CMS Announces July 31 Deadline for Medicare Shared Savings Program Applications : Bridging Business & Healthcare

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



However, CMS has announced a July 31 deadline.  An accountable care organization intending to submit an application must file a Notice of Intent by May 31 and obtain a CMS User ID by June 10.  Failure to meet these deadlines will disqualify an organization from MSSP participation in 2014.  CMS has not yet published the Notice of Intent form or the application packet.    CMS will be hosting a national provider call regarding the 2014 MSSP application process on April 9.  A second call is scheduled for April 23.
Source: pyapc.com

Video: Introduction to Medicare – Strengths, Weaknesses, and Applications of Medicare Data

Medicaid Expansion Through Premium Assistance: Arkansas and Iowa’s Section 1115 Demonstration Waiver Applications Compared

Arkansas Medicaid, Health Care Independence (a/k/a Private Options) § 1115 Waiver – FINAL (Aug. 2, 2013), available at https://www.medicaid.state.ar.us/general/comment/demowaivers.aspx; Iowa Dep’t of Human Servs., Iowa Marketplace Choice Plan § 1115 Waiver Application (Aug. 2013), available at http://www.dhs.state.ia.us/uploads/IAMktplaceChoice1115_Final.pdf; see also Kaiser Commission on Medicaid and the Uninsured, Medicaid Expansion through Premium Assistance:  Key Issues for Beneficiaries in Arkansas’ Section 1115 Demonstration Waiver Proposal (July 2013), available at http://www.kff.org/medicaid/issue-brief/medicaid-expansion-through-premium-assistance-key-issues-for-beneficiaries-in-arkansas-section-1115-demonstration-waiver-proposal/.  CMS has finalized regulations that permit states to implement the Medicaid expansion through premium assistance as a state plan option, without the need for a waiver, and also issued guidance governing possible § 1115 premium assistance demonstrations.  42 C.F.R. § 1015, 78 Fed. Reg. 42160-42322 (July 15, 2013), available at https://www.federalregister.gov/articles/2013/07/15/2013-16271/essential-health-benefits-in-alternative-benefit-plans-eligibility-notices-fair-hearing-and-appeal; HHS, Medicaid and the Affordable Care Act:  Premium Assistance (March 2013), available at http://www.medicaid.gov/Federal-Policy-Guidance/Downloads/FAQ-03-29-13-Premium-Assistance.pdf.
Source: kff.org

Learn How Medigap Applications Supplement Your Medicare

Debridement is a method for ridding all the foot of callus foot tissue. This callus material can include leg tissue with scales, foot tissue from fissures (cracked heels, etc.), corns, twelve inches tissue with lesions on the skin (foot ulcers), keratinized tissue, tyloma, kyperkeratosis or any other hardened or much too thick foot muscle tissue. Debridement can are more used to clean out dead tissue, strained tissue, or unhygienic tissue (as within case of a very foot ulcer). Sometimes a podiatric doctor will remove the callus tissue getting a scalpel or perhaps manual cutting system. Other times that this podiatrist will use a drill-like piano that gently lovers the dead alternatively damaged skin down.
Source: kienhoangle.com

Applications accepted for Centers for Medicare and Medicaid Services funding opportunity | CPHA

CMS is including public health pillars such as prevention, wellness, comprehensive care and population health as priority areas in the funding opportunity. Applicants with public health partnerships are welcome to apply. Letters of Intent are due to CMS by Friday, June 28, at 3 p.m. EDT.
Source: cphan.org

Practice How Medigap Applications Supplement Your Medicare

Regardless of whether you reach the particular where you ‘re no longer able to assist you be rehabilitated, but nevertheless , you still entail nursing care, observing have to manage to pay for your care. This might make using your savings or selling some assets to meet the cost connected care. If you reach the particular where you have cashed in almost your savings and also assets and most likely will no longer provide to pay when care, you can apply for Medicaid, which will then start paying for the long term the nursing profession home care. Marketing and pr is one of the perplexed areas for practice development; mainly doctors find difficult to get within an organized Chiropractic Practice Marketing plan. To run the best marketing plan you ought to have careful planning and timing. Disorganized and scattered marketing attempts have been ineffective and by enhancement unfruitful results. Medicare insurance Advantage. Thing C covers you see, the basic health care of the distinctive plan plus much more services like ocular care and dental professional care. This in turn plan can seem availed through enrolment in accredited health maintenance groups (HMOs). Get a Medicare Advantage cost review. For the right free cost consideration of all the top rated cover carriers call medigap plan f Advisors at 866-681-7712 or got you can our website demonstrated in the devices box of this page. Under the present single day medical system many people are powerless to pay because of preventative care. They often gust up in the hospital and achieve expensive surgeries which is they can’t allow to pay to. These surgeries may extend their lives, but may also may not allow them to labour again. An individual who will see medical care when the problem should be a small another may be well placed to work and furthermore pay taxes incredibly much longer than each individual who only gets care when the situation has become critical. Avalon provides each patient with a primary therapist to assess progress, provide assistance and offer one-on-one psychotherapy along when it comes to peer support. In addition that will help a daily approach group, psycho-educational coaches and teams address issues types of as self-esteem, process image, feelings management, assertiveness skill building, and relapse removal. Take, for instance, Terry who will becoming retiring a decade from now. “I’m anticipating the best premiums to increment from 100 big ones a month about 500 dollars,” the author reveals. The lady current monthly insurance policy premium already will cover her and my wife husband. One benefit or the modern day system is these familiarity with it. It’s like an old car that has a broken driver’s door and a gigantic gash in a passenger seat. We’ve gotten appeared to getting in issues from the person side and using a blanket over the main gash in the seat. One additional car will hold problems as appropriately. The car may be better or worse. That part is unacquainted. What is known is that the auto will be peculiar and buying a car is a big commitment. Medicare Part C is always also known although Medicare Advantage. Medicare Advantage Plans combine Medicare Equipment A and Gym and very nearly always include Medicare Portion D into a single plan. Medicare Part D is prescription prescription medication coverage for prescription drugs you use to home.
Source: typepad.com

Massachusetts Health Stats: For HPQ, Medicare Takes Away with One Hand, Gives Back with the Other

This blog overcomes the attempts from those on both the left and right of the political spectrum to use statistics to impose needless changes on one of the best healthcare systems in the world. Massachusetts Health Stats is an as-needed look at statistics about the Massachusetts healthcare delivery and insurance market and industry, including — occasionally — aspects of Medicare as they relate to Massachusetts seniors and the Medicare-eligible disabled. For Medicare-specific information with nationwide implications and some how-to hints for seniors see http://byrondennis.typepad.com/theabcsofmedicare/
Source: typepad.com

Error 404: file not found

You have reached this page because the requested document does not exist on this server. Please check that the URL is correct or inform the webmaster of the website of an incorrect link. Go to website home page
Source: candwcredentialing.com

The Medicare News You Can Use This Week: eRx Exemptions for 2012 and 2013, Billing Education, and eSignatures

Although there is no appeal or review process established for the eRx Incentive Program and payment adjustment, CMS encourages eligible professionals with questions or concerns about the eRx payment adjustment and hardship exemption requests to contact the QualityNet Help Desk.  Through the QualityNet Help Desk, CMS is working with eligible professionals and CMS-selected group practices that have questions about eRx payment adjustments and/or hardship exemption decisions.  CMS is handling all hardship exemption requests and any questions or concerns on a case-by-case basis.   Contact the QualityNet Help Desk if you have issues relating to the eRx payment adjustment and/or the rationale for denial of your hardship exemption request.
Source: managemypractice.com

Aflac Medicare Supplement Rate Increase in Mississippi

Tagged With: Aflac Medicare Supplement Increase Mississippi, Medicare Rate Increase, MedicareBob, Mississippi Medicare Increase, Mississippi Medicare Supplement, Mississippi Supplement Increase, Robert Bache, Supplement Rate Increase Mississippi
Source: srhealthcaredirect.com

Single Stop submits comments to Center for Medicare and Medicaid Services

Single Stop USA’s comments focused on addressing the following topics: (1) Encouraging transparency in the application process; (2) Integrating Navigators, In-Person Assisters, Certified Application Counselors; (3) Leveraging eligibility results to connect individuals to multiple benefit applications; and (4) Addressing the concerns of immigrant applicants. In addition to submitting our own comments, Single Stop worked with the other national benefits access providers and interested policy groups to have a shared voice about ways to maximize this important opportunity to advance on-line benefits access.
Source: singlestopusa.org

Mobile Alabama Medicare Supplement Quotes

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



Robert Bache aka MedicareBob owns and operates Senior Healthcare Direct. Senior Healthcare Direct is a National Telephonic Insurance Agency that represents over 26 Medicare Insurance Companies. It is our job to make sure that you always have the best price for your Medicare Supplement Plan.
Source: srhealthcaredirect.com

Video: Why Seniors are Paying too Much for their Medicare Supplement Plan?

Economist: Medicaid expansion a rural issue

McBride says that when researchers look at rural residents who could be covered by the Medicaid expansion, more than half live in states that opted not to expand coverage. He says when researchers look at urban residents eligible for expansion, more than half life in states that are expanding coverage.
Source: weau.com

Jogger assaulted after allowing thief to borrow cellphone in northeast Dallas

She said that she has not heard back from police whether the incidents are related and requested that her name not be used. She said she was out walking Sept. 7 at about 2 p.m. when a woman in a gold car pulled up to Henderson Avenue and Homer Street and asked to use her phone because she was having an emergency.
Source: dallasnews.com

mHealth: How Mobile Apps May Evolve the Healthcare Industry

Some of the health-conscious mobile apps currently available include the iTriage, which allows the user to input symptoms to obtain an unofficial diagnosis. It’s among the most successful health-related apps from a ratings standpoint, garnering an average rating of 5 out of 5 stars from 159 users. The iStethoscope application records the user’s heart-beat and allows them to playback the recording. It is less successful in the ratings, mustering 2 out of 5 with 38 reviews. ihealthBPM is a hub that allows users to test, track and record their blood pressure, sharing the results to certain social networks. Apple store user ratings average 3 out of 5 with over 300 reviews.
Source: planprescriber.com

MedicareBob’s Blog: Mobile Alabama Medicare Supplement Quotes Provided by Robert Bache aka MedicareBob

Robert Bache aka MedicareBob owns and operates Senior Healthcare Direct. Senior Healthcare Direct is a National Telephonic Insurance Agency that represents over 26 Medicare Insurance Companies. It is our job to make sure that you always have the best price for your Medicare Supplement Plan.
Source: blogspot.com

Can We Outlive Our Medicare?

Nugent, a veteran and a former county sheriff who has a lot of seniors in his district, keeps a close watch on Social Security and Medicare for them. Recently he reported: “ …the number one thing you need to know about Medicare … is the average two-income couple in America pays roughly $110,000 into Medicare over the course of their working lives.  The total cost of care for that couple, however is over $350,000 ….”
Source: senior.com

THE HIGH COST OF FREE SHIT

Our economic analysis shows that retirees who worked for 40 years and then live 20 years past retirement will receive more than twice what they, and their employers, contributed over their lifetime of working. Only retirees who survive a decade or less after their retirement do not take more out of Social Security than they contributed. Most people will agree that the retirees should receive his/her Social Security benefits at retirement. But with people living longer, who will pay for all the additional benefits now promised? Most people who have not done their homework (including Congress) fail to realize that the numbers for Medicare benefits exceed those for Social Security. Since 1965, Medicare required less than a 3 percent contribution from a worker’s gross wages, yet most people receive over $250,000 in medical benefits before reaching the age of 74, assuming no catastrophic illness. You can do the math on your own wages, assuming a lifetime salary of $100,000 per year for all 40 working years, a worker will have paid in only $120,000 into the Medicare system. Congress, after agreeing to take care of everyone after retirement for the rest of their lives, has broken a sacred trust and used incoming contributions to fund other government expenditures, instead of letting the contributions build over the past 50 years.
Source: theburningplatform.com

Medicare Community Meeting

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



This innovative program provides the structure and routine needed to ensure feelings of security and certainty in day-to-day life and include music, exercise, arts and crafts, gardening, resident pets and reminiscing, along with supervised family-life experiences, such as setting the table or folding laundry.
Source: assuredassistedliving.com

Video: Assisted Living Los Angeles Now Medicare Assisted Living

Minnesota Retirement Communities & Assisted Living from Lang Nelson, Inc.

, a nonprofit agency, has been providing services to seniors and their families for over 60 years in Hennepin and Wright Counties.  The Medicare Health Insurance Counseling program has been part of our services for over 20 years.  We have over 50 staff and volunteers that provide Medicare counseling to Medicare beneficiaries and their families in the entire state of MN.
Source: langnelson.com

Ombudsman Program Can Now Obtian Medicaid Support

I HAVE A FRIEND THAT WAS IN THE HOSPITAL AND HAD 2 EMERGENCY SURGERY FOR HIS INFECTION OF HIS LEG. THAT WAS VERY BAD, NOW HE IS IN A ASSIST LIVING ( BATH MANOR IN AKRON, OHIO ) TO GET BETTER SO HIS LEG WONT GET INFECTION WHILE IN THIS ASSISTED HE HAS NOTHING BUT POOR HELP CAN NOT GET HIS INSTLIN ON TIME , WHEN HE ARRIVED AT THIS ASSISTED LIVING HE HAD TO BE ON A WOUND PUMP THE ROOM WAS NOT SET UP NOBODY IN THIS BUILDING DID NOT KNOW HOW TO PUT TOGETHER WHEN HE RING IT TAKES 45 MINTUES OR MORE TO GET WHAT HE NEEDED, THE DIRECT OF NURSING KNOWS WHAT GOING ON BUT NOTHING DONE!! MY BROTHER ALWAYS GO SEE HIS FRIEND BEFORE HE GO TO WORK THURSDAY AUGUST 22, 2013 HE HAD TO BRING IN A PLUMBER TO UN CLOG THE TOILET .BECAUSE THERE WAS NOBODY FOR TWO DAYS TO CLEAN THE TOILET!! I THINK SOMETHING NEEDS TO BE DONE , THE PATIENT IS READY TO LEAVE THIS PLACE BECAUSE OF THE SERVICES, THANK YOU FOR LISTEN IF YOU HAVE A NUMBER I CAN CALL SOME THING NEED TO BE DONE BEFORE SOMEONE GET HURT .
Source: about.com

Bill Boosts Telehealth Use for Medicare Providers

This bill builds on the STEP Act for the Department of Defense health professionals, which is pending congressional vote, would allow enable Department of Veterans Affairs health professionals to serve any veteran in the U.S. without unnecessary cost and time delays of multiple state licenses through the use of telemedicine. The American Telemedicine Association is a big supporter of both bills.
Source: healthcare-informatics.com

Eldercare Resource Center: Understanding the differences between Medicare and Medicaid

For a seemingly simple question, this distinction causes an extraordinary amount of confusion.  The most simple answer is that Medicare is a health insurance program for all Americans age 65 and over.  Medicaid is a health insurance program for low income Americans with limited financial resources of any age.  Therefore for persons 65 and older, it is possible to be eligible for both Medicaid and Medicare.  Unlike many government programs, eligibility for these two programs is not mutually exclusive.  It is possible to be eligible for and concurrently receive benefits from both programs. Other than the eligibility criteria, Medicaid and Medicare also differ in their benefits.  Both programs cover medical care and prescriptions drugs (to an extent), what sets them apart is their coverage of long term care.  For nursing home care, Medicare will only pay for part of the cost for a period of 100 days.  Medicaid will cover the full cost of nursing home care indefinitely. For assisted living care, adult foster care or other forms of residential care in which personal care and assistance with the activities of daily living is provided but not full medical care, Medicare does not pay anything.  Medicaid, on the other hand, does cover these forms of care though some explanation of how it does is helpful.  Medicaid offers elderly beneficiaries what are called HCBS or 1915 Waivers.  Waivers allow beneficiaries to receive care services outside of nursing homes.  Waivers are state-specific and some states have waivers specifically to pay for assisted living and others offer only partial payment of assisted living costs. For non-medical, home care, Medicare again pays nothing.  Medicaid, similar to the way assisted living is covered, will pay for home care through Medicaid Waivers. Hopefully this provides a quick and easily understandable answer to the question of the difference between Medicare and Medicaid.  We’ve published several other blog posts which address Medicaid’s coverage of assisted living and home care. 
Source: blogspot.com

U.S. Bans New Home Health, Ambulance Providers In Three High

Fiscal Times: Abuse And Neglect In Assisted Living Facilities You’ve seen the sales pitches about America’s assisted living facilities. Seniors can flourish in bright, cheery alternatives to nursing homes and live out their golden years securely, monitored by medical professionals who tend to their every need. The business of assisted living paints a depressingly different picture, according to a provocative new documentary from PBS Frontline airing this Tuesday night, accompanied by a series from ProPublica that is being published this week. Nearly 750,000 American seniors live in assisted living facilities today — but instead of being cared for, many are abused and neglected, according to a year-long investigation (Mackey, 7/29).
Source: kaiserhealthnews.org

Director of Healthcare Accounts Receivable – Brookdale Senior Living, Inc.

Our client, Brookdale Senior Living, has provided exceptional service and care to seniors since 1981. They are one of the nation’s largest, most experienced and reputable senior living communities. They operate more than 600 properties across 36 states and continue to grow at a rapid pace. They have high resident satisfaction ratings and are committed to quality, high standards, and service excellence for their residents. The position is located at their corporate office in West Allis, Wisconsin. The Director of Healthcare Accounts Receivable will oversee the Revenue Cycle processes for all CCRC communities and Medicaid billing cycle for Assisted Living of large senior living provider servicing communities nationwide.  Manage Healthcare related Accounts Receivable, (Medicare, Medicaid, commercial Insurance and private) including ownership of billing cycles, collections, revenue accounting, reporting, compliance, systems and projects for government and insurance payers. Responsible for cash generation, customer satisfaction, process improvement and efficiencies measured by days sales outstanding, aging, bad debt write offs and reserves, internal scorecards, budget and customer satisfaction.
Source: hfmawisconsin.com

The Medicare Hospice Benefit

Grief and loss counseling in the form of hospice led bereavement support groups and a series of inspirational mailings are provided for up to one year following the loss. Because the Hospice Medicare Benefit Part A covers the costs of all authorized covered medical and support services related to the terminal condition, the patient receiving Hospice Medicare benefits may no longer use their traditional Medicare for medical or support services for the terminal illness. Medicare WILL continue to pay for covered benefits that are not related to the terminal illness.
Source: assisted1.com

Medicare still has an LTCI image problem

A research arm of Bankers Life and Casualty Company has published new data on that misunderstanding in a report based on a Web-based survey of 1,299 U.S. residents ages 49 to 67. The survey participants had annual household income of $25,000 to $75,000.
Source: lifehealthpro.com

Comments Off  :  Add Comment
September 18, 2013

What Exactly Is A Medicare Supplement Plan In Arizona State

Posted by:  :  Category: Medicare

The one is nicer? The short decision is it depends on your wishes. You should take on if you have medical issues where require expensive treatment method. Second, you really should consider how usually you travel along with if you system to move eventually. Thirdly, you require to weigh your actual options from an income basis. Do you will want unhindered access to actually medical care, or maybe are you wanting to spend a certain time shopping you are options to some?
Source: geocubes.com

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

House Republicans criticize rich Medigap plans

The authors — House Energy & Commerce Chairman Fred Upton, R-Mich.; Rep. Joe Pitts, R-Tenn., chairman of the Energy and Commerce health subcommittee; House Ways and Means Chairman Dave Camp, R-Mich.; and Rep. Kevin Brady, R-Texas, chairman of the Ways and Means health subcommittee — say the commentary will be the first in a series of Medicare reform papers.
Source: lifehealthpro.com

Top 10 Medicare Health Plans in the US

In addition to offering individual and family health insurance plans,  Health Insurance carriers also sell private health insurance plans to seniors and those eligible for Medicare. These products are called Medicare Advantage, Medigap or Medicare Supplemental Insurance, and Medicare Part D prescription drug cards.
Source: qooqe.com

Key Things to Know About Buying Medicare Supplemental Insurance

Additional benefits vary according to the plan selected. These benefits include a set amount of coverage for skilled nursing facility charges up to 100 days, and coverage of certain Medicare Part A deductible charges. Since 2006, Medicare Supplemental Insurance plans do not include prescription drug coverage as part of their benefits, and individuals requiring such coverage should investigate joining a Medicare Part D Prescription Drug Plan. Individuals should also be aware that Medigap plans generally do not cover such costs as private-duty nurses, dental or eye care, eyeglasses, hearing aids or long-term nursing care costs. Consider switching over to a Medigap Advantage Plan if prescription drug coverage is required.
Source: weatheringthefinancialstorm.org

Do I need a Medicare Supplement?

AARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medicare Supplement AARP Medicare Supplements AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 aetna Medicare Anthem Anthem Medicare Anthem Medigap Crowe and associates how to choose a Medicare Advantage plan How to choose a Medicare plan how to choose a plan How to choose a supplement how to enroll in a medicare plan MAPD Med Advantage Medicare Medicare A Medicare A and B Medicare Advantage MEdicare Advantage Connecticut Medicare Advantage plans medicare b Medicare Complete Medicare part B Medicare part B cost Medicare plan Medicare Supplement Medicare Supplement Connecticut Medigap Medigap connecticut Medigap rates 2013 Medigap rates NY 2013 Original Medicare sign up for medicare United medicare complete United Medicare complete 2013 Wellcare medicare
Source: croweandassociates.com

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

Precisely What Is The Best Quality Medicare Supplemental Plan

Best medical insurance plans come with different exclusions. It may be wise at your part, as a buyer, left through the exemption details to extract any confusion immediately after. Few of the main exclusions worth refering to here are pre-existing ailment/injury (generally forty-eight months prior towards issuance of foremost policy), diseases contracted during first 30 days of the type of policy start date, self-inflicted injury expenses, non-allopathic treatment, conditions caused by put on of alcohol probably drug, AIDS treatment expenses, congenital diseases, infertility treatment, dental, and more. Well, the best health and wellness insurance policy does indeed cover non-infective arthritis, joint replacement, coupled with other diseases created two consecutive insurance coverage years have been finished.
Source: wordsworthbooks.org

Understanding Medicare Supplemental Insurance

Medicare supplemental insurance is sold by private companies like AARP and Mutual of Omaha. There are 11 standard plans that vary in price. Each plan fills different “gaps” in Medicare coverage and offers different benefits. Customers can choose only one of these plans. Medigap plan F is the one most often chosen because it fills nearly all of the coverage gaps. If your spouse wants Medigap insurance, he or she will need to purchase a separate policy. Depending on what plan you choose, Medicare supplemental insurance may cover the cost of:
Source: terrencemalick.org

How to Choose a Medigap Supplemental Policy

You also need to be aware of the three pricing methods which will affect your costs. Medigap policies are usually sold as either “attained-age” policies which are premiums that start low but increase as you get older. “Issue-age” policies that increase prices due to inflation, not age. These policies may start out a little more expensive than attained-age policies but generally have few rate increases over time. And “community-rate” policies, where everyone in an area is charged the same premium regardless of age. Issue-age and community-rated policies will usually save you money in the long-run.
Source: downriversundaytimes.com

Comments Off  :  Add Comment
September 18, 2013

Medicare Part D Spotlight: Part D Plan Availability in 2011 and Key Changes Since 2006

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



It finds that the average Medicare beneficiary will have a choice of 33 Part D stand-alone prescription drug plans in 2011, despite a 30 percent reduction in the total number of stand-alone plans available nationwide. Monthly premiums for stand-alone prescription drug plans will rise by 10 percent, on average, to $40.72 in 2011 if beneficiaries stay with their 2010 plans.
Source: kff.org

Video: Medicare Home Health Changes: 2011 & Beyond

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

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

Medicare Changes for 2011

New Requirement for Face-to-Face Encounter as Part of Process for Certifying Beneficiary Home Health Care The Affordable Care Act (ACA) mandates that a physician conduct a face-to-face encounter to certify a beneficiary need for home health care services. The CMS rules to implement this provision require that the face-to-face encounter must occur within the 90 days prior to the start of home health care, or within the 30 days after the start of care. Review the details of this new requirement, which has significant impact on internists.
Source: acponline.org

Health Care Changes for 2011

It might only be October, but there are less than seventy-five days until the new year which also means more changes to our health care system. Previously in my blog I’ve discussed the changes and given you a time line of when you can expect them to take place. Below are the changes that are scheduled for 2011: Prescription Drug Discounts: effective January 1, 2011. Seniors who reach the coverage gap will receive a 50 percent discount when buying Medicare Part D covered brand-name prescription drugs. Over the next ten years, seniors will receive additional savings on brand-name and generic drugs until the coverage gap is closed in 2020. Free Preventative Care for Seniors: effective January 1, 2011. The law provides certain free preventative services, such as annual wellness visits and personalized prevention plans, for seniors on Medicare. Bringing Down Health Care Premiums: effective January 1, 2011. To ensure premium dollars are spent primarily on health care, the new law generally requires that at least 85 percent of all premium dollars collected by insurance companies for large employer plans are spent on health care services and health care quality improvement. For plans sold to individuals and small employers, at least 80 percent of the premium must be spent on benefits and quality improvement. If insurance companies do not meet these goals because their administrative costs or profits are too high, they must provide rebates to consumers.  Addressing Overpayments to Big Insurance Companies and Strengthening Medicare Advantage: effective January 1, 2011. Today, Medicare pays Medicare Advantage insurance companies over $1,000 more per person on average than is spent per person in Original Medicare. This results in increased premiums for all Medicare beneficiaries, including the 77 percent of beneficiaries who are not currently enrolled in a Medicare Advantage plan. The new law levels the playing field by gradually eliminating this discrepancy. People enrolled in a Medicare Advantage plan will soon receive all guaranteed Medicare benefits, and the law provides bonus payments to Medicare Advantage plans that provide high quality care. Learn more about improvements to Medicare.  Improving Health Care Quality and Efficiency: effective no later than January 1, 2011. The law establishes a new Center for Medicare & Medicaid Innovation that will begin testing new ways of delivering care for patients. These new methods are expected to improve the quality of care and reduce the rate of growth in costs for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). By January 1, 2011, HHS will submit a national strategy for quality improvement in health care, including these programs. Improving Care for Seniors After They Leave the Hospital: effective January 1, 2011. The Community Care Transitions Program will help high-risk Medicare beneficiaries who are hospitalized avoid unnecessary readmissions by coordinating care and connecting patients to services in their communities. New Innovations to Bring Down Costs: administrative funding becomes available October 1, 2011. The Independent Payment Advisory Board will begin operations to develop and submit proposals to Congress and the President aimed at extending the life of the Medicare Trust Fund. The Board is expected to focus on ways to target waste in the system, and recommend ways to reduce costs, improve health outcomes for patients, and expand access to high quality care. Increasing Access to Services at Home and in the Community: effective beginning October 1, 2011. They new Community First Choice Option allows States to offer home and community based services to disabled individuals through Medicare rather than institutional care in nursing homes. Be sure to continue tuning in to get all the new health care law updates. Remember, there are changes that will occur throughout the year 2015 and I’ll be sure to keep you updated about them all. Many of these changes happening in our health care system mean that the current nursing shortage is going to be exacerbated and more health care workers in general are going to be needed all over the country in the very near future. If you’ve been considering a career in nursing or health care, now is the perfect time to begin–or advance–your education. Check out The College Network today for exciting opportunities in nursing, including LVN/LPN to RN, RN to BS in Nursing, MS in Nursing and more. There are other opportunities in health care that you can also take advantage of through The College Network including Health Care Administration, Health Care Management, EMT to BS in Health Science – EMS Management, and more. Learn how you can gain experience and make a difference in our country during these incredible changes in our health care system.
Source: collegenetwork.com

Medicare Plans: What You Need to Know for 2011; Changes, Costs, Premiu…

Will my plan still be there next year? Some drug and health plans will disappear in 2011 for specific reasons — though not as a result of the new health care law. Drug plans: Some won’t be available next year, because of new Medicare rules that officials say are designed to offer consumers clearer choices between plans. Any insurer offering two or three plans must now make each plan’s benefit package significantly different — for example, by offering a much lower premium in one plan or coverage in the gap known as the "doughnut hole" in another.
Source: aarp.org

Voters Dislike GOP Plan to Change Medicare, Medicaid

Quinnipiac told half of the 1,408 registered voters the university polled that Medicare, Medicaid, Social Security and defense spending consume 60% of the budget. The other half weren’t. Among those who were told, 70% opposed efforts to change Medicare, compared with the 75% who weren’t told. For Medicaid, 57% of the first group opposed limits, compared with the 59% of the control group that also opposed changes. The only significant change came on the question of defense spending, with support for cuts increasing by 7% when voters were told how much the government spends on the military.
Source: wsj.com

Medicare Home Health Changes for 2011 & Beyond

The 36-month rule was actually put in place under the 2010 payment rule, but the 2011 payment rule provides further guidance on the application of the rule after a year of confusion. The 36-month rule prohibits the conveyance of the home health provider agreement to a buyer if the selling agency started within 36 months or a prior change of ownership took place in the last 36 months. Under these circumstances, the buyer must enroll in Medicare as a new, or initial, agency. The 2011 payment rule confirms it does apply to both asset and stock transactions. However, it will only be applied to changes in “majority” ownership, and several exceptions to the rule are provided, including death of an owner, indirect ownership changes and changes in entity structure. Take Action Now
Source: healthcarereforminsights.com

Comments Off  :  Add Comment
September 18, 2013

Medicare Open Enrollment Period Begins Oct. 15, 2013

Posted by:  :  Category: Medicare

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

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

Does Medicare or Medicaid Come with Disability?

Do you get Medicare coverage if you were approved for SSI? Claimants who are approved for SSI only typically receive Medicaid coverage in most states. And like SSI, Medicaid is subject to income and asset limitations. Medicaid is a needs-based, state- and county-administered program that provides for a number of doctor visits and prescriptions each month, as well as nursing home care under certain conditions. Can you ever get Medicare if you get SSI? Medicare coverage for SSI recipients does not occur until an individual reaches the age of 65 if they were only entitled to receive monthly SSI disability benefits. At the age of 65, these individuals are able to file an uninsured Medicare claim, which saves the state they reside in the cost of Medicaid coverage. Basically, the state pays the medical premiums for an uninsured individual to be in Medicare so that their costs in health coverage provided through Medicaid goes down. 
Source: disabilitysecrets.com

How Long Does It take to Get Medicare Coverage Through Social Security Disability (SSD)?

However, your onset date for payment purposes can only be 17 months before your application date — that’s because Social Security allows a maximum of 12 months of retroactive benefits. (This maximum gets you to 12 months before your application date, plus five months for the waiting period, so your earliest established onset date is 17 months before the application date.) In turn, the earliest you can become eligible for Medicare is two years after you apply for Social Security disability. (For more information on calculating your date of entitlement, our article on disability onset and backpay.)
Source: disabilitysecrets.com

Selling Marketplace Plans To Medicare Beneficiaries Will Be Illegal

With so much publicity surrounding the opening next month of the new Internet-based marketplaces, seniors could easily think the health law’s marketplaces, also called exchanges, offer options for them too. Federal officials have been eager to steer them away, in messages on both the exchange and Medicare sites and in a special notice that will appear in the 2014 Medicare & You handbook mailed this month to 52 million beneficiaries.
Source: kaiserhealthnews.org

Thinking Person’s Guide to Autism: How Will the Affordable Care Act Affect People With Disabilities?

Ari Ne’eman: We view the Affordable Care Act as a significant opportunity for people with disabilities, particularly people with intellectual and developmental disabilities (I/DD). Most people with I/DD have access to health insurance coverage through Medicare and Medicaid — as a result, our main focus has been analyzing the impact of ACA on the quality of that coverage as well as the potential that ACA brings to facilitate access to private insurance for our community. The Affordable Care Act’s most significant impact for people with disabilities is the end to pre-existing condition discrimination, which is huge. It’ll make it easier for the parts of our community that are not insured to gain access to coverage. However, just as significant is the insurance reforms that ACA mandates regarding benefits, access to providers and affordability. The law also includes substantial new options for states to take up regarding Medicaid home and community-based services. All in all, we think the law could have a major positive impact on people with disabilities, if properly implemented. What would be some example of “properly implemented”? That’s a great question. With a law of the size and scope of the ACA, a lot of the implementation will depend on the decisions made by states and the oversight provided by regulators. Already, we’re seeing significant differences in the decisions states are making about whether or not to expand Medicaid or set up their own health insurance marketplace. Those types of decisions have an impact on the availability and type of coverage available in those states. One of the issues we covered in our policy brief is that the Department of Health and Human Services (HHS) has decided to leave the decision about what constitutes Essential Health Benefits — the minimum health services all insurance plans must cover — to each state instead of establishing a uniform federal definition. That means that a lot of discretion is going to be left to state choices about what constitutes the bare minimum a health insurance plan must include. Prior to that decision, we in the advocacy community had hoped that a single federal definition would be put in place. Another area of interest is that ACA creates a number of opportunities and incentives for states to go above and beyond what they’re required to, particularly regarding services for people with disabilities. For example, the law authorized the creation of the Community First Choice (CFC) State Option, a new Medicaid option that offers states that eliminate waiting lists for certain kinds of disability services a 6% enhanced federal match for the costs of those services. Basically, this is the federal government stating that if a state is willing to make certain types of disability services an entitlement in that state, the feds will pick up an additional 6% of the costs in return. The CFC and other similar state options were some of the things that ASAN and other disability rights groups, like National Council for Independent Living (NCIL) and ADAPT, advocated for during the health reform debates several years ago So, both for good and for bad, state policymakers are going to have a lot of latitude in deciding how to implement this law. That’s why we produced this policy brief, to give advocates the information and tools they needed to push for the right steps to be taken. Will ACA reforms affect long-term care and support costs for people with disabilities? Yes, in a number of ways. First, the law has already imposed a number of reforms on insurance companies that should reduce costs for people with disabilities and family members. It prohibits lifetime dollar value limits on covering care and services, it has prohibited denying coverage to children with pre-existing conditions and it has prohibited insurers from arbitrarily rescinding coverage. In 2014, it will prohibit annual limits on the dollar value of coverage and make it illegal to deny coverage to anyone, adult or child, based on a pre-existing condition discrimination. The law also sets up a system of health insurance marketplaces that will open for enrollment next month on October 1st, and will offer coverage taking into effect on January 1st. These marketplaces will also offer multiple opportunities for people with disabilities and family members to reduce the cost of care. First, subsidies will be available to help uninsured Americans purchase health coverage for people making between 100% and 400% of the federal poverty level. Second, the marketplaces will make it easier to compare the cost and quality of different kinds of health insurance plans, sort of like an Expedia-type website for health insurance. Third, the marketplaces will sort each plan into “metal levels” of Bronze, Silver, Gold or Platinum, indicating the estimated percentage of the cost of care the plans will cover as compared to your out of pocket costs. So, for example, if you have a Platinum plan, it will be expected that your plan will likely cover about 90% of the actuarial value of the cost of care. If you have a Gold Plan, 80% and so on. Finally, the new Medicaid state options will incentivize states to expand Home and Community Based Services — the ACA sets up a number of new options for states in this regard, including the Community First Choice State Option, the State Balancing Incentive Program (for states that have historically lagged behind in de-institutionalization) and the re-authorization of the already highly successful Money Follows the Person program. What is a Qualified Health Plan as defined by the ACA? That’s a great question. To be included in the Marketplace, insurance plans have to meet certain minimum requirements — this is called becoming a Qualified Health Plan (QHP). The most commonly referred to is to include certain Essential Health Benefits. As mentioned earlier, this is something that states will have a lot of latitude to determine the minimum requirements around, as long as they include benefits in each of the ten categories set out by the law. However, becoming a QHP also includes minimum requirements around provider network access (“How easy is it for me to find a doctor or other service provider who will serve me?”) and other quality assurance provisions. ACA also has introduced a new broad based requirement on all insurance companies, which took into effect last year. It’s called a Medical Loss Ratio. What it means is that if an insurance company spends less than a certain percentage of the premiums it receives on health care — 80% in the individual market, 85% in the group market — it must refund its customers until that ratio comes back into alignment. It’s already led to many consumers receiving money back from their insurers. What are some of the disability community’s concerns about Essential Health Benefit Packages as defined and implemented under the ACA? One of the biggest ones is to what degree habilitative services — things like Occupational Therapy, Speech Pathology and a number of other interventions — will be required within the Essential Health Benefits package. The law instructs states to determine the Essential Health Benefits package in relation to a state-selected benchmark plan — essentially, states need to pick a plan from a series of options provided by the federal government and then require all plans on the Marketplace in relation to what is available in that plan. However, habilitative services are generally not covered by most private insurers. But the law requires their inclusion in the Essential Health Benefits package, as they are one of the ten required benefit categories. We feel the disability advocacy community in each state needs to carefully monitor how their state manages that contradiction and push for a robust habilitative services benefit. So people with disabilities are still at risk of falling through the cracks under the ACA and Medicaid expansion? Regardless of what choices states make in implementation, the basic minimum required under the ACA is going to be a vast improvement over the status quo prior to the law’s passage. However, we want to make sure that all potential mechanisms in the law to enhance the quality of health care available for people with disabilities are utilized. That’s going to mean putting pressure on state governments with respect to how they choose to implement ACA, and pressure on federal regulators to provide meaningful oversight. Just because something is better than what we had before, doesn’t mean we can stop advocating for all of our needs to be met. What are the benefits of allowing people with disabilities who are Medicaid beneficiaries to access Qualified Health Plan coverage from the newly established exchanges? I think the biggest benefit for people with disabilities regarding accessing the private insurance market is better access to providers. Medicaid is a great health insurance program as far as it’s scope of benefits, but it is far worse than private insurance when it comes to the number of clinicians and other providers that will accept it. That’s because Medicaid pays providers much less than both Medicare and private insurance do. If we can offer people with disabilities greater access to the private health insurance market, we can make it easier for people to find a doctor and even pick from multiple options. Why do people with disabilities need to pay particular attention to the issue of provider adequacy? We’ve put a lot of time and energy into ensuring that people have access to health insurance, which is great — but it’s not very useful if people still don’t have access to health care! Health insurance is a payment mechanism. For it to work, you need to have providers that will be willing to accept the payments and who are qualified to provide the services you want from them. Whether we’re talking about the Medicaid system and long term services and supports or the private insurance market and acute care, we need to pay attention to provider access. It is a critical and under-acknowledged area of public policy. How does the ACA stand to benefit people with disabilities, in terms of employment? Health care and employment have always had a close inter-relationship. Many people with disabilities who want to work and are able to find jobs either don’t accept them or keep their wages lower than what they could otherwise earn so that they don’t lose access to public health insurance, eligibility for which is linked to income support programs like Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). This is because as of the moment, our private health insurance market makes it either extremely expensive or impossible to get coverage if you have a disability. As of 2014, pre-existing condition discrimination will end and that will change. We think it will make it easier for people with disabilities to shift off of income support and access the private insurance market. That won’t be the end of our need for either income support or public health insurance, however. The policy brief outlines a number of ways that state policymakers can help offer hybrids of public and private insurance coverage options for individuals who still require benefits that are only available through Medicaid or who are not able to earn enough to totally replace income support payments. We believe that this part of our community should also have access to the expanded provider networks available under the plans on the Marketplace. So that expanded provider network access will vary by state? Yes, particularly because different states may make different decisions about how much access to the Marketplaces people who are on Medicaid will have. For example, we are urging states to utilize a long-standing state plan option called Section 1905(a) to buy people with disabilities now on Medicaid health insurance plans from the marketplaces and then provide wrap-around coverage to basically have Medicaid cover everything that private insurance doesn’t. We think this could be a Win-Win for everyone involved. People with disabilities get health insurance coverage with better access to providers, but also have Medicaid to cover the benefits that private insurance doesn’t include, as well as pay for co-pays and other cost-sharing present in private insurance but prohibited under Medicaid. States get to spend less on acute care costs, because the ACA makes it illegal for health insurance companies to charge people with disabilities more for coverage. However, there’s no guarantee that states will take that option – many may find it administratively complex or may be reluctant to shift large numbers of people with disabilities into the new Marketplace system, for fear that it will increase costs for the general population. So the decisions that get made by state policymakers will have a big impact on whether or not people with disabilities get to make the most of the opportunity offered by the ACA. How can the Department of Health and Human Services help ensure that the ACA benefits people with disabilities? Three things: 1) Give states the technical assistance necessary to make sure they use Win-Win opportunities like expanding Medicaid and what we’re recommending around 1905(a). We think this would benefit everyone involved, but it’s a new thing and states are often afraid of new things, particularly when so much else is changing around them. 2) Provide meaningful oversight on areas where states may be inclined to cut corners, like with respect to meaningfully monitoring access to providers in private insurance or the determination of what the minimum Essential Health Benefits package will be. We need state policymakers to know that if they don’t take into account the needs of people with disabilities, the Feds will be looking over their shoulder and ready to step in. 3) Don’t give away the farm on Medicaid flexibility. When the ACA was challenged in the courts, the Supreme Court ruled in NFIB (National Federation of Independent Businesses) v. Sebelius that it was mostly constitutional — with the surprising exception of the provision that required states to expand their Medicaid systems to cover childless adults up to 133% of the federal poverty level. This turned what was intended to be a mandatory part of the ACA into a state option. Now, many states are bargaining with the federal government, saying that they will take up the option if the feds give them flexibility regarding other aspects of the Medicaid program, such as allowing them to require greater cost-sharing from Medicaid beneficiaries or cut back on services that were previously considered required. While we want states to take up the Medicaid expansion, we think it’s important that the federal government protect the integrity of the Medicaid program. What sort of actions do disability advocates need to take, to ensure that the ACA benefits people with disabilities to the fullest extent? Talk to state policymakers, particularly insurance commissioners and Medicaid directors, and pressure your Governor’s office and state legislators to do the same. We need them to hear from you about the importance of making the most of the ACA by doing things like coming up with a strong definition of Essential Health Benefits and taking up new Medicaid options like the Community First Choice state option. Many of the people with decision-making power are incredibly busy, so the issues that have the loudest and most capable constituencies are the ones that get acted on. We need you to be a voice for meaningful implementation of health reform in your state. This policy brief is designed to give you the tools to make that easier for you to accomplish. Thanks so much for having me, and I encourage your readers to sign up to learn more about ASAN’s upcoming policy work by joining our mailing list or becoming a member of ASAN. You can do both at www.autisticadvocacy.org.
Source: thinkingautismguide.com

Workers’ Comp Settlements, Social Security and Medicare

One final factor to consider in settlement is actually somewhat connected to Social Security Disability benefits.  This factor is Medicare eligibility.  An individual usually becomes eligible for Medicare at age 65 or thirty months after the date of disability as determined by the Social Security Administration for Social Security Disability purposes.  Medicare eligibility or even an expectation of Medicare eligibility is important when considering settlement of a Workers’ Compensation claim because Medicare requires injured workers, employers, and insurance companies to consider Medicare’s interests when settling a claim.  What this really means is that Medicare does not want to end up paying for medical treatment that should have been paid for by the Workers’ Compensation insurance company.  For an injured worker considering settlement, this means that extra care must be taken when the injured worker is Medicare eligible or will soon be.  It also means that money may need to be “set aside” from any settlement to pay for possible future medical treatment.
Source: perkinslawtalk.com

Medicare vs other health insurance

This is why I deplore private insurance companies Emmie. The gosh honest truth is that my medicare actually seems to be better than the private insurance I had when i was working full-time and I had what was considered excellent private insurance. This private insurer always gave me a huge hassle about paying for mental health services and things like that. I have not had one single problem with medicare. Like Elvis said, you can pick up the medicare after you have received 24 monthly payments of SSDI. Medicare is 24 months after MOE for SSDI or 29 months after the EOD for SSDI if you take the 5 months of waiting into consideration…same thing really. When you take the medicare, the other private insurance you had thru your employer becomes a secondary payer but who cares. For me, medicare is superior. The number one goal of private insurers is to rake in as much premiums as they can, pay for things they have to pay for and deny as much as they can legitimately get away with to maximize profits for the company the the company shareholders. Providing excellent medical care to beneficiaries is of secondary importance.
Source: mdjunction.com

Social Security & Medicare for Adult Disabled Children

If you or your spouse are retired or disabled and receiving Social Security benefits and have a disabled adult child who has been denied the SSDI benefits, the experienced attorneys at Littman Krooks, LLP can assist you in filing an appeal, so that your child can obtain the benefits they are entitled to. Our firm represents adult children with disabilities in SSDI appeals on a contingent fee basis, which means that there is no out of pocket legal costs for filing the appeal.
Source: specialneedsnewyork.com

Number of the Week: Disability Fund Three Years From Insolvency

I have issues with awarding SSID to people who have drug and alcohol addiction. I also agree with the person below who suggested that people receiving benefits, unless they are clearly unable to work, need to be retrained and given jobs, particularly if they are suffering from depression, anxiety or back pain. People who work are more emotionally stable, in general. It would also help if we had universal health care so that low income people can get decent medical care.
Source: wsj.com

Disability Answers App Tells You If You Qualify for Disability Benefits or Medicare

“Disability Answers makes applying for Social Security Disability Insurance easier than it’s ever been before,” says Chris Gallagher, Vice President, Business Development at The Advocator Group. “And that’s important, because if you’re applying for SSDI, you’re probably in one of the more difficult times of your life. The SSDI process can be frustrating and overwhelming, but this app makes it easy to find the information you need, and determine if your individual situation is likely to qualify you for SSDI benefits. There’s a lot of information out there about SSDI that the disabled and their families could sift through. But because Disability Answers is based in real-world outcomes, it eliminates the noise and gets down to what people really want to know: Am I eligible for SSDI or not?”
Source: disabled-world.com

Comments Off  :  Add Comment
September 18, 2013

Lieberdouche, Medicare for All, 218, 50, 1

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



The minimal coalition for single payer or even a break-even self-funding Medicare buy-in proposal is 218 Democratic representatives, a Democratic vice president, a friendly Senate parliamentarian and 50 Democrats.  All of the Democrats who would need to vote yes need not to be scared of being defeated by a combination of Tea baggers, insurance industry flacks and hacks and Wall Street cash.
Source: balloon-juice.com

Video: Medicare for All

After the Affordable Care Act, Medicare for All

Here in brief are the main features of Medicare for All.  Every American would be automatically covered for life regardless of employment, health status, income, marital status, or residential location; everyone would receive a Medicare card to use any time or place that individual obtains medical care.  Job seekers would no longer have to choose jobs based on health benefits, and employers would no longer be burdened with providing insurance.  Private health insurance premiums would be replaced with a set of taxes earmarked for Medicare.  Everyone would pay at least some of the earmarked taxes so that there would be no free-riding—everyone would make a financial contribution to Medicare for All.  Patient cost-sharing would either be zero, or small and income-related, so there would be no need for private “medigap” insurance policies to cover patient cost-sharing or for Medicaid to pay medical bills.  Individuals would have free choice of doctors.  Medicare would use its single-payer bargaining power to negotiate the prices of medical goods and services.  Individuals would be free to obtain and pay for medical services outside of Medicare after paying Medicare taxes, just as they are free to send their children to private schools after paying taxes for public schools.  Medicare for All would be operated by the federal government so the problems that arise due to interactions with state governments would be avoided.  Medicare for All would be phased in by age—for example, 0-15 in year 1, 16-32 in year 2, 33-49 in year 3, and 50-64 in year 4; as population phases in, Medicare taxes would phase in and premium payments would phase out.
Source: nasi.org

Medicare Cuts, Obamacare Prompt Hospital Layoffs

“The sheer magnitude of the Medicare and Medicaid cuts impel us to look at all of our services and costs, including the largest component of our budget—personnel,” Cummings said, citing a 20 percent cut in Medicaid proposed by Democratic Gov. Dannel Malloy and approved by the state legislature resulting in a $550 million hit to Connecticut hospitals. Sequestration also resulted in an additional $1 million loss for L + M this year.
Source: freebeacon.com

More Transparency Could Help Fight Fraud and Strengthen Medicare

As we’ve written previously, a 1979 court injunction prevented the government from releasing data on payments to Medicare providers, under the theory that disclosing the amounts would violate the providers’ privacy. In May, though, the court lifted the injunction, allowing the government to consider anew whether it could release the data. In August, the Centers for Medicare & Medicaid Services (CMS), which administers Medicare, asked for public comment on whether, and how, it should release the data.
Source: foreffectivegov.org

Study: Medicare For All Would Save Half

That’s the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said.Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers Jr., D-Mich., and co-sponsored by 45 other lawmakers, would save an estimated $592 billion in 2014. That would be more than enough to cover all 44 million people the government estimates will be uninsured in that year and to upgrade benefits for everyone else.
Source: crooksandliars.com

The Crazy Way that Medicare Pays Doctors

As Joseph Antos, an American Enterprise Institute scholar who helped conceive of the system before it went into place, told me back in 2011, Medicare’s price-setting process totally ignores the patient-value side of the equation. “Asking committees of doctors to guess how much work is involved in something is the same thing as just setting prices,” he told me. And like all price control systems, it ends up being essentially arbitrary. Adding an extra layer of oversight, or a few more bureaucratic controls, isn’t likely to change that. If anything, it’s likely to make the system more complex, and more inscrutable—which is what happened in the 1980s to state-based health care price control systems every time legislators sought to address imbalances and inequities in the system. The whole system of health care price controls, in other words, is crazy, and plans to fix it through bureaucratic tweaking are likely to make it crazier. 
Source: reason.com

Brad DeLong : Susie Madrak: Medicare For All Would Save Half

Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses. That’s the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said. Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers… would save an estimated $592 billion in 2014… enough to cover all 44 million people the government estimates will be uninsured in that year and to upgrade benefits for everyone else. “No other plan can achieve this magnitude of savings on health care,” Friedman said.
Source: typepad.com

Evidence Supports Medicare For All

The poor US performance on preventable mortality.  The United States ranks last out of 16 countries in deaths that might have been prevented with timely and effective medical care, leading to an estimated 91,000 excess deaths annually. In this context, Goldman and Leive’s claim that high U.S. health spending is buying more effective treatment of breast and prostate cancer compared to other countries is of questionable significance as well as accuracy. Earlier diagnosis from greater screening improves survival times for cancers, especially at five years, but has very little impact on mortality.  At any rate, Medicare for All would not reduce spending on cancer treatment. The whole point of single payer is to shift resources we are squandering on bureaucracy (including the administrative burden on physicians and hospitals) into clinical care, increasing the amount available to care for patients by about $380 billion annually, according to the authors of a landmark New England Journal of Medicine study.
Source: healthaffairs.org

The in box. TRIP and Medicare info from the IEA.

The state will be implementing a Medicare Advantage Plan for Medicare-eligible State Employees’ Retirement System (SERS) and State Universities Retirement System (SURS) participants pursuant to the recently settled AFSCME state employment contract. Since the state also administers TRIP, along with the health insurance benefits of SERS and SURS retirees, it believes that by shifting to this type of plan for all retirees that it can provide the same level of health care services while reducing costs through:
Source: wordpress.com

Keeping Medicare Strong for All Generations

 “As Medicare continues to provide access to health care for millions of seniors and those with disabilities, AARP is celebrating its 48 successful years and advocating for responsible, commonsense solutions that will strengthen the program by lowering drug costs, improving care coordination and cracking down on over-testing, waste and fraud. Nearly 50 million Americans—15 percent of the nation’s population, and growing—depend on Medicare for health security which is why AARP will continue our work to ensure that it is there for current and future generations.
Source: aarp.org

Comments Off  :  Add Comment
September 18, 2013

Understanding Medicare Supplemental Insurance

Posted by:  :  Category: Medicare

While Medicare covers many things, there are different regulations depending on the state. There are also limitations, such as the length of time a person can stay in a hospital or nursing home, medical problems outside the United States, and so forth. That is why many people purchase additional Medicare supplements, also called Medigap, from a private insurance company.
Source: askamydaily.com

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

Understanding Medicare Supplemental Insurance

Medicare supplemental insurance is sold by private companies like AARP and Mutual of Omaha. There are 11 standard plans that vary in price. Each plan fills different “gaps” in Medicare coverage and offers different benefits. Customers can choose only one of these plans. Medigap plan F is the one most often chosen because it fills nearly all of the coverage gaps. If your spouse wants Medigap insurance, he or she will need to purchase a separate policy. Depending on what plan you choose, Medicare supplemental insurance may cover the cost of:
Source: terrencemalick.org

Key Things to Know About Buying Medicare Supplemental Insurance

Additional benefits vary according to the plan selected. These benefits include a set amount of coverage for skilled nursing facility charges up to 100 days, and coverage of certain Medicare Part A deductible charges. Since 2006, Medicare Supplemental Insurance plans do not include prescription drug coverage as part of their benefits, and individuals requiring such coverage should investigate joining a Medicare Part D Prescription Drug Plan. Individuals should also be aware that Medigap plans generally do not cover such costs as private-duty nurses, dental or eye care, eyeglasses, hearing aids or long-term nursing care costs. Consider switching over to a Medigap Advantage Plan if prescription drug coverage is required.
Source: weatheringthefinancialstorm.org

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

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

Top 10 Medicare Health Plans in the US

In addition to offering individual and family health insurance plans,  Health Insurance carriers also sell private health insurance plans to seniors and those eligible for Medicare. These products are called Medicare Advantage, Medigap or Medicare Supplemental Insurance, and Medicare Part D prescription drug cards.
Source: qooqe.com

Medigap vs. Medicare Advantage

The future of Medicare plans, in general, is something that has caused much anxiety for people who are over 65 or will be on Medicare soon. While there has been much debated in the last several years regarding Medicare and Medicare supplement plans, the majority of aspects of Medicare/supplement plans have not changed. Medigap really has not been touched at all, other than a 2010 restructuring of the standardized plans. Medicare Advantage, on the other hand, was involved in the PPACA, cuts to the Medicare Advantage program helped fund health care reform. As of now, though, both program still exist and are going strong. With 11,000 Medicare-eligibles aging in to Medicare every day, there is a constant influx of new people onto these plans.
Source: medicare-supplement.us

The Ins and Outs of Medicare Supplemental Insurance

Yes! So how does this relate to Medicare’s coverage? There is a general rule of thumb that is called the “80/20 rule.” Outside of some of the preventative items like mammograms, colorectal screenings, and some psychiatric care, Medicare covers the first 80 percent of medical bills, leaving you to cover the last 20 percent. Medicare will also cover certain medically-necessary pieces of equipment like seat lift mechanisms and diabetic shoes (fitted by a specialist, of course). It doesn’t seem so bad at first, especially if you’re a healthy individual, but if something happens that requires you to need urgent medical care or even an operation, you may have to spend tens- to hundreds-of-thousands of dollars. A June 2011 report from the Kaiser Family Foundation predicted that by the year 2020 the median out-of-pocket spending for seniors with Medicare is projected to reach 26 percent of all income, with the most money being spent in the last five years of their life. This is why supplemental Medicare insurance is a necessity for every senior. Not only do you really need Medicare supplemental insurance, you need it before something happens to you, and you likely won’t use it much until the last 5 years of life. So two points to keep in mind 1) If you wait until a procedure is needed or something unexpected happens to you, you’ve waited too long, and 2) Don’t make the mistake of cancelling your Medicare supplement policy because you’ve’ paid in more than you use. It’s health insurance and in this case it works best if it’s held to its natural end point.
Source: insideeldercare.com

Medicare and Health Insurance, What is Covered, Medicare Supplement

Medicare Part D pays for prescription drugs. This plan covers both generic and brand name prescription drugs. The initial enrollment period to join a Medicare drug plan is three months before your 65th birthday to three months after you turn age 65. Each year during the open enrollment period, you have the option to change your drug plan to fit your specific needs. Perhaps when you turned 65 you did not have need for extensive coverage, but as you get older and your needs change, this coverage can be increased as necessary.
Source: bradeninsurance.com

Brookhaven NY Auto, Business Insurance and Medicare Supplement Insurance

Commercial insurance means offering the right products for markets of every size. Brisotti & Silkworth Insurance can provide what you need when you need it. Whether you have basic commercial insurance needs or more complex and difficult exposures, our experienced agents will work with you to help you provide your customers with a comprehensive insurance program. Brisotti & Silkworth Insurance (BSI) sells and services many lines of commercial insurance throughout New York. Like auto insurance protects you from the risks of the road, commercial insurance protects you and your business from the risks you encounter every day.  If you own a business, you want to make sure it is always protected. More than likely, you have invested a large sum of money into your business to get it started. Every day, you will encounter risks that have the potential to bring down your business, and potentially your personal finances as well. In order to protect your business and personal finances, business insurance is necessary. Don’t do business without it.
Source: bsiins.com

Do I need supplemental health insurance with Medicare?

Under Medicare Part A and Part B there are deductibles, co-insurance and cost sharing that are the Medicare beneficiary’s responsibilities. The thing that is different about an insured’s responsibility under Medicare coverage is the fact that there is no limit to the amount that one is obligated to pay, unlike most other types of health insurance which have some form of a limit.
Source: reed-insurance.net

Examining Sources of Supplemental Insurance and Prescription Drug Coverage Among Medicare Beneficiaries: Findings from the Medicare Current Beneficiary Survey, 2007

This updated chartpack presents sources of supplemental and prescription drug coverage among Medicare beneficiaries in 2007, the most recent year for which national data are available. The chartpack looks at variations in supplemental and prescription drug coverage by income, race/ethnicity, age, urban/rural location, and health status. It also examines characteristics of Medicare beneficiaries with low incomes who are not enrolled in a Part D plan or receiving Part D low-income subsidies.
Source: kff.org

Comments Off  :  Add Comment
September 18, 2013

Health overhaul confuses Medicare beneficiaries

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



Next month, roughly 50 million Medicare beneficiaries will get a handbook in the mail with a prominent Q&A that stresses Medicare benefits aren’t changing. Federal health officials have also updated their training for Medicare counselors, and are prepping their Medicare call center and website. “We want to reassure Medicare beneficiaries that they are already covered, their benefits aren’t changing, and the marketplace doesn’t require them to do anything different,” said Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services. But she said call centers for the state exchanges are already fielding questions from Medicare recipients and rerouting them to the Medicare line. Bob Roza attended several meetings trying to figure out exactly what the Affordable Care Act means for him and his 69-year-old wife Gail, who has diabetes. “At that time, I didn’t know if Medicare would be secondary to some Affordable Care Act option. It was just a myriad of concerns and not knowing,” said the 72-year-old Roza, a retiree who lives in Oakdale, Calif., and is recovering from hip replacement surgery earlier this year. He now knows that his Medicare coverage won’t change, but says he’s now worried about the impact on the $614 a month he pays for Medicare supplemental insurance. Federal health officials said seniors will not be able to purchase Medicare supplemental insurance or Part D drug plans through the state exchanges. Jodi Reid, executive director of the California Alliance for Retired Americans, worries there hasn’t been enough outreach to seniors and that advocacy groups are spending the bulk of their advertising funds targeting those impacted by the exchange. Her organization, which represents nearly 1 million seniors in California, is putting together a one-page fact sheet to help dispel myths. “Nothing has been done that I have seen to deal with the 4.4 million people in California who are on Medicare who are not going to be impacted the same way as the rest of us so it’s causing a lot of confusion,” she said. AARP officials said they anticipate a spike in calls after the October launch date for the new state exchanges. To help clarify everything for seniors, the organization is holding various events around the country, such as a senior day next month at the state fair in Columbia, S.C. Next month, the group is also hosting 21 telephone town halls, which will include hundreds of thousands of phone calls to seniors. “Usually the marketing is just targeted to the Medicare beneficiary, this time it’s going to be spread out a little bit more. If they call the wrong places, we’re doing our very best to make sure they’re guided back to the correct place,” said Nicole Duritz, vice president of health education. In Illinois, it’s not only seniors who are confused, but also the social workers who help them, said Erin Weir of AgeOptions, suburban Cook County’s lead agency on aging. The agency coordinates a statewide training program for groups that work with older adults. During these trainings, Weir said, she’s repeatedly heard questions from social workers who think seniors will be able to sign up for Medicare programs on the new marketplace websites, even though they cannot. “We’ve been focusing on people who are already on Medicare, calming them down and saying, ‘You don’t have to do anything, you’re fine,'” Weir said. Advocates are also warning of scams that may pop up alongside legitimate door-to-door outreach about the Affordable Care Act ramps up and advising seniors not to give out personal information. Senior groups are also devoting resources to educating the 50- to 65-year-old group who are next in line for Medicare, a segment that could be greatly affected by the health reform. Under the new law, insurers will have to offer more benefits in some cases and are restricted in how much they can charge older, sicker people. They’re also banned from turning away those with pre-existing conditions. Anthony Wright, executive director of Health Access California, said many people nearing retirement age stand to benefit the most by the health care reform. “They’re the ones most likely to have pre-existing conditions, most likely to be charged more because of their age and medical condition and very likely to be an early retiree,” he said.
Source: modernhealthcare.com

Video: What is a Medicare health insurance exchange?

Medicare Cuts, Obamacare Prompt Hospital Layoffs

“The sheer magnitude of the Medicare and Medicaid cuts impel us to look at all of our services and costs, including the largest component of our budget—personnel,” Cummings said, citing a 20 percent cut in Medicaid proposed by Democratic Gov. Dannel Malloy and approved by the state legislature resulting in a $550 million hit to Connecticut hospitals. Sequestration also resulted in an additional $1 million loss for L + M this year.
Source: freebeacon.com

Media Teleconference: Healthcare Leadership Council to Release Results of Annual National Medicare Part D Senior Satisfaction Survey

ABOUT: The Healthcare Leadership Council (HLC), a coalition of chief executives from all disciplines within the healthcare system, launched Medicare Today in November 2004 to reach out to Medicare beneficiaries who needed reliable information on how to get the greatest value from the new Medicare benefits provided by the Medicare Modernization Act (MMA) of 2003. Medicare Today develops innovative tools for use by all partners, commissions research studies, and undertakes earned media efforts and outreach to inform beneficiaries about the value of the new benefits under the MMA.
Source: perrycom.com

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

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

Bill Boosts Telehealth Use for Medicare Providers

This bill builds on the STEP Act for the Department of Defense health professionals, which is pending congressional vote, would allow enable Department of Veterans Affairs health professionals to serve any veteran in the U.S. without unnecessary cost and time delays of multiple state licenses through the use of telemedicine. The American Telemedicine Association is a big supporter of both bills.
Source: healthcare-informatics.com

Medicare: seminar reviews annual wellness visits

Patients enrolled in Medicare Part B or Part C for more than 12 months may receive annual wellness visits. The yearly visit is not a physical or diagnostic exam. Rather, it is an educational visit that involves physicians assisting patients in developing or updating a personalized plan to prevent disease based on current health and risk factors.
Source: wiltonbulletin.com

Audit shows Sanford Health owes Medicare $65,000

The hospital in Fargo was known as MeritCare until it merged with Sanford of Sioux Falls, S.D., in 2009, creating the new Sanford Health network. Donald White, spokesman for the Office of Inspector General at Health and Human Services in Washington, D.C., said this round of audits did not review records of any other Sanford hospitals.
Source: wday.com

Nearly 90% of Seniors Oppose Medicare Cuts to Home Health

AAHomecare AARP Almost Family Almost Family Inc. Amedisys Amedisys Inc. American Association for Homecare American Association for Long Term Care Insurance Avalere Health Brookdale Senior Living Care.com CellTrak Technologies Inc. Center for Medicare & Medicaid Services Centers for Medicare & Medicaid Services CliftonLarsonAllen CMS Department of Health and Human Services Department of Justice Emeritus Senior Living featured Federal Bureau of Investigation Gentiva Health Services Inc. HHS Home Health Depot Home Health International Humana IntegraCare Intel-GE Care Innovations Jordan Health Services Kindred Healthcare Kindred Healthcare Inc. LHC Group NAHC National Association for Home Care & Hospice New York Times Paraprofessional Healthcare Institute Partnership for Quality Home Healthcare Partnership for Quality Home Health Care PHI Quantum Home Care Inc. Scripps Health The Partnership for Quality Home Healthcare VA Visiting Nurse Association Visiting Nurses Association
Source: homehealthcarenews.com

Comments Off  :  Add Comment
September 18, 2013

New York Health Benefit Exchange

Posted by:  :  Category: Medicare

Flickr

‘+msg+’

‘;d.body.style.margin=’0′;d.body.innerHTML=html;}}},200);} function get_frame_depth(){var win=self,frame_depth=0;while(win!==win.parent){frame_depth+=1;win=win.parent;} return frame_depth;} function debug(){if(is_debug){console.log(arguments);}} if(self_is_flickr&&self_loc===top_loc){}else if(self_is_offline){}else if(!self_is_flickr&&!self_whitelist_regex.test(self_loc)){should_wipe=true;}else if(bust_image_search&&photo_id&&referrer_is_image_search){should_bust=true;}else if(referrer&&!referrer_is_whitelisted&&get_frame_depth()>0){should_wipe=true;}else if(!referrer_is_flickr&&get_frame_depth()>1){should_wipe=true;} if(is_debug){debug({self_is_flickr:self_is_flickr,top_loc:top_loc,self_loc:self_loc,referrer:referrer,self_is_offline:self_is_offline,self_is_flickr:self_is_flickr,self_url:self_url,photo_page_re_result:photo_page_re_result,photo_id:photo_id,referrer_is_flickr:referrer_is_flickr,referrer_is_whitelisted:referrer_is_whitelisted,referrer_is_image_search:referrer_is_image_search,self_is_whitelisted:self_whitelist_regex.test(self_loc),frame_depth:get_frame_depth(),faq_url:faq_url,redir_url:redir_url,should_bust:should_bust,should_wipe:should_wipe,base:base});}else{if(should_bust){setTimeout(function(){w.onbeforeunload=w.onunload=null;redirect();},1000);setTimeout(wipe,2000);redirect();}else if(should_wipe){wipe();}else if(referrer_is_whitelisted&&!referrer_is_flickr){base=document.createElement(‘base’);base.target=’_top';document.getElementsByTagName(‘head’)[0].appendChild(base);}}

}(‘We’re sorry, Flickr doesn’t allow embedding within frames.

If you’d like to view this content, please click here.’, ‘http://www.flickr.com’, true, false));

(function(F){var el,w,d,n,ua,ae,is_away_from_tab,de,disabled=false,assigned_events=false;w=window;d=w.document;n=w.navigator;ua=n&&n.userAgent;var supportsActiveElt=false;if(‘activeElement’in document){supportsActiveElt=true;} function doF(e,me){if(is_away_from_tab&&e.target===w){is_away_from_tab=false;}else{el=e.target||me;}} function doB(e){if(el!==w&&e.target===w){is_away_from_tab=true;}else{el=undefined;}} function get(){var nt,in_doc;if(supportsActiveElt){el=document.activeElement;}else if(el&&(nt=el.nodeType)){if(d.contains){if((ua&&ua.match(/Opera[s/]([^s]*)/))||nt===1){in_doc=d.contains(el);}else{while(el){if(d===el){in_doc=true;} el=el.parentNode;}}}else if(d.compareDocumentPosition){if(d===el||!!(d.compareDocumentPosition(el)&16)){in_doc=true;}}else{var myEl=el;while(myEl){if(d===myEl){in_doc=true;} myEl=myEl.parentNode;}}} return in_doc?el:undefined;} function isInput(){var n=get(),nn;if(!n){return false;} nn=n.nodeName.toLowerCase();return(nn===’input’||nn===’textarea’);} function instrumentInputs(){if(!assigned_events){var i,me,inputs=document.getElementsByTagName(‘input’),tas=document.getElementsByTagName(‘textarea’),nInputs=inputs.length,nTextAreas=tas.length;if(nInputs||nTextAreas){for(i=0;i



Federally subsidized premium tax credits will be available for New Yorkers who purchase coverage for themselves, based on income level, to help further reduce their costs.  Individuals can determine if they qualify for the tax credits through the application process.
Source: mymedicaremadesimple.com

Video: ROMNEY: My Medicare Plan Is “Identical” To Ryan’s Voucher Plan

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

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

I Am Medicare Eligible But Also Insure Younger Family Members On My Plan and One Is Uninsurable Currently. What Do I Do?

If you are with a company of 20 or less employees, you will need to go ahead and enroll onto Part A (hospital) and Part B (outpatient services) with Medicare.  However, if you terminate your employer coverage to go fully onto either a Medicare Supplement and stand-alone drug plan or a Medicare Advantage/HMO plan, your family will potentially lose your employer coverage.  First check with the insurance company to see if your family would be eligible for Cobra.  If that is not the case or if the cost would be prohibitive, consider delaying terminating your employer plan until 12/31/13 and in the meantime connect with an agent who is knowledgeable about the insurance options available to individuals under the Affordable Care Act so that you can easily transition your family onto new individual health insurance coverage as of 1/1/2014 while you then proceed with enrollment onto one of the Medicare insurance options available to you.
Source: personalmedicareadvisor.com

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

Medicare and other insurance FYI

This is good to know Heather. I had to drop my retiree medical from my former employer b/c the premiums were over $500/month. I can pick up in latter years during any open enrollment period but they told me he would pay secondary to medicare. I think the reason for this is the retiree part. I am no longer an active employee. When your husband finally retires from his job, will they continue the BCBS and will they continue to pay for this coverage even after he retires. I worked for one of the largest fortune 500 companies in the world (nearly 100,000 employees) and once you finally retire, they told me medicare becomes the primary payer and the the optional retiree medical if you choose to purchase it after retirement pays secondary to medicare.
Source: mdjunction.com

Comments Off  :  Add Comment