medicare application and who can apply

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Source: australiaforum.com

Video: How to Apply For Medicaid in Florida Online

The Best of Florida Medicare

The Best of Florida Medicare   Florida Medicare Component B is an elective insurance offering and is essentially for other necessary medical expenses such as home healthcare, wellness and outpatient benefits. Coinsurance for this part is placed at twenty percent. Premiums range from smallest $96 to highest amount of $110 but an increment of $46 to $253 monthly may be paid in case annual income exceeds $85,000. Also, a deductible of $162 is required yearly before Medicare pays 80% of the total amount.   The third level or Component C is a health chart known as “Florida Medicare Advantage”, which combines the first two parts and can contain the component D benefits. Deductibles and copayments are also present in this type of health plans. An advantage afforded by this part is its lower price or premium than a supplement plan under Medicare. Accordingly, a lot of Florida’s policies pertaining to component C charge no premiums.   Drug benefits fall under component D. These may be availed of under a stand-alone policy that a private insurance company in Florida offers. Component C Medicare Advantage plan however, can offer similar drug-related provision upon enrolment. Choosing between these options will be a personal consideration for any interested applicant, either cost-wise or by virtue of practicality.   A number of insurance product carriers offer part C drug policies in Florida. Medicare supplement options are likewise available from these carriers. Included in the roster of viable carriers in Florida are the AARP UnitedHealthCare, Humana, Blue Cross Blue Shield of Florida, Gerber and Mutual of Omaha. There are other existing carriers but the mentioned names have the biggest networks in Florida.   The ideal choice among present networks is a concern that will only be determined by research and personal impression. Also, especially for those with critical minds, it is always a good thing to ask questions. Providers are in the best positions to answer queries so that a proper and informed decision can be made. Comparisons between providers ought to be made, further ensuring that coverage needs and costs parallel those of the original Medicare policy.
Source: topdatum.com

What are the factors in determining eligibility for SSD benefits?

Many Florida residents aren’t sure if they qualify for Social Security disability benefits. Maybe they worked at one time, but that was years ago. Or maybe they stayed at home with the kids while the other spouse worked, and now the spouse who stayed home with the kids is disabled while the working spouse keeps working. The question, then, is whether or not the stay-at-home spouse is eligible for benefits.
Source: floridassd.com

Health Subcommittee Examines Proposals for Reform and Improvement of the Medicare Part B Drug Program

Reimbursement rates under Medicare Part B have caused the shift of some patient populations, including those with cancer and other rare diseases, from physician offices to hospital outpatient centers. The reimbursement shift, as coupled with community cancer centers closing, has caused an increased cost to the Medicare system and patients. As Brooks added, “Medicare payments for chemotherapy administration services in hospital outpatient settings have more than tripled since 2005, while payments to community cancer clinics have actually decreased by 14.5 percent.”
Source: house.gov

Medicare Home Health Compare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

UniCare MedicareRx Rewards Part D

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Alabama, Alaska, Arizona, Arkansas, Connecticut, Delaware, Florida, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Washington, Washington D.C., West Virginia and Wyoming.
Source: affordablemedicareplan.com

Video: Unicare Medicare Advantage Plans – Compare to 180+ Companie

Salina Public Flu Vaccine Clinic To Be Held Wednesday

A drive-thru clinic for adults only will be conducted from 11:00AM-2:00PM in the east driveway behind the 4-H Building and Agriculture Hall.  Vehicle entry will be from the south in the dirt parking area across from the entrance to Kenwood Cove.  Participants at the drive-thru must be 18 years of age or older and are asked to wear short-sleeve shirts.
Source: todayinkansas.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

CMS Letter on Poor Performing Medicare Advantage Plans

CMS has also created an SEP allowing beneficiaries one chance to move from a “poor” performing plan to one that is rated 3-Star or higher after January 1, 2013.  This SEP is not agent driven however, so in order for someone to take advantage of this, the individual must call 1-800-MEDICARE. There are no timeframes, end dates, etc. associated with this SEP and CMS will be granting the SEP on a case-by-case basis. Beneficiaries will be receiving letters regarding this as well.
Source: agentpipeline.com

medical insurance california

googletag.cmd.push(function()googletag.display(‘div-article-top’);); When it comes to buying health insurance, a lot of options are thrown for a consumerinsurance agents, brokers and clubs that offer different plans. However, with the advancement of online technology, and the ease that it offers in buying a product, has made it possible for consumers to buy health insurance policies online. But is it simple? Is it safe buying health insurance online in Virginia? The answers to these crucial questions are hidden in the understanding of the consumer about internet technology and how efficiently he/she knows the platform from where the purchase is made. One of the most fundamental benefits of buying health insurance online in Virginia is that you wont be pressurized to make the decision immediately. Due to the absence of any human who is looking to close the deal or is coaxing you to make the decision quickly, you have all the time to search, understand and analyze before you make your final decision. In this article, we will like to discuss some points that are crucial for buying health insurance plans while residing in Virginia. While buying health insurance policies online, a consumer gets two options: 1.Buying directly from the website of the insurance company. The companies that provide health insurance in Virginia are Aetna, American National, Anthem Blue Cross and Blue, Shield, Assurant, CareFirst Blue Cross Blue Shield, Celtic, Golden Rule, Great American, Humana One, IAC, Kaiser Permanente, Patriot Health, Solera Dental, and UniCare. So, visiting the websites of any of these companies would be an option for the consumers. 2.Buying from a health insurance exchange portal where lots of companies are registered and the portal suggests the suitable plan after collecting some personal data necessary to make the right choice If you are fully confident that you want to buy from a particular insurance provider of Virginia, you can go directly to the website of that company. However, if you want to have a look at various plans offered by different companies, you can check some health insurance exchanges to find a suitable plan. Things to take care while buying health insurance online If you are buying from companys direct website Some companies do provide 15 days money-back guarantee. This should be a good option to check. Make sure you understand the medical care you need Understand the terms and conditions of the policy that you want to buy Know how to make reimbursement claims Check whether the company provides 24×7 customer care support If you are buying from a exchange portal To make sure the exchange portal is credible, talk to some of their customers who have bought health insurance from them. Online testimonials could be fake; talking in-person should be the best choice. Compare different plans based on the coverage provided and the rates associated to each one of them Know whom to contact in case you need some post-sales help regarding any issue to the medical insurance policy
Source: individualmandatehealthcare.com

WellPoint To Transfer UniCare Blocks

The old WellPoint Health Networks Inc., Woodland Hills, Calif., one of the companies that merged to form WellPoint Inc., created the UniCare business in 1995 to hold health insurance operations outside of California. Much of the business in the unit was acquired from Massachusetts Life Insurance Company, Springfield, Mass., in 1996 and from John Hancock Mutual Life Insurance Company, Boston, in 1997. Also today, WellPoint:
Source: lifehealthpro.com

Satisfying Retirement: Someone Explain Medicare to Me

Part D covers some of your presecition drug costs. If you don’t need a lot of drugs now, it still may be wise to take this coverage because of late enrollment penalties. Part D is provided by private insurance companies and varies widely in costs and coverage. There are usually copays and deductibles involved. The “Donut hole” limits coverage on what these plans will pay for your drugs. UNder the new health care plan, that donut hole is shrinking and has a new feature that gives you a 50% discount on covered brand name drugs. 
Source: blogspot.com

Employees Mutual Health Insurance Company Review

WellPoint wants to help employers and employees to maximize their health insurance dollars by purchasing services within WellPoint’s established relationship network (including doctors, hospitals, and healthcare clinics). Because of the sheer breadth of WellPoint’s relationships, individual employees can take greater control in identifying healthcare solutions. Employers receive greater cost controls while offering employees healthcare products and services.
Source: healthinsuranceproviders.com

CMS Announces 2013 Application Fee for Medicare, Medicaid and CHIP

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On November 30, 2012, CMS announced the 2013 application fee for those providers initially enrolling in Medicare, Medicaid, or CHIP or revalidating an enrollment or adding a new location.  This application fee applies to those providers submitting an 855A application form, which is the form that health centers use to enroll in the Medicare program. The 2013 fee will be $532.00, effective January 1, 2013.  This is a $9.00 increase over the 2012 fee.
Source: nachc.com

Video: Iranian Social Work, USCIS Help Center, SSI, Disability, Medical, Medicare Application

FCA Liability and Medicare Enrollment Requirements

In Renal Care, the Sixth Circuit was apparently persuaded by the fact that the company clearly made efforts to determine what was necessary to comply with the dense regulatory requirements.  But in MedQuest, another undercurrent to the opinion familiar to many FCA defense practitioners seemed to lead to the court’s decision:  the concept of unjust enrichment.  In MedQuest, there was no allegation that MedQuest did not provide the billed services, or that those services were unnecessary or inadequate for the beneficiaries.   Those factors appear to have influenced the Sixth Circuit judges who found that FCA liability, which would trigger the FCA’s mandatory multiple damages and steep penalty provisions, was not warranted. 
Source: healthlawpolicymatters.com

An Overview Of The Healthcare System In Australia

Medicare covers a wealth of out of hospital services, such as eye tests, various surgical and therapeutic procedures, consultation fees, tests, examinations, X-rays, dental services and a plethora of other medical services that many patients would not be able to afford otherwise. Moreover, the patient has the chance to choose the doctor that will treat him outside the hospital. Speaking of the medical fees, Medicare pays around 85% of the schedule fee for services that take place outside the hospital setting, and this is a great thing both for patients and for those who have 
Source: fin24.com

Medicare delays penalties for claims with invalid or missing NPIs : Getting Paid

The Centers for Medicare & Medicaid Services (CMS) announced late last week that, due to technical issues, implementation of phase 2 of the ordering and referring denial edits is being delayed from May 1 to an unspecified future date. As a reminder, these edits would have denied certain claims from physicians and other eligible professionals who lacked a valid individual National Provider Identifier. Those claims include Medicare Part-B claims involving laboratories, imaging centers, durable medical equipment, orthotics, and supplies that have an ordering or referring physician/nonphysician provider as well as Part-A home health agency claims that require an attending physician. 
Source: aafp.org

How Do I Resubmit Insurance Enrollment to Medicare?

You are eligible for medicare benefits when you are sixty five years or older. You can also be eligible for medicare benefits if you have a disability and are younger than sixty five. You are eligible to submit an insurance enrollment form to Medicare three months after you turn sixty five. This initial enrollment period will last for seven months. If you do not enroll during this period or if you were denied during this period, you can resubmit the insurance enrollment form for Medicare during the general enrollment period. The general enrollment period usually lasts from January 1st to March 31st. You can submit a Medicare 855R application if you wish to reassign your Medicare benefits.
Source: seniorcorps.org

CMS Imposes Medicare Enrollment Application Fee

[…] There is a hardship exception in which the applicant must submit a letter making a strong argument to support its request, including supporting documents.  There is no suggested format for this request or for the type of supporting documentation.  This letter must accompany the enrollment application.  The Fiscal Intermediary will forward the hardship request to a group called the “Provider Enrollment Operations Group” liaison to make a determination within 60 days of receipt of request.  There is no specific criteria for the determination, but if the applicant is declined, the decision and pending application will be returned to the applicant.Source: hfsconsultants.com […]
Source: hfsconsultants.com

Florida Medicare Supplement–A Financially Sound Decision

Posted by:  :  Category: Medicare

Coinsurance –  You are responsible to pay $283 per day when you are hospitalized from the 61st day through the 90th day.  And, when you are in the hospital from the 91st day though the 150th day, you are responsible for $566 per day.  There are some lifetime reserve days with Original Medicare.  A Florida Medicare Supplement will add an additional 365 lifetime reserve days.
Source: rtcinsuranceadvisors.com

Video: Choosing a Medicare Supplement in Florida in 2011

Sightings Over Sixty: Tips for Enrolling in Medicare

. This part of Medicare is actually something separate. It is a Medicare Advantage plan. This is an insurance plan supplied by a private company that works directly with Medicare. The Medicare Advantage plan consolidates all your other Medicare options into one overall plan.      So, with a Medicare Supplement plan (which does not count as Part C), you pay separately for Part B, Part D, for the supplement plan itself, and for any other insurance you might want — like a dental insurance plan, for example.      With a Medicare Advantage plan, or Part C, you pay one bill that includes your drug plan, and also typically offers a dental plan. However, the Medical Advantage plan is either an HMO plan, or a PPO plan. With an HMO, you must go to a doctor in the insurance company’s network. With a PPO you also go to a doctor in network. You can go to a doctor that’s out-of-network, but the insurance will only cover a smaller portion of the bill that Medicare doesn’t pay — leaving you exposed to unknown and perhaps very high medical costs.      Advice: If you want the convenience of a Medicare Advantage plan, and you want to stay with your current medical practice, you should call your doctor’s office and make sure the doctor is in the network of that particular plan.      Personally, when I was signing up, I thought I’d choose a PPO plan. I’d go to my doctor on a regular basis. But then, if I needed some kind of specialist that was out-of-network, I could go, and I’d just have to pay more.      Then I found out that my current medical group does not accept the Medicare Advantage plan of my old insurance company, which was HIP. That would mean I’d be paying out-of-network fees every time I go to the doctor.      It didn’t make sense to me that my medical group would accept regular HIP; but not accept HIP Medical Advantage. But that’s the policy. And my medical group is the biggest, most comprehensive medical group in my area. I did not want to change.      Then I researched the AARP offering, through United Healthcare. My medical group accepts the United Healthcare Medicare Supplement plan. But, for some reason, it does not accept the United Healthcare Medicare Advantage Plan. Therefore, again, with the Advantage plan every time I’d go to the doctor, I’d be paying out-of-service fees.      So I chose the AARP United Healthcare Medicare Supplement Plan. I do not have my insurance wrapped up into one policy. I pay a separate bill each, for Medicare Part B, Medicare Part D, and the Medicare Supplement plan. And then, since my supplement plan does not include dental, I purchased a separate dental plan through AARP, with yet another bill, for another $40-some per month.      I pay four separate bills. The good news is that altogether they are about a third less than what I was paying through my old medical insurance plan, as of two months ago.      I have yet to actually use Medicare. I haven’t been to the doctor yet. I sure hope the process becomes a little easier.      Meantime, I know there are lots of people with more Medicare experience than I have. So if I’ve got anything wrong here, I hope you will correct me. Or if there’s anything to add, which could help the Medicare neophyte, I hope you won’t hesitate to append your advice. Thanks and good luck!
Source: blogspot.com

10 Million Beneficiaries Enrolled in Medicare Supplement Program

Reaching the 10 million member mark is a notable landmark for the Medicare Supplement business. Medicare Supplement plans offer coverage of certain costs such as additional hospital coverage up to 365 days after Original Medicare benefits are exhausted, Part A and Part B co-payment or co-insurance coverage, and Part A and Part B deductible coverage. For an additional monthly premium, beneficiaries have the ability to have other potentially higher costs covered through a Medicare Supplement plan. These plans are offered through different carriers and may be priced differently, so it is recommended that you compare plans in your area to find one that is right for your needs. PlanPrescriber offers a Medicare Supplement Plan Comparison Tool that allows you to make side-by-side comparisons of plans in your area.
Source: planprescriber.com

FAQ: Medicare Supplement Plan Pricing

Case in point Here’s an example: A prospect called our office to say that she had recently experienced a rate increase on the Medicare supplement Plan F she had had for many years. Following this rate increase, her long-time agent had moved her to a Plan N, which was cheaper than her old Plan F. However, when she received her first bill, it included a $162 charge for her Part B deductible. This charge was a complete surprise to her. As you might imagine, she was very upset.
Source: lifehealthpro.com

2011 Medicare Open Enrollment Window

It is usually a good idea to get an application for traditional supplemental coverage in early to make sure that certain health qualifications can be met.  Underwriting requirements will differ between various providers, so working with an independent Medicare supplement agency (like us) can be a wise choice to ensure coverage is obtained.  This way Medicare eligible consumers can ensure a seamless transition to new coverage  that will become effective January  1, 2012.
Source: ohioinsureplan.com

Medicare Supplement Guaranteed Issue

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Source: medicarechoicesofarizona.com

Medicare Supplement Quotes

When folks first come to us for help in searching for a Medicare supplement we often find they are in one of 3 situations:   1) They are aging into Medicare at age 65 or are coming off an employer-sponsored plan after age 65 2) They currently have a Medicare supplement but feel they are paying too much and want to see if they can get a better deal. 3) They have had Medicare Parts A & B but have never purchased a Medigap policy. In any of these cases, we have a solution: Are you new to Medicare whether at age 65 or after age 65 due to being on an employer-sponsored health plan and need to get Medicare Supplement Quotes? If you are electing to take Medicare Part B coverage for the first time you will have some options available to you for limited to no medical underwriting for a period of time (usually 3-6 months after your birth month or the qualifying event date). In some cases you can choose any Medigap plan you would like. While in others you may be limited to guaranteed issue for just a few plans. In order to understand your situation and options available please call us at (877) 363-3442. Did you recently get a rate increase from your current Medicare supplement company and feel you are now paying too much for your Medigap policy? Let us do a Medicare Supplement Comparison for you today! Once you have made the decision to purchase a Medicare Supplement policy you will likely very much appreciate your Medicare Supplement provider’s customer service and claims-paying practice but may have issues with rate increases. Because of the way Medicare and Medicare supplement company’s claims are paid my customers very rarely have claims issues and the only real reason my client’s switch Medicare supplement companies is because we’re able to find a much better rate from another company for the exact same coverage. Once you are educated on Medicare supplements and realize they are standardized from company-to-company you’ll realize that you can occasionally shop for better rates. (For example, a Plan F from one company is going to work identically to a Plan F from another company). We help our clients not only find their initial policy but we re-evaluate on an annual basis. Our exclusive Medicare Supplement quote tool allows us to determine within seconds if there is another company that will offer a better rate than your current provider and, if so, allow you determine if it’s enough to switch. Have you had Medicare Part A & B only and not a Medigap policy for longer than 6 months?   If this is the case you will likely be subject to medical underwriting with most Medigap insurance companies and it may limit your choices on which plan you can take. Although Medicare supplement companies tend to have much more lenient underwriting guidelines than that of companies providing under 65 health insurance you will still be best served to discuss your pre-existing health conditions with one of our Medigap agents. Regardless of your situation, if you’re in the market for a Medicare supplement policy we’re confident we’ll be able to educate you on your options and ensure you’re getting the best price available. Furthermore, we will continue to monitoring pricing on an ongoing basis and will evaluate whether it makes sense to switch companies to obtain a better price. In our experience, when we initially place our clients with the lowest priced plan available it does not make sense to switch to another company for 5-7 years.   Allow one of our Medigap agents to work with you and you can ensure that you understand how Medicare and Medicare Supplements work and that you get the best pricing available to you from the start and for years to come. We’re only compensated for as long as you’re with us which ensures we have your best interest in mind and will always work to keep your rates down as much as possible. Give us a try by calling us at (877) 363-3442 or completing the Medicare Supplement Quote Form by Clicking Here.
Source: e-medigap.com

Medicare Supplements a Safe Haven With the Future of Medicare Uncertain

But they’re taking comfort when they find out that if they keep traditional Medicare and purchase the right Medicare Supplement Plan (AKA Medigap), they can receive up to 100% coverage on doctor and hospital charges for life without ever worrying about networks, co-pays or deductibles. This is because Medicare Supplement Insurance covers the gaps in traditional Medicare, with no provider networks or restrictions.
Source: disabled-world.com

Medigap Medical Loss Ratio Improvement Act

To no surprise, the insurance industry is opposed, and understandably so. In order to calculate the supplemental benefits to be paid under the Medigap plans, the insurers must still process all services, most of which are paid by Medicare, thereby involving the same administrative effort as comprehensive plans. Also, their marketing costs are similar to their comprehensive private plans. Thus their administrative costs and profits are proportionately much higher considering the small amount paid out in supplemental benefits.
Source: pnhp.org

The importance of Medicare Supplemental Insurance

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Source: medicalnoises.com

6 things you should know about Medicare Supplements

Medicare Supplement plans are subject to periodic rate increases: Medicare Supplement plans A-N are standardized (except in states: MA, MN, WI), and all Medicare Supplement plans with the same letter offer the same benefits, regardless of the state you live in or the insurance carrier providing the coverage. Put another way, a Plan N from “insurer 1” must provide the same benefits as a Plan N from “insurer 2.” But, medical costs, medical inflation and innumerable other issues impact the cost of Medicare Supplement plans, which means the monthly fees you pay for a plan will increase over time. If a plan premium increases to a level you can no longer afford, beneficiaries do have the option to change to a Medicare Advantage plan during the Medicare Advantage annual enrollment period, which runs from October 15th to December 7th in 2011.
Source: ehealthinsurance.com

Medicare Supplement Coverage and Part D

The main reason you should call Medicare to help find the best Part D plan for you is they can make the process go very fast.  While you are on the phone with them, they can take your RX list, find a plan, explain it to you, and enroll you immediately without any paperwork.
Source: medicaresupplementcenter.com

Veteran prosecutor describes SoCal as ‘epicenter’ of Medicare fraud

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Guv Brown is releasing rapists and perverts from prison after serving only 40% of their sentences.  In LA County if a male is given a 90 jail term or less, or a woman a 240 day jail term or less, they are immediately released, no time served.  In California being a criminal is no longer a problem—just ask the millions of illegal aliens roaming our streets, taking our jobs, filling up classrooms and hospital beds.  We are a tolerant people. Maybe that is why we are also the HQ for Medicare fraud.  People don’t see stealing from government is theft.
Source: capoliticalnews.com

Video: Medicare Supplement Plans California – Learn About Medigap Insurance CA

Stand up for medicare this summer!

Traditionally, a Health Accord is also a time for governments to expand public health care to cover new services, like a national drug plan, home and community care, vision and dental care. Without an Accord, Canadians will have a much more difficult time trying the expand public health care so that all Canadians get their medical needs covered, regardless of where they live or what stage of life they are in.
Source: rabble.ca

CA man pleads guilty to Medicare scam, aggravated ID theft

Documents filed in the case reveal that Movsesyan’s fraudulent Medicare claims, primarily for orthotic braces and supplies, falsely represented that the items had been prescribed and provided to the Medicare beneficiaries located in Ohio, California, South Texas, Florida, and other states. In reality, no items were ever ordered or provided. Additionally, Movsesyan’s claims falsely stated that multiple physicians had examined such beneficiaries and ordered these items, when in fact, the patients and physicians were wholly unknown to each other and no examinations had ever occurred. Movsesyan’s unlawful use of the names and Medicare numbers of patients and physicians led to the charges of aggravated identity theft. Medicare issued payments to Beltline Medical totaling more than $325,000 as a result of Movsesyan’s fraudulent claims.
Source: phiprivacy.net

Who Will Save Social Security and Medicare?

www.globalresearch.ca contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available to our readers under the provisions of “fair use” in an effort to advance a better understanding of political, economic and social issues. The material on this site is distributed without profit to those who have expressed a prior interest in receiving it for research and educational purposes. If you wish to use copyrighted material for purposes other than “fair use” you must request permission from the copyright owner.
Source: globalresearch.ca

Medicare supporters organizing for Premiers meeting

Medicare activists see the meeting as an important opportunity to convince the Premiers and Territorial Leaders to unite around defending the crown jewel of Canadian public programs.  Many are urging the provinces to speak out against what is seen as the Federal government’s abandoning of health care. The provinces must take an active role in preventing a watering down on this essential program to all Canadians.
Source: nupge.ca

Chatsworth, CA Tax Expert Guides You Through The New World of Medicare Decisions

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: tax4smallbiz.com

Medicare Fact Sheets for Professionals: Medicare Information

“I want to compliment your organization on the quality of the fact sheets and informational materials on your website. I think they are among the most accurate and clearly written materials on Medicare (and Medi-Cal) available anywhere.”
Source: cahealthadvocates.org

Future Medical Treatment and Liens for Personal Injuries Under Medicare v. Medicaid

Posted by:  :  Category: Medicare

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Medicare can and does claim a lien for Medicare paid medical bills that are related to the personal injury claims. This again includes future medical treatment for those injuries. Medicare’s payment of future bills related to the personal injury serves as the basis for the Medicare set-aside. The set-aside may be a portion or even all of the personal injury proceeds to cover future Medicare payments for medical treatment for the subject injuries.
Source: newmexicoinjuryattorneyblog.com

Video: New Mexico and Medicare Supplements

Sandoval County New Mexico Medicare Supplement Quotes

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

Quality New Mexico Medicare Supplement plans

In New Mexico, there are 14 Medicare Supplement plans to choose from, each with different combinations of benefits.  Offered through private insurance companies, all plans are standardized, meaning every company must offer the same exact benefits. However, that does not mean they sell them at the same price. Make sure to comparison shop to get the coverage you need at a price you can afford.  And remember, once you turn 65 and are enrolled in Medicare Part B, you have 6 months to enroll in a Medicare supplement plan. If you enroll during this time period, by law, insurance companies cannot refuse to cover you. If you miss this enrollment period, you can be denied coverage.
Source: newmexicomedicarehealth.com

ALBANY, N.Y.: Rochester, NY, cited for lowest Medicare spending

Rochester’s success at holding down costs provides a model that Gov. Andrew Cuomo’s administration wants to take statewide. Essentially, a standing regional advisory committee made up of various health care stakeholders reviews the need for new departments, new staffing and expensive pieces of equipment and recommends against those that aren’t needed in the community.
Source: heraldonline.com

No Prescription Nasofan Dosing Guidelines From Medicare Buy Nasofan In New Mexico

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Source: condodiaries.com

Obama’s Social Security, Medicare Cuts

Photo: Courtesy USC Roybal Institute on Aging Traducción al español WASHINGTON, D.C.–The Social Security and Medicare cuts President Obama included in his proposed budget would disproportionately harm Latino Americans and are deeply unpopular in our community. Rather than being part of a “Grand Bargain” offered to Republicans in exchange for possible tax increases, these cuts are a great betrayal of a group that proved essential to the president’s victory in the 2012 election. President Obama won an unprecedented 71 percent of the Latino vote nationwide, allowing him to edge out Mitt Romney in the key swing states of Colorado, Florida, Nevada and New Mexico. What many may not know is that like most Obama supporters, Latinos voted for the president in no small part, because they believed they could rely on him to protect Social Security, Medicare and Medicaid. Latinos Depend More on Social Security Latino voters believed President Obama in his 2011 State of the Union speech when he said we must “strengthen Social Security . . . without putting at risk current retirees, the most vulnerable or people with disabilities; without slashing benefits for future generations; and without subjecting Americans’ guaranteed retirement income to the whims of the stock market.” Social Security matters to Latinos, because we depend on it more than any other group. Three in four (77 percent) Latino households ages 65 or older rely on Social Security for a majority of their income, and over half (55 percent) rely on it for 90 percent of their income. That means Latino seniors are 18 percent more likely than the overall U.S. population to rely on Social Security for a majority of their income and 52 percent more likely to rely on it for 90 percent of their income. A major benefit cut in the president’s proposal would be to switch the formula for calculating annual cost-of-living adjustment (COLA) in Social Security and other programs. This so-called chained-Consumer Price Index (chained-CPI), would allow inflation to erode program benefits over time—and would hit Latinos especially hard. Because we are more likely to have lower career earnings, our Social Security benefits tend to be more modest to begin with—$12,491 each year for the average Latino senior and only and $10,438 per year for the average Latina senior. After 20 years receiving benefits under the chained-CPI—when they would be in their 80s–the average older Latino would lose an accumulated $7,774 in benefits, and the average Latina elder would lose $6,307. After 30 years, the cuts would grow, resulting in total benefit cuts of $17,049 for average Latino seniors and $13,832 for average Latina seniors. Change Would Increase Poverty Worse still, the chained-CPI punishes Latinos for being blessed with higher-than-average life expectancy, often combined with greater levels of chronic illness. Because the chained-CPI cuts benefits more as beneficiaries age, it would hit long-living Latinos harder than most. It’s no coincidence then that some experts fear that the chained-CPI will increase poverty among Latino seniors. More than one in four Latino seniors already lives in poverty—nearly twice the rate among white seniors. The White House claims it will protect “the most vulnerable” chained-CPI, with a special “birthday bump” increase for those seniors at age 76. But in the past, such carve-outs have proven inadequate. An analysis by Social Security Works showed that protecting all vulnerable groups from the chained-CPI would erase half of the budget savings from the measure. Even if significant numbers of Latinos were shielded from the chained-CPI due to their lower incomes, this birthday bump might have unintended consequences. Carve-outs—special treatment–of any kind are likely to be misconstrued as handouts for ethnic groups. We already have to deal with enough nasty stereotypes portraying us as recipients of “welfare” or “government handouts.” Proposed Medicare ‘Pain’ The Medicare benefit cuts President Obama proposes are also a step in the wrong direction that would cause Latino seniors real pain. Rather than dealing with the high costs of health care, the budget shifts health costs to beneficiaries by increasing deductibles, premiums and co-payments. The president’s plan would also create a new surcharge. The White House claims these cuts will make Medicare beneficiaries better health care consumers, but this is a flawed argument. Doctors–not beneficiaries—make medical decisions, so the idea that seniors can shop around for health care is ludicrous. As a result, Latino seniors who cannot afford the higher out-of-pocket costs are liable to forego needed care—until their conditions become more acute and costly to treat. So-called means testing of Medicare will not only affect the rich—over time, it would increase premiums for Latino seniors making up to $47,000 a year. Seniors already spend three times more of their incomes on their direct health care costs as the rest of the population. Under the president’s budget, the reduction in Latino seniors’ income would be two-fold: They would be hit by the chained-CPI, and their out-of-pocket health care costs would increase on top of that. In addition, the president’s budget provision requiring a $100 co-payment per episode for home health care services could severely impact those who depend on home health aides to treat their diabetes and other chronic diseases. This would disproportionately affect Latino seniors who have higher rates of diabetes than the overall population. For example, in Chicago, where diabetes is the most prevalent in the country, 25.8 percent of Latinos over 65 suffered from diabetes compared with 15 percent of non-Hispanic whites. The White House has defended the proposed Social Security and Medicare reductions as “not ideal” measures needed to achieve a compromise with Republicans in Congress. Not the Problem—But a Solution There is no question that the president faces difficult choices as he navigates unprecedented Republican obstruction. But at times, President Obama appears to have adopted the Republican framing as well: That our budget problems are due to over-generous Social Security and Medicare benefits. In fact, Social Security does not and legally cannot contribute one penny to the annual deficit and cumulative national debt. Medicare’s rising costs are due to skyrocketing private health care costs. In fact, Medicare has proven far more effective at controlling medical inflation than its counterparts in the private insurance market. Latinos voted for a president bold enough to start a new conversation about the challenges of aging, health care and economic security, not someone beholden to the same old Republican talking points. A real “adult” conversation on our aging boomer population would begin by acknowledging that America has a retirement security and health care crisis. Social Security and Medicare are the solutions to those crises, not the problem. The Latino community appreciates President Obama’s leadership on immigration rights and health care reform. Now it is time for him to honor his promise to Latinos and other vulnerable elders to protect and strengthen Social Security and Medicare. Eva Dominguez is the executive director of Latinos for a Secure Retirement, an advocacy group in Washington, D.C.
Source: newamericamedia.org

New universal background check law blocks 10 purchases

FILE – In this Jan. 6, 2013 file photo, Ken Haiterman, of Pioneer Market, holds a CMMG 5.56mm AR 15 during the 2013 Rocky Mountain Gun Show in Sandy, Utah. A bipartisan quartet of senators, including two National Rifle Association members and two with “F” ratings from the potent firearms lobby, are quietly trying to reach compromise on expanding the requirement for gun-sale background checks. (AP Photo/Rick Bowmer, File)
Source: dailycaller.com

Lovelace joins Medicare payment project

Making the system work requires intense cooperation between doctors and hospitals, says project consultant Dr. Richard E. White Jr., an orthopedic surgeon with New Mexico Orthopaedics and research director for the New Mexico Center for Joint Replacement Surgery. The demonstration project also encourages standardized treatment, such as adding pre-operative counseling before surgery, he says. White estimates that 20 percent to 30 percent of orthopedic patients get pre-operative counseling. Under the new system it could increase to 80 percent to 90 percent, he says.
Source: abqjournal.com

Gov’t cuts might force NM Cancer Center to stop treating some Medicare patients

Reporter RSS Feed The Albuquerque-based New Mexico Cancer Center might have to stop treating up to 300 Medicare patients because of cuts to Medicare brought on by the federal sequestration budget cuts, the Cancer Center

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September 10, 2013

FAQ: Hospital Observation Care Can Be Poorly Understood And Costly For Medicare Beneficiaries

Posted by:  :  Category: Medicare

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A. Hospitals provide observation care for patients who are not well enough to go home but not sick enough to be admitted.  This care requires a doctor’s order and is considered an outpatient service, even though patients may stay as long as several days. The hospitalization can include short-term treatment and tests to help doctors decide whether the patient should be admitted. Medicare guidance recommends that this decision should be made within 24 to 48 hours, but observation visits exceeding 24 hours nearly doubled to 744,748 between 2006 and 2011, federal records show.    
Source: kaiserhealthnews.org

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

The Medicare Prescription Drug Benefit Fact Sheet

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

Daily Kos: Despite bungling Bush’s Medicare drug rollout, GOP still attacks Obamacare ‘navigators’

The contrast with the Democratic response to President Bush’s Medicare drug plan could not be greater. Democrats in both the House and the Senate largely opposed the bill precisely because it had no “public option” and barred the government from negotiating lower prices with the drug companies. (That was just part of the reason that the program’s cost ballooned from an estimated $395 billion over 10 years in December 2003 to a forecast of $700 billion just two years later. None of it was funded because, as Utah Sen. Orrin Hatch later admitted, “It was standard practice not to pay for things.”) And yet, Democratic governors stepped up to protect seniors during Part D’s disastrous launch. Unlike some of their Republican counterparts today, Democratic representatives helped their constituents through the brutal process. And it was President Obama and the Democratic-controlled Congress which in 2010 improved the Medicare drug benefit by moving to shrink the so-called “donut hole” in coverage. The point was not lost on the authors of NBC News’ First Read: Here’s a thought exercise on this summer morning: Imagine that after the controversial Medicare prescription-drug legislation was passed into law in 2003, Democrats did everything they could to thwart one of George W. Bush’s top domestic achievements. They launched Senate filibusters to block essential HHS appointees from administering the law; they warned the sports and entertainment industries from participating in any public service announcements to help seniors understand how the law works; and, after taking control of the House of Representatives in 2007, they used the power of the purse to prohibit any more federal funds from being used to implement the law. As it turns out, none of that happened. (For more background, see “To Attack Obamacare, Republicans Forget the Lessons of Bush’s Medicare Reform.”)
Source: dailykos.com

Medicare Prescription Drug Coverage, Medicare Part D, Doughnut Hole

Medicare has an optional program — called Medicare Part D — that provides insurance to help you pay for prescription drugs. If you select to have the coverage, you pay a monthly premium. This guide explains how the program works and helps you make decisions in choosing a plan that’s right for you.
Source: aarp.org

Making Medicare Decisions Easy

“The two basic options are original Medicare and a supplement policy with a separate Part D drug plan. That’s the original way, that’s the best coverage, but also a little bit higher in cost,” said co-owner of Creekside Insurance Advisors, Jim DeBrueler. “Then we have others who prefer to keep the insurance premiums lower and pay a little bit as you go with co-pays and coinsurance.”
Source: tv3winchester.com

Medicare Insurance Provider San Diego Talks Part D

SBHIS.net can help you enroll in the Part D prescription drug plan.  The Medicare Prescription Drug Plan adds drug coverage to your existing Medicare coverage. It can help you save thousands. According to the latest reports, individuals saved $1,061 per year on average. That’s a significant figure for most seniors on a tight budget.
Source: pomeradonews.com

Top 5 Medicare Questions Asked By Seniors

Eligible individuals have the opportunity to enroll in or make changes to their Medicare Advantage and/or Part D Prescription Drug Plan during the Annual Enrollment Period, which runs from October 15 to December 7 of each year. Medicare Advantage plans must offer at least the same coverage as Original Medicare (Part A and Part B) and may include additional benefits. Stand-alone Part D plans provide coverage for eligible prescription drug costs. Another type of coverage that beneficiaries may be interested is a Medicare Supplement plan, which fills in the gaps in coverage left behind by Original Medicare. However, the best time to enroll in these plans is when you are first eligible and not necessarily during AEP. If you are looking for more information regarding the differences between MA and Medicare Supplement plans, check out this blog post. If you are trying to choose between Original Medicare and enrolling in a Medicare Advantage plan, this post may be helpful.
Source: planprescriber.com

Medicare Open Enrollment Period Begins Oct. 15, 2013

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

Give Your Medicare Part D Coverage an Annual Checkup

48th Anniversary of Medicare ACA Affordable Care Act African Americans Aging AIDS Alsaka Natives American Indians Asians Atlantic Philanthropies Champions for Coverage chronic conditions Dade County Dallas County Economic Empowerment elders of color Financial Literacy Florida health healthcare health care Health Insurance HHS HIV+ Language access Latinos LGBT limited english Marketplaces Medicare National Committee to Preserve Social Security and Medicare National Hispanic Council on Aging (NHCOA) Navigator grant NCPSSM NPR ObamaCare Older Adults older adults of color President Lyndon Johnson SAGE Secretary Kathleen Sebelius seniors Seniors of color Texas U.S. Department of Health and Human Services
Source: diverseelders.org

The Affordable Care Act Saved 6.6 Million Medicare Beneficiaries $7 Billion on Prescription Drugs

These savings are thanks to the provision in the Affordable Care Act that closes the gap in Medicare Part D coverage, often referred to as the doughnut hole, over time. Under Medicare Part D, beneficiaries pay part of the cost of their prescriptions until they reach a certain cost limit. Then, they enter the coverage gap. Before the passage of the Affordable Care Act, when beneficiaries reached this gap, they were responsible for the full cost of prescriptions until they hit another cost limit and catastrophic coverage began. In this coverage gap, beneficiaries had to shoulder the entire cost of their prescriptions, which made important medications unaffordable for many. The Affordable Care Act is changing this by phasing in discounts for brand name and generic prescription drugs while beneficiaries are in the coverage gap. By 2020, the discounts will effectively close this gap.
Source: standupforhealthcare.org

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September 10, 2013

Faces of Dually Eligible Beneficiaries: Profiles of People with Medicare and Medicaid Coverage

Posted by:  :  Category: Medicare

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This report illustrates the diverse experiences of dually eligible beneficiaries – low-income seniors and younger adults with disabilities who are eligible for both Medicare and Medicaid – in obtaining medical care and non-medical, supportive services. Based on personal interviews, the profiles of 14 dually eligible beneficiaries residing in California, Florida, Massachusetts, Michigan, and Oklahoma highlight day-to-day experiences with accessing care, maintaining relationships with providers, managing prescription medications and personal finances, and relying on family and friends for additional support. Such personal stories add a human dimension to the ongoing conversations among federal and state policymakers about the importance of high quality, coordinated care for this population.
Source: kff.org

Video: Dual Eligibility: Choice and Access for Individuals Eligible for Medicare and Medicaid

Waiting for Medicare: ACA Will Help Fill the Gap

However, once she was back at work, it became clear she wasn’t bouncing back and in fact was getting worse.  Karen’s walking challenges were not the problem. MS imposes more than physical burdens on its sufferers – it also causes cognitive challenges, such as an inability to concentrate.  For Karen, MS’s pernicious effect on her ability to focus and multi-task made it increasingly difficult for her to do her job. Her doctor told her she should stop working permanently because of the severity of her symptoms.  But Karen was hoping to put off that day, and worked as long as she could before taking a second short-term disability leave.  It was during that time that she came to terms with the difficult reality of her condition. MS is a chronic, progressive disease, and she would never again be able to effectively perform in a job she had taken great pride in for 22 years.  While still out on short term disability, Karen applied for Social Security Disability Insurance (SSDI), a federal program that provides income support to individuals and their families if they have worked and paid Social Security taxes long enough to qualify for benefits.
Source: georgetown.edu

Am I eligible for Medicare

Anyone can access a Medicare rebate if they are experiencing mental health difficulties. But to be eligible to access a Medicare rebate you must first go to your GP, who will undertake a brief assessment of your situation. You need to be granted a Mental Health Treatment Plan from your GP. This will then allow you to gain most of the cost of a session with a Balance Psychologist back from Medicare.
Source: com.au

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September 10, 2013

Kusserow’s Corner: DME Fraud Remains High Enforcement Priority

Posted by:  :  Category: Medicare

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July 11. In the McAllen, Texas area, Marcello Herrera, the owner of now defunct RGV DME was ordered to prison for submitting fraudulent claims of approximately $11.1 million to Medicare and Medicaid.  Herrera and his co-defendants engaged in and directed a scheme to submit fraudulent claims for power wheelchairs, incontinent supplies, hospital beds, mattresses, and other DME supplies. They committed theft of the identities of beneficiaries and doctors.  Herrera received a sentence of 120 months for the conspiracy conviction in addition to a mandatory 24-month term for aggravated identity theft, which must be served consecutively to one another, resulting in a total 144 months in federal prison. He will also serve three years of supervision following his release, as well as pay restitution in the amount of $6,103,953.74.  As part of his guilty plea, he also agreed to a money judgment in the sum of $6,103,953.74, as well as forfeiting wheelchairs, scooters, and other DME items discovered in his leased storage facility.
Source: wolterskluwerlb.com

Video: Priority Health Medicare 120 sec TV spot

Government austerity with Medicare reform as a top priority

Medicare was designed to be health insurance for the poor elderly when it was originally conceived. We need means testing for participation in Medicare. People should be able to spend what they put into the Medicare system over the years and then be means tested for additional participation.. As they approach using up what they put in they need to be means tested looking at their total financial picture not just their unhidden liquid assets. They can then choose to buy into Medicare if they are above a certain financial level or purchase private insurance or pay for their care from their assets with little or no insurance. Those with less income and assets would continue to receive Medicare benefits after they meet their annual deductible. Sixty Five is a fine starting point for entry. The reforms in Medicare must come in the area of obscenely overpriced procedures, some fair and ethical discussion and decisions on end of life issues and tort reform to eliminate costly defensive medicine costs. A closer handle on eliminating non physician fraud would be helpful as well.
Source: kevinmd.com

Secretary Sebelius: Medicare Helps Millions

Another way we’re strengthening Medicare is by rooting out fraud, waste and abuse in the system – ensuring we protect taxpayer dollars and the health of our seniors. Earlier this year, Attorney General Eric Holder and I announced another take-down of Medicare fraud schemes involving hundreds of millions of taxpayer dollars in cities across the country. The law makes it harder for criminals to submit fraudulent claims and get paid in the first place, and our work has resulted in record Medicare fraud recoveries: Nearly $15 billion in the last four years.
Source: aarp.org

Priority Health Medicare: Your Health Is The Top Priority

If you are nearing the age 65 and do not have a health care card yet, you might want to start looking around and searching for the best health insurance plans for you or your loved ones.  Remember too that it is never too early to prepare for your medical care needs.  Even if you are still in your 40s or 50s, you can already start preparing for your future medical care needs.  We all want to feel at peace when it comes to our health especially when we reach our golden years. The price of health care is not getting any cheaper; I believe everyone should be financially ready for their future medical expenses.
Source: medicarebase.com

Medicare Innovation: Whose Priorities, Whose Interests?

Carol Levin asks the right question in her post, while failing to address all of the potential answers. She stresses the need to address the needs of elderly patients under Medicare and argues that their interests are paramount. While one can make the case for this answer, any focus on patients needs to be balanced by a focus on the needs of the nation and the overall fiscal capacity of the federal government. We need to look very carefully at the core question of who should being paying for all the wonderful care that she envisions. An examination of this issue will reveal that no improvements in care for the elderly that reduces costs for them can come to grips with the sheer magnitude of the costs of Medicare as a middle class entitlement program. We cannot continue to assume that we as a nation can afford to provide the care that all the elderly need regardless of their ability to pay. Individuals in my Medicare eligible generation, including myself, who can afford to pay more of our own costs should be required to do so in order to free up Medicare funds for those who are truly needy. This reform known as means testing for benefits, coupled with higher contributions based on income and an increase in the age at which the benefit commences, could pave the way for real savings on top of those which improved methods of care could provide. In short fix the long term fiscal challenge in all this ways and we may get some relief from the pending crisis.
Source: healthaffairs.org

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September 10, 2013

Autocrine Role of Transforming Growth Factor pi on Rat Granulosa Cell Proliferation (DISCUSSION)

Posted by:  :  Category: Medicare

The apparent failure of exogenous fibronectin to fully mimic TGFp1 effects should be interpreted with caution. Fibronectins are in fact a family of adhesive glycoproteins that have variable primary structures owing to cell type-specific splicing of a primary transcript . Cellular fibronectins differ from plasma fibronectins in that they have so-called extra domains (EDs) in the molecule. The fibro-nectin used in the present study is a plasma isoform and therefore may not be equivalent to the form produced by granulosa cells under TGFp stimulation. In addition, fibro-nectin fragments produced by proteolytic cleavage (but not the intact fibronectin molecule) are mitogenic for cultured fibroblasts . In this regard, we have provided evidence indicating that TGFp1 treatment modulates both the alternative splicing and the proteolytic processing of fibronectin in a bovine granulosa cell line . Furthermore, in bovine granulosa cells a synthetic peptide corresponding to the ED-I exon (not present in plasma fibronectin) was found to be mitogenic, whereas the plasmatic form was without effect.
Source: medicare-partd-for-you.com

Video: Medicare PartD

Medicare Part D Data Spotlight: A First Look at Part D Plan Offerings in 2012

This data spotlight examines the stand-alone Part D drug plan options available to Medicare beneficiaries in 2012. Medicare beneficiaries will, on average, be able to choose from 31 stand-alone Medicare Part D prescription drug plans to choose from, a new Kaiser analysis finds. Average premiums would increase by 4 percent from 2011 to 2012 if beneficiaries remain with their current plans during the open enrollment period, which begins October 15 and December 31. That represents the lowest projected increase since the program began in 2006.
Source: kff.org

Medicare Part D Donut Hole, Coverage and Changes 2013

Medicare Part D 2013 Changes for this year include, once you hit the donut hole you will be eligible for a onetime $250 rebate cheque. You will also receive a 50% discount on brand name drugs in the donut hole; you will also pay less and less for your generic part D drugs in the donut hole. It is planned that as from 2020 the coverage gap will have been closed such that there will be no donut hole. In this case you will only pay 25% of the cost of your drugs until you reach the spending limit. You will also get continuous Medicare coverage throughout this time for your prescriptions as long as you are in the prescription drug plan There is no need to keep track of your retail drug costs or retail drug spending, your Medicare part D plan provider will gather all the retail costs and keep a keen track of your record till you reach the donut hole Phase. You can also check out:
Source: medicalbillingcodings.org

Demystifying Medicare Part D Prescription Drug Coverage

Companies that sponsor Medicare Part D prescription drug plans are required to offer a basic benefit, either the standard Part D benefit defined by law or an equivalent benefit design. In 2012, the standard benefit has a deductible of $320, and possibly a coinsurance of 25% up to an initial coverage limit of $2,970 in total drug spending, a coverage gap (also known as the “doughnut hole”), and catastrophic coverage after $4,750 in costs. Plan sponsors can also offer plans with enhanced drug benefits. Enhanced plans are required to have a greater actuarial value than basic plans, but plans vary in the ways in which they improve coverage. Enhanced plans may reduce or eliminate the deductible, charge less (on average) than the standard 25 percent coinsurance, and cover drugs in the coverage gap. The best way to find out what types of coverage are available in their area is to speak to a benefit Advisor and they can go over the pricing differences as the enhanced plan will be more costly on a monthly premium stand-point.
Source: extendconnections.com

28% of #Medicare #partD plans receive poor star ratings from CMS

Alabama 50% Alaska 40% American Samoa 0% Arizona 48% Arkansas 47% California 42% Colorado 46% Connecticut 43% Delaware 42% Florida 42% Georgia 47% Guam 0% Hawaii 40% Idaho 40% Illinois 44% Indiana 48% Iowa 42% Kansas 39% Kentucky 48% Louisiana 50% Maine 46% Maryland 42% Massachusetts 43% Michigan 44% Minnesota 42% Mississippi 47% Missouri 50% Montana 42% Nebraska 42% Nevada 48% New Hampshire 46% New Jersey 43% New Mexico 43% New York 31% North Carolina 43% North Dakota 42% Northern Mariana Islands 0% Ohio 48% Oklahoma 43% Oregon 40% Pennsylvania 39% Puerto Rico 81% Rhode Island 43% South Carolina 53% South Dakota 42% Tennessee 50% Texas 42% Utah 39% Vermont 43% Virgin Islands 0% Virginia 50% Washington 40% Washington D.C. 42% West Virginia 39% Wisconsin 45% Wyoming 42%
Source: themeddiva.com

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