicare Doesn’t Cover Dental Care

Posted by:  :  Category: Medicare

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What is ironical is that yesterday while I was on hold on the telephone waiting to talk to a Medicare representative, I was informed by a recording that I am currently eligible for coverage under Medicare for cardiac screening, colon-and-rectal cancer screening, prostate cancer screening, diabetes screening, osteoporosis screening, a flu shot, and an annual examination by my primary care doctor.
Source: blogspot.com

Video: Medicare Dental Plans | Medicare supplemental Plans dental plans

Does Medicare Pay For Dentists

Medicare does cover any dental care needed in order to protect a patient’s overall health, according to Medicare Interactive. Medicare’s official website reports it will also pay for the removal of any teeth as needed in order to complete other medically necessary procedures. For example, if a patient requires jaw surgery and the doctor must remove teeth, this is Medicare-covered.
Source: blogspot.com

Welcome to Seymour Dental

The practice tries to let people know an estimate of the cost of treatment. It sometimes is difficult to give an exact figure as treatment may need to be varied. Decay in a tooth may be deeper than anticipated and the nerve is exposed. A tooth being removed may be more difficult than it appears on the xray. the filling is in a difficult area. A crack is found in the after removing the decay and then requires more protection such as a crown.
Source: com.au

Benefits Of Medicare Dental Plans ~ Article Zone

Biggest advantage that these dental plans have brought are that these plans are gone beyond teeth protection. If you will hire dental services, it can cost you as high as you might be not able to afford but if you will choose any dental plan, it will lessen the cost. Another advantage for which dental plans are at great demand, that there will be a regular visit to your doctor in case of following a dental plan. More regularly you will visit your dentist there will be less chances of facing any tooth problem as you will have all protective measures on hands. One more advantage that you might be neglecting is that in case of immediate help or emergency if you will require, you will be able to consult with your doctor at right time. You will not require wasting your time for thinking for high fees for dealing with emergency condition as your dentist whose plan you are following will be responsible for giving you quick treatment.
Source: infoarticlezone.com

Dental insurance and Medicare – the Medicare Dental & Vision Benefits

Medicare is health insurance plan in US for the seniors as well as disabled people. It gives the basic medical policy, and really helps the seniors & disabled pay for the health care. However, original Medicare doesn’t pay out for everything, as well as dental and vision benefits are limited. The routine care, such as checkups, fillings or glasses, aren’t generally covered in dental insurance and Medicare. The services are covered in case, they are linked with the medical issue such as illness and injury. For instance, dental insurance and Medicare might pay for the hospital stay in case of the complicated dental method. However, it might not at all cover actual dental work. For other example, the Medicare doesn’t generally cover the eyeglasses and contacts. But, it can pay after cataract surgery.
Source: cryonicssocietyofcanada.org

Dental and Vision Coverage for Medicare Recipients

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Source: insurance-forums.net

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July 10, 2013

CONNECTICUT STATE COURT FINDS MSA NOT NECESSARY WHERE BENEFICIARY WOULD INCUR FUTURE MEDICAL BILLS

Posted by:  :  Category: Medicare

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The court concluded that the settlement agreement did not reflect compensation for future medical costs that might be covered by Medicare.  Rather, the settlement amount represented payments for noneconomic damages, with a small portion to be used for non-Medicare economic damages. While there were conditional Medicare payments made to the plaintiff, the court held that the sum would be reimbursed to Medicare after the settlement amount was conveyed to plaintiff’s counsel. As such, the court found that the defendants in the underlying personal injury suit, along with their carriers, lacked liability for the payment of plaintiff’s future medical expenses. Typically, courts will only determine whether a settlement requires an Medicare Set Aside (“MSA”) in the following two situations: (1) where the parties agree that an MSA is required, but cannot obtain the approval of CMS for the MSA arrangement; and (2)  where the parties have a settlement agreement but disagree as to whether the settlement agreement’s terms included the creation of an MSA.  The decision in Sterret is unique in that the court appears to provide an advisory opinion with respect to whether a MSA was required as part of the settlement in a personal injury case.  Click here for a discussion of Early v. Carnival Corp., No. 12-20478, 2013 U.S. Dist. LEXIS 16711 (S.D. Fla. Feb. 7, 2013).
Source: themedicarespa.com

Video: Connecticut Medicaid Title XIX nightmare and lawsuit.

Medicare Supplement Rates Connecticut 2013

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 Crowe and associates 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 b Medicare Complete Medicare Complete connecticut Medicare Connecticut Medicare part B Medicare part B cost Medicare part D Medicare plan Medicare Supplement Medicare Supplement Connecticut Medigap Medigap rates 2013 Medigap rates NY 2013 Original Medicare united healthcare United Healthcare AARP United medicare complete United Medicare complete 2013
Source: croweandassociates.com

Federal authorities target Medicare fraud

Earlier this month, the U.S. Centers for Medicare & Medicaid Services unveiled a plan to provide recipients with a new, easier to understand statement for claims and services. The new statements, which will be provided each quarter, should make it easier for people to understand exactly what their providers are billing. The redesigned statements, which are part of improvements made possible by the Affordable Care Act, should allow recipients to take a more active role in alerting authorities to possible instances of health care fraud – particularly when a provider bills for a service a patient did not receive.
Source: connecticutcriminaldefenseattorneyblog.com

Medicare Advantage Plans Connecticut « Insurance News from Crowe & Associates

Aetna- Currently offer plans in Fairfield, Hartford, Litchfield and New Haven county. They have a $0 premium plan HMO, $94.00 HMO and a $90 PPO plan. The $0 premium plan has benefits second only to Wellcare when compared to the other $0 premium plans in the state. They also have a substantial network to go with the plan and allow for access to any Aetna Medicare HMO provider nation wide. The Aetna PPO is not competitive at this point due to a $1,000 out of network deductible.
Source: croweandassociates.com

Man who owned Trumbull dental practice pleads guilty in Medicaid fraud scheme

“This defendant’s illegal operation of three Connecticut dental clinics, and his failure to pay income on the substantial amount of money he received from his involvement in this scheme, has siphoned millions of dollars from the Medicaid program and the U.S. Treasury,” said Acting U.S. Attorney Deirdre M. Daly. “Health care fraud increases costs and threatens the integrity of our health care system, and we are committed to protecting American taxpayers by prosecuting these crimes. I want to thank HHS-OIG, IRS-Criminal Investigation and the FBI for their investigative efforts, and thank the Connecticut Attorney General’s Office, which has provided important assistance during the course of this investigation.”
Source: trumbulltimes.com

You’ve Earned a Say Connecticut Update: AARP Calling for Responsible Solutions, Not Harmful Cuts

In 2012, AARP launched a major national initiative called You’ve Earned a Say – to give our members and all Americans a voice in the continuing debate over the future of Medicare and Social Security.  In Connecticut, we hosted listening sessions and voter forums in local communities, and engaged thousands of residents through surveys and questionnaires.  Nationally, AARP engaged over 6.5 million people in the conversation.  We listened to your feedback and now we are taking the next step.  AARP is calling for responsible solutions that keep the promises our nation has made to seniors and their children and grandchildren, not harmful cuts.
Source: aarp.org

HealthSpring, Cigna Use Both Names To Market Medicare Plans

The television campaign is within the company’s existing marketing budget, said HealthSpring spokeswoman Graham Harrison. Cigna and HealthSpring researched each company’s brand to determine how to best market Medicare products in the future. The campaign is meant to build on Cigna’s strength as a known health service company and HealthSpring’s expertise in Medicare.
Source: courantblogs.com

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