Medicare Open Enrollment FAQ

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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

Video: Medicare supplement Insurance Plans VS Medicare Advantage plans

Aetna Announces Major Expansion Of Medicare Advantage Network

Last week, the Fairfield County Medical Association said doctors were calling the organization to say they received letters notifying they had been cut from UnitedHealthcare’s network. The association says UnitedHealthcare is cutting 810 primary care physicians and 1,440 specialists. The insurer declined to say how many doctors have been cut, but UnitedHealthcare has said it will have an adequate network that includes more than 1,500 primary care physicians and more than 4,000 specialists.
Source: courantblogs.com

250,000 Seniors Sign Up to Protect Medicare Advantage

Last spring when the Centers for Medicare & Medicaid Services (CMS), the agency that oversees the Medicare program, proposed deep new cuts to the program, more than 40,000 coalition members called, wrote, and met with congressional offices urging their representatives to speak out against the proposed cut.  As Congress debates the budget this fall, including potential changes to Medicare, seniors in Medicare Advantage will again be reaching out to members of Congress to tell their stories about the value Medicare Advantage provides to them and the impact additional cuts to the program would have on their health care.
Source: ahipcoverage.com

2014 HumanaChoice PPO Medicare Advantage Plan Details

HumanaChoice PPO® is a Medicare Advantage Preferred Provider Organization (PPO) which offers additional benefits to your original Medicare. HumanaChoice® gives you the freedom to choose which hospitals, specialists, and doctors you would like to use. No referral is required and you do not need to select a primary care physician (PCP). You can also go to providers outside of the network but you reduce your costs when you use the large list of in network providers. Some plans offer Prescription drug coverage better or equal to the requirement for a Medicare Part D Plan (depending on your region). HumanaChoice PPO® offers worldwide coverage for emergency care. And features an affordable monthly plan premium for most plans. Coverage for annual screening are also offered at no additional charge. Here are some examples of coverage of three plans offered by HumanaChoice® that show your in network benefits. You can browse the Medicare Advantage HumanaChoice PPO R-5826-005 complete plan details here.
Source: qooqe.com

Taking Advantage of Medicare Advantage

It makes little sense for the government to overpay private insurers in the first place, but that is exactly what’s been going on for several years. During the administration of George W. Bush, which supported the privatization of the Medicare program, Congress passed legislation to provide incentives to insurers to offer private plans to compete with traditional Medicare. This enabled the plans to offer richer benefits than traditional Medicare at little or no additional cost to beneficiaries while also making a tidy profit.
Source: abreachoftrust.com

Medicare Advantage: What it means for private insurers

When working adults turn 65, they have a lot of options about their health coverage. According to the Kaiser Family Foundation, currently about 25 percent of Medicare enrollees have opted for Medicare Part C, also known as the Medicare Advantage (MA) plan. Such plans have been growing at a tremendous rate; since 2004, the number of beneficiaries enrolled in private plans has more than doubled from 5.3 million to 13.1 million in 2012, as determined by the Foundation. However, the coverage varies, making it a challenge for seniors and their insurance agents to find the best plan for their needs.
Source: lifehealthpro.com

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

Washington State Insurance Update: What to do if your Medicare Advantage plan is going away

Medicare open enrollment starts Oct. 15. Some people may have already received a notice saying their Medicare Advantage plan is going away. If you or someone you know has received a notice, here’s some steps to take:
Source: blogspot.com

Massachusetts / Rhode Island NATP Chapter: New IRS Form 8959

Posted by:  :  Category: Medicare

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The IRS has issued a draft of its new Form 8959 which will be used to calculate the portion (if any) of the Medicare Tax W-2 withholding which may be applied against income tax liability arising from the 3.8% surtax on certain high-income taxpayers. The issue for taxpayers and tax preparers is that the medicare surtax is an addition to the regular income tax which applies, so it is included in the calculation of required payments/withholding necessary to avoid an underpaid tax penalty.  If the payroll system gets it right and withholds more than the otherwise required 1.45% on payroll to which the surtax applies, the Form 8959 then Identifies this supplemental medicare withholding included in box #6 on the W-2 form and reports it as part of the total federal income tax withholding on line #62 of Form 1040. Likewise, there is a separate section on the form for calculating the portion (if any) of the medicare tax on self-employment and/or railroad retirement income which is supplemental and, therefore, eligible for reclassification as income tax withholding reported on line #62. This form, although complicated in presentation because almost everything associated with Obama Care is complicated, appears to be something which good tax preparation software can handle without the active involvement of the tax preparer.
Source: blogspot.com

Video: Medicare Basics

Romney Lies About Medicare/Medicaid Change Of Address Form

There were periods during my government service when the business-does-it-this-way was fashionable.  Public private partnership (acronym PPP) became popular.  At some point what tended to happen or be realized was the understanding that the public service does not have, cannot have the same “bottom line” as a for-profit organization.  Wall Street exemplifies the outsize for-profit situation these days…I do not think most people want the government to emulate that value system when it comes to exercising government authority.  And, frankly, when you look at it, the basic myth at bottom of the business school takeaway about efficiency has a lot of flaws…not the least of which is that large, major corporations with their overpayment of failing executives and with their taking-care-of-the-top first motif are the opposite of even the the narrowest definition of “efficiency.”  
Source: talkleft.com

Premium and Prescription Savings are Good News for People with Medicare

Posted by:  :  Category: Medicare

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Other Affordable Care Act changes that pay hospitals and doctors based on the quality of care they deliver for patients—like reducing hospital readmissions, which have started to drop after being stuck for the past five years—are beginning to have an effect.  Programs like Hospital Value-Based Purchasing and Accountable Care Organizations are making sure that improved quality of care for patients is at the center of efforts to reduce cost growth.  Over the last four years, the stronger anti-fraud measures instituted by the Affordable Care Act has enabled the Obama administration to recover over $14.9 billion for taxpayers.
Source: cms.gov

Video: Cassidy Discusses Medicare Premium Support Reform Proposal

Medicare Part B Premium Costs Will Hold Steady in 2014

USA Today: Medicare Part B Premiums Won’t Go Up In 2014 The premiums for Medicare Part B will remain flat in 2014 and seniors have saved $8.3 billion on Part D prescriptions since the Affordable Care Act was enacted in 2010, the Department of Health and Human Services announced Monday. Medicare Part B covers medically necessary services, as well as preventive services (Kennedy, 10/28).
Source: kaiserhealthnews.org

CMS Announces 2014 Medicare Part A Premiums, Deductible

The daily coinsurance amounts for 2014 will be $304 for a beneficiary’s 61st through 90th day of hospitalization (days one through 60 are fully covered), $608 for lifetime reserve days — the extra days Medicare will cover with a high coinsurance after the 90-day benefit period ends, limited to 60 per person in their lifetime. Additionally, patients will pay $152 for days 21 through 100 of extended care services in a skilled nursing facility during a benefit period.
Source: beckershospitalreview.com

Medicare Part B premiums to remain flat for 2014

"We continue to work hard to keep Medicare beneficiaries’ costs low by rewarding providers for producing better value for their patients and fighting fraud and abuse. As a result, the Medicare Part B premium will not increase for 2014, which is good news for Medicare beneficiaries and for American taxpayers," said CMS Administrator Marilyn Tavenner.
Source: allvoices.com

What Makes Medicare Benefits Not Taxable?

The Medicare system for US citizens is a very complicated one. It leaves so many questions unanswered for most of them. It is a program in place for the benefit of senior citizens, and for people with certain disabilities. Medicare benefits are usually tax free. But under certain circumstances, they become taxable. If annually what you earn is less than $25,000 you will not have to pay any tax to the federal government. When an individual makes over $940 monthly, he has to report the Medicare benefits as income to the federal government. A high income only attracts taxes i.e. only if you can afford to pay are you taxed. Are Medicare premiums tax deductible? Read ahead and find out.
Source: taxpremium.com

Comparison of Medicare Premium Support Proposals

The brief compares the premium support provisions of these proposals, including how the level of premium support for beneficiaries would be determined; whether traditional Medicare would remain an option; what protections would be provided for low-income beneficiaries; and whether and how the proposals would cap federal spending on Medicare. These differences have important implications for Medicare beneficiaries, the federal budget, health care providers, and private health plans.
Source: kff.org

Medicare Beneficiaries to Save with Historically Low Premiums and Deductibles

CMS also announced a decrease in the Medicare Part A premium, which pays for inpatient hospital, skilled nursing facility, and some home health care services. The premium will drop $15 in 2014 to $426, and is paid by enrollees age 65 and over who are not otherwise eligible for benefits under Medicare Part A and by certain disabled individuals who have exhausted other entitlement. Although about 99 percent of Medicare beneficiaries do not pay a premium for Part A since they have at least 40 quarters of Medicare-covered employment, enrollees age 65 and over and certain persons with disabilities who have fewer than 30 quarters of coverage pay a monthly premium in order to receive coverage under Part A. Beneficiaries who have between 30 and 39 quarters of coverage may buy into Part A at a reduced monthly premium rate which is $9 less than 2013, at $234 for 2014.
Source: wolterskluwerlb.com

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November 12, 2013

The Medicare Program: A Brief Overview

Posted by:  :  Category: Medicare

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Medicare provides older Americans and people with disabilities with health security. This fact sheet provides an updated overview of the current Medicare program, including the services covered, who is covered, how covered services are delivered, how the program is financed, and how much the program spends.
Source: aarp.org

Video: Medicare card scam targets bank info

Medicare Information Act of 2011 (2011; 112th Congress S. 1655)

Medicare Information Act of 2011 – Amends part A of title XI of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to provide to each eligible individual annually a statement of Medicare part A (Hospital Insurance) contributions and benefits in coordination with the annual mailing of Social Security account statements.
Source: govtrack.us

Helpful Info About 2014 Medicare Plans

I am going to be switching to Medicare for the first time in my life, and it is going to happen in the near future. Actually, I should have my Medicare insurance at the beginning of the new year, if everything goes according to plan. However, I am looking into other types of insurance right now, to maybe help cover what is not covered by Medicare. I do not know a lot about the subject yet, or what I need to do. As such, I want to find info on medicare plans for 2014 that is helpful in nature, and will help me begin to understand the different options that are available to me.
Source: wqrp.org

Medicare open enrollment continues till Dec. 7, but online info may not be up to date

Overall, premiums for Advantage plans, the private-insurer version of Medicare coverage, are projected to go up next year—by 5 percent, or $1.64, on average, to $32.60 a month, according to the Centers for Medicare and Medicaid Services (CMS), the agency that runs Medicare. For drug plans, the average basic-plan premium will be $31, which it said was about the same as this year.
Source: alpha-1foundation.org

Medicare Fraud Enforcement and Prevention Act of 2013 (H.R. 418)

Directs the HHS Secretary to provide for a study that analyzes the feasibility and benefits in reducing waste, fraud, and abuse of carrying out a program that implements biometric technology to ensure that individuals entitled to benefits under Medicare part A or enrolled under Medicare part B are physically present at the time and place of receipt of certain items and services for which payment may be made.
Source: govtrack.us

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November 12, 2013

2012 Medicare Deductibles and Premiums: Is This the Year You'll Collect Deductibles at Time of Service?

Posted by:  :  Category: Medicare

The largest factor affecting the contingency margin for 2012 is the current law formula for physician fees, which will result in a payment reduction of about 29 percent in 2012.  For each year from 2003 through 2011, Congress has acted to prevent smaller physician fee reductions from occurring. The 2012 reduction is almost certain to be overridden by legislation enacted after Part B financing has been set for 2012. In recognition of the strong possibility of increases in Part B expenditures that would result from similar legislation to override the decrease in physician fees in 2012, it is appropriate to maintain a significantly larger Part B contingency reserve than would otherwise be necessary.  The asset level projected for the end of 2012 is adequate to accommodate this contingenIn 2012, Social Security monthly payments to enrollees will increase by 3.6 percent.    The dollar increase in benefit checks is expected to be large enough on average to cover the increase in the Part B premium of $3.50 that most beneficiaries will experience. For those who were paying the standard premium of $115.40, their benefits checks will only increase.
Source: managemypractice.com

Video: Medicare Supplement plan F High Deductible Explanation

Medicare Beneficiaries to Save with Historically Low Premiums and Deductibles

CMS also announced a decrease in the Medicare Part A premium, which pays for inpatient hospital, skilled nursing facility, and some home health care services. The premium will drop $15 in 2014 to $426, and is paid by enrollees age 65 and over who are not otherwise eligible for benefits under Medicare Part A and by certain disabled individuals who have exhausted other entitlement. Although about 99 percent of Medicare beneficiaries do not pay a premium for Part A since they have at least 40 quarters of Medicare-covered employment, enrollees age 65 and over and certain persons with disabilities who have fewer than 30 quarters of coverage pay a monthly premium in order to receive coverage under Part A. Beneficiaries who have between 30 and 39 quarters of coverage may buy into Part A at a reduced monthly premium rate which is $9 less than 2013, at $234 for 2014.
Source: wolterskluwerlb.com

Medicare Announces 2011 Deductible and Coinsurance Rates

Last week, Medicare announced on CMS.gov in a fact sheet titled “Medicare Premiums, Deductibles for 2011″. This fact sheet gives detailed information on the increases to the yearly premium and deductible Medicare patients will have to face in the coming year.
Source: about.com

2011 Medicare Deductibles Shocking News

The Centers for Medicare and Medicaid Services (CMS) has set the Medicare premiums, deductibles and coinsurance amounts to be paid by Medicare beneficiaries in 2011. For Medicare Part A, which pays for inpatient hospital, skilled nursing facility, and some home health care, the deductible paid by the beneficiary when admitted as a hospital inpatient will be $1,132 in 2011, an increase of $32 from this year’s $1,100 deductible. The Part A deductible is the beneficiary’s cost for up to 60 days of Medicare-covered inpatient hospital care in a benefit period. Beneficiaries must pay an additional $283 per day for days 61 through 90 in 2011, and $566 per day for hospital stays beyond the 90th day in a benefit period. For 2010, the per-day payment for days 61 through 90 was $275, and $550 for beyond 90 days. For beneficiaries in skilled nursing facilities, the daily co-insurance for days 21 through 100 in a benefit period will be $141.50 in 2011, compared to $137.50 in 2010. Those who enroll in Medicare Advantage plans may have different cost-sharing arrangements. All of these Part A program payment changes are determined in accordance with a statutory formula. About 99 percent of Medicare beneficiaries do not pay a premium for Medicare Part A services since they have at least 40 quarters of Medicare-covered employment. However, some enrollees age 65 and over and certain persons with disabilities who have fewer than 30 quarters of coverage obtain Part A coverage by paying a monthly premium established according to a statutory formula. This premium will be $450 for 2011, a decrease of $11 from 2010. Individuals who have between 30 and 39

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November 12, 2013

Key Senate, House Committee Chairmen Offer Plan To Fix Medicare Doctor Payments

Posted by:  :  Category: Medicare

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The proposal would make a historic shift in doctor payments, moving physicians from the traditional system in which they are paid for volume and instead use financial incentives to encourage them to move to alternative payment models emphasizing quality care. The framework would repeal the SGR and hold doctors’ pay at current levels as alternative payment models are developed and tested. It would combine some existing Medicare physician quality programs into a new initiative starting in 2017 that would offer doctors additional pay based on their performance on value-based criteria, such as making more same-day appointments for urgent needs and enhancing their use of electronic medical records.
Source: kaiserhealthnews.org

Video: Medicare Advantage – 5 Things To Know About Advantage Plans Before You Enroll

How Democrats Saved Bush's Medicare Drug Program

The headlines in late 2005 and early 2006 tell the tale. The launch of the enrollment period for 43 million seniors to use their new drug benefit to purchase prescription coverage from private insurers was met with stories like “Medicare prescription drug plan stump seniors” (USA Today) and “Officials’ pitch for drug plan meets skeptics” (New York Times). In mid-October 2005, Bush administration officials delayed the launch of their new prescription drug comparison web site for a few days, ostensibly to avoid offending Jewish Americans during Yom Kippur. Almost a month later, the site was still idle, prompting the Washington Post to conclude, “The rollout of the new Medicare drug benefit has been anything but smooth.” Well into 2006, the Bush administration was dogged by stories like “Medicare drug plan still not generating much enthusiasm” and “majority of Americans say drug plan is not working” (Gallup).
Source: crooksandliars.com

The Medicare Program: A Brief Overview

Medicare provides older Americans and people with disabilities with health security. This fact sheet provides an updated overview of the current Medicare program, including the services covered, who is covered, how covered services are delivered, how the program is financed, and how much the program spends.
Source: aarp.org

Ron Wyden selling a new Medicare plan to budget conference

Wyden said he thinks that gives him an opening to pump his latest plan for Medicare, which is to re-orient the program so that it does a much job of managing the chronic illnesses of the sickest seniors.  In many ways, Wyden’s plan focuses on the hot new idea in managing health care costs — that if you focus on keeping the sickest patients from having to go into the hospital, you’ll save huge amounts of money while giving them a better quality of life.
Source: oregonlive.com

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

UM to drop from Pioneer ACO program, will continue to seek Medicare cost savings

The University of Michigan Medical School’s Faculty Group Practice this week joined six of the 32 other Pioneer accountable care organizations nationally in announcing plans to drop out of the Pioneer ACO program – one of Obamacare’s most ambitious cost containment and quality improvement test projects. But David Spahlinger, M.D., the faculty plan’s executive director, said the UM Pioneer ACO is not giving up on the concept of coordinating care for Medicare patients. For efficiency, physician partnership and integration reasons, Spahlinger said the UM Pioneer ACO plans to join a larger ACO in Medicare’s shared savings ACO program for which it already participates. Under health care reform, ACOs are groups of physicians, hospitals and other providers who band together to contract with Medicare. If approved by Medicare, the UM Pioneer ACO would join The Physician Organization of Michigan ACO, an organization formed last year by UM and eight other physician organizations in Michigan. The POM ACO board also is expected to vote on adding UM later this month. The POM ACO includes 1,800 physicians and cares for more than 81,000 Medicare beneficiaries across Michigan. UM’s Pioneer ACO, which cares for 23,000 Medicare patients, includes 2,000 faculty physicians and IHA, an Ann Arbor-based multispecialty practice with ties to Ann Arbor-based St. Joseph Mercy Health System. UM Pioneer ACO reported it achieved cost savings of 0.3 percent for Medicare during 2012. To share savings with Medicare, however, the UM Pioneer ACO needed to achieve a minimum 2 percent savings, Spahlinger said. “We didn’t receive any additional revenue in 2012,” said Spahlinger, noting that the UM faculty group has been participating in a Medicare shared savings project since 2005 when it was part of the Medicare Physician Group Practice demonstration project, a forerunner of ACOs. “We have had savings of 3.4 percent, 2.9 percent …” in the past, he said. “You get to a point of diminishing returns” trying to remove costs out of Medicare patient care. Spahlinger said UM could have continued in the Pioneer program and generated additional savings by increasing use of care coordinators to reduce chronic care costs and working more closely with home health agencies. “We went through the pros and cons of that,” he said. “We just decided to combine the two programs. It is simpler, and as an academic center we get referrals from all over the state. The partnerships we develop with other groups across the state help us develop relationships for coordination of care.” Spahlinger said one-third of the Medicare patients in the UM Pioneer ACO receive care outside of the university system. Detroit Medical Center, which operates Michigan Pioneer ACO, reported first year savings of 4.5 percent, said Mohamed Siddique, M.D., chairman of the Michigan Pioneer board. “When we all embarked on the ACO journey, many of us were unsure and anxious,” Siddique said in a statement. “But we were willing to take on the challenge of changing the course of health care in Southeast Michigan. We knew we would take care of one of the sickest patient populations.” In a statement, Medicare said costs for 669,000 beneficiaries enrolled in the 32 Pioneer ACOs rose only 0.3 percent in 2012 compared with a 0.8 percent rate for other Medicare patients. Some 13 out of 32 pioneer ACOs produced shared savings with CMS, saving nearly $33 million for Medicare. The Pioneer ACOs earned more than $76 million. Only two Pioneer ACOs lost money, totaling approximately $4 million. Seven of the Pioneer ACOs that did not produce savings, including the UM Pioneer ACO, have asked Medicare to drop out of the Pioneer program and apply to the Medicare Shared Savings Program, another ACO model. However, all 32 Pioneer ACOs, including UM’s, improved in all 15 quality measures and earned incentive payments. Under Medicare’s shared savings program, the quality and cost of care are measured differently while the goal of reducing costs and improving health of patient remains. Unlike Pioneer ACOs, which assume financial risk for patients under their care, shared savings ACOs do not assume financial risk. “We still have to save 2 percent (under shared savings),” Spahlinger said. “We feel we can reduce administrative costs and eliminate staff duplication by being a part of one ACO.” POM ACO includes the University of Michigan Health System, Oakland Southfield Physicians, Olympia Medical Services, United Physicians, Advantage Health/St. Mary’s Care Network, Crawford Mercy Physician Hospital Organization, Lakeshore Health Network, Physicians’ Organization of Western Michigan and Wexford Physician Hospital Organization.
Source: crainsdetroit.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

250,000 Seniors Sign Up to Protect Medicare Advantage

Last spring when the Centers for Medicare & Medicaid Services (CMS), the agency that oversees the Medicare program, proposed deep new cuts to the program, more than 40,000 coalition members called, wrote, and met with congressional offices urging their representatives to speak out against the proposed cut.  As Congress debates the budget this fall, including potential changes to Medicare, seniors in Medicare Advantage will again be reaching out to members of Congress to tell their stories about the value Medicare Advantage provides to them and the impact additional cuts to the program would have on their health care.
Source: ahipcoverage.com

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