Medicare FAQ: What is Original Medicare, Part A and Part B?

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These individuals will want to enroll during their seven month Initial Enrollment Period (IEP), which starts three months before they become Medicare eligible and lasts for three months afterwards. If they do not sign up during their IEP, they can sign up during the General Enrollment Period. This enrollment period lasts from January 1 and March 31 of each year with coverage starting on July 1. However, this means that you will have to pay a higher monthly premium for late enrollment. The length of these late enrollment penalties will depend on how long you could have enrolled in Part A and/or Part B coverage and did not.
Source: planprescriber.com

Video: Original Medicare

ibm medicare options: IBM Extend Health

Doctors rarely “drop out” of original Medicare. They might stop accepting new Medicare patients but if they “drop out” of Medicare it means they have NO Medicare patients. That is a radical decision for a provider if they have a number of Medicare patients.  They’ll likely phase out of Medicare but are unlikely to abruptly stop treating you.   However, doctors often do drop out of MA plans abruptly and it is usually because of how those plans pay them. The MA plans not only might pay providers less than original Medicare but may be slow to pay providers.  When providers  leave HMO plans you can no longer go to the doctor and have to find a new doctor in the HMO.  For other types of MA plans a doctor can stop accepting the MA plan at any time.  So, you might have an MA PPO plan and are being treated for a complex condition by a doctor you trust.  That doctor can decide to not accept your plan any time during your treatment.     
Source: blogspot.com

Original Medicare: The Obamacare Tin Plan

Original Medicare is such terrible insurance more than 95% of Medicare beneficiaries make other — often private — insurance arrangements. In Massachusetts where I live, seniors will probably spend as much as another $5500 a year or more per couple (in Massachusetts) for private Medicare insurance (many disabled people on Medicare in Massachusetts cannot even get supplemental insurance).
Source: typepad.com

Medicare Questions and Answers (Original Medicare)

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Source: croweandassociates.com

Obamacare And Medicare: Don’t Believe The Rumors

Call centers for state health insurance exchanges are already receiving calls from Medicare recipients, according Julie Bataille, of the Centers for Medicare and Medicaid Services. Such inquiries, which are redirected to the Medicare line, are just one indication that seniors are confused about the implications of Obamacare for their coverage.
Source: kera.org

Chart of the Day: Public Ignorance About Medicare is Really, Really High

It also turns out that when you ask people why Medicare costs are rising, they rate fraud and poor management at the top and new technology at the bottom. The truth, again, is just the opposite. Medicare has some fraud problems, but they’re fairly modest. It’s basically a pretty well managed program. New drugs and new treatments, however, are responsible for nearly half of the increase in Medicare costs over the past few decades. It’s the #1 cost driver by a ton. Adrianna McIntyre has the details here.
Source: motherjones.com

Entitlement to Original Medicare, Premiums, & Eligibility

the month they turn 65 if they have received Social Security or Railroad Retirement benefits for at least 4 months before they turn age 65, without having to fill out any additional application for those benefits. They also are given an opportunity to refuse Part B coverage.
Source: rxfreehelp.com

Benefits Of Medigap Insurance

There are important things clients should understand before attempting to purchase Medigap. To get Medigap, Part A or Part B Medicare is required. Applying for Medigap is possible if you already have a Medicare Advantage Plan; before your Medigap policy starts, however, you must cancel the Medicare Advantage Plan. Paying a private insurance company each month is possible; the payments can cover the Medigap policy and the Part B plan that is paid to Medicare. If you want to get Medigap coverage for many people, each individual will need coverage; several policies must be purchased because Medigap just covers one individual. Finding a provider is not tough; many insurance companies will offer Medigap; search for companies that are licensed within your state. When clients buy Medigap; they get a guarantee; most standardized policies are renewable. If clients have health issues, they can still renew. Some coverage polices are different depending on the year the policy was sold. Policies offered years ago covered prescription drugs; policies sold after 2006, however, does not cover prescription drugs. Clients that need prescription drug coverage must consider Medicare Prescription Drug Plan (Part D). A Medicare Medical Savings Account Plan is not allowed if you want a Medigap policy; it is illegal.
Source: deborahserani.com

Giving Up Original Medicare

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Source: medicaresimplifiedforyou.com

Stay On Top Of Your Medicare Plan When You Move

Individuals with Original Medicare should expect to continue the same level of care when they move. But if you also have a Medigap policy, be sure to touch base with your insurer. Your premium may change, based on your new location. Also, if you are enrolled in Medicare SELECT, you may need to buy a supplemental policy in order to use doctors and hospitals within the correct network.
Source: seonewswire.net

Medicare Drug Plan Polls Suggest Bright Future for Obamacare

Looking back on it, the public’s turnaround from initial rejection to growing support for Part D was understandable. The unfunded $400 billion program that President Bush signed into law in December 2003 was needlessly complex for seniors and unnecessarily expensive for taxpayers. Rather than having the government negotiate prices directly with pharmaceutical firms and add drug coverage into the traditional Medicare program, President Bush and his Republican allies in Congress instead gave recipients subsidies to purchase plans from private insurers. Making matters worse, millions of “dual eligible” already receiving drug coverage from Medicaid had to switch to the new scheme, a process that left millions unable to pay for their prescriptions for weeks in early 2006.
Source: crooksandliars.com

2011 Medicare Payments to Massachusetts Hospitals (z

Posted by:  :  Category: Medicare

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Another advantage of z-scores is that they measure every data point in terms of how far it is from the mean, measured in standard deviation units. So, an outlier payment (high or low) on a low-priced procedure (say one with a mean payment of $5,000) “sticks out” (up or down, actually) on this chart as much as a comparable outlier on a much higher priced procedure (one with a mean payment of $40,000, for example). In other words, a hospital payment that is two standard deviations above the mean shows up in the chart at the +2 level on the vertical axis, regardless of the actual dollar amounts. In this way, this z-score chart shows, across all 100 DRGs, which hospital’s average payments are “ahead of the curve” (above the zero line) and which are “behind the curve” (below the zero line), and by how much.
Source: rac3.com

Video: Doctor Accused of Misdiagnosing Cancer for Medicare Payments

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

NEWS: Sebelius responds to Governor Calvo’s Letter; Lifts Garnishment of Medicare Payments

The letter points directly to the under-funded mandates of the federal government. Governor Calvo highlighted Guam’s challenges with the Medicaid Program Costs and the increasing demand the Compact of Free Association places on hospital resources. GMHA and the government of Guam remains committed to paying down the hospital’s debt and paying their obligations to their vendors.
Source: guam.gov

How Medicare payments are set

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Source: marginalrevolution.com

Medicare Payments to Psychologists Suddenly Reduced

Table 134 in the Aug. 12 The Register shows 57 specialties and services impacted by the corrected practice expenses and the combined impact on total allowed charges. For example, independent laboratories will see a 14 percent reduction overall but Family Practice gets a 7 percent increase and Internal Medicine a 5 percent increase. Examples of specialties other than psychology taking a hit include neurology (minus 7 percent), radiation oncology (minus 7 percent), pathology (minus 6 percent), physical medicine (minus 4 percent), audiology (minus 4 percent) and cardiology (minus 2 percent).
Source: nationalpsychologist.com

Doctors Brace for Medicare Pay Incentives by 2015

Kavita Patel, a health expert at Brookings’ Engelberg Center for Health Care Reform, said the smaller the medical group, the more challenging it will be for the doctors to adjust to a new system where they must report quality measures to Medicare and may have their pay docked if they underperform. “Most big practices have figured out how to integrate it into their work flow,” she said. “If you think of groups of 10 or more, the upside makes a lot of sense, but I’m still concerned how these smaller practices will too share in downside risk.”
Source: thefiscaltimes.com

AHCJ urges government to release Medicare payment data

AHCJ’s letter was the second to CMS recently. Last month, the group called upon the agency (PDF) to ensure that its release of data under the Physician Payment Sunshine Act was useful for reporters. The Sunshine Act requires all pharmaceutical and medical device companies to publicly report their payments to physicians. While the data set contemplated by CMS will include names and addresses, AHCJ encouraged the agency to also include unique identifiers so that individuals with the same name would not be incorrectly aggregated. It cited as an example family members working at the same address.
Source: healthjournalism.org

70 Iowa hospitals face financial difficulties if Medicare payments reduced

The Critical Access Program provides extra money to more than 1300 small-town hospitals in the United States. Through an open records request to the federal government, The Des Moines Register got a list of the 70 hospitals that would face deep cuts. According to The Register, the hospitals are in the following towns: Albia, Algona, Anamosa, Atlantic, Audubon, Belmond, Bloomfield, Boone, Britt, Chariton, Charles City, Cherokee, Clarinda, Clarion, Corning, Cresco, Creston, Denison, De Witt, Dyersville, Elkader, Emmetsburg, Estherville, Fairfield, Grundy Center, Guttenberg, Hamburg, Hampton, Harlan, Hawarden, Humboldt, Ida Grove, Independence, Iowa Falls, Jefferson, Knoxville, Lake City, Le Mars, Leon, Manchester, Maquoketa, Marengo, Missouri Valley, Mount Ayr, Mount Pleasant, New Hampton, Manning, Nevada, Onawa, Orange City, Osage, Osceola, Oskaloosa, Pella, Perry, Primghar, Red Oak, Rock Rapids, Rock Valley, Sac City, Sheldon, Shenandoah, Sibley, Sioux Center, Storm Lake, Sumner, Washington, Waverly, Webster City and West Union.
Source: radioiowa.com

Medicare Attestations and NPPs; Division of Payments; EHR Coding Mistakes

A: The amount applied to deductible for the primary insurer is then the patient’s responsibility. The secondary insurer, depending on the plan, may only pick up coverage after copays and deductibles are met for the first plan and a balance remains. The statement that “the insurer does not cover for these services” is pretty broad. This could speak to actual benefits and covered services, not just the division of payments between payers. On the last point, that you can’t balance bill the patient, if you are a participating provider with this insurance entity look at your contract. It may confirm if this is the case. If you are not a participating provider with this plan, however, the insurer cannot tell you that you cannot balance bill the patient.
Source: physicianspractice.com

Rural hospitals could lose Medicare payments

The Wisconsin State Journal reports the proposal from the inspector general at the Department of Health and Human Services would strip special payment status from two-thirds of the nation’s 1,328 critical access hospitals — those not considered to be in sufficiently remote areas — including 42 in Wisconsin.
Source: channel3000.com

Rebates on Medicare Part B Drugs Deserve a Closer Look, OIG Says

Posted by:  :  Category: Medicare

September 12, 2013—The Department of Health and Human Services Office of Inspector General (OIG) has urged the Centers for Medicare and Medicaid Services (CMS) to consider calling for the enactment of a Medicare Part B drug rebate program.
Source: drugdiscountmonitor.com

Video: Medicare rebates for mental health problems

OIG Call for Medicare Part B Drug Rebates Rejected by CMS : Health Industry Washington Watch

A new OIG report estimates that Medicare could realize significant savings if drug manufacturers were required to pay rebates on Medicare Part B drugs, similar to rebates under the Medicaid program. Specifically, Medicare could have collected $3.1 billion in 2011 if manufacturers had been required to pay rebates based on average manufacturer price (AMP) for 60 high-expenditure Part B drugs, while rebates based on average sales price (ASP) for the same drugs could have generated $2.7 billion in payments. In the report, the OIG recommends that CMS examine establishing such a Part B drug rebate program and, if appropriate, seek legislative change. CMS rejected this suggestion, noting that developing such a plan – which would require new legislative authority — would necessitate analysis of the effects of making fundamental changes to the Part B claims payment system, the impact on providers, and the impact on access to care. CMS maintains that it is “unable to devote significant administrative resources at this time to a proposal that is neither a provision of current law or actively under consideration.” (The Administration has, on the other hand, advocated rebates for Medicare Part D drugs furnished to low-income subsidy beneficiaries as part of its FY 2014 budget proposal.) 
Source: healthindustrywashingtonwatch.com

PBMs and Rebates to Medicare

Sponsors routinely underestimated the amount of rebates they expected to receive in their bids to offer the drug benefit.  This leads to higher premiums and results in both the Government and beneficiaries overpaying for the benefit.  The government recoups some of this over payment but beneficiaries do not recoup any of the money they paid in higher premiums.
Source: whistleblowerlaws.com

Breast lift/augmentation and Medicare rebates.

My understanding is that Medicare pretty much only pays if there is a medical need for the procedure. So, for example, for a reduction, the woman would need to have had ongoing issues with pain etc that makes the reduction necessary. In terms of augmentation, the only situation I’ve ever heard of it being covered by Medicare is in the context of breast reconstruction after breast cancer. For eg, if a woman has had one breast removed and reconstructed, and has the other breast lifted/augmented so that the reconstructed breast and the healthy breast match each other. In that instance the surgery there is a rebate and the surgery can be done in the public hospital system. I have also read that Medicare pays a rebate for lifts only if the degree of breast droop (ptosis) is of a certain severity (nipple has to lie below the crease under your boob) provided your child is under a certain age, but in that instance implants/augmentation would not be paid for. I don’t know whether you could get it done through the public system (I suspect it would be a verrrrrrrry long wait) so there are likely to be other costs involved if you see a private surgeon. If this is something you want to pursue, it’s worth having a chat to your GP and if possible get a referral to see a surgeon who operates both in the public/private system as they will know how it works in both places (sometimes you can get get added to their surgery list at the public hospital andit works out a bit cheaper that way).
Source: com.au

Medicare Rebates for Psychology Treatment

PLEASE NOTE: Psychologists are able to offer you private health fund rebates if you have extras cover. Depending upon your health fund, you may be eligible for rebates for both individual and group therapy. These rebates significantly reduce the cost of your treatment. If you are unsure what your entitlements are, you are advised to check with your health fund before commencing treatment. You are not entitled to claim both your Medicare rebate and your private health fund rebate for any one given psychological session, you either claim under Medicare or under your private health fund, but not both.
Source: com.au

Restoring Drug Rebates in Medicare Would Save $141 Billion

Today, members of Congress in both the House and the Senate introduced the Medicare Drug Savings Act of 2013, which would restore drug rebates for low-income people with Medicare. President Obama included a similar proposal in his budget last week, and for good reason. Getting Medicare a better price on prescription drugs would save the federal government more than $140 billion without shifting costs to low- and middle-income seniors.
Source: standupforhealthcare.org

A Tax Hike Disguised as a Rebate

The Medicare Part D rebate proposal will not only raise costs for seniors but will deny them access to drugs they need. Currently, the more than 37 million seniors enrolled in Part D are able to choose from an array of plans that best meet their budget and medical needs. Private insurance plans compete with one another offering varying drug coverage, deductibles, and premiums, and the feds subsidize the premiums. Market competition between the plans vying for seniors’ attention will keep premium cost low translating into less taxpayer money being used for subsidies.
Source: heartland.org

Debunking Medicare Myths: Drug Rebates for Dual Eligibles 

[1] Center for Medicare Advocacy, "So, What Would You Do? Real Solutions for Medicare Solvency and Reducing The Deficit", available at: http://www.medicareadvocacy.org/2011/06/so-what-would-you-do-real-solutions-for-medicare-solvency-and-reducing-the-deficit/. [2] Senator Jay Rockefeller, Press Release, available at http://www.rockefeller.senate.gov/public/index.cfm/press-releases?ID=617fffeb-4c5a-4123-a5b3-1f8b790e5f8b. [3] Ben Adams, InPharm, "U.S. Prescription Drug Prices Rise Above Inflation", August 27, 2010, available at: http://www.inpharm.com/news/us-prescription-drug-prices-rise-above-inflation. [4] AARP Public Policy Institute, Rx Watchdog Report: Brand Name Drug Prices Continue to Climb Despite Low General Inflation Rate, available at: http://assets.aarp.org/rgcenter/ppi/health-care/i43-watchdog.pdf. [5] Committee on Oversight and Government Reform, "Private Medicare Drug Plans: High Expenses and Low Rebates Increase the Costs of Medicare Drug Coverage", October 2007, available at: http://www.allhealth.org/briefingmaterials/housemajoritystaff-965.pdf. [6] Id. [7] GAO, Prescription Drugs: Trends in Usual and Customary Prices for Commonly Used Drugs, available at: http://www.gao.gov/new.items/d11306r.pdf. [8] PhRMA, 2011 Profile Pharmaceutical Industry, available at: http://www.phrma.org/sites/default/files/159/phrma_profile_2011_final.pdf. [9] Mac-Andre Gagnon, Joel Lexchin, "The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States", January 2008, available at: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050001. [10] Center for Medicare Advocacy, "Keeping Medicare and Medicaid Strong?" available at: http://www.medicareadvocacy.org/2011/04/keeping-medicare-and-medicaid-strong/. 
Source: medicareadvocacy.org

AARP Supports Legislation to Require Drug Manufacturers to Provide Rebates to Medicare Part D Beneficiaries

AARP is a nonprofit, nonpartisan organization, with a membership of more than 37 million, that helps people turn their goals and dreams into real possibilities, strengthens communities and fights for the issues that matter most to families such as healthcare, employment and income security, retirement planning, affordable utilities and protection from financial abuse. We advocate for individuals in the marketplace by selecting products and services of high quality and value to carry the AARP name as well as help our members obtain discounts on a wide range of products, travel, and services.  A trusted source for lifestyle tips, news and educational information, AARP produces AARP The Magazine, the world’s largest circulation magazine; AARP Bulletin; www.aarp.org; AARP TV & Radio; AARP Books; and AARP en Español, a bilingual news source.  AARP does not endorse candidates for public office or make contributions to political campaigns or candidates.  The AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. AARP has staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Learn more at www.aarp.org.​
Source: aarp.org

Why Seniors Should Say ‘No’ to Paying for the Medicare Doctor

The Medicare Drug Savings Act of 2013 introduced by Sen. Jay Rockefeller (D-W.V.) would save Medicare money on prescription drugs by requiring drug manufacturers to provide rebates for low-income Medicare beneficiaries and those eligible for both Medicare and Medicaid. The rebates existed before Medicare Part D was first implemented in 2006 and the bill would reinstate them.
Source: tacticalminc.com

Census: More Americans Have Health Insurance As People Age Into Medicare

Posted by:  :  Category: Medicare

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One provision — which took effect Sept. 23, 2010 — allowed parents to keep their children as dependents on their health insurance policy until age 26. Much of the benefit was realized in comparing 2011 uninsured rates with 2010 rates for people 19 to 25 years old, but there was some continued help last year, Day said. The number of uninsured Americans 19 to 25 years old decreased from 8.27 million in 2011 to 8.21 million last year, a drop of 66,000, or one-half of a percent of the 30 million in that age category. Connecticut passed this provision in 2009, earlier than the federal law.
Source: courantblogs.com

Video: Medicare healthcare medical billing insurance Fraud

Medicare Beneficiaries Not to Worry about Obamacare and Health Insurance Marketplace

Obamacare was signed into law by President Barack Obama in March of 2010, and since then, 50 million seniors and disabled individuals have felt the impact of the health reform. As a result of the law, beneficiaries now have access to annual wellness visits and free preventative services that are covered fully by Part B.  Additionally, the health reform has made strides in phasing out the Medicare Donut Hole, changing how Medicare Advantage plans are paid and rewarded, and increasing Medicare taxes for high-income households in order to strengthen the program’s financial outlook, improve quality of care, and make coverage more affordable.
Source: planprescriber.com

No change in Medicare benefits under health law

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.
Source: spokesman.com

AHIP Statement on Medicare Advantage

“While today’s announcement is good news for seniors and people with disabilities, we are concerned that Medicare Advantage beneficiaries may experience higher out-of-pocket costs and disruptions in their coverage when the ACA’s $200 billion in payment cuts are fully phased-in over the next several years.  These cuts will be compounded by the ACA’s new tax on Medicare Advantage coverage that is projected to increase costs for seniors in the program by $3,500 over the next ten years.”
Source: ahipcoverage.com

Medicare and Medicaid, Age and Income

Yet, this trend masks a great deal of variation between race and Hispanic origin groups.  As the figures show, the non-Hispanic white population is the only group that participates more in Medicare than Medicaid.  Given that to be eligible for Medicare, participants must be 65 and older, one of the biggest reasons for this is the different age distributions among these groups, and the non-Hispanic white population is much older than the other groups. For instance, in 2012, 17 percent of non-Hispanic whites were 65 and older compared with 10 percent of blacks, 10 percent of Asians and 6 percent of Hispanics. Moreover, with the large non-Hispanic white baby-boom population now starting to enter the Medicare-eligible age group, higher Medicare coverage rates for non-Hispanic whites will continue for some time.
Source: census.gov

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: webmd.com

Affordable Care Act’s 10 Essential Health Benefits

As of Oct. 1, every state will have a health insurance marketplace, where consumers can shop for coverage. In addition to mandating that insurers in those marketplaces offer the 10 essential health benefits, the health care law also sets certain standards that all insurers must meet, whether they’re providing health insurance through an employer or directly to individuals and small groups. The law:
Source: aarp.org

Medicare and Healthcare Reform

A: The Fed­eral Medicare agency has a “5-Star” qual­ity rat­ing sys­tem for Medicare Advan­tage plans. You can use the star rat­ing to check your plan’s per­for­mance. The rat­ing sys­tem gives insur­ance com­pa­nies a strong incen­tive to improve your care. Check your plan’s rat­ing at www.medicare.gov.
Source: amvets.org

Free “Health Insurance” Workshops to Educate New Yorkers

The New York City Health and Hospitals Corporation (HHC) is a $6.7 billion integrated healthcare delivery system with its own 420,000 member health plan, MetroPlus, and is the largest municipal healthcare organization in the country. HHC serves 1.4 million New Yorkers every year and more than 475,000 are uninsured. HHC provides medical, mental health and substance abuse services through its 11 acute care hospitals, four skilled nursing facilities, six large diagnostic and treatment centers and more than 70 community based clinics. HHC Health and Home Care also provides in-home services for New Yorkers. HHC was the 2008 recipient of the National Quality Forum and The Joint Commission’s John M. Eisenberg Award for Innovation in Patient Safety and Quality. For more information, visit www.nyc.gov/hhc or find us on facebook.com/nycHHC or twitter.com/HHCnyc.
Source: nyc.gov

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September 24, 2013

Top 5 Medicare Questions Asked By Seniors

Posted by:  :  Category: Medicare

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

Video: Medicare Questions – Company Benefits & Credible Coverage for Medicare Part D

Do you Have Medicare Questions? SHIP of Union County will be at Overlook Downtown Beginning in September

Programs at SAGE Eldercare include: HomeCare; Meals On Wheels; Spend-A-Day Adult Day Health Center; GPS (Guidance, Planning and Support) Services; InfoCare free information and referral service; Fall Prevention Initiative; Home Repair Service; Grocery Shopping and Errand Service; Bill Paying Service; Holistic Living Services; Alzheimer’s and PREP caregiver support groups; Community Education; and Union County Medicare SHIP (State Health Insurance Assistance Program).  In addition, SAGE has operated a Furniture Restoration Workshop, run by volunteers who specialize in caning and rushing chairs and refinishing furniture, and a Resale Shop for more than 50 years.  Both provide essential funding that supports the organization’s programs and services for older adults in the community. 
Source: thealternativepress.com

7 Common Questions (and Answers!) about Medicare

Debbie,.. I too feel very blessed. My new coverage includes eye exams, hearing and DENTAL! What concerns me is the rumor that those with Medicaid are going to have to pay their deductables as of January 2014. I’m not sure what that means yet. I don’t take alot of meds, but medicare has stopped paying for infusion therapy for Fibromyalgia and they won’t pay for hormone therapy cream but they will pay for hormone pills. Of course, which have terrible side affects. NATURALLY! leave it to the government to allow a medication that will cause breast cancer= MORE MONEY for drug companies until you die!! With my new meds, I am looking at about $5.30 every three months. If I was able to get my three therapy treatments that I desperately need, I would be paying an extra $410 per month. It makes no sense that the government allow or condone complete alternative health care, nor will insurance plans pay for logical wellbeing healthcare. It’s all about the upper crust who can afford the out of pocket expenses, verses those who can’t. You stay in pain longer, but you are also on the preplan for early departure from life. Medicare is not a product for overall wellbeingness and health.
Source: care2.com

What You Need to Know about Medicare and the Affordable Care Act

Ross Blair has applied more than 26 years of technology experience to develop PlanPrescriber.com, a website that makes it easier for seniors and their caregivers to select and enroll in the best Medicare products for their specific needs. In his role as CEO, he has worked closely with pharmacists, insurers, physicians, caregivers and seniors to identify the most critical and complex aspects of Medicare and create a system that delivers this information to consumers in a format that is easy to use and understand. Google+
Source: ehealthmedicare.com

Medicare Questions and Answers (Original Medicare)

AARP AARP Connecticut AARP Medicare AARP Medicare Complete AARP Medicare Supplement AARP Medicare Supplements AARP Medigap AARP Medigap 2013 AARP Rates 2013 AARP Supplement AARP Supplement 2013 aetna Medicare Anthem Anthem 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

Medical company declines to answer Senate questions on Medicare billing

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

James Roberson can answer all your Medicare questions.

James Roberson is a medicare counselor and community educator.  He is the coordinator of the Alabama State Health Insurance Assistance Program (SHIP) and is the go to guy for information that can help you make informed choices about your health insurance.  SHIP is a service provided through the Area Agency on Aging.  SHIP can help you understand your Medicare benefits.  They can help you determine which Medicare Prescription Drug Plan best fits your needs.  They can answer questions about Medigap, long-term care insurance policies and other health insurance programs for seniors.  They can assist Medicare beneficiaries in specific areas such as home health benefits, Medicare claims and appeals and other similar issues.  This is a free service.  SHIP will not try to sell you any insurance.  They only provide education and counseling.
Source: caregiversunite.org

Medicare ‘doc fix’ clears hurdle in the House, but providers still have questions

The measure would repeal the sustainable growth rate, replacing the mandated annual physician reimbursement cuts with a pay-for-performance model. Under this system, physicians will receive a 0.5% annual update, with additional reimbursement available to high-performing providers starting in 2019. The bonus pay would be based on quality measures in existence or new ones that would be developed. Underperforming doctors would see reimbursements reduced.
Source: mcknights.com

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September 24, 2013

What is the Difference Between Original Medicare and Medicare Part D?

Posted by:  :  Category: Medicare

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Another way to get Part D coverage is by enrolling in a Medicare Advantage Prescription Drug (MAPD) plan that combine prescription drug coverage with hospital and medical insurance. However, if a beneficiary chooses to enroll in a Medicare Advantage (MA) plan that does not offer prescription coverage, they may not be able to join a stand-alone Part D plan for medication coverage. The only types of MA only plans that allow a beneficiary to also enroll in a PDP include: Private-Fee-For-Service (PFFS), Medical Savings Account (MSA), or Cost plan. If an MA plan without drug coverage does not allow enrollment in a PDP, beneficiaries should consider looking into switching into an MAPD during the next Medicare Annual Enrollment Period (AEP).
Source: ehealthmedicare.com

Video: What Does Medicare Part B Cover And What Are The Part B Costs?

Medicare FAQ: What is Original Medicare, Part A and Part B?

These individuals will want to enroll during their seven month Initial Enrollment Period (IEP), which starts three months before they become Medicare eligible and lasts for three months afterwards. If they do not sign up during their IEP, they can sign up during the General Enrollment Period. This enrollment period lasts from January 1 and March 31 of each year with coverage starting on July 1. However, this means that you will have to pay a higher monthly premium for late enrollment. The length of these late enrollment penalties will depend on how long you could have enrolled in Part A and/or Part B coverage and did not.
Source: planprescriber.com

Medicare and Reform: 50 States of Confusion

Closes the Coverage Gap: The Coverage Gap — also known as the donut-hole — is the portion of a Part D plan where beneficiaries pay a higher portion of their medication costs until they reach a certain dollar amount, known as an out-of-pocket maximum. Since 2010, with the help of pharmaceutical manufacturers, CMS has lowered the copayment amounts on brands and generics. Since this change began in 2010, beneficiaries have saved $1,000, on average. By 2020, the Coverage Gap will go away completely. Surprisingly, 77% do not know that the Coverage Gap is in the process of closing due to reform and are unaware of the current savings.
Source: express-scripts.com

Railroad Medicare is Part B Medicare for retirees

If a provider or supplier you want to work with participates in Medicare, but states “not Railroad Medicare,” Palmetto GBA recommends that they call Palmetto’s Provider Contact Center at (888) 355-9165. Palmetto’s staff is trained to discuss these matters with all Part B providers and suppliers. They also recommend providers or suppliers visit Palmetto’s website at www.PalmettoGBA.com/RR.
Source: utu.org

Opinion: Cuts to Medicare Part B will hurt older Coloradans

Unfortunately, the cuts are already hitting community health clinics hard, especially in rural areas. A recent survey conducted by the American Society of Clinical Oncology found that nearly 50 percent of oncology practices are sending Medicare patients elsewhere for treatment, primarily to a more expensive hospital setting due to sequestration. Twenty-two percent reported that they either have closed or will have to close clinics if sequestration cuts continue.
Source: healthpolicysolutions.org

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

Benefits Of Medigap Insurance

There are important things clients should understand before attempting to purchase Medigap. To get Medigap, Part A or Part B Medicare is required. Applying for Medigap is possible if you already have a Medicare Advantage Plan; before your Medigap policy starts, however, you must cancel the Medicare Advantage Plan. Paying a private insurance company each month is possible; the payments can cover the Medigap policy and the Part B plan that is paid to Medicare. If you want to get Medigap coverage for many people, each individual will need coverage; several policies must be purchased because Medigap just covers one individual. Finding a provider is not tough; many insurance companies will offer Medigap; search for companies that are licensed within your state. When clients buy Medigap; they get a guarantee; most standardized policies are renewable. If clients have health issues, they can still renew. Some coverage polices are different depending on the year the policy was sold. Policies offered years ago covered prescription drugs; policies sold after 2006, however, does not cover prescription drugs. Clients that need prescription drug coverage must consider Medicare Prescription Drug Plan (Part D). A Medicare Medical Savings Account Plan is not allowed if you want a Medigap policy; it is illegal.
Source: deborahserani.com

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September 24, 2013

Managed care reduces hospitalizations in nursing home residents with advanced dementia

Posted by:  :  Category: Medicare

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The new research showed that managed-care residents, who had more primary-care visits, predominantly from nurse practitioners, were more likely to have a do-not-hospitalize (DNH) order in place (63.7 percent for manage-care residents vs. 50.9 percent for fee-for-service residents). These residents also had fewer hospital transfers for acute illness (3.8 percent vs. 15.7 percent) than those in traditional Medicare insurance. In addition, the research suggests that managed-care residents may have been more likely to enter hospice, and that family members may have been more satisfied with overall care at the nursing home.
Source: sciencecodex.com

Video: Parts A & B – Traditional Medicare

Comparing Medicare Traditional to Medicare Advantage: Outcomes, Visits, Case Weight, and HHCAHPS

SHP reports on four metrics from its database for the calendar year 2012, showing a side-by-side comparison of Medicare Traditional to Medicare Advantage. Take a look at the data, particularly the difference in length of stay (LOS) but with little impact on quality metrics.
Source: shpdata.com

ICYMI: Health Affairs Study

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

Medicare Advantage Fact Sheet

Since 2006, Medicare has paid plans under a bidding process.  Plans submit “bids” based on estimated costs per enrollee for services covered under Medicare Parts A and B; all bids that meet the necessary requirements are accepted.  The bids are compared to benchmark amounts that are set by a formula established in statute and vary by county (or region in the case of regional PPOs).  The benchmarks are the maximum amount Medicare will pay a plan in a given area. If a plan’s bid is higher than the benchmark, enrollees pay the difference between the benchmark and the bid in the form of a monthly premium, in addition to the Medicare Part B premium.  If the bid is lower than the benchmark, the plan and Medicare split the difference between the bid and the benchmark; the plan’s share is known as a “rebate,” which must be used to provide supplemental benefits to enrollees.  Medicare payments to plans are then adjusted based on enrollees’ risk profiles.
Source: kff.org

Part 1 of 6: Does Medicare or Traditional Health Insurance Pay for Elder Care Services in Indianapolis Indiana?

Julie Sullivan is the Owner at GreatCare of Indianapolis IN. GreatCare is a licensed, personal services agency, providing in-home care services to the Indianapolis, Indiana and surrounding areas. We serve the personal health and daily care needs of seniors or individuals who prefer to stay at home, but require assistance with everyday activities, such as dressing, personal hygiene, meal preparation, laundry or errands. Our team of certified nurse aids and home health aids can provide you with personalized, in-home care services to meet your needs, including: Daytime hourly in-home care Temporary or post-hospital respite care 24-hour, around-the-clock home care Morning and evening care Overnight / Slumber care In addition, we offer our Care Compass service, to assist in setting the course for the next stage in your loved ones life. We guide you through the currents of aging, and help you find your true north. Our licensed nurses, with experience in hospice and geriatric care, will help guide you through the complex and often sensitive journey of selecting an in-home care service, and will provide a smooth transition to a new way of life for your loved one, without the anxiety and fear.
Source: ineedgreatcare.com

Medicare Drug Plan Polls Suggest Bright Future for Obamacare

Looking back on it, the public’s turnaround from initial rejection to growing support for Part D was understandable. The unfunded $400 billion program that President Bush signed into law in December 2003 was needlessly complex for seniors and unnecessarily expensive for taxpayers. Rather than having the government negotiate prices directly with pharmaceutical firms and add drug coverage into the traditional Medicare program, President Bush and his Republican allies in Congress instead gave recipients subsidies to purchase plans from private insurers. Making matters worse, millions of “dual eligible” already receiving drug coverage from Medicaid had to switch to the new scheme, a process that left millions unable to pay for their prescriptions for weeks in early 2006.
Source: crooksandliars.com

Energy and Commerce and Ways and Means Committees Explore Efforts to Modernize Medicare Program

WASHINGTON, DC – House Energy and Commerce Committee Chairman Fred Upton (R-MI), Ways and Means Committee Chairman Dave Camp (R-MI), Energy and Commerce Health Subcommittee Chairman Joe Pitts (R-PA), and Ways and Means Health Subcommittee Chairman Kevin Brady (R-TX) today released the first paper in a series examining the flaws in the existing Medicare program and outlining opportunities for reform. The series, Modernizing Medicare for the 21st Century, will outline a bipartisan approach that will both protect beneficiaries and reduce costs. With these papers, the members seek “to initiate a discussion on how to protect seniors and place the Medicare program on sound financial footing.”
Source: house.gov

Medicare Advantage Plans Outperform Traditional Medicare

Perhaps most importantly, Medicare Advantage insurers place a strong emphasis on preventive care, which helps them keep members healthy and avoid expensive hospital stays. Insurers offering Medicare Advantage plans often implemented such practices as detailed analytics that identify at-risk members, remote vital-sign monitoring and home visits from a multidisciplinary team of providers, the study noted.
Source: hcafnews.com

Medicare advantage costs often exceed traditional Medicare costs

Using newly available government data, Marsha Gold, a senior fellow with Mathematica Policy Research, found that risk-adjusted MA plan costs in 2009 were, on average, 4 percent higher than those for traditional Medicare. Among plan types, only health maintenance organizations (HMOs) had lower average costs, while costs for more than 75 percent of local preferred provider organizations (PPOs) and private fee-for service plans exceeded traditional Medicare’s. According to Gold, the wide variation in MA plan costs relative to traditional Medicare suggests there is room for many of these plans to deliver care more efficiently and keeps costs down.
Source: wordpress.com

Senior Citizens and The Affordable Care Act

Victor S. Kostro is an attorney in private practice with the law firm of O’Brien, Riemenschneider & Wattwood, P.A.  He has extensive experience as a corporate, transactional, healthcare attorney having served as Associate Corporate Counsel/Corporate Risk Manager for Health First, Inc.  In this role, Vic provided representation related to physician employment, practice sales/acquisitions, regulatory and compliance issues, peer review and disciplinary actions, and counseled on issues related to fraud and abuse, anti-kickback laws, Stark, self-referral and the False Claims Act. In addition, Vic managed the entity’s Risk Management Department, which included oversight of all medical negligence and personal injury claims asserted against the entity, its hospitals and physicians. Vic is well versed in medical practice entity formation, and contractual matters, employment, shareholder and partnership agreements, purchase and sale agreements, estate planning and asset protection.  Vic holds a Master of Laws in Taxation from the University of Florida.
Source: spacecoastdaily.com

Daily Kos: Chuck Todd Is The Embodiment Of A Delegitimized Traditional Media

Alumbrados, Superskepticalman, Sylv, DeminNewJ, KeithH, Yosef 52, scribeboy, Maudlin, Liberal Thinking, maracucho, OLinda, eeff, brn2bwild, frisco, RubDMC, rasbobbo, 714day, gayntom, wonmug, artebella, dksbook, Redfire, Texknight, kharma, Joe Bacon, jsmagid, American Zapatista, figbash, delphine, mnguitar, rlharry, lcrp, clarknyc, zerelda, Curt Matlock, KayCeSF, Vicky, mosesfreeman, Black Max, Sybil Liberty, sebastianguy99, sawgrass727, Ohkwai, Desert Rose, historys mysteries, ichibon, Shrew in Shrewsbury, citizenx, fixxit, majcmb1, stevemb, SteveRose, sunbro, Tunk, rofodem, Rusty in PA, Joes Steven, bunsk, laurel g 15942, mightymouse, Land of Enchantment, ThatSinger, skywriter, redcedar, Orinoco, Keone Michaels, RustyBrown, cybersaur, dopper0189, dougymi, greenearth, blueoasis, gooderservice, Libby Shaw, DSPS owl, real world chick, JVolvo, Up to here, va dare, Ian Reifowitz, NancyWH, Johnathan Ivan, daeros, Aaa T Tudeattack, cpresley, BeninSC, bvljac, Cronesense, verso2, Da Rat Bastid, Stwriley, Matt Z, Dave in Northridge, bnasley, jayden, martyinsfo, leonard145b, chujb, TomP, Empower Ink, gizmo59, rmonroe, Mighty Ike, JDWolverton, misterwade, kimoconnor, HappyinNM, zerone, Sixty Something, Thomas Twinnings, Involuntary Exile, Ronald England, smrichmond, Its any one guess, Calamity Jean, royce, Hanging Up My Tusks, steve2012, Gemina13, palantir, dmhlt 66, maggiejean, enemy of the people, Turn Left, ewmorr, banjolele, mkor7, Remediator, kravitz, followyourbliss, RJH, kevinpdx, Cats r Flyfishn, hopeward bound, Its the Supreme Court Stupid, estreya, Polly Syllabic, JoanMar, DiegoUK, Texnance, Betty Pinson, DrTerwilliker, ericlewis0, dot farmer, kerflooey, annominous, I love OCD, bgblcklab1, Tommye, implicate order, freesia, La Gitane, mrsgoo, Haf2Read, thomask, BarackStarObama, createpeace, wintergreen8694, stevie avebury, ratcityreprobate, jack23, weinerschnauzer, Chitown Kev, Cpqemp, allergywoman, hulibow, Eric Nelson, barkingcat, a2nite, JGibson, ANY THING TOO ADD, Lorinda Pike, infinitygoddess, reginahny, Canines and Crocodiles, lunachickie, terrybuck, avsp, bluebarnstormer, raina, 4mygirls, George3, mumtaznepal, simple serf, newinfluence, argomd, kleinburger, remembrance, unfangus, alice kleeman, kmfmstar, Aunt Pat, ggfkate, bob152, IndyinDelaware, furrfu, marcr22, starduster, skepticalcitizen, htowngenie, Mark Mywurtz, Ticorules, OldSoldier99, Treetrunk, trkingmomoe, Keeping It Real
Source: dailykos.com

GAO Report Finds Excess Spending in Medicare

According to a recent U.S. Government Accountability Office (GAO) report, private insurers offering Medicare Advantage plans receive inflated payments because insurers tend to use relatively high risk rates when calculating what Medicare should pay insurers per enrollee. The Centers for Medicare and Medicaid Services (CMS) offsets these higher rates by decreasing payments using a risk score adjustment, but the GAO reports that the CMS has not adequately adjusted these payments. The GAO estimates that this has resulted in “substantial excess payments” to Medicare Advantage plans—totaling in the range of $3.2 to $5.1 billion between 2010 and 2012.
Source: upenn.edu

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September 24, 2013

Medicare Open Enrollment Period Begins Oct. 15, 2013

Posted by:  :  Category: Medicare

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

Video: How to Select the Best Medicare Advisor to help me with all my Medicare Insurance Needs

Seniors Who Discuss Medicare With Advisors Are Better Off: Survey

Mary Dale Walters, senior vice president of the Allsup Medicare Advisor, a Medicare plan selection service for Medicare-eligible individuals, noted in a statement that Allsup’s survey of seniors with advisors “found that while only a small number discuss Medicare with their advisors, three of their five major concerns relate to health care and Medicare.”
Source: thinkadvisor.com

Learn how ACA might affect Medicare

Every day, around 10,000 people nationwide turn 65, qualifying for Medicare enrollment. Around 15 percent of Cowlitz County’s population is eligible for Medicare, and that number is expected to increase to 25 percent by 2030. Wahkiakum County’s Medicare population will increase by 42 percent.
Source: tacticalminc.com

Medicare Plan Finder for Health, Prescription Drug and Medigap plans

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

Time for Medicare choices

The Medicare Part B premiums will increase from $104.90 per month in 2013, but the amount hasn’t yet been announced. The announcement will be made before open enrollment begins. If you earn more than $85,000 for a single person or $170,000 for married people filing jointly, you’ll pay additional premiums based on your income. Part D premiums also are subject to these sliding scales. These income levels haven’t increased since 2010, so more people will face these income penalties.
Source: bankrate.com

ibm medicare options: IBM Medicare Extend Health Pre

Medicare Advantage plans are a substitute to original Medicare and are offered by private insurance companies but must conform to government rules.  If you use an MA plan that private insurance company becomes your payer.  There will  be a group of doctors associated with the plan and a doctor can decide at any time to not be part of the group. How much doctors charge depend on whether they are “in network” or “out of network” – for the latter your copay will be higher.   The plans are zip code based so you must use the doctors that are part of their group.  If you move to another area you must get a new MA plan. These plans must cover all the procedures that original Medicare covers but they can vary copays from service to service.  So, an ambulance ride might have a 50% copay. Most MA plans do not include use of specialty clinics. MA plans can also include prescription drug insurance. They might also require an additional premium over an above the part B premium you pay out of Social Security.  Look on www.medicare.gov to see what MA plans are sold in your zip code so that you have a comparison to plans offered by Extend Health.  Reminder – MA plans are sold by profit and loss institutions. The federal government insurance pool obviously is not. 
Source: blogspot.com

With Medicare Open Enrollment Approaching, the LPL Financial Advisors at IWM Partners Will Host a Medicare 101 and 2014 Plan Benefits Workshop, Tuesday, October 8

The workshop will include information on Medicare eligibility, the differences between Parts A, B, C, and D, coverage options, supplement insurance plans, and more. It is an opportunity for those already familiar with Medicare to find out what changes have taken place since last year, and for those who are just becoming eligible or who have friends and family becoming eligible to learn the basics of how Medicare works and what the options are.
Source: entrepreneur-parenthood.biz

Choose Medicare carefully

Part C is the Medicare Advantage Plan and includes all benefits and services covered under Part A and Part B. The plans often have more benefits than traditional Medicare, including dental and vision coverage, and usually include prescription drug coverage. These plans are provided through private insurance companies that have a contract with Medicare.
Source: triblive.com

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September 24, 2013

Medicare Drug Plan Polls Suggest Bright Future for Obamacare

Posted by:  :  Category: Medicare

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Looking back on it, the public’s turnaround from initial rejection to growing support for Part D was understandable. The unfunded $400 billion program that President Bush signed into law in December 2003 was needlessly complex for seniors and unnecessarily expensive for taxpayers. Rather than having the government negotiate prices directly with pharmaceutical firms and add drug coverage into the traditional Medicare program, President Bush and his Republican allies in Congress instead gave recipients subsidies to purchase plans from private insurers. Making matters worse, millions of “dual eligible” already receiving drug coverage from Medicaid had to switch to the new scheme, a process that left millions unable to pay for their prescriptions for weeks in early 2006.
Source: crooksandliars.com

Video: Larry Summers Cries, Exploding Medicare Checks & The Next Crisis

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

Bill would end hospital inpatient requirement for SNF Medicare coverage

Currently, Medicare Part A only reimburses for skilled nursing facility care after a person has spent at least three days as a hospital inpatient. However, SNFs now can provide services that used to be available only in hospitals, McDermott stated when introducing his legislation Thursday. Eliminating the three-day inpatient rule would also resolve the urgent problem of hospitals keeping people for extended stays under “observation” status, which does not qualify a person for SNF coverage.
Source: mcknights.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

Medicare and Medicaid, Age and Income

Yet, this trend masks a great deal of variation between race and Hispanic origin groups.  As the figures show, the non-Hispanic white population is the only group that participates more in Medicare than Medicaid.  Given that to be eligible for Medicare, participants must be 65 and older, one of the biggest reasons for this is the different age distributions among these groups, and the non-Hispanic white population is much older than the other groups. For instance, in 2012, 17 percent of non-Hispanic whites were 65 and older compared with 10 percent of blacks, 10 percent of Asians and 6 percent of Hispanics. Moreover, with the large non-Hispanic white baby-boom population now starting to enter the Medicare-eligible age group, higher Medicare coverage rates for non-Hispanic whites will continue for some time.
Source: census.gov

AHIP Statement on Medicare Advantage

“While today’s announcement is good news for seniors and people with disabilities, we are concerned that Medicare Advantage beneficiaries may experience higher out-of-pocket costs and disruptions in their coverage when the ACA’s $200 billion in payment cuts are fully phased-in over the next several years.  These cuts will be compounded by the ACA’s new tax on Medicare Advantage coverage that is projected to increase costs for seniors in the program by $3,500 over the next ten years.”
Source: ahipcoverage.com

HHS on Medicare Advantage: Enrollment high, premiums low

Helping to increase enrollment in MA: The majority of beneficiaries (99.1%) have access to these higher-quality plans, according to HHS. The department expects the average number of plan choices will remain about the same in 2014 and access to supplemental benefits will remain stable.
Source: hmenews.com

Wide Disparities in the Income and Assets of People on Medicare by Race and Ethnicity: Now and in the Future

This report includes important distributional information about the means of current and future Medicare beneficiaries.  It updates and complements our prior work in this area by focusing on differences in the income and assets of people on Medicare by race/ethnicity, using data from the DYNASIM microsimulation model developed by researchers at the Urban Institute.  A table summarizing the income and assets of Medicare beneficiaries in 2012 and 2030, by selected demographic characteristics, is included in Table A1.  Data are rounded to the nearest $50 and are presented on a per person basis, rather than per household; for married people on Medicare, income and assets are divided equally between spouses to calculate per capita income, savings, and home equity.  More information about the methodology can be found in the Appendix. This analysis provides new information about disparities in incomes and assets among the Medicare population by race and ethnicity to inform ongoing discussions about potential changes to Medicare, Medicaid, Social Security and other policy proposals that could have important implications for the economic security of current and future Medicare beneficiaries.
Source: kff.org

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September 24, 2013

Video: Extra Help with Medicare and Part D

Posted by:  :  Category: Medicare

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Source: medicarechoicesofarizona.com

Video: medicare extra help

Sign up now for Medicare Help!

Beginning October 22, The State Health Insurance Assistance Program (SHIP) and Brighton Center’s Senior Medicare Patrol are offering free Medicare Prescription Drug Plan comparison assistance for Medicare beneficiaries. Representatives from SHIP will also be screening individuals to see if they are eligible for extra-help to pay for Medicare expenses.
Source: seniorservicesnky.org

Programs that help seniors with health care costs

To help you find out if you’re eligible for these programs, use the National Council on Aging Web-based tool at benefitscheckup.org. You’ll need to fill out an online questionnaire that asks things like your date of birth, ZIP code, expenses, income, assets and a few other things. Once completed you’ll get a report detailing which programs you may qualify for, along with downloadable application forms and, in the case of Extra Help, allow you to complete your entire application online. The program even knows the specific MSP eligibility rules in your state.
Source: pomeradonews.com

Top 3 Myths of Health Care Reform and Medicare

Fact: The simple fact of the matter is that the cuts to Medicare are related to the reimbursement rates that the doctors will receive.  The Affordable Care Act has mandated the availability of preventive services, and this actually means Medicare beneficiaries will now have access to an annual preventive check-up rather than the initial one-time physical exam previously offered.  A number of other preventive procedures related to the assessment of diabetes and other chronic illnesses will also be covered with no cost sharing required.
Source: upstateseniors.org

Do You Qualify for Medicare's Extra Help Program?

Every individual who qualifies represents an important potential benefit to our tribal communities. Social security is responsible for implementing that benefit; we call it “extra help.” Many Medicare beneficiaries won’t have to file for assistance because they’ll automatically get it based on benefits they receive.
Source: indiancountrytodaymedianetwork.com

Medicare ‘Extra Help’ Now Easier to Get

“These changes to the ‘Extra Help’ program make it easier for more people to get help paying for their prescription drugs,” said Marilyn Tavenner, CMS Principal Deputy Administrator in a press release. “Even if you were turned down for ‘Extra Help’ before, you should reapply. If you qualify, you will receive help paying for Medicare prescription drug coverage premiums, copayments and deductibles.”
Source: about.com

Do You Qualify for Free Medicare Part D?

If you decide to apply and find out you don’t qualify, don’t worry because there are other programs at the state level that may be able to help you cover your prescriptions.  Find out by visiting Medicare’s “Helpful Contacts” page- Click here to visit the page.  This page can help you find a program at the state level that may be able to provide some assistance to pay for prescription drugs.
Source: firstseniorfinancialgroup.com

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