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

Posted by:  :  Category: Medicare

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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

Video: What Does Medicare Cost?

ibm medicare options: IBM Medicare Extend Health Does NOT Negotiate Insurance Premiums

It has been confirmed a couple of times that the Extend Health Medicare insurance products we will be offered are a subset of the SAME products in the general marketplace and will be the SAME price. One would think Extend Health would have more leverage with insurance companies.  Here’s an even bigger irritant.  EH will probably not offer the cheapest Medicare insurance products in your zip code.  They offer insurance products where they are paid a commission from the insurance company to sell those products.  I continue to urge you to decide what kind of products you want to get BEFORE you talk to an Extend Health advisor.  By way of example, I will tell you what I am doing.  I looked on Extend Health’s website to see what was offered to employees of other companies.  I did that by looking at www.extendhealth.com/dupont and www.extendhealth.com/gm  (isn’t it interesting that anyone can go to www.extendhealth.com/ibm which is the site we are using to enter our profile information) and I saw the products offered by EH in my zip code in 2013. I am reasonably sure it will be the same stuff offered to us.  I am specifically interested in a medigap plan called F high deductible (F+).  Unfortunately, the F+ plan offered by Extend Health is not the cheapest plan in my zip code.  That’s really irritating as there is no difference in the content of a medigap plan from one company to another.  By law, all F+ plans must offer the same coverage.  However, I have to use the one offered by EH to get the HRA subsidy.  Here’s my decision on what kind of products I want to buy:
Source: blogspot.com

Income Thresholds For Medicare Part B And Part D Premiums

While the surtax due to higher Medicare premiums that resulted from the Roth conversion was not huge, at only 1.6%, it nonetheless represents an entirely manageable – and potentially avoidable – surtax that planners and clients should carefully consider. For instance, the client might have decided to convert only $27,000 in the prior example – rather than $39,350 – to keep from exceeding the $87,000 AGI threshold that triggers the first Medicare premium increase, allowing the conversion to have a cost of "only" the 25% marginal tax bracket, and not 26.6%. On the other hand, if the client’s income was higher, the impact would have been more severe. For instance, if AGI was already $85,000, then a $5,000 conversion would result in $1,250 of taxes (at a 25% tax) plus the same $619.20 (for additional Medicare premiums), which leads to a marginal "tax" of $1,869.20 and a marginal tax rate of 37.4%; on the other hand, if the conversion was $10,000, the marginal rate would only be 31.2% (since the additional taxes would rise to $2,500 but the Medicare premium impact would still be the same $619.20/year). The end result: the closer clients are to an income threshold, the better it is to either stay right below the line, or rise far above it until the next threshold (or a new tax bracket) approaches, because the additional Part B and Part D premiums are a flat additional amount even if clients are just $1 across the line (unlike tax brackets, which are always a percentage of additional income). And because the premium adjustments are calculated based on AGI, anything that increases AGI can impact exposure, from IRA withdrawals and Roth conversions, to capital gains, to dividends and interest and income from pass-through entities; on the other hand, any deductions that are taken above the line, such as capital losses or certain business losses, can also reduce exposure.
Source: kitces.com

Families USA Executive Director Explains How To Understand Medicare Premiums

Part D premiums are similarly tied to the costs of prescription drugs. Medicare Advantage premiums are determined by a more complicated process, but they also reflect trends in costs. Because Part D and Medicare Advantage plans are run by private companies, premiums can vary a lot.
Source: smmirror.com

Health gaps may explain varying Medicare costs

The new study by Reschovsky and colleagues, however, found that the health status of beneficiaries near death varied considerably by number and types of conditions, and that these differences accounted for 84 percent of the health-care costs in the final year of life. This differed little—only two percentage points less—when the same casemix indicators were applied to the entire elderly Medicare population.
Source: futurity.org

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

The other Washington could hold the key to Medicare's cost crisis

 But in Washington state, which is known for its progressive politics, the measure, requested by former Democratic Gov. Christine Gregoire, sailed through the legislature, albeit with an appeals process amendment the governor vetoed. “Medicare should be doing this, but it gets rolled by the Congress,” said Dr. Robert Berenson, a health policy expert at the Urban Institute and former commissioner of the Medicare Payment Advisory Commission (MEDPAC), an independent agency that advises Congress on issues affecting Medicare. Berenson pointed to several high-profile examples of Congress meddling with coverage policy, including the case of the late Sen. Ted Stevens of Alaska, who at the behest of the PET scan industry almost single-handedly forced Medicare to cover the scan as a test for Alzheimer’s, a policy that existing science did not support.
Source: publicintegrity.org

Medicare Increase $1 In Price From The Past Three Years

USA Today: Medicare Premiums To Remain Stable In 2014 Medicare Part D premiums will average about $31 in 2014 — up from $30 for the past three years. The Part D deductible will fall from $325 to $310 in 2014. “There is continued very strong competition within the Part D plan,” said Jonathan Blum, deputy administrator and director for the Center of Medicare. When the coverage gap program began, “there was lots of concern that filling in the doughnut hole would cause Part D costs to go up” (Kennedy, 7/30).
Source: kaiserhealthnews.org

Underuse of Hospice Care by Medicaid

Posted by:  :  Category: Medicare

Patients and Methods Using linked patient-level data from California (CA) and New York (NY) state cancer registries, state Medicaid programs, NY Medicare, and CA Surveillance, Epidemiology, and End Results–Medicare data, we identified 4,797 CA Medicaid patients and 4,001 NY Medicaid patients ages 21 to 64 years, as well as 27,416 CA Medicare patients and 16,496 NY Medicare patients ages ≥ 65 years who were diagnosed with stage IV lung cancer between 2002 and 2006. We evaluated hospice use, timing of enrollment, and location of death (inpatient hospice; long-term care facility or skilled nursing facility; acute care facility; home with hospice; or home without hospice). We used multiple logistic regressions to evaluate clinical and sociodemographic factors associated with hospice use.
Source: ascopubs.org

Video: N.Y.S. Medicaid will no longer cover certian drugs starting October 1, 2011

NY wants to use housing to cut Medicaid costs

Moving high-risk low-income patients into supportive housing in order to cut healthcare costs has been a practice that has stretched back several years. In Sacramento, hospitals have collaborated to obtain housing for patients that regularly frequent their emergency rooms. Similar programs have been adopted in Oregon and Southern California.
Source: fiercehealthfinance.com

Roundup: Feds Cut N.Y. Medicaid Payments $1.2B; 93,000 Fewer Kids Enroll In CHIP In Pa.

California Healthline: Changes Set Stage For ‘Shakeout’ Of Medical Suppliers, Services Shifts in contracting practices — part of the trickle-down effects of health care reform — are going to change the landscape of medical equipment and service suppliers in California, stakeholders predict. … Bob Achermann, executive director of the California Association of Medical Product Suppliers … predicted the number of California businesses providing medical supplies and services may be cut in half over the next few years. Two changes are at the heart of the “thinning of the herd,” as Achermann calls it. One is state-driven: California is shifting beneficiaries of Medi-Cal — California’s Medicaid program — from fee-for-service to managed care. The second is a federally mandated change in the way Medicare contracts with suppliers (Lauer, 4/1).
Source: kaiserhealthnews.org

Court of Appeals Holds that School District’s Long

The New York State Court of Appeals recently ruled that a school district’s voluntary payment of Medicare Part B premiums for over-65 retirees, after a contractual requirement to do so was dropped, gave rise to a binding expectation that it would continue providing such benefits. In Chenango Forks CSD v. New York State Public Employment Relations Board, 2013 WL 2435066 (June 6, 2013), the Court noted that the dispute arose when the school district circulated a memorandum to its faculty and staff announcing that, due to the cost, it was terminating its long practice of reimbursing Medicare Part B premiums to retirees 65 or older.  The district was at one time required by its health care insurance plan to reimburse these premiums.  The parties then negotiated a switch to a new plan, reflected in a collective bargaining agreement (CBA) between the parties that was silent regarding that benefit.  Subsequent CBAs between the parties were also silent on the issue but, nonetheless, the district continued to provide it. 
Source: hancocklaw.com

Health Care Subsidy for Medicare

Posted by:  :  Category: Medicare

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“Please do not cut the Health Care Subsidy for Medicare-Eligible retirees.    The cutoff for the full $150 subsidy in the Senate budget is $1600 a month.  $1600/mo X 12 = $19,200/yr.  This amount is 124% of the federal poverty level.   You are jeopardizing the ability of retirees to continue to have health care, pay other bills and stay in their homes.  This is just not fair when there are tax loopholes that could be cut thereby hurting education, health care, senior citizens, disabled and disadvantaged people.”
Source: rpecwa.org

Video: Preserve Social Security & Medicare – AARP WA Speaks Out

Medicare levy increase to fund DisabilityCare Australia

$20 applies ato budget business cfo chief financial officer debt deprecation e-mail electronic equipment family financial advice financial advisor financial plan for forgiveness gst how ideas improvement key medicare medicare levy meeting million mini of on payroll perth quarterly reviews sacrifice salary small business accountants perth smsf investment strategy tax exemptions taxpayer tax return to turnover wa wealth creation
Source: com.au

Social Security and Medicare Reports Little Changed from 2012

It is also worth noting that even in this scenario, the projected increases in payroll taxes over the next three decades would not be hugely different than over the last three. Since 1980, the Social Security tax rate has increased by 2.24 percentage points (or about 2.8 percentage points when factoring in the higher rate on the self-employed) and the Medicare tax rate has risen by 1.9 percentage points. The total effective increase in the payroll tax since 1980 of 4.7 percentage points is only slightly less than the 5.1 percentage point increase for 2045, assuming no other changes in the programs, that would be implied by the projections in these reports.
Source: ssworkswa.org

Reps. Reichert and Thompson Introduce Bipartisan Medicare Secondary Payer and Workers' Compensation Settlement Agreement Act

The Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act establishes clear and consistent standards for an administrative process that provides reasonable protections for injured workers and Medicare.  It would benefit injured workers, employers and insurers by creating a system of certainty, and allows the settlement process to move forward while eliminating millions of dollars in administrative costs that harm workers, employers and insurers.
Source: house.gov

New Report Finds Cutting Social Security and Medicare Would Hurt Washington Small Business Owners

#6 I know you are a troll and all, but wtf? Stop drinking the Rush Limbaugh Kool-Aid and the vapors and cob webs may clear out of your brain. Anyway, if cutting Social Security was just a republican priority, I’d have nothing more to say. But unfortunately the main impetus right now in Washington DC for cutting Social Security is Barack Obama and his stubborn pursuit of a ‘Grand Bargain.’ I think there is a very big misconception out there among both dems and repubs about the president’s agenda. Cutting Social Security is a priority for him and has been from the very get-go. The sequester is just the latest tactic in pursuit of this policy and is intended to force liberal/progressive legislators to accept cuts to Social Security and Medicare as much as it is intended to force republicans to accept new revenue. This is third way, triangulation, new democrats, DLC all over again. And Wall Street is behind it all. So yea, republicans are amoral, greedy anti-American hypocrites. That much is obvious. Too bad the leadership of the democratic party ain’t much better, at least when it comes to protecting Social Security, Medicare, and Medicaid.
Source: thestranger.com

Medicare and Chiropractor in Kent WA Care

Many patients question whether or not Medicare will pay for Chiropractor in Kent WA treatment in order to fix a subluxation. Unfortunately, Medicare will not cover it because it is considered therapy. They will not cover X-Rays, supplementation, orthopedic visits or evaluation services done by individual offices. There are some doctors that will work with their patients so that they can coordinate a payment plan that works in their favor. Kent Chiropractor care services are very good about catering to their patients and making sure that they are getting top notch results from the experience that they have with the doctors. Many of the physicians are also willing to coordinate a payment method for the patient out of convenience.
Source: remediessite.com

Take lessons from past to guide future for Social Security and Medicare | Economic Opportunity Institute

Mark Schmitt, a senior fellow at the Roosevelt Institute, is a former editor of The American Prospect magazine and also a staff member of former U.S. Sen. Bill Bradley (D-NJ). Schmitt estimates that Social Security lifts half of all seniors out of poverty, where most of them were before it started. He says both programs have worked to transform and stabilize the lives of the elderly.
Source: eoionline.org

Armed With Bigger Fines, Medicare To Punish 2,225 Hospitals For Excess Readmissions

In the third round of the program, starting in October 2014, Medicare is increasing the final maximum penalty to a 3 percent payment reduction for all patient stays. Also that year, Medicare plans to consider readmissions for more conditions, including chronic lung disease and elective hip and knee replacements. Health experts have also designed a way to measure all of a hospital’s readmissions, and that may ultimately be used for the penalties. In addition, several of Medicare’s other experiments in alternative payment plans, including accountable care organizations and bundled payments, aim to give hospitals full financial responsibility for patients.
Source: kaiserhealthnews.org

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

Posted by:  :  Category: Medicare

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

Video: Jed Weissberg, MD, Talks About Medicare Advantage Health Plans and the Special Enrollment Period

Consumers Look to Medicare To Rate Highest

“Medicare members should select a plan that is proactive in helping them stay healthy and active as they age. They need to know if their plan does a good job preventing them from getting sick through screenings, vaccines and tests,” says Jed Weissberg, M.D., medical director, Kaiser Permanente Medicare plans. “They also need to know how well their plan manages chronic conditions such as high blood pressure, high cholesterol and diabetes.”
Source: copyrightfreecontent.com

Medicare comes to Kaiser Permanente

Please do not include any medical, personal or confidential information in your comment. Conversation is strongly encouraged; however, Kaiser Permanente reserves the right to moderate comments on this blog as necessary to prevent medical, personal and confidential information from being posted on this site. In addition, Kaiser Permanente will remove all spam, personal attacks, profanity, and off topic commentary. Finally, we reserve the right to change the posting guidelines at any time, at our sole discretion.
Source: kaiserpermanentehistory.org

Medicare Advantage 2010 Data Spotlight: Plan Enrollment Patterns and Trends

As of March 2010, a record 11.1 million people – nearly one in four of all Medicare beneficiaries – were enrolled in private Medicare Advantage plans, up from 10.5 million in March 2009. The gain in enrollment occurred even though the total number of Medicare Advantage plans declined between 2009 and 2010. Notably, while most Medicare beneficiaries have dozens of private Medicare Advantage plans available in their community, enrollment is highly concentrated among a small number of firms in nearly all states.
Source: kff.org

Dir Medicare Sales & Operation ( Job Number: 202222 ) position at Kaiser Permanente in Honolulu

Further informations about this position opportunity please give attention to these descriptions. Provide leadership and direction to the Medicare Department/Line of Business. Directs the day to day operations and workin! gs of the Medicare Line of Business (LOB). Establish department goals, objectives, policies, and standards consistent with regional and national objectives. This includes managing individual and group Medicare sales and member retention, operations, product development and product management. The Medicare line of business for KPHI is significant in that it generates approximately 33% of KPHI’s revenue annually. Provides strategic planning for product design and development, membership growth targets, continuous improvement of administrative processes, and compliance with CMS regulations. Supervises assigned staff. Essential Functions:
Source: blogspot.com

Kaiser study: Romney’s Medicare plan raises costs

What’s more, as Sahil Kapur added, the study “does not project the longer-term implications for traditional Medicare. Many analysts warn that over time, sicker and older patients would choose traditional Medicare over private plans as private insurers tailored their plans to younger, healthier beneficiaries. Without strict rules and adequate risk adjustment, this would put traditional Medicare premiums on a ‘death spiral’ and the public plan would collapse.”
Source: msnbc.com

Kaiser Permanente opens new IT center

About Kaiser Permanente ColoradoKaiser Permanente Colorado is the state’s largest nonprofit health plan, proudly working to improve the lives and health of Colorado residents for more than 40 years. Kaiser Permanente Colorado provides comprehensive health care services to more than 540,000 members through 26 medical offices and a network of affiliated hospitals and physicians. The health plan was named “Highest in Member Satisfaction” among Commercial Health Plans by J.D. Power and Associates for the sixth straight year. Kaiser Permanente was recognized by the National Committee for Quality Assurance (NCQA) as the top-ranked commercial health plan in Colorado, No. 6 in the nation and the second ranked Medicare plan in the U.S. Kaiser Permanente was also recently recognized as a 2012 Hypertension Champion by Million Hearts(TM). In 2011, Kaiser Permanente proudly directed more than $90 million to community benefit programs to improve the health of all Coloradans. For more Kaiser Permanente news, visit kp.org/newscenter or follow on twitter @kpcolorado or facebook.com/kpcolorado.
Source: metrodenver.org

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

Posted by:  :  Category: Medicare

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

Video: What Does Medicare Cost?

Update to Disproportionate Share Instructions in the 2014 IPPS Final Rule

CMS has calculated an estimated per-discharge (or per-claim) amount for each hospital eligible to receive interim uncompensated care payments and will pay that estimated amount on a per-discharge basis by adding it to the payment otherwise made on that claim. The estimated per-discharge amount is based on the amount of the uncompensated care payment CMS has calculated for the hospital for a fiscal year divided by the average number of discharges, or claims, in the most recently available three fiscal years of the Medicare claims data set. For FY 2014 payments, CMS will use the average number of claims from the most recent three years of MedPAR claims data:  FY 2010, FY 2011 and FY 2012. The total amounts paid on a per-discharge basis during the federal fiscal year will be reconciled with the amount of the uncompensated care payment calculated for the hospital for the fiscal year at cost report settlement.
Source: healthcarereforminsights.com

Medicare Cost Contract Extension Act of 2011 (2011; 112th Congress S. 1497)

The United States Code is the compilation of permanent laws enacted by Congress. Temporary and other non-permanent laws do not appear in the United States Code. (About half of the United States Code is the law itself, called positive law. The other half is merely a compilation of the laws but has no legal significance.)
Source: govtrack.us

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

Income Thresholds For Medicare Part B And Part D Premiums

While the surtax due to higher Medicare premiums that resulted from the Roth conversion was not huge, at only 1.6%, it nonetheless represents an entirely manageable – and potentially avoidable – surtax that planners and clients should carefully consider. For instance, the client might have decided to convert only $27,000 in the prior example – rather than $39,350 – to keep from exceeding the $87,000 AGI threshold that triggers the first Medicare premium increase, allowing the conversion to have a cost of "only" the 25% marginal tax bracket, and not 26.6%. On the other hand, if the client’s income was higher, the impact would have been more severe. For instance, if AGI was already $85,000, then a $5,000 conversion would result in $1,250 of taxes (at a 25% tax) plus the same $619.20 (for additional Medicare premiums), which leads to a marginal "tax" of $1,869.20 and a marginal tax rate of 37.4%; on the other hand, if the conversion was $10,000, the marginal rate would only be 31.2% (since the additional taxes would rise to $2,500 but the Medicare premium impact would still be the same $619.20/year). The end result: the closer clients are to an income threshold, the better it is to either stay right below the line, or rise far above it until the next threshold (or a new tax bracket) approaches, because the additional Part B and Part D premiums are a flat additional amount even if clients are just $1 across the line (unlike tax brackets, which are always a percentage of additional income). And because the premium adjustments are calculated based on AGI, anything that increases AGI can impact exposure, from IRA withdrawals and Roth conversions, to capital gains, to dividends and interest and income from pass-through entities; on the other hand, any deductions that are taken above the line, such as capital losses or certain business losses, can also reduce exposure.
Source: kitces.com

The Facts about the Government’s Medicare Cost Projections

This chart compares Congressional Budget Office long-term projections of the debt held by the public from 2010 with long-term projections calculated in 2007. In 2007, the CBO projected that the debt held by the public would surpass 60 percent in 2023. Note that this long-term projection incorporated policy changes that were deemed likely at the time. Using the same methodology last year, the CBO projected that the debt will exceed 60 percent of GDP by the end of 2010. In the three years between projections, the debt milestone has accelerated by 13 years. This unforeseen acceleration is worth careful consideration; as the government consumes more credit, less will be available to the private sector.
Source: reason.com

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September 12, 2013

Oregon Chiropractic Association

Posted by:  :  Category: Medicare

Regence is building on our existing utilization management program efforts for our group and Individual products, including Medicare Advantage plans. We have selected an experienced third-party vendor, CareCore National, LLC (CCN), to administer a new physical medicine program component of our overall utilization management program.
Source: oregonchiroassoc.com

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

Regence BlueCross BlueShield to drop its Portland

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

Finding What You Need Online: Regence Medicare Advantage insurance

If you want to purchase Regence Medicare Advantage Health Insurance you should read a review of Regence and other health plans. Searching for Regence Medicare Advantage health insurance can  be an overwhelming task.  Why not eliminate this worry by comparing over 180 health insurance companies side by side, thereby allowing you to get the best plan at the best price? These prices are fixed by law, you cannot find a better price for the same product. Go to the best site, http://www.GetHealthQuotes.net  Here at this site you can do all of your shopping for health insurance in one place. Try now, and get free quotes!
Source: blogspot.com

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

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

Medicare Updates for 2011

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

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

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

Annual Enrollment Workshops for Medicare Advantage Plans 2011

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

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September 12, 2013

Medicare Supplements (Medigap) For Dummies

Posted by:  :  Category: Medicare

[…] 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 Medicare 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 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 2013Source: croweandassociates.com […]
Source: croweandassociates.com

Video: AARP Medicare Supplement Plan F

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

Utah Medicare Supplements

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

Cheap Home Insurance Medicare Advantage Vs Medicare Supplement Medigap Plan F

MANVILLE: Candidate explains his idea of civic RepublicanismPacket OnlineEven some Democrats we talked to feel the town is on “auto-pilot” with taxes increasing year after year. The four candidates … The flood expenses Manville has encountered are always passed on to all homeowners in town with higher property tax bills … […]
Source: unitel.cc

Medicare Supplement Plan F

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

Seniors See Value in Medicare Supplement Plan G

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

Medicare Supplement Plan F

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

Medicare Supplements: No Changes Coming

“We were unable to find evidence in peer-reviewed studies or managed care practices that would be the basis of nominal cost sharing designed to encourage the use of appropriate physicians’ services. Therefore, our recommendation is that no nominal cost sharing be introduced to Plans C and F. We hope that you will agree with this determination,” the NAIC wrote in the Dec. 19 letter.
Source: tacticalminc.com

What are Medicare Supplements?

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Source: medicarechoicesofarizona.com

Will Obamacare Affect Medigap?

Concerning Medigap, a provision of the ACA required the NAIC to review the most popular Medigap plans (C and F) and determine whether or not employing “nominal cost-sharing” would deter enrollees from misusing physician services. The implication was that, because these Medigap plans fill in the gaps of Medicare (thereby covering 100% of Medicare fees) people are over utilizing doctor visits since it comes at no cost to them, and that employing more cost-sharing would help cut federal health care spending.
Source: medicaresupplement.com

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September 12, 2013

Thursday, August 8, 2013: Bipartisanship, Medicare and wind power — Opinion — Bangor Daily News — BDN Maine

Posted by:  :  Category: Medicare

Flickr

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

Video: Medicare Supplemental Insurance in Maine by Medicare Pathways

What Medicare and Medicaid mean to Maine’s hospitals

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

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

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

Maine Senate Passes Historic Medicare Expansion, Hospital Repayment Bill LD 1546 Along Party Lines

125th legislature 126th Legislature 2012 election aca afa appropriations barack obama bowen budget charlie webster chellie pingree christian civic league congress dawn hill dhhs dnc2012 economy education emily cain equalitymaine gestapo GLAD gop gun control healthcare hospital debt jeff mccabe justin alfond ld 1066 ld1333 ld 1546 lepage lgbt libya liquor contract maine afl-cio mainecare maine democratic party maine gop maine house democrats maine people’s alliance maine refounders mainers united for marriage maine senate democrats mark eves marriage equality mary mayhew mea medicaid medicaid expansion medicare mike michaud mitt romney msea-seiu obama Obamacare olsen olympia snowe open thread paul lepage potus presidential race president obama protect maine voting rights rnc romney ron paul senate race seth berry seth goodall speaker of the house mark eves tea party troy jackson us senate women’s rights
Source: wordpress.com

Eight Maine hospitals sue head of DHHS over payments for low

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

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

Friday, August 9, 2013: Medicare, turbines and baseball — Opinion — Bangor Daily News — BDN Maine

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

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

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

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

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

Maine AG Warns of Medicare Scam

          Morning Classical              Goodbye Letter From Suzanne           Maine Things Considered           Maine Calling           Speaking in Maine           Down Memory Lane           Jazz Tonight           In Tune           Prime Cuts           Something Else           Additional MPBN Programs        Morning Classical Music        PLAYLISTS           Classical 24        Radio & TV Stations        Car Talk Vehicle Donation Program        Down Memory Lane        Podcasts        Music That Moves ME  Television        Take the MPBN TV Viewer Survey        TV Schedule        Sustainable Maine        Video On-Demand        Local Television Programs           Maine Watch           Basketball              Basketball Schedule              Tournament Scores              Basketball DVDs              Tournament Brackets                 Class A Boys Bracket                 Class A Girls Bracket                 Class B Boys Bracket                 Class B Girls Bracket                 Class C Boys Bracket                 Class C Girls Bracket                 Class D Boys Bracket                 Class D Girls Bracket              Basketball FAQ           Sustainable Maine              Archived Programs              Saving Our Lakes              Basket Trees              Pools, Policies and People           Making Our Way: Autism (Featuring Temple Grandin)              What is Autism?              Making Our Way:Autism Resources                 Occupational Therapy                 Autism Screening Tools                 Speech Therapy & Augmentative Communication                 Read Articles on Autism              Reach Out & Find Support              About “Making Our Way: Autism”           Conversations with Maine           Maine Experience               Maine Experience Full Programs           Making $ense New England           Broken Trust           Easing the Burden: Parkinson’s Disease           Caring for the Caregiver/Dementia and Alzheimer’s               Dementia & Alzheimer’s Disease Basics              Resources for Caregivers              If You Have Dementia              Quality Care              Safety Issues for Caregivers              Financial/Legal Topics                 Starting the Search for Long Term Care Insurance              Find a Support Group               Caring for the Cargiver: Contact Information              Share Your Story                 Losing my father a piece at a time.                 All Shared Stories                 Being a Caregiver for a Loved One with Alzheimer’s                 It’s the simple things that matter                 Our Journey with Early On-Set Alzheimer’s Disease              Watch Caring for the Caregiver Online           A Downeast Smile-In           Incredible Maine           Fresh to Flavorful           Sixteenth Maine at Gettysburg              Stripes in My Pocket Stars by My Heart        MPBN Community Films           The Films           Contact MPBN Community Films        “Natural Maine Minute”        TV Programs A-Z        Kids’ TV Schedule        TV & Radio Stations        PBS Digtal Studios Remixes
Source: mpbn.net

PORTLAND, Maine: Maine hospitals awaiting nearly $500M from state

State hospital taxes have gone up, costing hospitals about $20 million a year, he said, and the Legislature cut outpatient reimbursement rates for Medicaid by 10 percent, costing them an additional $15 million to $20 million a year. On top of that, mandated federal budget cuts that went into effect this year cut Medicare reimbursement rates by 2 percent, costing another $20 million or so annually, he said.
Source: myrtlebeachonline.com

Licensed Medicare Appeals Nurse Consultant position at Aetna in Portland

Detailed specification about this position opportunity kindly read the description below. This is a telework role, but candidates must live within commuting distance of an Aetna office. All external candidates must have an active RN license in the state in which they! reside.POSITION SUMMARY The Medicare Clinical Appeal Team (MCAT) is part of the National Clinical Appeal Unit, and is charged with the clinical review of Aetna Medicare Advantage Plan members. MCAT nurses and pharmacists work closely with the Medicare Grievance and Appeal Unit (MGAU), providing timely clinical reviews on a diverse range of clinical topics. Each team members work is directly linked to the success of Aetna’s Medicare Star Quality Rating system. The MCAT values positive teamwork, independent thinking, problem solving skills, and drive for excellence. Responsible for the review and resolution of clinical documentation, clinical complaints and appeals of Medicare Advantage Plan members. Reviews documentation and interprets data obtained from clinical records to apply appropriate Medicare – Centers for Medicare & Medicaid Services (CMS) clinical criteria and policies in line with regulatory and accreditation requirements for member and provider issu! es. Independently coordinates the clinical resolution with int! ernal/external clinician support as required. Requires an RN with unrestricted active license. EDUCATION The minimum level of education required for candidates in this position is a High School diploma, G.E.D. or equivalent experience. LICENSES AND CERTIFICATIONSNursing/Registered Nurse (RN), Nursing/Licensed Practical Nurse (LPN), or Nursing/Licensed Vocational Nurse (LVN) is required.FUNCTIONAL EXPERIENCESFunctional – Nursing/Medical-Surgical Care/1-3 YearsFunctional – Nursing/Clinical Claim Review and Coding/1-3 Years Functional – Clinical/Medical/Concurrent Review/Discharge Planning/1-3 Years REQUIRED SKILLS Benefits Management/Interacting with Medical Professionals Benefits Management/Understanding Clinical Impacts Leadership/Driving a Culture of Compliance DESIRED SKILLS Leadership/Fostering a Global Perspective Service/Creating a Differentiated Service Experience Technology/Leveraging Technology ! Please note that benefit eligibility may vary by position. Clickhereto review the benefits associated with this position. Aetna does not permit the use of tobacco related products or drugs in the workplace. Job Function: Health Care – . If you were eligible to this position, please email us your resume, with salary requirements and a resume to Aetna.
Source: blogspot.com

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September 12, 2013

Why the next government must reform medical training

Posted by:  :  Category: Medicare

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Up to 75% of new GP fellows (1/3 training program and 2/3 overseas trained doctors are being generated in rural, judging from Medical Training Review Panel report pie charts). Most of these gravitate to Metro on completion of training or after serving the moratorium period in the case of OTDs. DoHA stats show significant increase in such flow recently. The influx of OTDs continues at a high level. This is multifactorial but includes reduced requirements for fellowship acquisition. The influx, combined with increased GP training program output, is vastly increasing GP supply and a number of parameters from DoHA statistics suggest oversupply since 2009 at least. Specialists are in much better supply and so are up-taking general practice function, some of which is also increasingly passing to allied health practitioners. This ship would take some time to turn around and action is best commenced soon to have a good look at workforce requirements and sensible courses of action. In rural the role of GPs in both community and hospitals has so far had formal Federal recognition only in remote and very remote areas but not in regional. The Government funded medical sector is a significant part of the economy but it is taxation derived and so may contribute to the economy much less than might appear. It may therefore be counterproductive to over-expand government funded medical services, a pitfall of universal bulk-billing. Federal and State administrations need to combine forces to preserve the rural hospital networks, which requires good training (National function), good disposition (Function of both) and good remuneration (State function). There has been little combined planning thus far. Mike Moynihan President Rural Doctors Association Victoria PS 25% of all medical student education is now conducted by rural doctors
Source: theconversation.com

Video: Cheryl Bradley lectures on Medicare Billing

More from CMS on FQHC Medicare Billing

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

Incident To Services – Medicare Documentation and Correct Billing Guidelines

•          Supervision requirement is met in physician clinic situations when there is a supervising physician responsible for the services performed by the NPPs and ancillary staff.  The Physician need not be the physician who determined the patient’s plan of care, nor have to be the same specialty as the originating physician, but do have to be members of the same group, using same tax ID number · Billing is under the supervising physician
Source: ebixinc.com

Medicare Billing Certificate Programs for Part A and Part B Providers

Learn about the Medicare Program and the specifics for your provider type with a special focus on Medicare billing, and receive a certificate in Medicare billing from CMS for successful completion of the program. Successful completion consists of completion of all required web-based training courses, required readings, and a 75-percent or higher score on the post-assessment. To participate in either the Part A or Part B provider type program, visit
Source: wordpress.com

Medical company declines to answer Senate questions on Medicare billing

JOIN THE DISCUSSION We welcome comments. To post one, you must sign in using either your McClatchyDC login or your login for Facebook, Twitter or Disqus. Just click the appropriate box below. Please keep your comment civil, short and to the point. Obscene, profane, abusive and off topic comments will be deleted. Repeat offenders will be blocked. If you find a comment abusive or inappropriate, please flag it for the moderator by placing your cursor on the comment, then clicking the “flag” link that appears. Thanks for your participation.
Source: mcclatchydc.com

Medicare billing training

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Source: fluxfeatures.com

Fraud & Abuse Training required for Medicare Advantage Plans

The comment period on proposed changes to this very rule just ended December 8, 2009. See page 54644 of http://edocket.access.gpo.gov/2009/E9-24756.htm in which CMS actually admits this and proposes that providers enrolled in Medicare are deemed to have met the training requirement of MA plans. Of course, the final, final rule has not come out yet, but you should expect that healthcare providers will be exempt from this and that MA plans CAN NOT terminate a provider for failure to participate in that plan’s [required] training. Even at this time, MA plans cannot withhold monies owed or terminate a provider for not having completed this “training.”
Source: wordpress.com

2014 Inpatient Prospective Payment System Final Rule

HC Healthcare Consulting has a team of experts that are available to assist you with revisions to your processes, policies and procedures related to these changes.  We are also available to provide your administrative, clinical, coding and billing staff with customized education and training regarding these critical Medicare updates.  We recommend a thorough review of the Final IPPS rule to identify all of the key changes that affect your organization.
Source: hchealthcareconsultingllc.com

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

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

Medical Billing for Skilled Nursing Facilities

Commercial health insurance plans devise their own methods of SNF reimbursement. As with many things in healthcare reimbursement, CMS sets a standard, and eventually, other third-party payers follow suit. Professional medical billers who are cognizant of Medicare’s rules regarding SNF billing will be able to apply that knowledge in other situations. With an education based on correct coding, and an understanding of contractual obligations regarding how to submit clean claims appropriately, medical billers who have received accredited training and have earned certification are preferred over people who have no training. A proper eduction in medical billing and medical coding is an asset when seeking a job in an SNF’s billing department. It is a specialized aspect of medical billing, but it so is any aspect of medical coding. Many SNF medical billers find rewarding careers after finishing their education.
Source: medicalbillingandcodingu.org

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September 12, 2013

Aetna, ConnectiCare Push Collaborations With Health Providers In Private Medicare Plans

Posted by:  :  Category: Medicare

Treatment of some Medicare patients presents unique challenges, the insurers say. Patients who require more than basic care often have several doctors or other points of contact in the medical care system, which means coordinating treatments can be more difficult. For instance: ConnectiCare said a typical Medicare patient sees more than seven doctors in a year and uses nine different medications, so a key piece of its pilot program will be identifying high-risk patients and providing data to help coordinate their care.
Source: courant.com

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

ConnectiCare Enters Medicare Advantage Market

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

Connecticare Sets The Stage For Fun In 2010

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

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

Healthways (HWAY) is the largest independent global provider of well-being improvement solutions. Dedicated to creating a healthier world one person at a time, the Company uses the science of behavior change to produce and measure positive change in well-being for our customers, which include employers, integrated health systems, hospitals, physicians, health plans, communities and government entities. We provide highly specific and personalized support for each individual and their team of experts to optimize each participant’s health and productivity and to reduce health-related costs. Results are achieved by addressing longitudinal health risks and care needs of everyone in a given population. The Company has scaled its proprietary technology infrastructure and delivery capabilities developed over 30 years and now serves approximately 40 million people on four continents. Learn more at www.healthways.com or www.silversneakers.com.
Source: gymrat-fitness.com

Medicare Advantage, Medicare « Heath Insurance News

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

Connecticut Nursing Jobs: Health Navigator (NR12

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

CT Medicare Advantage, Medicare Supplement, Prescription Drug Plans

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

Medicare Advantage Plans Connecticut

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

Flu shots available Tuesday in Fairfield

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

Insurer Teams With Medical Group To Improve Patient Care

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

Connecticare signs deal to offer new fitness program

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

Medicare Advantage Plans Connecticut 2012 « Heath Insurance News

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

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