North Carolina Health News

Posted by:  :  Category: Medicare

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

Video: North Carolina Medicare Enrollment.wmv

N.C.’s nascent Medicaid reform

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

MedicareBob’s Blog: Mecklenburg County North Carolina Medicare Supplement Quotes

The three most comprehensive Medicare Supplement Plans are: Medicare Supplement Plan F: Full Coverage Medicare Supplement Plan G: Small Deductible ($147.00) Medicare Supplement N: Small Deductible & Copays (Part B Excess
Source: blogspot.com

Survey: Physicians Mixed on Medicare Payment Data Transparency

The survey was spurred by the recent movements in healthcare data transparency along with an overturned ruling that prevented the Centers for Medicare and Medicaid Services (CMS) from releasing information about payments to individual physicians, ACPE says. In May and June, the CMS released data on hospital outpatient charges for hospitals nationwide. Local governments, like in North Carolina, have gotten in on the act, requiring hospitals to provide public pricing information on medical procedures and services.
Source: healthcare-informatics.com

Medicare Blue Button Makes Health Records Accessible

But the body of information doesn’t end there. With the advent of Medicare Blue Button—a program that lets people download personal health records to a file—patients can also come to appointments with their medical history in tow. Until recently, retrieving medical records was the duty of a physician’s administrators or a third-party record retrieval firm, but now Medicare patients can use Blue Button to avoid waiting for their information to arrive at the doctor’s office.
Source: altmannporter.com

MGMA Analysis of 2014 Proposed Medicare Physician Fee Schedule

Diamond Level Platinum Level Gold Level Biz Technology Solutions, Inc. First Citizens Bank rmsource, Inc. Wells Fargo Insurance Services Silver Level Ball Dermpath McGladrey Medical Protective SunTrust Bank United HealthCare Group Bronze Level Allegacy Business Solutions – JBA Benefits & Cooperative Payroll Allscripts Apex Technology Assured Waste Solutions, LLC Bactes Imaging Solution Bernard Robinson & Company, LLP Call-A-Nurse Capario ChoiceHealth, Inc. Coverys, Inc. DataMax Corp / Interstate Credit Collections The Doctors Company Eastman Kodak Company Fifth Third Bank Ford & Harrison GMK Associates, Inc. Gordon Asset Management, LLC Greenway Medical Henry Schein Medical Humana Konica Minolta LabCorp Marketing Works McNeary, Inc. Medicus Insurance Company Medstaff National Medical Staffing mindShift Technologies, Inc. MSOC Health NCHA Strategic Partners NextGen Healthcare ONLINE Information Services Physician Discoveries Physicians’ Alliance of America Prince Parker & Associates Professional Recovery Consultants SCA Collections, Inc. Solstas Lab Partners SouthData Stanley Benefits Stern & Associates, P.A. Attorney at Law Total Merchant Services Transworld Systems, Inc. TriMed Technologies Corp TriZetto Provider Solution – Gateway EDI
Source: wordpress.com

Doc leaders split over public Medicare payment data

Brian Harte, M.D., is president of South Pointe Hospital, a 173-bed acute care, community teaching hospital in Warrensville Heights, Ohio, and part of the Cleveland Clinic Health System. He is also the medical director of the medical operations department of business intelligence and former chairman of the department of hospital medicine. He specializes in perioperative care and hospital-based medical illnesses. He is a senior fellow of hospital medicine with the Society of Hospital Medicine.
Source: fiercehealthcare.com

Coming to NC for 2014: NEW Medicare Advantage Plan

About GarityAdvantage Agencies We are specialists in the Senior Market with over 75 years combined experience helping independent brokers grow their business and client base. As a national field marketing organization (FMO) specializing in the Medicare/Senior Market, we offer independant insurance agents outstanding service, competitive products and top commissions across a wide range of senior products including Medicare Advantage, Medicare Supplement, Final Expense, Funeral Trust, Hospital Indemnity and more.
Source: wordpress.com

Forsyth County North Carolina Medicare Supplement Quotes

Tagged With: AARP Supplement, Aetna Supplement, Aflac Supplement, Best Supplement, Cheapest Premium, Cigna Supplement, Forsyth County North Carolina, Forsyth County North Carolina Cheapest Medicare supplement rates, Forsyth County North Carolina cost effective Medicare supplement rates, Forsyth County North Carolina Medicare, Forsyth County North Carolina Medicare Supplement Quotes, Forsyth County North Carolina Medicare Supplements, Forsyth Medicare Agent, Forsyth Medicare Supplement Quotes, Forsyth North Carolina supplement quotes, Lowest premium, Medicare, Medicare Health Insurance, Medicare Supplements Plans, MedicareBob, Medigap, Mutual of Omaha Supplement, North Carolina Medicare, Plan F, Plan G, Plan N, Related:srhealthcaredirect.com, Robert Bache, United Healthcare Supplement, “Medicare *Supplement* Savings”
Source: srhealthcaredirect.com

Hospitals: Block of Medicaid expansion jeopardizes care in NC

About 72 percent of Mission’s patients are covered by Medicare or Medicaid or have no insurance at all. In 2012, Mission Health provided more than $37 million in unreimbursed costs for the treatment of Medicare and Medicaid patients and provided almost $76 million to treat charity-care patients and cover unreimbursed medical costs and other community-benefit investments. Last year, Mission Health also provided almost $32 million in free care for uncollectible accounts.
Source: carolinapublicpress.org

Side Effects: Massachusetts Seniors Will Lose Medicare Advantage Plans in 2011

Posted by:  :  Category: Medicare

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It shouldn’t come as a surprise that Medicare Advantage plans are beginning to drop like flies. In April, CMS Chief Actuary Richard Foster wrote: “We estimate that in 2017, when the MA provisions will be fully phased in, enrollment in MA plans will be lower by about 50 percent.” Furthermore, in recent Heritage research, Robert Book, Ph.D., and James Capretta noted “the MA cuts will substantially restrict the ability of Medicare beneficiaries to choose the health plans that best meet their needs and will result in substantial reductions in coverage for many millions of seniors.”
Source: fixhealthcarepolicy.com

Video: Medicare Advantage Plans 2011

Projecting Medicare Advantage Enrollment: Expect the Unexpected?

It is not entirely clear why enrollment has continued to climb since 2010, or if the trend will continue at the current clip. Analysts believe that the bonus payments have certainly helped to mitigate the effects of payment reductions, and that plans appear to be doing more to reduce their costs. Some speculate that Medicare Advantage plans are benefitting from the slowdown in medical spending, enabling them to keep premiums low. Others ascribe the growth in enrollment to the influx of baby boomers who may have greater comfort with managed care plans than previous generations. As additional payment reductions are phased in over the next few years, the growth in enrollment could stall or even reverse, if plans pull out of the market because they feel they cannot operate profitably. Even if enrollment continues to increase, there is some speculation that plans may scale back benefits and/or increase cost-sharing in response to reductions in Medicare payments and the soon-to-be implemented annual fee on health insurance that was enacted in the ACA, which also applies to Medicare Advantage.
Source: kff.org

Firm Perspectives on the Medicare Advantage Market

Based on interviews with senior executives at 14 large firms, the issue brief finds that insurers anticipate continuing to offer Medicare Advantage plans in 2012, in part because of a Medicare demonstration project that will award bonus payments to plans based on their quality standards.
Source: kff.org

MedicareIsSimple: Medicare Advantage and Prescription Drug Plan Fact Sheet

As of May 2013, there were 14,691,443 enrollees in Medicare Advantage related programs, including 86.4% in Local HMOs and Local PPOs; 2.6% in PFFS plans; 7.4% in Regional PPOs and 3.6% in Other Programs including Cost, PACE, MSAs, and pilots. 87.7% of these MA beneficiaries had a MA prescription drug plan; 11.6% were Special Needs Plans enrollees; and 18.2% were Employer Plan enrollees. 1 The top five states for Medicare Advantage enrollment as of May 2013, which account for 42% of total MA enrollment, are as follows: California – 1,964,365; Florida – 1,333,278; New York – 1,080,942; Pennsylvania – 954,089; and Texas – 909,142. There are fourteen states and territories with over a one-third penetration rate (compared to the national overall rate of 28.6%): Puerto Rico – 72.1%, Minnesota – 49.9%, Hawaii – 46.2%, Oregon – 42.5%, Pennsylvania – 39.5%, Arizona – 37.8%, California – 37.6%, Ohio – 37.6%, Florida – 36.2%, Colorado – 35.4%, Rhode Island – 35.4%, New York – 33.9%, Wisconsin – 33.7% and Utah – 33.4%. 2 As of May 2013, there were 22,564,532 enrollees in Medicare Prescription Drug Plan enrollees, including 19.8% that are Employer Plan enrollees. 1   The top five states for PDP enrollment, which account for 31.9% of total PDP enrollment, are as follows: California – 1,989,753, Texas – 1,516,077, Florida – 1,324,743, New York – 1,322,296 and Illinois – 1,051,467. There are eighteen states with over a 50% penetration rate (compared to the national overall rate of 43.9%): North Dakota – 65.3%, Delaware – 63.4%, Iowa – 61.5%, South Dakota – 58.9%, Mississippi – 57.7%, Michigan – 57.5%, Nebraska – 57.5%, Vermont – 56.9%, Kansas – 56.2%, Wyoming – 55.9%, New Jersey – 55.3%, Kentucky – 53.8%, Illinois – 53.4%, North Carolina – 52.2%, Indiana – 52.2%, Maine – 51.7%, New Hampshire – 51.0% and Oklahoma – 50.1%. 3 Previously, there were 6.9 million MA enrollees in 1999, 5.6 million in 2005 and 13.1 million in 2012, with overall penetration rates of 18% in 1999, 13% in 2005 and 27% in 2012. 4
Source: blogspot.com

Medicare Advantage: Facts, Fallacies, And The Future

In 1997, this program was absorbed into the Medicare+Choice program as a result of the Balance Budget Act of 1997 (BBA). Medicare+Choice expanded the type of private plans available to Medicare beneficiaries and also made a series of changes in payment. While the intent was to gradually reduce payment variation across counties, the main operational effect in most counties was to limit payment increases to 2 percent annually. The BBA also added “floor”, or minimum payment levels, in rural counties. (Two years later authority for a second, and higher, “urban floor” was added.). These changes broke the link between fee-for-service (FFS) and MA payment levels in counties, and initiated changes which led to some counties being paid substantially more than FFS. The BBA also authorized the phase-in of a strengthened program of risk adjustments in rate setting that better reflected differences in the health status of enrollees in the programs. These adjustments are important since research on Medicare HMOs showed Medicare overpaying private plans by failing to adequately adjust for the health status of patients enrolled in them.
Source: healthaffairs.org

GAO finds CMS negligent in risk adjustment for Medicare Advantage plans

Risk adjustment is important to ensure that payments to MA plans adequately account for differences in beneficiaries’ health status and to maintain plans’ financial incentive to enroll and care for beneficiaries regardless of their health status. Our work confirms that differences in diagnostic coding caused risk scores for MA beneficiaries to be higher than those for comparable beneficiaries in Medicare FFS in 2010, 2011, and 2012. CMS’s decision to use a 3.4 percent adjustment to risk scores for 2010 through 2012 instead of the higher adjustments called for by our analysis resulted in excess payments to MA plans. The existence of such excess payments indicates that CMS’s adjustment does not accurately account for differences in treatment and diagnostic coding between MA plans and Medicare FFS—the stated goal of the statute that required CMS to develop a diagnostic coding adjustment. In our January 2012 report, we recommended that CMS take steps to improve the accuracy of the adjustment to account for excess payments due to differences in diagnostic coding. We noted that CMS could, for example, account for additional beneficiary characteristics, include the most recent data available, identify and account for all the years of coding differences that could affect the payment year for which an adjustment is made, and incorporate the trend of the impact of coding differences on risk scores. CMS’s adjustment for 2013 is the same as it used in 2010, 2011, and 2012. However, given our finding that this adjustment was too low and resulted in estimated excess payments to MA plans of at least $3.2 billion, we continue to believe that it is important for CMS to implement our recommendation that it update its methodology to more accurately account for differences in diagnostic coding.
Source: pnhp.org

Medicare Advantage in PPACA: Undermining Seniors’ Coverage Options

Seniors Forced Back into Poorly Performing Traditional Medicare. Large reductions in MA will force a mass migration back into the traditional FFS program, which is the source of many problems observed in American health care. Medicare FFS provides strong incentives for fragmented care that is poorly coordinated across institutions and provider settings. The result is an emphasis on volume instead of quality care for patients. Moreover, downsizing the role of MA plans will make it more difficult to pursue the kinds of structural changes that are needed to ensure that Medicare can be financially sustained over the long term.
Source: heritage.org

Choosing Traditional Medicare vs. Medicare Advantage

If you need to add prescription drug coverage to traditional Medicare, you also will be faced with dozens of different plans. You can compare these in the same way you compare Medicare Advantage plans. If you don’t currently take any drugs, you may want to choose the plan with the lowest premium to get coverage at the least cost. Otherwise, it’s best to choose a plan according to the specific drugs you take, because plans charge widely varying copays even for the same drug. The plan finder on Medicare’s website automatically does the math to find your best deal. You can enroll through Medicare or directly with the plan.
Source: aarp.org

Enrollment Still Growing In Medicare Advantage Plans, GAO Says

While the health law’s changes had little impact on MA enrollment this year, more changes may be in store. The GAO report notes that the Congressional Budget Office has predicted that those $136 billion in cuts to MA plans would decrease enrollment by about 35 percent through 2019. The Office of the Actuary at the Centers for Medicare and Medicaid Services has found that the reduction in MA payments would eventually lead to those plans offering less-generous benefit packages.
Source: kaiserhealthnews.org

Medicare Physician Payments: Reforming the Sustainable Growth Rate

Posted by:  :  Category: Medicare

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The language in the House discussion draft—linking Medicare physician pay to compliance with government-established guidelines—accelerates a troubling trend reinforced by Obamacare itself. The national health care law, with 165 provisions affecting Medicare,[23] not only retains the SGR, but, like the SGR, it also imposes a hard cap on the growth of all Medicare spending. It creates an Independent Payment Advisory Board (IPAB), which will have the power to enforce the cap, and recommend even more Medicare reimbursement cuts for physicians and other medical professionals. It creates new institutions to change Medicare payment and delivery through administrative action, such as the Center for Medicare and Medicaid Innovation, with demonstration programs designed to end traditional fee-for-service (FFS) payments. Beyond these new institutions, the health law creates new Medicare “quality” programs and extends the Physician Quality Reporting Initiative (PQRI), which will enforce new bonus and penalty payments for physician compliance. As the Congressional Research Service (CRS) reported in its first evaluation of the statute, the new law “makes several changes to the Medicare program that have the potential to affect physicians and how they practice in ways both small and large, immediately and over time.”[24]
Source: heritage.org

Video: Ryan Medicare Reform Plan Suffers Blow

FAH Submits Letter to Ways & Means Chairman Camp Regarding Medicare Beneficiary Payment Reforms

Hospitals have withstood $95 billion in Medicare cuts in just the past three years alone.  Over the next ten years, hospitals are facing nearly a half trillion in cuts.  These cuts have already resulted in reduced services, reduced access to care, and thousands of job cuts across health care.  Hospitals have done their part and have implemented a number of reforms that contribute to the cost reduction and savings trends occurring now.  As policymakers look for further areas of reform, FAH believes that these cost-sharing proposals are an appropriate area for discussion and, ultimately, modernization.
Source: fahpolicy.org

Daily Kos: To attack Obamacare, Republicans forget the lessons of Bush’s Medicare reform

FDA approval Oral colchicine had been used for many years as an unapproved drug with no prescribing information, dosage recommendations, or drug interaction warnings approved by the U.S. Food and Drug Administration (FDA).[8] On July 30, 2009 the FDA approved colchicine as a monotherapy for the treatment of three different indications (familial Mediterranean fever, acute gout flares, and for the prophylaxis of gout flares[8]), and gave URL Pharma a three-year marketing exclusivity agreement[9] in exchange for URL Pharma doing 17 new studies and investing $100 million into the product, of which $45 million went to the FDA for the application fee. URL Pharma raised the price from $0.09 per tablet to $4.85, and the FDA removed the older unapproved colchicine from the market in October 2010 both in oral and IV form, but gave pharmacies the opportunity to buy up the older unapproved colchicine.[10] Colchicine in combination with probenecid has been FDA approved prior to 1982.[9] ~~~~ Marketing exclusivity in the United States As a drug predating the FDA, colchicine was sold in the United States for many years without having been reviewed by the FDA for safety and efficacy. In 2009, the FDA reviewed an NDA submitted by URL Pharma and approved colchicine for gout flares, awarding Colcrys a three-year term of market exclusivity, prohibiting generic sales, and increasing the price of the drug from $0.09 to $4.85 per tablet.[24][25][26]
Source: dailykos.com

WHAT THEY’RE SAYING: Support Building for Bipartisan Medicare Physician Payment Reform Effort

American Association of Nurse Anesthetists “As Certified Registered Nurse Anesthetists (CRNAs) providing 34 million anesthetics annually, our primary interest is in patient safety and access to cost-effective healthcare. We support the bill’s provisions replacing the damaging SGR formula with a positive 0.5 percent Part B update for each of the next five years as refinements to quality measurement incentive systems and alternative payment systems are developed through open and publicly accountable processes. These payment adjustments are particularly important since the 2013 budget sequestration has taken 2.0 percent from this year’s Part B payments and the SGR threatens additional 24 percent cuts beginning January 2014. We also thank the Committee for accepting our evidence-based recommendation that quality measures, quality reporting and incentive payment systems treat CRNAs the same as physicians when the same service is provided.”
Source: house.gov

Obamacare Reset: A Free Market Vision for Health Care Reform

Health care reform founded in the principles of individual freedom and personal responsibility will provide effective and viable remedies for unsustainable health care costs and for inadequate access for the poor and for those with pre-existing conditions. President Obama’s health care law puts our medical care into the hands of Washington bureaucrats. It’s funded by typical Washington accounting tricks and, ultimately, massive deficit entitlement spending.  Free market health care reform will lower health care costs for individuals, families, small and large businesses, and government at all levels. True reform will strengthen the economy, increase employment, lower our national debt and unfunded liabilities, and restore our children’s opportunity to live in freedom and prosperity.
Source: acton.org

NewAmerican: Sen. Rand Paul's Medicare Reform Bill: $1 Trillion in Savings in 10 Years

subscrib/i)) $(“body”).addClass(“anon”) else $(“body”).addClass(“auth”) if(roles.match(/premium/i)) $(“body”).addClass(“prem”) if(roles.match(/subscrib/i)) $(“body”).addClass(“sub”) if(roles.match(/admin/i)) $(“body”).addClass(“admin”) if(roles.match(/mod/i)) $(“body”).addClass(“mod”) if(userNum==15029
Source: dailypaul.com

Opinion: Boomers need immigration reform

In the low-achieving states where Latinos make up a high proportion of the foreign born population, Mexican foreign-born migrants are the majority of that population.  For instance, in California, where 25 percent of the population is foreign born, the plurality of these are from Mexico.  This is a similar dynamic in Illinois and Texas. We might assume, then, that this is a generational problem that will take care of itself, as the next generation is more likely to go to college.  Yes and no.  The most pressing issue for the Mexican population is social and economic integration of the undocumented. Without some formal integration process, such as the Dream Act or comprehensive immigration reform, Latinos in these low-achieving states will continue to be at a disadvantage.
Source: nbclatino.com

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

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

Immigration Reform And The Financial Health Of Medicare

Our study, published today as a Health Affairs Web First article, examines these variables as they relate to the Medicare program and finds evidence that contradicts the pervasive wisdom. We calculated the total dollars contributed to and received from the Medicare Hospital Insurance Trust Fund (“Trust Fund”), which pays primarily for inpatient care, for both immigrants and U.S. born citizens. We found that between 2002 and 2009, immigrants contributed $115.2 billion in excess of what they utilized. During this same time frame, US born persons withdrew $28.1 billion more than they contributed. Although we could not measure the contributions to the Supplementary Medical Insurance Trust Fund (which primarily pays for outpatient care), we examined average expenditures by immigrants and US-born persons to this fund and found that immigrants spent less than US born persons: $175 per year less on average.
Source: healthaffairs.org

Medicare reform: healthcare coalition pushes funding change

Of course, the issue in health is that few people are average. People are either sick or well, and those who are sick spend much more than average on healthcare and those who are well spend much less. From both an equity and efficiency perspective we need to ensure that resources are focussed on those with the greatest need. This group (or groups) can be difficult to identify as health care affordability can be as much to do with the type of illness and the timing of care needs as it is to do with overall income level. A healthy young person on a low income is probably much more able to meet her own healthcare costs than a family on a middle, or even high, income where one or more members have a chronic illness.
Source: com.au

House Committee Approves Medicare Physician Pay Reform Bill

The bill would get rid of the SGR as of next year, and physicians would receive a 0.5 percent increase in Medicare reimbursements every year until 2018, after which they would receive payments based on quality reporting and outcomes. Starting in 2019, physicians could gain or lose 1 percent of their Medicare payments, depending on their quality scores.
Source: beckershospitalreview.com

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September 04, 2013

Comparison of Medicare Supplements and Private Medical Insurance

Posted by:  :  Category: Medicare

These figures show that individuals with private medical insurance actually are paying more money in total premiums than what an individual with Medicare actually pays. So, an individual is going to pay more for private coverage than what they would with Medicare. This is something important to consider when it comes down to standard coverage. Of course, Medicare does not cover everything and does not provide the same in-depth coverage insurance companies. Essentially, Medicare covers inpatient hospital care, nursing facilities, hospice care and other general requirements (in addition to some medication, if the individual is enrolled in the Medicare D plan). However, there are other services Medicare does not cover that health insurance does. This includes
Source: mizozo.com

Video: Medicare Supplemental Insurance Comparison

Retiree with No Technology Background Launches Medicare Supplemental Insurance Comparison Site

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

Are You Looking For a Medicare Supplemental Comparison?

Having a Medicare supplement policy is so vital because with regular Medicare there are so many out of pocket expenses that just cannot be handled in any other way. You do not want to be in a situation where you have Medicare plans A and B but you are still paying thousands of dollars of expenses out of your own pocket. What would be the point in insurance then? Sure, it will pay for the first three nights in hospital but what if you need to stay for 7 or 8 nights? You will be paying for insurance your whole life but you will still have to pay $2000 or $3000 at the end of your hospital stay.
Source: seniorcorps.org

How To Compare The Different Medicare Supplement Plans

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

Health Care Proponents of America

Medicare supplement insurance is one of the only products that can actually deliver peace of mind to senior citizens worrying about their health care and the potential costs. Unlike any other health programs available to older individuals, Medicare supplement insurance is designed to pay most hospital and medical bills that original Medicare does not pay in full. In addition, all of the deductibles and usual 20% co-payments that most individuals must pay are covered by a Medicare insurance policy. Medicare insurance can be applied for by any individual that has both Medicare Part A and Part B, but the sooner the better. Individuals that apply for coverage through a Medicare insurance program as soon as they are eligible for Medicare will not have to pass any medical underwriting requirements and receive the best rates possible. While most health insurance programs require that an individual only uses the services of certain doctors and providers, a supplement insurance policy will allow an enrollee to go absolutely anywhere that Medicare is accepted. For individuals that do not want to spend their golden years worry about health care costs and medical bills, selecting Medicare supplement insurance is certainly the way to go. Additional discounts may be given to people that also have their insurance with the same insurance company. Of all the methods to save, the most effective is looking around and comparing numerous quotations online. At an insurance comparison website you can compare multiple quotes from the Nations Leading providers and save hundreds of dollars on all types of insurance. The protection is utterly essential, but there is no harm in getting the lowest price for insurance. About the Author: Read more about this and other topics related to
Source: hcpam.com

Medigap vs. Medicare Advantage Plan

Medicare Advantage comprises a variety of private health plans — most often HMOs and PPOs — that Medicare offers as a coverage alternative to the traditional program. Every plan must cover all the same benefits that traditional Medicare covers. But the plans can charge different copayments (often lower than the traditional program but not always) and offer extra benefits. Most charge a monthly premium in addition to the Part B premium, but some don’t. Most include prescription drug coverage at no additional cost. Some cover routine hearing and vision services, usually as a separate package for an additional premium. Another difference from the traditional program is that most plans require you to go to doctors and other providers within their service network or pay higher copays for going out of network.
Source: aarp.org

Medicare Supplemental Insurance Comparison Releases New Article “Five Tips for Saving on Medicare Supplemental Insurance”

(EMAILWIRE.COM, March 22, 2013 ) Los Angeles, Ca — Medicaresupplementalinsurancecomparison.net announced today that they have added and an informative new article on their website that teaches readers five important tips when searching for Medicare supplemental insurance. For many people searching for Medicare supplemental insurance can be a daunting process. Faced with thousands of websites that provide information that is questionable at best, for the discerning researcher finding reputable information is often times as hard is finding affordable insurance itself. Because of this, the website Medicare Supplemental Insurance Comparison (MSIC) has released a brand-new learning Center that helps researchers tackle some of the many questions they will face when looking for insurance companies. The learning Center talks about the different types of Medicare supplemental insurance and helps the readers navigate the often times confusing differentiations between the plans.

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September 04, 2013

Compliance Check: Medicare Part D Annual Disclosure Notice Requirement

Posted by:  :  Category: Medicare

aetna benefits survey benefit trends Blue Shield California california public employees retirement system City Ordinance commuter benefits compliance Contract Negotiations CoveredCA covered california current-events DOMA employee benefits employee health benefits exchange FMLA FSA Plans government HDHP healthcare reform Health Care Security Oridance Health San Francisco Health Savings Accounts High Deductible Health Plan HSA human resources IRS kaiser family foundation leave of absence marketplace medical plan costs medical plan design medicare medicaid military Network Update notice requirements Out-of-network Paid Time Off politics PPACA pre-tax pregnancy private medical insurance public health care exhange retirement plans Safe Time San Francisco Seattle SHOP Sick Time state healthcare exchange state health exchange
Source: wordpress.com

Video: Medicare Advantage – 5 Things To Know About Advantage Plans Before You Enroll

Fact Check:Will Increased Longevity Bring Down Medicare?

The customary formulation of this myth is that Medicare is doomed by its own success in keeping its beneficiaries alive. Not only will the ranks of the program’s beneficiaries increase as the vaunted baby boom generation reaches the statutory age of eligibility, but because people are staying alive longer, Medicare’s costs will explode. The first part of this contention is indisputably true: entitlement to Medicare occurs when a person reaches age sixty-five, and the baby boom generation that is generally calibrated as starting in 1946 has arrived at that threshold. As a result, additional Medicare beneficiaries enter that program every day, and because the baby boom generation dwarfs any preceding age cohort, it is highly likely that more beneficiaries will be added to the program than are lost as older beneficiaries pass away. Consequently, the number of Medicare beneficiaries will inexorably increase over the next decade or so. Ceteris paribus, more beneficiaries mean higher aggregate costs.
Source: thehealthcareblog.com

Social Security uses marriage information to check on available benefits

You can apply for spousal benefits the same way that you apply for benefits on your own record. That means you can apply for reduced benefits as early as age 62 or for 100 percent of your full retirement benefits at your full retirement age. The benefit amount you can receive as a spouse, if you have reached your full retirement age, can be as much as one-half of your spouse’s full benefit. If you opt for early retirement, your benefit may be as little as a third of your spouse’s full benefit amount.
Source: mysanantonio.com

Why Obamacare always was a public option

According to Medicaid.gov, “Beginning in January 2014, individuals under 65 years of age with income below 133 percent of the federal poverty level (FPL) will be eligible for Medicaid. For the first time, low-income adults without children will be guaranteed coverage through Medicaid in every state without need for a waiver, and parents of children will be eligible at a uniform income level across all states.”
Source: netrightdaily.com

Check Out the Medicare Eligibility Georgia

You might be aware of the popularity of Medicare plans in Georgia, because large numbers of people are switching over to these plans for increasing number of benefits. Whether you have a health insurance policy or not, the most important thing that you need to consider is that whether you are eligible for the plans. Well, the Medicare Eligibility Georgia is different from any other health insurance plans that are available in Georgia. Therefore, you must know the eligibility criteria when you look forward to such plans. Talking to your experts in this context will definitely be beneficial for you.
Source: gamedicareplans.com

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September 04, 2013

Medicare Open Enrollment Period Begins Oct. 15, 2013

Posted by:  :  Category: Medicare

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Medicare recipients reaching the drug donut hole will benefit from lower costs. The gap in prescription drug coverage starts when someone reaches the initial coverage limit, estimated at $2,850 in 2014. It ends when they have spent $4,550, when catastrophic coverage begins. (These are reductions of $120 and $200, respectively, from 2013.) During the donut hole, all costs are covered by individuals out of their own pocket. In 2014, those who reach the donut hole can receive a 52.5 percent discount on brand-name drugs and 28 percent discount on generic drugs (an increase from 21 percent in 2013).
Source: disabled-world.com

Video: Understanding Medicare Advantage Plans

Figuring Out Medicare Choices : CONSUMERMOJO.COM

Filed under 55 Plus News, All 55 Plus, Latest News, Medicare, Video: Most Viewed, Videos, Vids: 55 Plus, Vids:Medicare · Tagged with Advice, Babara Nevins Taylor, Barbara, barbara nevins, barbara nevins taylor, Boomers and Medicare, Community Service Society, ConsumerMojo, Joe Baker, Medicare, Medicare Advantage, Medicare Basics, Medicare choices, Medicare confusion, Medicare enrollment, Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, Medicare Part F, Medicare Rights Center, Medicare Supplemental, Medicare Supplemental Insurance Plans, Nevins, Taylor, United Healthcare
Source: consumermojo.com

Employer Sponsored Health Coverage in the Age of Obamacare

Econintersect sends a nightly newsletter highlighting news events of the day, and providing a summary of new articles posted on the website. Econintersect will not sell or pass your email address to others per our privacy policy. You can cancel this subscription at any time by selecting the unsubscribing link in the
Source: econintersect.com

No Shopping Zone: Medicare Is Not Part Of New Insurance Marketplaces

Enrollment in health plans offered on the marketplaces, also called exchanges, begins Oct. 1 and runs for six months. Meanwhile, the two-month sign-up period for private health plans for millions of Medicare beneficiaries begins Oct. 15. In that time, seniors can shop for a private health plan known as Medicare Advantage, pick a drug insurance policy or buy a supplemental Medigap plan. And in nearly two dozen states, some Medicare beneficiaries who also qualify for Medicaid may be choosing private managed care plans. None of these four kinds of coverage will be offered in the health law’s marketplaces.
Source: kaiserhealthnews.org

Policy Options to Sustain Medicare for the Future

The report is intended to serve as a reference guide for policymakers and others as the debate moves forward. The report does not endorse or recommend a specific set of Medicare policy options, nor is it designed to achieve a specific savings target. Rather, it was designed to review options that may be considered. Savings and revenue options were compiled from government reports, recent debt reduction proposals, the literature, and interviews with dozens of leading health care and Medicare policy experts.
Source: kff.org

People with Medicare and the Health Insurance Marketplace

Frequently Asked Questions HOW WILL THE HEALTH INSURANCE MARKETPLACE THAT STARTS IN 2014 AFFECT MY MEDICARE COVERAGE? The Health Insurance Marketplace is designed to help people who don’t have any health insurance. You have health insurance through Medicare. The Marketplace won’t have any effect on your Medicare coverage. Your Medicare benefits aren’t changing. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan, you’ll still have the same benefits and security you have now, and you won’t have to make any changes. The Marketplace provides new health insurance options for many Americans. If you have family and friends who don’t have health insurance, tell them to visit HealthCare.gov to learn more about their options. DO I NEED TO DO ANYTHING WITH MARKETPLACE PLANS DURING MEDICARE OPEN ENROLLMENT (OCTOBER 15 – DECEMBER 7, 2013)? Medicare’s Open Enrollment isn’t part of the new Health Insurance Marketplace. It’s against the law for someone who knows that you have Medicare to sell you a Marketplace plan. Medicare Open Enrollment (October 15 – December 7, 2013) is the time when all people with Medicare are encouraged to review their current health and prescription drug coverage, including any changes in costs, coverage and benefits that will take effect next year. If you want to change your coverage for next year, this is the time to do it. If you’re satisfied that your current coverage will continue to meet your needs for next year, you don’t need to do anything. For more information on Medicare Open Enrollment, visit Medicare.gov or call 1-800-MEDICARE. NOTE: The Health Insurance Marketplace Open Enrollment period (October 1, 2013 to March 31, 2014) overlaps with the Medicare Open Enrollment period (October 15 – December 7, 2013). Therefore, people with Medicare who are looking to make Medicare coverage changes should make sure that they are reviewing Medicare plans and not Marketplace options. WHAT SHOULD I DO IF I’M CONTACTED ABOUT SIGNING UP FOR A HEALTH PLAN? „„ The Medicare open enrollment period is a time when there’s a higher risk for fraudulent activities. „„ It’s against the law for someone who knows that you have Medicare to sell you a Marketplace plan. „„ DO NOT share your Medicare number or other personal information with anyone who knocks on your door or contacts you uninvited to sell you a health plan. „„ Senior Medicare Patrol programs are teaching people with Medicare how to detect and report fraud, and protect themselves from fraudulent activity and identity theft. „„ To learn more about health care fraud and ways to protect against it, visit StopMedicareFraud.gov or the Senior Medicare Patrol (SMP) program in your area (locate your SMP at SMPresource.org). This information is provided by the United States Department of Health and Human Services.
Source: seagoedd.org

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

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

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September 04, 2013

Augusta needs Medicaid expansion, and so does Georgia

Posted by:  :  Category: Medicare

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This idea that a 2% increase in our budget…and consequently an increase in OUR taxes…..is okay is the kind of thinking that is killing those of us who PAY the taxes. “Oh, it will create jobs” is always the answer but somehow it never does, and the welfare, SSI, food stamp, and Medicaid rolls keep growing because we keep offering them a better deal. Meanwhile the taxPAYERS are stuck with the 2% increase for this, and a 4.9% increase for that, and a sales tax increase for the roads, and, if you actually PAY you medical bills a 3% increase on your medical devices. This line of thinking that federal or state budget increases, more taxes, and more spending on give away programs are somehow good for the economy….good for the taxpayer…..is simply crap. Everyone, even the Democrats and the CBO, are already admitting that Obamacare is a BUST at controlling or lowering the cost of medical care. They already know that the federal government is not going to be able to afford even the 90% that they promised and many of the states know that they cannot afford the 10% and that the feds will most likely figure out how to get out of paying their 90%.
Source: augusta.com

Video: Georgia Health Insurance Medicare

Emory University to Pay $1.5 Million to Settle False Claims Act Investigation

This civil settlement resolves a lawsuit filed by Elizabeth Elliot under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private citizens to bring civil actions on behalf of the United States and share in any recovery obtained. The case, pending in the Northern District of Georgia, is filed under United States of America and State of Georgia ex rel. Elizabeth Elliott v. Emory University, et al., Civ. No. 1:09-cv-3569-AT (Northern District of Georgia, December 18, 2009). Ms. Elliot will receive a share of the settlement payment that resolves the qui tam suit that she filed. The claims settled in the civil settlement are allegations only, and there has been no determination of liability.
Source: sandpointpr.com

Health care group faces Medicare fraud charges

While the two men facing criminal charges in this matter will fight an uphill battle in combating the accusations made against them and their employing company, they will have the opportunity to present the facts of their case when they go to trial. Though the results of a criminal trial are never guaranteed, federal prosecutors are required to make a case for each charge that they bring against an individual and that individual is entitled to defend himself against those charges.
Source: atlantacriminaldefenseattorneysblog.com

Georgia offering Medicare info

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Source: augusta.com

University Pays $1.5M In Legal Settlement : The Emory Wheel

The allegations state that the University billed two separate entities — Medicare/Medicaid and a clinical trial sponsor — for the same medical care and services, according to the settlement. The clinical trial sponsor had agreed to pay for the medical services that the University then charged to Medicare and Medicaid. In some cases, Emory was paid twice for the same services, according to the press release.
Source: emorywheel.com

Georgia's Medicare patient care stalls

The answer is obvious: the Medicare and Medicaid patients that no one else will see are already flooding into MCG, because MCG will not refuse to see them. Medicare payments were cut by 21% effective March 1, so MCG will be sucking up a 21% cut on every Medicare patient they see, and they will not be allowed to refuse care to anyone. Combined with the call for budget cuts from the Board of Regents, times do not bode well for MCG.
Source: augusta.com

Georgia’s New “Limited Medical” Law Shifts Costs to Medicare

After July 1, 2013, the amended Georgia Workers’ Compensation Act reducing the Employer/Insurer’s overall medical exposure insidiously shifts the responsibility (after 400 weeks) to Medicare in certain cases.   Prior to July 1, 2013, the WCMSA would be forced to contemplate future medical expenses for the life of the injured workers.  Now, the WCMSA analysis simply stops after 7.5 years of treatment from the date of accident in non-catastrophically designated claims.  Consequently, if the injured worker is a Medicare beneficiary, or there is a reasonable expectation he or she will be within 30 months, Medicare will likely bear the cost of the bulk of the injured workers’ future medical treatment.  For example, if an injured worker required a replacement of an artificial knee, this cost would likely be thrust upon Medicare.  This would also include diagnostic scans, films, and medication related to the Georgia work injury.
Source: ramoslawblog.com

Georgia Woman Rewarded For Taking Stand Against Medicare Fraud

While working as a contracts officer at Bard’s Covington office, Darity noticed a pattern of illegal kickbacks being paid by the medical device company to doctors and hospitals that used its products. Over an eight-year-period, according to Darity’s whistleblower lawsuit, Bard inflated the cost of its radioactive seeds used to treat prostate cancer. The hospitals would then charge Medicare the inflated price and Bard would pay kickbacks to the doctors and hospitals from the excess revenue.
Source: personalinjuryattorneycolumbusga.com

Georgia, South Carolina not expanding Medicaid

“For the provisions of the Affordable Care Act related to health insurance coverage, CBO and JCT’s latest estimates are quite similar to the estimates we released when the legislation was being considered in March 2010. The following figure shows CBO and JCT’s projections of the effects of the ACA on the number of people who will be uninsured or will receive insurance coverage through employer-sponsored insurance (ESI), insurance exchanges, or Medicaid or the Children’s Health Insurance Program (CHIP). Although the latest projections extend the original ones by three years (corresponding to the shift in the regular 10-year projection period since the ACA was first being developed), the projections for each given year have changed little, on net, since March 2010.”
Source: augusta.com

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September 04, 2013

Utah Medicare Supplements

Posted by:  :  Category: Medicare

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A Utah Medigap (also called Utah Medicare Supplement Insurance) policy is private health insurance that is designed to supplement Original Medicare. This means it helps pay some of the health care costs (gaps) that Original Medicare doesn’t cover (like copayments, coinsurance, and deductibles). If you are in Original Medicare and you have a Medigap policy, Medicare will pay its share of the Medicare-approved amounts for covered health care costs. Then your Medigap policy pays its share. (Note: Medicare doesn’t pay any of the costs for you to get a Medigap policy.)
Source: utahseniorservices.com

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

Bloomfield's News on Money

First of all, it’s important to understand that any Medigap policy which would fall under the Medicare supplement quotes is going to be regulated and standardized by the government. The federal and state laws which are in place are put there to protect you in a variety of different ways. For example, any policy that works along with Medicare must be identified as such and will carry the term “Medicare supplement insurance” along with it. In most states in the United States, the Medigap policies that are available are going to offer the same basic benefits, although there may be additional benefits that are offered under some policies. Those are the things that should be considered when looking for Medicare supplement quotes.
Source: bloomfieldnm.info

Compare Medicare Supplement Plans Online

One final thing to think about when looking at Medigap coverage is your out-of-pocket limit. This is also something that is going to differ from one policy to another. In most cases, the Medigap policy is going to cover 100% of the services that are necessary once you have reached your annual out-of-pocket limits. This is something that should be considered carefully, especially if the time comes when you need regular care.
Source: thinkitout.net

Do I need a Medicare Supplement?

AARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medicare Supplement AARP Medicare Supplements AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 aetna Medicare Anthem Anthem High F plan Anthem Medigap Anthem Supplement Crowe and associates 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 A Medicare A and B Medicare Advantage MEdicare Advantage Connecticut Medicare Advantage plans medicare b Medicare Complete Medicare part B Medicare part B cost Medicare plan Medicare Supplement Medicare Supplement Connecticut Medigap Medigap connecticut Medigap rates 2013 Medigap rates NY 2013 Original Medicare sign up for medicare United medicare complete United Medicare complete 2013
Source: croweandassociates.com

An Explanation Of Medicare supplement plan F

Medicare supplement plan F is the most sought after Medicare supplement plan because it provides the most coverage. It is also the most expensive of the plans. Medicare supplement plans cover the deductibles in part A, which is the hospital portion of Medicare, and the 20% that Medicare does not cover, which is the doctor’s portion of the plan. The plans are labeled plans A, B, C, D, F, G, K, L, M, and N.
Source: willkapampa.org

The Cost of Minnesota’s Average Medigap Plan

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

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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September 04, 2013

Social Security and Medicare: Twin Disasters Loved by All Age Groups

Posted by:  :  Category: Medicare

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I understand why people blame the old folks for these programs. Yes, at the margin, old folks vote for them. But this does not explain why the programs are so incredibly popular. This does not explain why any politician who challenges Social Security and Medicare is going to be defeated at the next election. The old people are not able to do this alone. It’s the young people who are behind it. It’s the present workers who love the two programs. These workers will go out and vote as a bloc against any politician who threatens their future gravy train. They are happy to pay their taxes into the government now, because they are absolutely convinced that they’re going to get more out of the system than they put into it. They don’t want personal responsibility for their retirement, and they want to stick that responsibility on the rest of the population.
Source: garynorth.com

Video: FOX NEWS: McConnell To Democrats Raise eligibility age for Medicare

Old age may not ruin Medicare budgets after all

There have been a few issues with prior studies of morbidity in the elderly,which this study tried to avoid. For example, some surveys that those studies are based on only ask seniors about their chronic conditions; others look at how functional the elderly are in their day-to-day lives—measuring the practical effect of those chronic conditions, as well as more isolated maladies. For this paper, however, the authors used the Medicare Current Beneficiary Survey, by the federal government’s Medicare and Medicaid administrative department. The MCBS annually surveyed over 10,000 senior citizens from 1991 to 2009, across a wider range of health metrics and with nationally representative respondent demographics. More importantly, the NBER paper links those results to death records through 2008, matching all deaths to the ailments that appeared prior to death—regardless of whether they ended up causing the fatality. So the study offers a unique measure of morbidity by time until death for a large, representative elderly population.
Source: tacticalminc.com

More Good News on Health Care: Medicare Costs Are Down, Down, Down

The financial crisis and economic downturn […] do not appear to explain much of the slowdown. First…from 2000 to 2005, the growth in the average payment rate programwide was similar to growth in the CPI-U. Second, we did not find evidence to suggest that beneficiaries’ considerable loss of wealth and reduced income growth significantly affected their collective demand for care. Third, it is not clear whether the recession played a role in reducing the rate at which providers purchased new, cost-increasing technologies. Finally, and in contrast, some evidence suggests that high unemployment during the recession boosted providers’ incentives to deliver services to Medicare beneficiaries by reducing the demand for care in the private sector, though we could not empirically confirm the mechanisms by which unemployment might have had such an effect.
Source: motherjones.com

Employer Sponsored Health Coverage in the Age of Obamacare

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Source: econintersect.com

The Medicare Mom: The Ice Age Cometh!

by Jody Worsham All rights reserved for..wait, was that my cell phone? I have declared today as Local Clean Out the Freezer Day. I think I have things in there left over from the first Ice Age. With school starting on Monday I am in a frenzy to get all those jobs done that I was going to do all summer in the hopes that with school starting and me having six hours of uninterrupted thought patterns, I could get some writing done because I have to write and submit. My friend said so. That is only going to happen if I accomplish those pesky household chores now. On the way to the laundry room with the first pile of laundry, I noticed my lonely i-pad on my desk. It is Hump Day, after all. Lots of e-mails on Hump Day. I better stop and check my humor groups on the I-pad. Laughing makes the trip to the laundry room more fun. Oh, there’s the refrigerator and it IS Local Clean Out the Freezer Day. From the arctic depths of the refrigerator freezer, I can hear the “ping” of my i-pad. Better go back and check that to see if there is a response to ….anything. After reading four more e-mails, squeezing out a damp mop in preparation for a “swipe and wipe” of the den floor, I reward myself with a quick glance at the lap top. Sometimes it gets things the i-pad doesn’t, especially if I forget to recharge the i-pad. And there might be a link to something I’m missing. To recap: It is 8:52. I got up at 6 a.m. I am still in my pj’s. I have read five humor pieces, made six comments, walked the pile of dirty clothes to the laundry room (that’s as far as I got), opened the freezer door observing the frozen wasteland, and have a damp-soon-to-be-dry mop leaning against the den wall. The kids and Dr. Hubby are down at the Trump Chicken Condos laying a brick floor in preparation for the arrival of 50 baby show chickens on Tuesday. It’s quiet now. Maybe I should take advantage of that. I made a pretty good start on the chores. I think I deserve some computer writing time. Now if I could just think of something to write about. Dang, I forgot. It is Quilting Day down at the Center. If I can get dressed, find my quilting needles and thread, I will only be 30 minutes late. I’ll celebrate Local Clean Out the Freezer tomorrow. The ice should be melted by then. Jody the Medicare Mom Jody can be found most days observing household clutter, identifying archeological scrapings from burned dinners, watching damp mops dry and wondering why, like her friend Wanda, she never gets anything done.
Source: blogspot.com

Retirement Session: Medicare 101

Are you planning for retirement and want to know more about Medicare? Do you think you might work past age 65 and want to know how to handle your Medicare enrollment? Perhaps you want to help your loved ones with their Medicare choices and wish you understood more? Acuna’s presentation will prepare you to make educated decisions.
Source: vanderbilt.edu

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September 04, 2013

N.C.’s nascent Medicaid reform

Posted by:  :  Category: Medicare

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

Video: NC Senior Medicare Patrol – Medicare Summary Notices

North Carolina Medical Society

At the end of July, before legislators left for the recess, they took a major step forward in the decade long effort to repeal the SGR formula when the House Committee on Energy and Commerce voted 51-0 to support the “Medicare Patient Access and Quality Improvement Act” (H.R. 2810). This bill repeals the SGR and replaces it with annual updates of 0.5 percent. Beginning in 2019, physicians would be able to report data under a new Quality Update Incentive Program (QUIP) and earn up to an additional 1 percent update. Those scoring low on quality measures would potentially face a net cut of 0.5 percent. Under the bill, medicine will play a central role in designing the quality metrics. The bill also creates a pathway for physicians to design and participate in Alternative Payment Models (APMs) under which they would be exempted from the QUIP requirements.
Source: ncmedsoc.org

Group Medicare Account Advisor

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Source: insurancesalesweb.com

Madame Defarge: NC Medicaid ‘forgot’ to Include Wrap

Prior to the LME’s completely managing Medicaid in NC (in my practice area, it is Smoky Mountain Center LME, about to become the largest LME in NC as Western Highlands Network LME is to be incorporated into SMC LME 10.1.2013), this Medicare CPT code, 96152, paid appropriately and it automatically wrapped around to a DIFFERENT outpatient therapy code via NC Medicaid.
Source: blogspot.com

Coming to NC for 2014: NEW Medicare Advantage Plan

About GarityAdvantage Agencies We are specialists in the Senior Market with over 75 years combined experience helping independent brokers grow their business and client base. As a national field marketing organization (FMO) specializing in the Medicare/Senior Market, we offer independant insurance agents outstanding service, competitive products and top commissions across a wide range of senior products including Medicare Advantage, Medicare Supplement, Final Expense, Funeral Trust, Hospital Indemnity and more.
Source: wordpress.com

Survey: Physicians Mixed on Medicare Payment Data Transparency

The survey was spurred by the recent movements in healthcare data transparency along with an overturned ruling that prevented the Centers for Medicare and Medicaid Services (CMS) from releasing information about payments to individual physicians, ACPE says. In May and June, the CMS released data on hospital outpatient charges for hospitals nationwide. Local governments, like in North Carolina, have gotten in on the act, requiring hospitals to provide public pricing information on medical procedures and services.
Source: healthcare-informatics.com

North Carolina Medical Society

Medicare does not require a taxonomy code to process a claim; however, Palmetto will verify that the taxonomy code is valid by comparing it with the latest National Uniform Claim Committee (NUCC) Healthcare Provider Taxonomy Codes (HPTC) code set if it is submitted on the claim. We would include the taxonomy code on any crossover to another insurance company. You may wish to check with your clearinghouse or billing company to ensure they are not stripping the taxonomy number from your claim prior to transmitting to Medicare.
Source: ncmedsoc.org

North Carolina Trial Law Blog: Useful link to Medicare and MSPRC billing and diagnostic codes for auditing conditional payment letters

The information provided on this blog is of a general legal nature and should not be taken as specific legal advice. No post on this blog creates an attorney client relationship. I’m a NC lawyer, so anything I post applies only to NC. If someone else posts something legal, I can’t take responsibility for what they say. This is all pretty straight forward stuff, but you have to say it if you are a lawyer, right?
Source: nctriallawblog.com

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