Anthem issues MLR refunds to qualifying Medicare Supplement members

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As you may be aware, Medicare Supplement premium changes are based on anticipated health care costs and claims trends. To support these changes, Anthem reviews Medicare Supplement premiums annually to ensure our cost estimates meet state regulated Medical Loss Ratio (MLR) requirements.  MLR is the percentage of premiums that an insurer must spend on medical care.
Source: barricksinsurance.com

Video: Anthem Blue Cross of California Medicare Supplement

Medicare Supplements (Medigap) For Dummies

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

monicafones: Anthem Medicare Preferred General Ppo

Can there be an finest Top 5 Reasons Why Medicare Supplement Plans Are a Good Idea plan this is actually at this periods in the showcase? Seeking to remedy which will nightmare without having to place the case right framework does absolutely not result in factor for a a possibility Medicare supplement plan founder. For the duration experience valuation, is definitely enormously straightforward inform you Plan North includes essentially essentially the most broad and should consequently become generally called the preferred Medicare supplemental insurance plan, a over-all start off thinking of cost expense but also suitability, do no longer possibly be with that being said enthusiastic so you’re able to go along. Medicare insurance Supplements New You are able to plans will clearly become a faithful asset for senor life the ways it covers one plans with considered necessary medical aids. The main numerous medicare supplement insurance policies covers different in business services. Section A, includes medical center insurance which may possibly possibly concede to remain highly needed created by most of people in any staging. Part B and Part J included medical insurance plan and advantage diet plans & D entails total coverage when it comes to prescription drugs. Some sort of survey released back in July 2010 made by the National Local authority or council on Aging (NCOA) indicated that typically 17% of the aged across the country music were able in the market to correctly answer 0 . 5 of the eleven random questions over the new physical condition reform law coupled with its key changes. The survey, which was executed by Harris Enjoyable from July several to July 12, was based with regards to 636 responses through adults ages 29 and older. In line with the new law, Medicare insurance will cover a large number of preventive care benefits, so these profits will be fallen from Medigap Programs. The Home Recovery benefit will additionally be dropped from Medicare supplement Plans. This skill viewpoint is completely wrong. People are seldomly ever aware of any limitations of Medicare insurance. They only believe it when these guys face some monumental unexpected medical charges which the Medicare health insurance does not cover, and by the idea is too past due. So, it is the most suitable to correct the entire misconception about Medicare health insurance much before a suitable person faces of these consequences. Medicare supplemental health insurance policies have on to follow rules put down by Govt and state polices that were provided to protect customers. One such law is also that all medicare supplemental insurance policies are standardised and identified from the letters A huge through N and as well , each policy must offer the exact benefits designated basically its letter regardless which insurance manufacturer offers it. What that ways is that a person want a respected medigap plan almost all insurance companies have to have to offer it for the exact very same thing coverage with costs being the no more than difference. So, what brings in this particular tripling in the quantity of time it will eventually take to wide-range underwriting? Rapid solution is The of men and girls are applying in order for protection for your current duration of this moment period because attached to to different requirements.
Source: blogspot.com

Will My Anthem Medicare Supplement Fill In All The Gaps?

In today’s economy, just having health insurance is not enough. Due to the increasing cost of co-payments, deductibles and the rising cost of coinsurance, many people are faced with added expenses and are having a hard time staying on a budget. Therefore, Anthem Medicare Supplement was specifically developed to tackle the escalating cost concerning out of pocket expenses with Medicare patients in mind. The majority of Medicare insurance plans cover the basics such as doctor visits, annual physical exams and prescription drugs as well as an occasional need for hospital assistance. However, these traditional healthcare plans require a certain amount of extra expenses in the form of deductibles, coinsurance and co-pays also known as gaps in insurance coverage.
Source: seniorcorps.org

Anthem Medicare Supplemental Insurance Reviews

With Anthem Medicare Supplemental Insurance you’ll have the freedom to rely upon coverage for deductibles and co-insurance that traditional Medicare coverage doesn’t cover. You will also have the liberty of enjoying the security of knowing these benefits will not change regardless of the changes in your health. Freedom to choose plans offering 100% coverage for the basic benefits is also standard and that includes preventative care service as well. You will also have the option of selecting plans that cover well-trained nursing facilities, Medicare Part B Excess fees, and even far-off travel emergencies while exploring the world.
Source: ihealthcoalition.org

Medicare Supplement Plans Rising

Medicare supplement policies, often called Medigap insurance, are a variety of plans sold by private insurance companies to fill gaps in coverage provided by the traditional, federal-government-managed Medicare A and B plans. The government-run doctor-and-hospital plans for people 65 and older, and some people with disabilities, don’t cover all expenses. Medicare supplement plans are designed to reduce out-of-pocket expenses.
Source: courant.com

Anthem Medicare Supplement Insurance Quotes in Ohio

In order to qualify, individuals must switch from an existing supplemental policy to a new  Anthem plan with equal or lesser coverage.   This means if you currently own Plans F or J, you can switch to a modernized Plan F (Plan J is no longer for sale as of June 2010) with no health questions asked.   Likewise, you could switch from Plan G to Plan G or Plan N to Plan  N, etc.
Source: ohioinsureplan.com

Medicare Supplement Plan F from Anthem Blue Cross Covers All of Your Health Care Needs

In addition to all of this, Plan “F” also has a foreign travel emergency benefit, which is useful for seniors on the go. If this sounds like a program that you would be interested in, find out more information today by calling the insurance agents at Benefit Packages. At Benefit Packages, we are an independent insurance agency that works with many different insurance companies. We can help you find the best Medicare supplement for your situation.
Source: benefitpackages.com

Need Help Understanding Medicare Options?

Posted by:  :  Category: Medicare

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The Mental Health Association in New Jersey (MHANJ) offers free, objective, confidential counseling which includes assistance with questions about Medicare, Medigap, Medicare Advantage, Medicare Part D, Long-Term Care Insurance and Dual-Eligibility. Sessions are conducted by telephone, toll-free, so that travel is not necessary. The number to call to make a counseling appointment is 1-866-202-HELP (4357). We can also arrange for an informative Medicare presentation for your organization.
Source: mhanj.org

Video: Understanding Medicare Advantage Plans

News Article/Update on State Medicare Advantage Plans

The complete program information is now available on the CMS website for both the College Insurance Program (CIP) and the State Employees’ Group Health Program. The TRAIL Decision Guide includes an explanation of plan options, plan comparison chart, rate chart, coverage map, and contact information for the four plan administrators. The site also offers a comprehensive FAQ (Frequently Asked Questions) sheet for CIP and State Employees. At this time, the enrollment form is not available.
Source: surs.com

Seniors lose insurance AND doctors under Obamacare

The company is asking elected officials to avoid further cuts to the program, “We’ve been lobbying Congress to help insure that Medicare Advantage is appropriately funded to avoid further increases in premiums and changes in the product,” Vincz told TheDC. “We are hoping to make this a one time experience.”
Source: dailycaller.com

Medicare Health Plan Advisor in San Diego Discusses Senior Plan Options

Annual Open Enrollment is occurring right now. If you are a Medicare recipient, you will start getting post cards, letters and flyers inviting you to meetings, promoting different plans and offering services of various insurance brokers. If you are considering changing your plan, please make sure that you choose the right person to help you out.  Check his/her record at the California Department of Insurance website. Ask how many companies do they represent (currently there are 12 MAPD and many more Medicare Supplements and PDP companies available in San Diego county). Make sure the broker you choose has offices in your county.  Research his/her knowledge about the doctors and hospitals that you are using.  Ask about their credentials and training. Make sure they will be available to you after enrollment.
Source: pomeradonews.com

Most Seniors Compare Medicare Plans Without Prescription Drug Costs

This data comes from a recent study conducted by eHealth. When we looked back at the 2013 Medicare Annual Election Period (also known as the Medicare Annual Enrollment Period or AEP), our researchers found that fewer than one-in-four shoppers (22%) entered the names and dosages of prescription drugs they were taking while comparison shopping for Medicare Advantage Prescription Drug (MAPD) plans or stand-alone Medicare Prescription Drug Plans (PDPs) at eHealthMedicare.com or PlanPrescriber.com.
Source: ehealthmedicare.com

Medicare Open Enrollment FAQ

Review your benefits and costs for 2014, compare alternatives and decide whether to keep or change plans during Medicare’s annual open enrollment period Oct. 15 through Dec. 7. This year, Medicare’s open enrollment overlaps with open enrollment for the new insurance marketplaces or exchanges created under the Affordable Care Act, also commonly referred to as Obamacare — but don’t let that throw you. Medicare’s 50 million-plus beneficiaries, most of them seniors, will steer clear of the marketplaces. Got questions? Here’s what you need to know about Medicare’s open enrollment in the marketplace era.
Source: aarp.org

Why Obamacare needs a Medicare for all option

In a more honest America, private insurers would send letters to customers telling them that the policy they currently have is below the standards of the new law and can no longer be offered. Instead, they are sending out cancellation notices and offering those same people more expensive policies – without bothering to inform them that they are not obligated to remain with the same company, and that better, cheaper policies may be available from another company on the ACA exchange.
Source: allvoices.com

Take Time to Evaluate Options During Medicare Part D Enrollment

With a number of changes to Medicare prescription drug plans in 2014, and with 13 percent more stand-alone plan options available than last year, understanding the plans and shopping around for the right one might be warranted and might mean decreased costs for some Medicare Part D enrollees.  Premiums and out-of-pocket expenses aside, exploring different plans might also lead to increased convenience and quality in coverage.
Source: azhealthconnections.com

Seniors lose insurance AND doctors under Obamacare

Posted by:  :  Category: Medicare

The company is asking elected officials to avoid further cuts to the program, “We’ve been lobbying Congress to help insure that Medicare Advantage is appropriately funded to avoid further increases in premiums and changes in the product,” Vincz told TheDC. “We are hoping to make this a one time experience.”
Source: dailycaller.com

Video: Medicare Plans from Blue Cross and Blue Shield of Minnesota and Blue Plus

Blue Care Network expands Medicare Advantage service area, Blue Cross and Blue Care Network add plan options

In addition, BCN Advantage members will now be able to “buy up” to more comprehensive dental and vision benefits for a modest additional premium. Members will receive partial coverage on restorative services such as fillings, root canals, crowns and crown repairs. They’ll also get an allowance for frames and lenses to improve their vision health.
Source: hcwreview.com

Newsroom – Blue Cross Blue Shield of Michigan broadens Medicare options with new Medicare Advantage PPO product

October 1 is the first day BCBSM and Medicare Advantage carriers across the nation can market their Medicare Advantage products for 2010. Beneficiaries in BCBSM Medicare Advantage products will receive letters in the next 10 days about the new product line-up. "Blue Cross remains fully committed to providing products to Medicare beneficiaries and will continue to have the broadest array of Medicare Advantage products in the state," said Mark Owen, BCBSM vice president for federal and individual business. "It’s important for Medicare beneficiaries to know that there is no immediate change to their coverage. They have until the end of the year to make their selection for 2010." In addition to the three BCBSM products for 2010, seniors also can select from three Medicare Advantage products offered by Blue Care Network, the BCBSM-affiliated HMO. "We will be working with insurance agents and other groups across the state to reach out to Medicare beneficiaries to help them navigate these product and premium changes," said Owen. Seniors who meet low income guidelines can receive subsidies from the state and/or federal government to pay for all or part of their premiums. Medicare Advantage premiums vary by product and region. The new PPO product is expected to provide beneficiaries with value for their premium. For example, the BCBSM Medicare Plus Blue PPO, which includes Part D prescription drug coverage, will cost between $61 and $141 a month (premiums vary by geographic region), while traditional BCBSM Medicare Supplemental (Medigap) Plan C plans cost $183 when combined with a stand-alone Part D BCBSM prescription drug program. Medicare Advantage plans offer Medicare benefits through private health insurance plans and most include Part D prescription drug coverage. When you purchase a Medicare Advantage plan, you do not need to also purchase a Medigap policy. Medicare Advantage plans are regulated solely by the federal government, while Medigap plans are regulated by the state. The announced product changes are only for Medicare beneficiaries who directly purchase their Medicare Advantage products, not for beneficiaries enrolled in a group plan. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Source: bcbsm.com

Satisfying Retirement: My Medicare Decisions Are Only A Few Months Away

Advantage plans (Medicare Part C) are plans approved by Medicare but run by private companies. They cover everything Medicare does plus offer extra services that include drug, vision, and dental coverage. Many of these plans offer $0 monthly premiums, $0 deductibles, and $0 copays. How do they make money? These companies are paid by the federal government to handle what Medicare usually covers as well as provide them with a reasonable profit.
Source: blogspot.com

Health care reform myth busters

MYTH:  I can only reach out to my own insurance agency for help. FACT: Insurance agents and Health Plan Advisors are valuable resources and a good place to turn for help in understanding coverage options and different plans and price points.  Blue Cross has experts available on the phone to answer questions for individuals at 855-892-8089, regardless of whether or not they have BCBSM.  You can also search localhelp.healthcare.gov to find a navigator, application assister, certified application counselor or government agency to provide personal help in your community.  The federal government also has live chat at healthcare.gov/chat and a toll-free call center.
Source: mibluesperspectives.com

6 Reasons to Choose a New Medicare Part D Plan for 2014

By Emily Brandon Retirees have the option to switch Medicare Part D prescription drug plans between now and Dec. 7. Most seniors who stick with their current plan in 2014 can expect to pay higher premiums and other out-of-pocket costs than they did in 2013. Only 13 percent of participants picked a new prescription drug plan voluntarily during this annual enrollment period between 2006 and 2010, according to a Kaiser Family Foundation analysis of Centers for Medicare and Medicaid Services data, but many of these retirees were able to significantly decrease their premium costs. Here’s why you should consider picking a new Medicare Part D Plan for 2014. Medication changes. Your medication needs could change throughout your retirement. If you are now using new medications or think you might in the coming year, you should consider evaluating which plan will cover you best going forward. Plans can and do change which medications they will cover each year and how much participants are charged for each medication. Just because your medications were covered with a given copay in 2013 doesn’t mean they will continue to be covered at the same level or at all in 2014. “Because plans can change pretty much every feature of the benefit design, including the list of drugs that they cover, people might want to switch out of a plan if, for example, the plan stops covering a drug that they are taking,” says Juliette Cubanski, a policy analyst at the Kaiser Family Foundation. “It might cost them a lot of money if they had to pay for it out of pocket outside of Part D.” Find lower premiums. The average premium is expected to increase by 5 percent from $38.14 in 2013 to $39.90 in 2014 if retirees stay in their current Part D plan, according to a recent Kaiser Family Foundation analysis of 2014 plan offerings. Many beneficiaries (44 percent) will pay between $1 and $10 more if they remain in their current plan in 2014, and 14 percent will experience a monthly increase of more than $10. Premiums will increase by more than 50 percent next year in United HealthCare’s AARP Medicare Rx Saver Plus and First Health Value Plus. Retirees enrolled in the First Health Essentials and the Humana Preferred Rx Plan will also face double-digit premium increases unless they switch plans. Avoiding high premiums is the most common reason retirees select new prescription drug plans. Nearly half (46 percent) of enrollees who switched plans paid at least 5 percent less in premium costs the following year, compared to 8 percent of those who did not switch plans, KFF found. More than a quarter (28 percent) of beneficiaries facing a monthly premium increase of $20 or more switched prescription drug plans during the annual enrollment period, versus 7 percent of those facing a more modest premium increase of up to $10 or no change in their premium. “Some plans do increase their premiums quite considerably from one year to the next,” Cubanski says. “When faced with that kind of sticker shock, that can motive people to go and look at what other plans are available that the person might think is more affordable.” Seek lower copays and other cost sharing. Besides premiums, Medicare Part D beneficiaries face a variety of other out-of-pocket expenses, including deductibles, copayments, coinsurance and costs in the coverage gap. When both premiums and cost sharing for drugs are considered, 44 percent of retirees who switched plans had overall costs that were at least 5 percent lower than the previous year. Only 28 percent of seniors who didn’t switch plans saw their out-of-pocket costs decline by at least 5 percent. “If the particular drugs you use are on more expensive tiers or not on the formulary, that can lead to higher out-of-pocket costs,” says Jack Hoadley, a health policy analyst at Georgetown University. “Go on the online plan finder on Medicare.gov and use your current mix of drugs to calculate your total out-of-pocket costs and not just the premiums.” Reduce your deductible. Just over half of prescription drug plans will charge a deductible in 2014, and most charge the maximum possible amount of $310 before any drug costs will be covered. The share of plans with a smaller deductible has declined from 24 percent in 2010 to just 4 percent in 2014. However, 47 percent of plans will charge no deductible in 2014, meaning retirees will get coverage on their first prescription, often in exchange for a higher monthly premium.
Source: dailyfinance.com

Blue Cross Blue Shield of Michigan Offers New Medicare Plans

HMO’s (health maintenance Organizations) let you select a primary care physician from the BCBS provider network and this PCP manages your overall care. He or she will refer you to a specialist or to a selected hospital for care should you need additional services beyond his scope of practice. Referring yourself to an outside provider will cause a forfeit of benefits and out-of-pocket costs. The four BCBSM HMO products, formerly known as Options 1, 2, and 3, will now be known as BCN Advantage Elements, Classic , and Prestige. The Blues Care Network will also continue to offer the BCN Advantage Basic Plan.
Source: emaxhealth.com

Duck Dynasty plus Carrie Underwood plus Brad Paisley = CMAwesome [photos]

rlgill81_gill RT @WSCP2: Obamacare Gets Spanked At Country Music Awards Duck Dynasty Stars Rock! Best CMA Open Ever!! http://t.co/lBQXIUoeOV #TeaParty … 16 hours ago • reply • retweet • favorite
Source: twitchy.com

Hospitals’ responses to Medicare cuts

Posted by:  :  Category: Medicare

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Exploiting exogenous changes in Medicare hospital payment policy from 1995 to 2009, White (2013) found that a 10 percent reduction in the Medicare payment rate was associated with a 7.73 percent reduction in the private rate. This price spillover is the antithesis of cost shifting. Finally, He and Mellor (2012) also found evidence consistent with spillovers. In their analysis of outpatient surgical procedures at Florida hospitals during 1997–2008, they found that Medicare rate cuts were associated with an increase in volume from private insurers that paid fee-for-service prices. This volume shifting is inconsistent with cost shifting and is expected to accompany price spillovers. It suggests hospitals reduce private prices (though still keep them above Medicare rates) in response to lower Medicare ones to attract a larger volume of higher paying patients (Morrisey 1994). […]
Source: academyhealth.org

Video: Members of the GOP Doctors Caucus Address Medicare Reimbursement Rates

Income Thresholds For Medicare Part B And Part D Premiums

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

Payment rate variation likely to continue

Many who work in the health care industry are aware that payment rates for the same service vary depending on the setting of care delivery.  For example, the bill for a Medicare patient who sees their cardiologist for an EKG in a freestanding, physician-owned clinic will be less than if the same patient gets an EKG from their cardiologist who works in a hospital-owned outpatient clinic.  Because the service delivered is exactly the same, patients often do not realize that this was the case until they receive a bill and their co-pay or deductible is treated differently depending because of where the service was performed.  The Medicare Payment Advisory Commission (MedPAC) has made recommendations over the last several years to eliminate this “site of service differential” and normalize payment rates for the same service across care settings; however it does not appear that this is an issue of priority for parties other than MedPAC in Washington, making a change in the near future unlikely.
Source: leavittpartners.com

Medicare Part B Premium 2014

But Koko Mackin, the company’s vice president of corporate communications, has repudiated the message. "It contains incorrect information received by an employee who redistributed it to six others," he told reporters. "We have a longstanding policy against distributing chain emails like this, and actions have been taken to reinforce this policy. We apologize for any confusion or concern this email may have caused."
Source: aarp.org

Stefan Karlsson’s blog: Joe Wilson Was Right

Joe Wilson was widely criticezed for telling Obama “You lie!” during Obama’s speech to Congress, but more people need to follow his example and confront Obama when he lies.    Because he does that very often. Here are just three example compiled by Scott Sumner   1. Taxes: The president defended his proposal by saying that, for high-income taxpayers, “the tax rates would just go back to where they were under President Clinton.” The president reminded his listeners that the economy grew at a rapid clip during the Clinton years, adding tens of millions of new jobs. [Added below is an excerpt from Sumner’s linked text, which was written in 2010] In 2010, the top income tax rate bracket for ordinary income is 35 percent. Besides wages and interest income, this income category includes profits from pass-through business firms—sole proprietorships, partnerships, and S-corporations. Under the president’s proposal, the top bracket will rise to 39.6 percent. A stealth provision that phases out high-income taxpayers’ itemized deductions will also be reinstated, adding another 1.2 percentage points to the effective tax rate, bringing it to 40.8 percent. Wages and some of the pass-through income will also remain subject to a 2.9 percent Medicare tax. These 40.8 and 43.7 percent tax rates, which will apply in 2011 and 2012, match the 1994 to 2000 rates—the same top bracket, stealth provision, and Medicare tax were in place then. But the picture changes in 2013. Under the healthcare law adopted in March, the Medicare tax will rise that year, from 2.9 to 3.8 percent. Also, a new 3.8 percent tax, called the Unearned Income Medicare Contribution (UIMC), will be imposed on high-income taxpayers’ interest income and most of their pass-through business income that’s not subject to Medicare tax. So, under the president’s proposal, virtually all of top earners’ ordinary income will be taxed at 44.6 percent, starting in 2013. We’re not just going back to the Clinton-era rates of 40.8 and 43.7 percent. A similar pattern holds for capital gains. Under the president’s plan, in 2011 and 2012, the top rate on gains, now 15 percent, will go to 20 percent, with the stealth provision adding 1.2 percentage points, sending the tax back to its 1997–2002 level of 21.2 percent. Starting in 2013, though, capital gains will also be hit by the UIMC, pushing the rate to 25.0 percent. Under the president’s proposal, virtually all of top earners’ ordinary income will be taxed at 44.6 percent, starting in 2013. We’re not just going back to the Clinton-era rates of 40.8 and 43.7 percent. Dividends may, or may not, face a much steeper tax increase. If Congress does nothing, the top dividend tax rate will rise from 15 percent today to the Clinton-era effective rate of 40.8 percent in 2011 and 2012, with the UIMC pushing the rate to 44.6 percent in 2013. To his credit, though, President Obama has called for dividend tax rates 19.6 percentage points below these levels, leaving dividends taxed much more lightly than under Clinton. It remains to be seen whether congressional Democrats will go along.  2. Spying: WASHINGTON – The White House and State Department signed off on surveillance targeting phone conversations of friendly foreign leaders, current and former U.S. intelligence officials said Monday, pushing back against assertions that President Obama and his aides were unaware of the high-level eavesdropping. Professional staff members at the National Security Agency and other U.S. intelligence agencies are angry, these officials say, believing the president has cast them adrift as he tries to distance himself from the disclosures by former NSA contractor Edward Snowden that have strained ties with close allies  3. Healthcare: President Obama repeatedly assured Americans that after the Affordable Care Act became law, people who liked their health insurance would be able to keep it. But millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.
Source: blogspot.com

Medicare rate change worries nursing homes

The Centers for Medicare & Medicaid Services, commonly abbreviated as CMS, annually issues new rules regarding payment. Greg Crist, vice president of public affairs for the Washington, D.C.-based American Health Care Association, said there is usually an adjustment of one to two percent. The huge increase was because the federal government believes it “overpaid by $4 billion nationally [for rehabilitation services] and they are taking it back.”
Source: marylandreporter.com

FAQ On Medicare Doctor Pay: Why Is It So Hard To Fix?

Today’s problem is a result of yesterday’s efforts to control federal spending – a 1997 deficit reduction law that called for setting Medicare physician payment rates through a formula based on economic growth and known as the “sustainable growth rate” (SGR). For the first few years, Medicare expenditures did not exceed the target and doctors received modest pay increases. But in 2002, doctors reacted with fury when they came in for a 4.8 percent pay cut. Every year since, Congress has staved off the scheduled cuts.  But each deferral just increased the size – and price tag – of the fix needed the next time.
Source: kaiserhealthnews.org

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November 10, 2013

BCBS, Priority Health rank highest in state for Medicaid, Medicare

Posted by:  :  Category: Medicare

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If you enjoy the content on the Crain’s Detroit Business Web site and want to see more, try 8 issues of our print edition risk-free. If you wish to continue, you will receive 44 more issues (for a total of 52 in all), including the annual Book of Lists for just $59. That’s over 55% off the cover price. If you decide Crain’s is not for you, just write “Cancel” on the invoice, return it and owe nothing. The 8 issues are yours to keep with no further obligation to us. Sign up below.
Source: crainsdetroit.com

Video: Priority Health Medicare — Understanding Medicare Video

Medicare Innovation: Whose Priorities, Whose Interests?

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

Priority Health Medicare: Your Health Is The Top Priority

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

Priority Health now offers free dental cleaning to Medicare patients!

Medicare age people that have Priority Health Insurance now have Delta Dental coverage for one periodic exam and one prophy (cleaning) per year paid at 100%.  They also cover one set of bitewings x-rays per year paid at 50%.
Source: wilderndental.com

New Group To Set Priorities for Medical Effectiveness Research

Doctors trained to do things one way may be more likely to trust the consensus of their colleagues and their patients’ preferences than new data. Some also fear the data will be used for payment decisions, undermining physicians’ autonomy and leading to rationing. And while research can shed light on what treatments do not work for the majority of people, a subset of patients may still benefit. Study methods can also be faulty and results contradictory. ‘A Subjective Call’ “That’s still a subjective call they [researchers] are making,” says Jennifer Jaff, executive director of Advocacy for Patients with Chronic Illness, a Connecticut-based group that helps patients appeal medical coverage decisions. “If you find a medical journal article that says, ‘no’ [a particular treatment doesn’t work], I can find you one that says ‘yes,’ it does.”
Source: kaiserhealthnews.org

Helpful advice for Minister Dutton: on the review of Medicare Locals, and other priorities…

1. Remove the ability to patent human genetic material. Australians need a commitment by the new Health Minister to draft legislation to remove the ability to patent human genetic material. We could wait years for the courts to work though the molecular biology arguments in which they find themselves. This is not really a legal matter, but an ethical one – at most an unintended consequence of legal interpretation.  We need to provide certainly for patients, researchers and ethicists. The Australian community finds it disturbing that bits of our bodies can be owned by commercial interests, researchers find it frustrating and patients find the current status limiting and uncertain. 2. Speed up drug approvals processes. While maintaining the integrity of the TGA, PBAC and MSAC approvals processes for new drugs and co-dependent technologies, commit to streamlining and reducing the time between registration and decision, so that Australian patients are not waiting longer than those in other western countries for access to proven innovative therapies.  Also arrange to prune the approved lists for subsidy of superseded drugs. 3. Prioritise and streamline clinical trial reforms. As we move further towards personalised medicine, the number, purpose and design of clinical trials need to change.  We would like to see the new Government take up a nationally coordinated approach to clinical trials, including a review of the effective role and numbers of ethics committees.
Source: com.au

UMHS signs with Priority Health HMO/PPO effective March 1

Effective March 1, 2013, UMHS will become a participating provider with Priority Health for their commercial HMO and PPO plans. Priority Health is a subsidiary health plan of Spectrum Health System. Priority Health HMO and PPO members may be seen at UMHS for both primary and specialty care at an in-network benefit level beginning March 1, 2013. Additionally, UMHS has been a participating provider with Priority Health’s Medicare Advantage plans since September 2012. UMHS remains a non-contracted provider for Priority Health’s Medicaid and MIChild plans. Staff should continue to follow the Medicaid Specialty Access process for Priority Health Medicaid members.
Source: umhsheadlines.org

Priority Health Says Health Care Price Comparison Tool Will Save Consumers Big Bucks

In a world with eBay, Trip Advisor and Angie’s List, it’s common for consumers to compare the quality and price details of a car, resort or plumber. Health care service shopping can be as straightforward as many other online shopping experiences. The Healthcare Blue Book tool from Priority Health makes health care comparison shopping easier by identifying fair prices of more than 200 common procedures, including surgery, labs and imaging tests. And since price and quality are both important factors, consumers can also review quality rankings and consumer reviews of hospitals and physicians through Healthgrades, an independent website used by more than 225 million consumers.
Source: tacticalminc.com

Government austerity with Medicare reform as a top priority

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

Prognosis for Medicare Locals still unclear

“The establishment of Medicare Locals has been an important step to improving the coordination of care, addressing service gaps and improving the patient journey between the primary health, community health and acute hospital sectors. There is still opportunity for further gains to be made and the simplification of funding arrangements and reporting requirements would reduce the administrative burden on Medicare Locals allowing greater focus on coordination of services and improving access to care.”
Source: com.au

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November 10, 2013

VIDEO: Tips for Medicare Enrollment

Posted by:  :  Category: Medicare

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The dates and process to enroll in Medicare are different from those enrolling through the Health Insurance Marketplace. It’s important for Medicare beneficiaries to understand that their enrollment and eligibility haven’t changed because of healthcare reform.
Source: express-scripts.com

Video: Medicare Annual Enrollment Period 2014

Seniors: Pay close attention to details when enrolling in Medicare

Other changes in plan costs next year will be more subtle.  About 72 percent of drugs plans will direct members to the preferred pharmacies if they want to save money on prescriptions, according to a study by The Kaiser Family Foundation, released last week.  (Kaiser Health News is an editorially independent program of KFF.) Very few plans had these pharmacy arrangements when the drug benefit was introduced in 2006.
Source: mylocalhealthguide.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

Measuring ACA Enrollment: Lessons from Medicare Part D

But what about enrollment?  Similar to the schedule the White House recently announced, the Bush Administration waited to release the first enrollment numbers until a month after open enrollment started.  The first release from the Department of Health and Human Services (December 13, 2005) reported that about 1 million people enrolled in standalone drug plans during the first month and another 200,000 enrolled for the first time in Medicare Advantage plans with drug coverage.  These were not the only participants in the new program, since the law required the transfer of Medicare-Medicaid dual eligibles from Medicaid drug coverage to Part D.  Plus, those already enrolled in Medicare Advantage plans had a simple option to add drug coverage to their current plan.  But the total of voluntary new enrollments in the first month was about 1.2 million people.
Source: georgetown.edu

5 tips for Medicare enrollment

Take advantage of tools and help.  There are a number of tools and resources available today that can help simplify this often complex process. For those retirees who want to change to another plan, it’s important to know that in some cases, you might have to answer medical questions to make a change to a Medicare Supplement plan (Medigap). It is a good idea to speak with someone to understand the circumstances under which you can change plans. 
Source: benefitspro.com

Medicare enrollment sessions offered

Senior citizens receiving Medicare benefits have until Dec. 7 to choose or change a prescription drug plan under Medicare Part D. Representatives from the Southwestern Connecticut Agency on Aging will visit the Wilton Senior Center on Thursday, Nov. 7, to go over options with seniors in one-on-one appointments. The agency is not affiliated with any insurance company and representatives will not be selling anything.
Source: wiltonbulletin.com

Avoid Medicare Late Enrollment Penalties

A way to avoid paying Medicare Part D penalties is to sign up for a Part D drug plan as soon as you’re eligible. You can also delay enrolling in Medicare Part D without penalty by making sure you have other prescription drug coverage that is as good as Medicare Part D(known as creditable coverage). If you go 63 or more consecutive days without creditable drug coverage and choose to enroll in a Part D plan in the future, you may have to pay a late enrollment penalty. This penalty is calculated based on how many months you were eligible but failed to enroll in a Part D plan. This amount is then added to your monthly premium.
Source: ehealthmedicare.com

Insurance changes for Illinois State Retiree Health Insurance

The following is information regarding recent changes to Illinois State Retiree Health Insurance. These changes only apply to those who are enrolled in Medicare.  If you are affected by this change, you should be receiving a letter from CMS regarding the proposed changes to the SURS health insurance plan this week.  Note: if you are covering a dependent, you must both be enrolled in Medicare for this change to affect you.  If only one of you is enrolled in Medicare, then you will keep your existing coverage and May benefit choice period.
Source: bluestemfa.com

NewsDaily: Ill. seniors can get help with Medicare enrollment

Counselors from the agency’s Senior Health Insurance Program will help beneficiaries and caregivers understand their options. They can explain drug, health, and supplemental plan and paperwork associated with the program. They also can help file Medicare appeals.
Source: newsdaily.com

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