Medicare Buz

Advocacy groups like the Medicare Rights Center oppose restricting Medigap plans, saying it would simply shift more costs from the government to elderly and low-income people who can least afford it. “Some in government feel people in Medicare don’t have enough ‘skin in the game,’” says Ilene Stein, federal policy director for the center. In fact, she says, people on Medicare already pay 15 percent of their incomes for health care, well above the level paid by non-Medicare households. While the proposals would cap maximum annual spending per enrollee to $5,500 or $7,500, “that’s a lot of money for someone making $22,000,” the median household income for those on Medicare, she says. 
Source: kaiserhealthnews.org

Video: Medigap plans ARE created equal

California Medigap Policies Cover What Medicare Doesn’t

California seniors have many different Medigap options available to them. To see a wide range of health insurance policies to supplement your Medicare, contact the independent insurance agents at Benefit Packages. We have been helping Californians find the right medical insurance for since 1987. We will go through the options with you and help you choose the best Medicare supplement for your health situation. Whether you are interested in Anthem Blue Cross, Blue Shield, or other health insurance policies, we can get you the information you need.
Source: benefitpackages.com

Financial Success: Medigap & Medicare Advantage Plans

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Source: wpengine.com

Medigap Supplemental Policies

When you are choosing a policy, consider your health status and family medical history.  The differences among plans can be small and rather confusing, so you should do your homework and pick a plan that is best for you.  We suggest you visit the Choosing a Medigap Policy website or stop by the Senior Center and pick up a printed copy.   All Medigap policies with the same letter must cover the exact same benefits, so once you find the option that best suits your need, you should shop for the least expensive policy.  You will get the best price if you sign up within six months after enrolling in Medicare Part B.  During this open enrollment period, the insurer cannot refuse to sell you a policy or charge you more based on your health.
Source: dgcoseniorservices.org

Government Wants Seniors with Medigap Policies to Pay More Out

The NAIC was required by the Accountable Care Act to recommend to Kathleen Sebelius, Secretary of Health and Human Services (HHS), specific cost-sharing opportunities that could reduce Medicare spending for unnecessary treatments. This recommendation was to be based on peer-reviewed studies or successful managed-care practices, noted the Kaiser Health News article. The NAIC Seniors’ Task Force and Health Insurance Committee, in fact, determined that this idea could have the reverse effect, raising Medicare costs over time.
Source: darkdaily.com

Will health reform make it easier to buy Medigap plans?

It’s also worth mentioning that fact that your premiums may have gone up because you bought a plan with so-called “attained-age” premiums. They’re deliberately designed to start out low when you’re 65 and increase the older you get. People buy them because they’re cheap, not realizing that when they get to be your age, they’re going to be the most expensive. We recommend purchasing policies that are community rated, meaning that premiums are the same no matter what your age. They’ll be a little more expensive when you first buy them, but less expensive than an attained-age policy when you get older.
Source: consumerreports.org

How to Choose a Medigap Supplemental Policy

Instead of getting original Medicare, plus a Medigap policy and a separate Part D drug plan, you could sign up for a Medicare Advantage plan that provides all-in-one coverage. These plans, which are sold by insurance companies, are generally available through HMOs and PPOs. To find and compare Advantage plans, visit medicare.gov/find-a-plan.
Source: medbill.net

The Importance Of Medigap Plans

Keep in mind that a Medigap policies are sold by private insurance companies. They are looked upon as Medicare Supplement Insurance. Depending on the Medigap plan you choose, will determine how much you will pay for the policy and what the policy will cover. There are various benefits of Medigap policies such as medical costs, inpatient hospital care, blood that you might need and other additional benefits such as emergency care and preventative care.
Source: iirojappinen.com

Medicare Supplemental Plan

The second reason to enroll in a Medicare supplemental plan is that you can get more health coverage. A variety of therapies and at-home services are covered under some of the plans. Coverage for emergencies when traveling abroad is also an option. Medigap policies are not part of a managed care program, such as an HMO, PPO or Fee-for-Service plan. They are purchased through a Medicare approved private insurance companies.
Source: allabout101.com

Changing Medicare Supplement Insurance (Medigap) Plans

If you happen to have an old Medigap policy that was purchased prior to 1992, you may remain on a non-standardized version of that plan. If you purchased Plans D or G before June 1, 2010, you may keep the older versions of them, even though current iterations of those plans have vastly different benefits. Additionally, the old Plan H, I, and J once offered, but are no longer sold, with Medigap prescription drug benefits. Should you choose to make the switch to a newer Medicare Supplement plan, however, please note that you will not be able to get the old plan and benefits back as they are no longer offered.
Source: planprescriber.com

How to Choose a Medigap Supplemental Policy

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

What is Medicare Supplement (Medigap) Insurance

In order to sign up for Medicare Supplement coverage, you must already have Part A and Part B. These plans are offered by private insurance companies and come in 10 standardized policy types that are denoted by the letters A-N. The standardization of these plans means that no matter where you shop, the Medigap policy details remain consistent. For example, the benefits associated with Plan F are the same no matter where you buy it, though costs may differ across all carriers. Not every carrier of Medicare Supplement Insurance offers all 10 plan types, and three states in the U.S. have their own version of these plans: Massachusetts, Minnesota, and Wisconsin.
Source: ehealthmedicare.com

Putting a Donut Hole Back in Medicare: Proposals to Increase Medigap Costs Put Vulnerable Beneficiaries at Risk 

[1] See Medicare Supplement Insurance First Dollar Coverage and Cost Shares Discussion Paper, National Association of Insurance Commissioners (NAIC), Senior Issues Task Force, Medigap PPCA Subgroup, (October 2011), available at: http://www.naic.org/documents/committees_b_senior_issues_111101_medigap_first_dollar_coverage_discussion_paper.pdf.  Also see, e.g., Leadership Council on Aging (LCAO) issue brief “Reforming Medigap Plans by Shifting Costs onto Beneficiaries: A Flawed Approach to Achieving Medicare Savings” (December 2012), available at: http://www.lcao.org/docs/LCAO-Medigap-Issue-Brief-12-12.pdf [2] Medigap Reform: Setting the Context, Kaiser Family Foundation, (September 2011), available at http://www.kff.org/medicare/8235.cfm. [3]Medigap Reform: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs, Kaiser Family Foundation, (July 2007), available at http://www.kff.org/medicare/8208.cfm. [4] See, e.g., previous Weekly Alerts, including finding drug savings in Medicare (November 2011) http://www.medicareadvocacy.org/2012/11/15/deficit-reduction-and-medicare-save-money-without-harming-beneficiaries/ ; Prescription Drug Rebates (July 2011) http://www.medicareadvocacy.org/2011/07/21/debunking-medicare-myths-drug-rebates-for-dual-eligibles/ ; and additional options for achieving Medicare savings (June 2011) http://www.medicareadvocacy.org/2011/06/09/so-what-would-you-do-real-solutions-for-medicare-solvency-and-reducing-the-deficit/.
Source: medicareadvocacy.org

Medicare Supplemental Insurance

Another issue that should be kept in mind with Medigap policies, is that it is wiser to purchase a supplemental coverage within the first six months of being on Medicare Part B. This is when the insurers cannot deny the individual because of a preexistent health issue. Many insurance companies will tell the individual that they have better plans and better coverages. This is not true. The Medigap program is a national one and the coverage is the same no matter who one attains the policy from. The only difference may be the amount of the premium one is required to pay.
Source: youneedtoknowme.org

Information presented on Personal Finance Blog by MoneyNing is intended for informational purposes only and should not be mistaken for financial advice. While all attempts are made to present accurate information, it may not be appropriate for your specific circumstances. Any offers and rates shown on this site can change without notice and may contain information that is no longer valid. For further validation, always visit the official site for the most up-to-date information. This site may receive compensation from companies to offer an opinion about a product or service. We strive to provide honest opinions and findings, but the information is based on individual circumstances and your specific experiences may vary. We also treat your privacy seriously. Please take some time to understand our full policies and disclaimers by clicking here.
Source: moneyning.com

Video: Medicare Part D and Prescription Drugs

Analysis Finds Lax CMS Oversight of Prescribers in Medicare Part D

Further, the data showed that 50% of the top 20 prescribers of OxyContin in 2010 have been either criminally charged, convicted or settled fraud claims, or have been disciplined by their state medical boards. Among those, eight have been charged, convicted or barred from prescribing controlled substances, or been disciplined by licensing boards. However, all but one of those doctors still are able to prescribe drugs for Medicare.
Source: californiahealthline.org

Workshop Offered to Help with Understanding of Medicare Plans, Part D

The presentation will weigh the benefits and drawbacks of Medicare Advantage plans and discuss why so many people are switching over to them. Participants also will hear a description of Medicare Part D, the different phases of coverage and how the Affordable Care Act affects the coverage gap (doughnut hole) in Part D benefits.
Source: trtnj.com

Medicare Chief Queried on Medicare Part D Preferred Pharmacy Plans

In recent months, significant questions have been mounting regarding preferred pharmacy plans in the Medicare Part D drug benefit. They have been expressed by patients, community pharmacists (including NCPA), 30+ Members of Congress and a key congressional advisory panel known as the Medicare Payment Advisory Commission. Most recently, they played out at a U.S. Senate Finance Committee hearing April 9 concerning the nomination of Marilyn Tavenner to be the Administrator for the U.S. Centers for Medicare & Medicaid Services (CMS), the agency that runs Medicare.
Source: wordpress.com

Medicare Part D: Coverage, Costs, Eligibility

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 Supplement Insurance Plans and Medicare Part D

There are limited times when you can sign up for Medicare Part D. For instance, you can sign up when you are turning 65. You have a seven month enrollment period. This is called your Initial Enrollment Period (IEP). It begins 3 months before the month of your birthday, includes the month of your birthday and ends the last day of the third month after your birthday. There is also the Annual Enrollment Period (AEP). During the AEP you can enroll in a Part D plan for the first time or change from one plan to another. There are also various Special Enrollment Periods (SEP) when you can enroll under certain circumstances, for instance if you are losing employer coverage you may qualify for an SEP.
Source: allabout101.com

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

Video: Medicare : How to Qualify for Medicare Under 65

Daily Kos: Hope for Medicaid expansion in Michigan fades

Under the Affordable Care Act, a company of 50 or more employees must provide health insurance or pay a penalty for not providing insurance. If Ohio expands Medicaid, businesses would not have to pay a penalty for employees who are Medicaid eligible. If Ohio does not expand Medicaid, the associated cost to employers would be from $59 to $88 million based on a study by Jackson Hewitt. Jamie Adams, who works and attends school, spoke about how her family would benefit from Medicaid expansion. “For us, Medicaid expansion is not a political issue,” said Adams. “It is real life. It affects us, immediately and every day.” http://www.thecincinnatiherald.com/…
Source: dailykos.com

Medicare Essential – Is this the future of Medicare?

The combined deductible idea is echoed in a recent article in Health Affairs that proposes unification of Parts A and B, and Part D drug benefits. The Health Affairs article also proposes reducing beneficiary cost sharing to levels comparable to Medicare Advantage plans, eliminating the need for Medicare Supplemental coverage. The new Medicare plan, called Medicare Essential, would become the default for people who qualify for Medicare for the first time. New Medicare beneficiaries could opt out and take old traditional Medicare, and go buy their own Part D and Medicare Supplement plans, or they could buy Medicare Advantage plans. Medicare Essential would have a much higher premium than Medicare Part B, but the authors of the article claim that the overall cost would be less than Part B plus Part D plus the full-coverage Medicare Supplement Plan F that most seniors select. So proponents could argue that the added cost of the increased premium is a bargain and that people could always opt out and avoid the higher cost if they wanted to. Medicare Essentials could show significant savings by avoiding the broker commissions that add to the cost of Medicare Supplemental and Medicare Advantage plans. Whether the new program would be able to achieve the supposed 2% administrative cost ratio sometimes claimed for Medicare is highly suspect, but elimination of the need to re-process claims to pay Supplement benefits, along with simplification of coverage rules overall, would probably yield some further efficiencies.
Source: gormanhealthgroup.com

Health Law’s Medicaid Expansion And Online Marketplaces Offer Veterans New Care Options

Mike Sage, 64, a Vietnam War combat veteran, pays $15 per visit for primary-care services and $50 for specialist care at the VA clinic near his home in Monmouth, Ill. Prescription drugs are $8 for a 30-day supply. But his wife, Kay, like many veterans’ spouses, doesn’t qualify for VA health care. They plan to check out the policies offered on the Illinois health insurance exchange this fall to see if there’s a better option than the catastrophic-coverage plan with a $5,000 deductible that she currently carries.
Source: kaiserhealthnews.org

Medicaid Pay Increase For Hospitalists Confirmed For 2013

And that folks is how a pediatric cardiologist gets a Medicaid pay increase for their E&M services in CY 2013 and 2014.  The interpretation of this law adds 44 additional specialty designations to the qualifying list for Medicaid parity.  What is the gist of the argument?  A pediatric cardiologist is trained in the specialty designation of pediatric medicine and thus qualifies for Medicaid fee increases to match Medicare payment rates for 2013 and 2014.   The law says if a physician is recognized by the American Board of Physician Specialities (ABPS), the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) as a specialist or subspecialist within the primary care categories, they receive Medicaid parity for their E/M charges. What if the physician is not certified by any of these boards?  The law allows for Medicaid pay raises if  60% of the codes billed in the calendar year of enrollment were for qualified primary care services that has been defined above.  I suspect the 60% applies to the absolute number of codes submitted and not 60% of the total RVU value for the calendar year.  If the answer is absolute codes, then almost any qualifying physician could qualify by virtue of submitting at least two E&M codes for every non E&M procedure code done in the procedure suite.  That would give them a 66% rate of E&M charges which is  above the required 60% threshold.  I’m confident most medical subspecialists could clear the 60% threshold with no problem as long as they average at least two E&M charges for every non E&M procedure code they provide on any given day. What about services provide by nonphysician practitioners?  Do nurse practitioners, pharmacists, midwives, certified registered nurse anesthetists  or other qualified nonphysician practitioners  receive the mandatory increases in Medicaid payments?  The answer is only if they are billing under the supervision of an eligible physician.  That means the answer is no for independent nonphysician practitioners but yes if they are working with physicians in the qualified specialties listed above.  Seems silly, doesn’t it?  A pediatric cardiologist can spend 80% of their time in the cath lab doing procedures, but if they submit at least 60% of their codes as E&M charges they can get Medicaid parity on their office visits, hospital consults and hospital follow-up codes.  But the independently practicing certified nurse midwife administering the flu shot to protect mom and baby cannot. Oh, and sorry OB/Gyn doctors.  You may be the only physician for your patients and provide 100% primary care to 80% of your patient population, but you don’t qualify for federal subsidized Medicaid fee increases because you didn’t train in pediatric medicine, family medicine or general internal medicine.   Maybe you should have been a pediatric cardiologist instead.  ObamaCare says they are  providing massive amounts of primary care these days, and by primary care, I mean telling the patient to contact their primary care provider to fill out the Family Medical Leave Act paperwork so they can have mom and dad at the bedside while they take Junior to the cath lab. What about states that don’t plan on expanding Medicaid eligibility?  That has no bearing on the requirement for eligible physicians providing eligible E&M services to get paid 100% of their Part B Medicare rate on their Medicaid charges for CY 2013 and 2014.  Whether states decide to expand Medicaid or not, qualified doctors  providing qualified E&M charges get a raise on their Medicaid payment rates. What happens after 2014?  As noted in the Federal Registrar, states are required to report Medicaid participation rates to Congress in anticipation of decisions to continue or discontinue the current federal subsidy for qualifying Medicaid charges.  I’m sure that’s  going to be another political fight.  I’ve asked a few of my colleagues about what they intend to do with  Medicaid.  All of them say they have no intention of expanding their clinic slots to include a greater proportion of Medicaid patients.  My facebook post confirms that.  They can easily fill up their clinic with follow-up visits on their current panel of patients with chronic disease. I suspect after these two years are up we’re going to see no increase in Medicaid participation.  Physicians don’t run their business on a two year horizon.  Imagine expanding a clinic to include a large influx of Medicaid patients only to try and balance the budget based on unstable Medicare politics and a Medicaid policy that falls off the cliff after CY 2014. What physician in their right mind would budget that?  I’m willing to bet almost none.  The quirks of this law are simply mind boggling.  Pediatric cardiologists and hospitalists will get Medicaid parity for their ICU work but an independently practicing certified nurse midwife trying to take care of mom and baby as the only provider from conception to birth will not.  I don’t need to say anything more.  Oh yeah, one last thing.  How much is this little experiment going to cost?  The expected cost to the federal government for this Medicaid parity pay increase is 5.6 billion dollars in calendar year 2013 and 5.745 billion dollars in 2014 (using 2012 constant dollars).  What’s another 11 billion dollars we don’t have matter, right?  
Source: blogspot.com

Medicare Beneficiaries Sue HHS Over Medicare’s Observation Status

A group of Medicare beneficiaries is suing HHS Secretary Kathleen Sebelius, seeking for Medicare to stop its use of “observation status,” which the plaintiffs say deprives Medicare enrollees of the Part A coverage to which they are entitled, according to a Kaiser Health News report. Several senior citizens — who were placed on observation status for a least part of their hospital stay and did not receive Medicare Part A coverage, for which they were eligible at the time — filed the suit. The Medicare program considers “observation status” to be an outpatient service and billed under Medicare Part B. Inpatient hospitalization is covered and billed under Medicare Part A. The lawsuit claims patients on observation status generally receive the same treatment as those patients who have been formally admitted, but the use of “observation status” causes beneficiaries to absorb significantly more hospital costs that otherwise would have been paid for under Medicare Part A. Observation status also affects Medicare coverage for seniors’ skilled nursing facility care. SNF care is conditioned on patients’ spending a minimum of three consecutive days as an inpatient in the hospital. Beneficiaries who spend three or more consecutive days in a hospital under “observation status” do not qualify for Medicare coverage of SNF care.   The suit also claims the incidence of placing beneficiaries on observation status, and the average time period in which patient stay on observation status, has been “increasing dramatically in recent years.” If the judge won’t eliminate observation care, the seniors’ lawyers are asking that hospitals be required to tell patients when they are in observation and allow them to appeal that decision before they leave. Currently, beneficiaries placed on observation status do not receive written notification of their status and have no appeal rights to challenge that status, the suit claims. In the Kaiser Health News report, a Medicare spokeswoman declined to answer questions about the suit because it is agency policy not to comment on pending litigation.
Source: beckershospitalreview.com

Medicaid Eligibility in Texas

Following an initial check of the information, all applicants are required to visit a Health and Human Services Commission Benefits office. This visit interviews the applicant to ensure all information is present and correct – forming the final part of the application. Applicants who have specific reasons why they cannot travel to the Health and Human Services Commission Benefits office may be able to complete the review by telephone, or a representative may make a home visit.
Source: tex.org

Medicare Options for People With Less Work Experience

The amount you pay for the Part A premium in 2013 is $243 a month (if you have 30 to 39 work credits) or $441 a month (if you have fewer than 30 work credits). These amounts usually increase each year. If you continue working until you’ve earned 40 credits (about 10 years’ work in total), you’ll no longer be required to pay Part A premiums. If you buy Part A, you must also enroll in Part B. But you can enroll in Part B without having Part A. You can get Part D prescription drug coverage if you’re enrolled in Part A or Part B.  To join a private Medicare Advantage plan or to buy Medigap supplemental insurance, you must have Part A and Part B. It’s important to know that if you don’t enroll in Part B when you’re supposed to, you risk having to pay a permanent late penalty when you finally sign up, even if you haven’t worked long enough to qualify for Part A without paying a premium for it. (Related article: “Can You Be Penalized for Not Enrolling in Medicare?”)
Source: aarp.org

2. How does the health plan work? – All plans sold in the exchanges must show you a summary of benefits and coverage (SBC), a short document that explains in plain language what the plan covers and how cost sharing works in that plan. Each SBC sheet has to show examples with dollar amounts for two scenarios: having a baby and managing type 2 diabetes. Looking at the SBC will give you an idea of how the plan might work for you, says Christine Barber, a senior policy analyst for Community Catalyst, a nonprofit organization that promotes affordable health care.
Source: insurancequotes.com

Video: Low Cost Major Medical Health Insurance Plans

Coverage Problems Could Still Remain For Young Adults

Despite such requirements, some coverage isn’t assured. For example, employers in the large-group market don’t have to cover the essential health benefits. Young women enrolled in such plans might find themselves without maternity coverage if they become pregnant. The Pregnancy Discrimination Act of 1978 requires employers with 15 or more workers that offer insurance to cover maternity care. But the law doesn’t cover dependent children. Dan Priga, who heads the performance audit group at human resources consultant Mercer, estimated that roughly 70 percent of self-funded employers who pay their workers’ claims directly don’t offer maternity coverage for dependent children. 
Source: kaiserhealthnews.org

Ask An Expert: All About Group Health Insurance Plans

Tony was here in February discussing individual health insurance plans. Today (with help from his colleague Ken Whitley), he’ll be offering his expertise on employer-group insurance plans, including how the Affordable Care Act ("ObamaCare") will affect your company’s plan and possibly even your organization itself. Ken has been marketing group health insurance plans exclusively for over 30 years, and is one of the most knowledgable group health insurance brokers in the U.S. Have questions for them? They’re here for the next hour—ask away!
Source: lifehacker.com

Helpful Guidance For Determing The Best Health Insurance Plan

Hiring an insurance agent is an advisable alternative if you believe misplaced while searching for the best health care insurance strategy. An insurance policy dealer can assist you in finding the right feasible medical insurance having a affordable price tag. Insurance policy agents are also qualified in status-particular insurance regulations and legal guidelines, assisting you steer clear of nasty issues. Just like insurance coverage itself, you must compare the track record and cost for each broker well before deciding on a single.
Source: soul2soul.ca

Health Insurance Exchanges Will Make Medical Coverage Easier to Find and Afford

"AARP fought to ensure the new health law would prevent insurance companies from pricing older Americans out of affordable coverage and denying people because of preexisting conditions," says Ariel Gonzalez, AARP’s director of health and family advocacy. "Now we’re working to ensure the new health marketplace is transparent and provides older Americans quality and affordable choices."
Source: aarp.org

Oregon gets first peek at health insurance market

The oregonhealthrates.org website provides the filings by the individual carriers and a comparison of certain requested rates in the individual and small business market, broken down by region. The rate comparison shows identical standard-benefit plans rated bronze, silver or gold for their level of benefits for small businesses, as well as individual non-smokers aged 21, 40 and 60.
Source: spokesman.com

Should Taxpayers Pay for Health Coverage that Doesn’t Improve Health?

But even if it is, there’s little reason to believe that Democrats would have been willing to go that route with Obamacare. Barro’s financial-risk focused “not-too-much” approach would have pushed the law in the general direction of universal catastrophic insurance, or, at the very least, less comprehensive coverage. But Obamacare’s Democratic authors made the law’s guarantee of certain broadly defined “essential” benefits a key part of the law. And Health and Human Services Secretary Kathleen Sebelius has made it clear that her concept of meaningful health insurance does not include simple protection from catastrophic health expenses. “Some of these folks have very high catastrophic plans that don’t pay for anything unless you get hit by a bus,” she said recently at a congressional hearing. “They’re really mortgage protection, not health insurance.” The clear implication is that health insurance should pay for a bunch of health services, not merely protect one from unusually large health expenses. And sure enough, what the Oregon Medicaid study reveals is that Medicaid pays for a lot of health care expenses—but doesn’t, in the process, appear to significantly improve one’s physical health.
Source: reason.com

[1]  Health Care Reform consists of two separate laws, the Patient Protection and Affordability Care Act of 2010 (PPACA), Pub.L. 111-148  (March 23, 2010),  and the Health Care and Education Reconciliation Act of 2010 (HCERA), Pub. L. 111-152 (March 30, 2010).  The laws often are collectively referred to as the Affordable Care Act (ACA). [2] "The Employment Situation." Economic News Release. U.S. Bureau of Labor Statistics, http://www.bls.gov/news.release/empsit.nr0.htm. [3] For a comparison of the various deficit reduction proposals, see, Kaiser Family Foundation, Comparison of Medicare Provisions in Deficit Reduction Proposals  (January 2011), http://www.kff.org/medicare/upload/8124.pdf. [4] "Preliminary Analysis of the President’s Budget for 2012," March 18, 2011, http://www.cbo.gov/doc.cfm?index=12103. [5] Even before enactment of health care reform, experts argued that lowering spending growth in Medicare is only possible if lower spending growth is reflected in the private sector. Gail Wilensky, "The Challenge of Medicare," in Restoring Fiscal Sanity 2007: The Health Spending Challenge, Brookings Institution Press, 2007. [6] Congressional Budget Office, H.R. 2, Repealing the Job-Killing Health Care Law Act. Feb 18, 2011, available at: http://www.cbo.gov/doc.cfm?index=12069 [7] "2010 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds," August 5, 2010, https://www.cms.gov/ReportsTrustFunds/downloads/tr2010.pdf. [8] PPACA §§ 3601, 3602. [9] Douglas W. Elmendorf, Director, Congressional Budget Office, Letter to the Honorable Paul D. Ryan, November 17, 2010, http://www.cbo.gov/ftpdocs/119xx/doc11966/11-17-Rivlin-Ryan_Preliminary_Analysis.pdf; Paul N. Van de Water, Ryan-Rivlin Plan Would End Guaranteed Medicare, Shift Medicaid Costs To States And Beneficiaries(Center on Budget and Policy Priorities, March 17, 2011), http://www.cbpp.org/cms/index.cfm?fa=view&id=3429. [10] Ryan-Rivlin Plan Would End Guaranteed Medicare, Shift Medicaid Costs to States and Beneficiaries, supra. [11] Ibid. [12] PPACA §§ 3203,3301, 3315 4103, 4104, HCERA § 1101,amending 42 U.S.C. §§1395l(a)(1),  1395w-22(a)(1)(B); and adding  42 U.S.C. §1395w-114A. [13] Alice Rivlin and Paul Ryan, A Long-Term Plan for Medicare and Medicaid, November 17, 2010, available at http://paulryan.house.gov/UploadedFiles/rivlinryan.pdf [14] Medicare Payment Advisory Committee, Report to the Congress:  Medicare Payment Policy, Chapter 8 (March 2011) http://www.medpac.gov/documents/Mar11_EntireReport.pdf. [15] Report of the National Commission on Fiscal Responsibility and Reform, The Moment of Truth, December 2010. [16] Ryan-Rivlin Plan Would End Guaranteed Medicare, Shift Medicaid Costs to States and Beneficiaries, supra. [17] PPACA §§ 3308, 3402, amending 42 U.S.C. §§ 1395r(i), 1395w-113(a). [18] Center for American Progress, "Higher Tolls on the Roadmap", February 15, 2011, available at http://www.americanprogress.org/issues/2011/02/ryan_roadmap.html. [19] HCERA §§ 1102, amending 42 U.S.C. §1395w-23. [20] PPACA, §§ 6401-6411, HCERA § 1304. [21] Congressional Budget Office, H.R. 2, Repealing the Job-Killing Health Care Law Act, supra. [22] PPACA §§ 3001-3015. [23] PPACA §§ 3021, 3022, adding 42 U.S.C §§ 1315a, 1395jjj. [24] PPACA § 2602, adding 42 U.S.C. § 1315b. [25]  PPACA §§ 3302, 3303,amending 42 U.S.C. §§ 1395w-114(a),(b). [26] Edwin Park, Matt Broaddus, Medicaid Block Grant Would Shift Financial Risks and Costs to States, (Center for Budget and Policy Priorities, February 23, 2011) http://www.cbpp.org/cms/index.cfm?fa=view&id=3409.
Source: medicareadvocacy.org

Video: What is a Medicare health insurance exchange?

State Highlights: Feds Sue Fla. Senate President’s Former Co. Over Medicare Billing

San Jose Mercury News: Barbara Lee Bill Would Push States To Roll Back Criminal HIV Laws California and other states would be pressured to amend or repeal criminal laws that single out HIV-positive people under a bipartisan bill co-authored and introduced this week by Rep. Barbara Lee. Lee, D-Oakland, said 32 states and two U.S. territories have laws that criminalize exposing another person to HIV even if the virus isn’t actually transmitted. And 36 states have reported at least 350 cases in recent years in which HIV-positive people have been arrested or prosecuted for consensual sex, biting and spitting, according to the Center for HIV Law and Policy (Richmond, 5/9).
Source: kaiserhealthnews.org

GOP Again Tries to Take Away Health Care From Millions of Seniors, Women and Families

Make it more expensive to get preventive care. Preventive health services are now provided without co-pays in all new private insurance plans and through Medicare. These benefits include an expanded list of preventive health services for women, from domestic violence counseling to contraception. More than 71 million Americans have already benefited from the full range of these services. Repeal would restore co-payments and increase out-of-pocket costs for everyone.
Source: healthcareforamericanow.org

Fact Check:Will Increased Longevity Bring Down Medicare?

The customary formulation of this myth is that Medicare is doomed by its own success in keeping its beneficiaries alive. Not only will the ranks of the program’s beneficiaries increase as the vaunted baby boom generation reaches the statutory age of eligibility, but because people are staying alive longer, Medicare’s costs will explode. The first part of this contention is indisputably true: entitlement to Medicare occurs when a person reaches age sixty-five, and the baby boom generation that is generally calibrated as starting in 1946 has arrived at that threshold. As a result, additional Medicare beneficiaries enter that program every day, and because the baby boom generation dwarfs any preceding age cohort, it is highly likely that more beneficiaries will be added to the program than are lost as older beneficiaries pass away. Consequently, the number of Medicare beneficiaries will inexorably increase over the next decade or so. Ceteris paribus, more beneficiaries mean higher aggregate costs.
Source: thehealthcareblog.com

Nationalized health care would have saved Medicare an extra $34.1 billion in 2012, say advocates

“We’ve long known that Medicare has been paying private insurers more than if their enrollees had stayed in traditional fee-for-service Medicare, but no one had added up the total extra cost to the taxpayer since contracting with private insurers began 27 years ago,” said Hellander, lead author of the study. “Nor has anyone systematically examined the many ways that private insurers have gamed the system to maximize their bottom line at taxpayers’ expense. In 2012 alone, private insurers are being overpaid $34.1 billion, or $2,526 per Medicare Advantage enrollee.”
Source: sciencecodex.com

Medicare Advantage – or DISAdvantage?

Following a 20-year career as a corporate insurance executive, Wendell Potter left his position as head of communications for Cigna in 2008 to advocate for comprehensive health care reform. He is now an analyst at the The Center for Public Integrity and president of Wendell Potter Consulting. He has also served as a consumer representative to the National Association of Insurance Commissioners. His book, Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans, was awarded the Ridenhour Book Prize for “outstanding work of social significance” in 2011. Previously, he wrote A helping hand for Marsha Blackburn and  Want to fix health care? Watch this movie. for the Health Insurance Resource Center Blog.
Source: healthinsurance.org

Study Takes on the Myth of Medicare Cost Shifting

Contrary to the theory, I found that hospital markets with relatively slow growth in Medicare inpatient hospital payment rates also had relatively slow growth in private hospital payment rates during 1995–2009. Using regression analyses, I found that a 10 percent reduction in Medicare payment rates led to an estimated reduction in private payment rates of 3 percent or 8 percent, depending on the statistical model used.
Source: firedoglake.com

In attack on health reform, Republicans target Medicare advisory board

Rockefeller argued that politics needed to be taken out of the equation when it comes to setting Medicare payments to providers. So he and others proposed a 15-member board of health care experts, appointed by the President for six-year terms, which is required to recommend Medicare spending reductions if costs exceed fiscal targets set out in the health care reform law. Its first report to Congress is due in 2014.
Source: ctmirror.org

Progressives Suddenly Support Health Insurance Marketing

One of the many claims that progressives made was that because private health insurance was for profit, then the denial of claims went directly to profit. This argument was was invalid for several reasons. 1) health insurance companies have strong disincentives against denial of valid claims due to threat of suit, whereas, government death panels have sovereign immunity from suit. 2) The easiest way to increase Health insurance companies profits is to increase market share. With more market share, they are able to spread the risk and they are better able to dictate prices in markets. Same as hospitals are better able to dictate prices in markets where the hospital chain has greater market share. If the health insurance company begins to deny claims, especially in the group plans, the agents and large employers in a market begin to seek alternative plans.
Source: coyoteblog.com

Fidelis Care’s Pharmacy Department routinely contacts members who take certain medications to treat chronic illnesses, to encourage them to be tested to ensure their medication is a helpful part of their disease management. The Clinical Care staff at Fidelis Care also provide a variety of case management services to assist members with chronic conditions such Diabetes, Asthma, and low bone mineral density in women. An emphasis is also placed on educating our members about the importance of obtaining breast and colorectal cancer screening tests. Women enrolled in Medicare Advantage and Dual Advantage programs who had not obtained a recent mammogram received a reminder postcard as part of this process.
Source: readmedia.com

Video: New Cigna Supplement Opportunity!

Fidelis adds urological surgeons to network

Fidelis Care, the New York State Catholic Health Plan, has added Capital Region Urological Surgeons PLLC to its provider network.   Capital Region Urological Surgeons, with 13 physicians and 2 nurse practitioners, has been providing urologic care in the Capital Region for nearly 30 years. The group’s specialties include urologic oncology, prostate disorders, kidney stone therapy, infertility, urinary incontinence and female urology. Offices are located in Albany and Saratoga Springs.
Source: timesunion.com

Brooklyn’s Family Health & Wellness Guide (NY Metro Parents Magazine)

PREMIER CARE Premier Care of Bellmore  2459 Merrick Road, Bellmore  516-826-2273  Premier Care of Commack  6500 Jericho Turnpike, Commack  631-858-2273  Premier Care of Great Neck  415 Northern Blvd., Great Neck  516-829-2273  Premier Care of Levittown  3276 Hempstead Turnpike, Levittown  516-796-2273  Premier Care of Lindenhurst  656 North Wellwood Ave., Lindenhurst  631-225-4227  Premier Care of Lynbrook  585 Merrick Road, Lynbrook  516-764-2273  Premier Care of Maspeth  74-25 Grand Ave., Maspeth  718-803-2273  Premier Care of Park Slope  418 – 420 5th Ave., Park Slope  718-965-2273
Source: nymetroparents.com

REPORT: Iran’s Revolutionary Guards overseeing missile fire

“The IDF continues to operate surgically in the Gaza Strip – precise strikes, not against outposts, not against police stations, but against rocket-launching sites,” he said. “So far, a very harsh blow has been dealt to the long-range fire of Hamas and Islamic Jihad.”
Source: wordpress.com

insurance: MEDICARE ADVANTAGE/MEDICARE HEALTH PLANS

Medicare Advantage/Medicare Health Plans SHIIP Publications: Frequently Asked Questions About Medicare Advantage PFFS Plans Is A Medicare Advantage Private-fee-for-service Plan Right For Me Medicare Advantage Comparison Guide (2008) Your Guide To Medicare Private-fee-for-service Plans Medicare Advantage Summaries of Benefits SHIIP Publications: Aarp Medicarecomplete Choice Aarp Medicarecomplete Plus Plan 1 Aarp Medicarecomplete Plus Plan 2 Advantra Freedom – Plan 1, Plan 2 (005), Plan 5 (001) Advantra Freedom – Plan 2 (010),plan 3 (006-013), Plan 5 (002) Advantra Savings (msa) – Plan 1 Aetna Medicare Open Plans America’s 1st Choice – Patriot Plus And Presidential Plus America’s 1st Choice – Patriot-presidential Blue Medicare HMO Plans Blue Medicare PPO Plans Cigna Medicare Access Plans One, Two And Three – Version A Cigna Medicare Access Plans One, Two And Three – Version B Cigna Medicare Access Plans One, Two And Three – Version C Cigna Medicare Access Plans One, Two And Three – Version D Evercare – Dh – Special Needs Plan Evercare – Ih – Special Needs Plan Evercare – Mh – Special Needs Plan Fidelis – Secure Comfort – Special Needs Plan Fidelis – Secure Comfort Plus – Special Needs Plan Fidelis – Secure Independence – Special Needs Plan Health Net Pearl – Plans 009-014-015 Healthmarkets Care Assured Plans Humana – Special Needs Plan Humana Goldchoice – H1804 -216 Sb08 Humana Goldchoice – H1804-007 Sb08 Humana Goldchoice – H1804-016 Sb08 Humana Goldchoice – H1804-217 Sb08 Humana Goldchoice – H1804-278 Sb08 Humana Goldchoice – H1804-279 Sb08 Humanachoiceppo – H3405-001 Sb08 Humanachoiceppo – H3405-002 Sb08 Humanachoiceppo – Regional – R5826-003 Sb08 Securehorizons Medicaredirect Plan 3 Securehorizons Medicaredirect Plan 3a Securehorizons Medicaredirect Rx Plan 51 Securehorizons Medicaredirect Rx Plan 51a Securehorizons Medicaredirect Rx Plan 54 Securitychoice Classic-enhanced-plus-enhance Plus – Area A – Securitychoice Classic-enhanced-plus-enhanced Plus – Area B Securitychoice Essential-essential Plus Southeast Community Care – Dual Plus Plan – Special Need Plan Southeast Community Care – Plus Plan Sterling Option I Sterling Option Ii Sterling Option Iii Sterling Option Iv Today’s Options – Basic Plus, Value Plus, Premier Plus Today’s Options – Basic, Value, Premier Today’s Options Powered By Ccrx Unicare 2008 Msa Summary Benefits WelLCare Benefit Summary A WelLCare Benefit Summary B WelLCare Benefit Summary C WelLCare Benefit Summary D WelLCare Benefit Summary E
Source: blogspot.com

Health Benefit Cost Growth Accelerates, Survey Says

The union said in a statement that the state required the fund to participate in a new program — the Family Health Plus Buy-In Program — beginning in 2008. The union said it expected that by joining the program, many of its members would qualify for state assistance for health-insurance coverage. “Instead they raised insurance rate increases without any increase in funding, and then cut Medicaid funding to the same workers nine times in the last three years,” the union said in a statement.
Source: wordpress.com

The American Spectator : The Spectacle Blog : GOP Report Charges AARP Getting “Kickbacks” In Dem Health Care
Bills

Richo, you are ignorant with to regards to the actual benefits that the Medicare Advantage Plan provides. I was skeptical when I was first informed by an insurance agent that there would be no monthly fees. I then learned that my medicare payments through Social Security, the $96.00 monthly, would be paid to the Medicare Advantage provider in return for my Medical Insurance coverage, both “A” and “B”. I also get a good discount on my one perscription drug of a least 70% over what I was paying with my Medicare “D” through Anthem. In addition, The SilverSneakers program for maintain my physical health is a big plus. I am 71 years old and in good physical condition. I enrolled in the Silversneakers program through our newly constructed YMCA. I paid the $75.00 joiner fee and The Medicare Advantage pays my monthly membership. How can you argue that this is not a cost savings for those of us who have been retired and needed assistance with our health insurance cost? Would you please e-mail your reply or rebutal. Jack, Wabash, Indiana
Source: spectator.org

HealthMetrix Research Selects 2009 Medicare Advantage Plans for Best Overall Ben… ( COLUMBUS Ohio Oct. 30 /

Breaking Medicine News(10 mins):Health News:Renowned Rim Fitments Provider SizeItUp Launched Database Integrations for the 2012 Hyundai Genesis 2Health News:Metal-on-Metal Hip Implants: Bernstein Liebhard LLP Comments on New Study Finding that Tissue Damage Precedes Pain in Metal-on-Metal Hip Replacement Patients 2Health News:Metal-on-Metal Hip Implants: Bernstein Liebhard LLP Comments on New Study Finding that Tissue Damage Precedes Pain in Metal-on-Metal Hip Replacement Patients 3Health News:Metal-on-Metal Hip Implants: Bernstein Liebhard LLP Comments on New Study Finding that Tissue Damage Precedes Pain in Metal-on-Metal Hip Replacement Patients 4Health News:hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Announce the Best Weight Loss Through New Whole Foods, Healthy Snacks and Prescription Strength hCG Treatments 2Health News:hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Announce the Best Weight Loss Through New Whole Foods, Healthy Snacks and Prescription Strength hCG Treatments 3Health News:Spice Addiction Treatment and Synthetic Marijuana Drug Rehab Announced by Recovery Associates 2Health News:Ayurveda Spa Treatments Now Offered at the California College of Ayurveda Panchakarma Center 2
Source: bio-medicine.org

FIMRC established the Micro Health Insurance Program in June 2008 to assist the community achieve a higher level of baseline health at Project Las Delicias in El Salvador. Because FIMRC strives for sustainability and innovation, these components are key in the Micro Health Insurance Program.  MHIP is the first non-monetary model of health insurance that combines health education and community development projects with improved access to medical services to provide comprehensive health care for the entire family, all at zero financial cost to participants. Through MHIP, individuals participate in health education sessions, home visits, community-wide health events, monthly wellness visits, and quarterly feces exams to prevent and treat the spread of parasites.
Source: fimrcblog.com

Video: ‘Obamacare is Far from a National Health Insurance Program’

Health Policy Brief: The CO

A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation discusses the Consumer Operated and Oriented Plan (CO-OP) program, a provision of the Affordable Care Act. Starting in October, many Americans will be able to enroll in health plans through the health insurance exchanges in their states. Recognizing that in some states a person’s options for insurance plans may be limited, the CO-OP program was designed to increase competition among health plans and improve consumer choice by creating new, nonprofit insurance plans governed by consumers. The federal government has awarded nearly $2 billion in loans to help create 24 new CO-OPs in 24 different states.
Source: healthaffairs.org

Chancellor announces return to Berkeley

Student leaders from the Associated Students of the University of California (ASUC), the Graduate Assembly, the campus Committee on Student Fees and the Student Health Advisory Committee felt strongly that it was in the best interests of UC Berkeley students to leave UC SHIP and return to a Berkeley-based plan. Although there are many possible advantages in a system-wide plan, there also are features in our health coverage which are best optimized campus by campus. The advantages of having a Berkeley-specific student health-insurance plan have been made to me very forcefully in a letter (PDF) from the ASUC and Graduate Assembly, and this letter helped me reach this decision.
Source: berkeley.edu

Does health insurance pay for a gym membership?

Aetna offers gym membership discounts with most of its plans, says Ethan Slavin, a communications officer at Aetna. This year, Aetna also launched a fitness reimbursement program, which is open to a number of employer-sponsored health care plans. In addition to gym memberships, plan members can receive reimbursement for purchasing at-home exercise equipment, group classes and wellness counseling. Employers are able to customize the program and decide how much money their employees are eligible to be reimbursed for their fitness-related expenses.
Source: insurancequotes.com

$125 million more requested to implement Obamacare in Colorado

Health care exchanges are among the pillars of Obamacare, allowing individuals and small businesses to band together to shop for low-cost insurance. How they will look and operate will vary from state to state. Those that choose not to open an exchange will have one opened for them by the federal government.
Source: dailycaller.com

May Post of Bonnie’s Blog: Navigating Maryland’s Health Insurance Navigator Program

Confusion begins with what is a navigator for health insurance and why are they “in the news?” Navigators are in the news because the Affordable Care Act (ACA) drew on the concept of health navigators—people who help people work their way through health care systems.  The ACA navigators are to help people work their way through the health insurance marketplace exchanges established by the federal law. They are to help people learn about and enroll in Qualified Health Plans. The navigators will be hired, trained and expected to assist consumers during the open enrollment period that begins in October, 2013. More will be known as they begin to function across the state and nation.
Source: umd.edu

Is Health Insurance Good for Health?

For studies with null results, the absence of evidence does not mean an evidence of absence. There are many reasons why detecting a causal effect between insurance and health outcomes is complex and challenging. Methodologically, detecting changes in health status in a short time period provided from an academic study is very difficult. Mortality is a rare event, requiring large sample sizes to detect change (which is probably why the Oregon experiment did not measure it), while morbidity is still relatively infrequent (which the study did measure) – but also not so easy to change even with health insurance (just think about the last time you tried to lose weight, stop smoking, or reduce your blood pressure!)
Source: cgdev.org

HIPP Pays Health Insurance for Some Families with a Person on Medicaid

Before you can qualify for HIPP, Medicaid has to determine that it is more cost effective to reimburse your family for health insurance premiums than to pay the medical bills for a family member(s) on Medicaid. This saves the state money while helping families obtain health care. It does this by making private insurance the main payer and Medicaid the second payer for individuals on it. Based on individual circumstances, HIPP might not cover insurance costs for everyone in a family and some families may have to pay a percentage of the cost.
Source: texas.gov

For a Medigap policy to apply, a person does need to be signed up for Medicare first, including Parts A and B. Folks who have both pay two premiums, one for the Medigap plan and one for the Medicare Part B program. Further, it’s important to note that while Medicare will cover both a person and a spouse, a single Medigap policy with a private provider will not. A consumer has to take out two Medigap plans to cover a spouse and himself. Further, Medigap is no longer allowed to cover pharmaceutical costs under Part D of Medicare. Those have to come out of pocket from a consumer under federal law. Unfortunately, drugs tend to be the biggest medical expense for seniors on average.
Source: edvox.org

Video: Medicare Advantage vs. Medicare Supplement Insurance

What is Medicare Supplement (Medigap) Insurance

In order to sign up for Medicare Supplement coverage, you must already have Part A and Part B. These plans are offered by private insurance companies and come in 10 standardized policy types that are denoted by the letters A-N. The standardization of these plans means that no matter where you shop, the Medigap policy details remain consistent. For example, the benefits associated with Plan F are the same no matter where you buy it, though costs may differ across all carriers. Not every carrier of Medicare Supplement Insurance offers all 10 plan types, and three states in the U.S. have their own version of these plans: Massachusetts, Minnesota, and Wisconsin.
Source: ehealthmedicare.com

Medicare Supplemental Insurance

Another issue that should be kept in mind with Medigap policies, is that it is wiser to purchase a supplemental coverage within the first six months of being on Medicare Part B. This is when the insurers cannot deny the individual because of a preexistent health issue. Many insurance companies will tell the individual that they have better plans and better coverages. This is not true. The Medigap program is a national one and the coverage is the same no matter who one attains the policy from. The only difference may be the amount of the premium one is required to pay.
Source: youneedtoknowme.org

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

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

FAQ: Seniors May See Changes in Medigap Policies

Advocacy groups like the Medicare Rights Center oppose restricting Medigap plans, saying it would simply shift more costs from the government to elderly and low-income people who can least afford it. “Some in government feel people in Medicare don’t have enough ‘skin in the game,’” says Ilene Stein, federal policy director for the center. In fact, she says, people on Medicare already pay 15 percent of their incomes for health care, well above the level paid by non-Medicare households. While the proposals would cap maximum annual spending per enrollee to $5,500 or $7,500, “that’s a lot of money for someone making $22,000,” the median household income for those on Medicare, she says. 
Source: kaiserhealthnews.org

Newsroom – Insurance Commissioner Ruling on Medigap Rates Clarifies that Blue Cross Blue Shield of Michigan Does Pay Taxes

DETROIT  – Today’s ruling by the Michigan Insurance Commissioner — that Blue Cross Blue Shield of Michigan must discount its premiums on Medicare Supplemental policies by an amount equal to 1% of the company’s total revenue — makes clear that BCBSM is liable for paying a state-imposed annual assessment of about $181.5 million based on 2008 revenue.
Source: bcbsm.com

Policymakers, Stakeholders Propose Changes to Medigap Policies that Could Threaten Affordability

As part of the current budget discussions, AHIP is urging policymakers to avoid changes that will threaten benefits that millions of seniors and people with disabilities rely on. Earlier this week, the President released a budget proposal for 2014, which calls for a 15 percent surcharge on new beneficiaries who choose Medigap policies with low cost-sharing requirements.  The recent budget proposal is one of several proposals that would impose a new tax on the average Medigap premium.  The Medicare Payment Advisory Commission (MedPAC) has discussed a 20 percent surcharge.  Adding a new tax on Medigap would increase costs for vulnerable beneficiaries who rely on the predictability and financial protection Medigap provides.
Source: ahipcoverage.com

Medicare Supplemental Insurance

Medicare was created to help senior citizens acquire health insurance at a reasonable price. The majority of people are in need of health insurance far more often in their senior years than in their younger ones. Realizing that seniors pose a bigger health risk to insurance companies than the younger generation, the United States government knew that if insurance providers were allowed to operate without any kind of regulation in how they dealt with seniors, they would charge much more expensive premiums to the elder generation. This would have priced many seniors right out of healthcare coverage.
Source: lindacoleman.org

Ohio Medigap rate increases?

Why has my Medicare supplement rate gone up?.. I haven’t even used my coverage this year! Medicare supplement rate increases apply equally to all insured members regardless of their health conditions experienced in the last year. An insurance carrier cannot exempt you from rate increases because you are well. Just the same, they cannot single you out for an increase just because you are sick. If they did that, then what would be the point of insurance that you can no longer afford? Instead, Medicare supplement insurance companies calculate their total loss ratios for all clients, and then apply rate increases to certain “blocks of business.” For example, some Medigap companies increase rates across all clients in a certain geographic area. Others have automatic increases when insured members reach a certain age band, such as age 70 or 75. Still others will apply rate increases to everyone insured on a certain policy, such as Plan F or Plan G or Plan N. The important things to remember are that every insured member usually experiences at least one rate change per year, and that has nothing to do with whether you are sick or well. The nature of insurance coverage relies on actuarial tables and company’s ability to spread out the potential risk, or losses, over a group of policyholders.
Source: ohiomedigapinsurance.com

To assist lawmakers in addressing the sustainability of the program, this report provides an overview of reform proposals designed to mitigate the growth in SSDI rolls. Most of the proposals discussed in this report focus on reducing the inflow (incidence) of new beneficiaries into the program. These proposals include implementing stricter SSDI eligibility criteria, improving consistency in the disability determination and adjudication process, and incentivizing employers to provide supported-work services for employees following the onset of disability (i.e., rehabilitation, workplace accommodation, and a partial wage replacement). On the other hand, some of the proposals seek to increase the outflow (termination) of beneficiaries from the program. Proposals to reduce the current beneficiary population entail providing stronger incentives for beneficiaries with some residual functional capacity to return to the labor force, as well as increasing the number of continuing disability reviews (CDR) performed by the Social Security Administration (SSA).
Source: cornell.edu

Video: Social Security: Just the Facts

The problem with Social Security Disability Insurance is worse than you think

The benefits would run out after 27 months, and after 18 months of collecting benefits, employees could apply for Social Security Disability Insurance payments. That’s a much longer wait time than the current five-month SSDI waiting period. The idea is that this would give employers an incentive to accommodate disabled employees and give those employees a strong incentive to stay in the workforce by not reducing benefits if they keep working (as happens under SSDI). But the plan is also intended to leave SSDI in place for beneficiaries who really cannot work.
Source: aei-ideas.org

Robbing Social Security to Pay Insurance Companies?

The bill does authorize the federal government to implement a series of revenue programs. Here again, though, the numbers do not add up. One program is to raise taxes on upper income Americans through the Medicaid payroll system. Individuals who make above $200,000 and couples who make over $250,000 per year in earned income, or the same amounts as investment income, will have to pay a tax of 3.8 percent on both forms of income. The federal government’s Joint Committee on Taxation estimates these taxes will bring in about $210 billion in new revenue over a six year period.  Another program is to charge an excise tax on what are called “Cadillac Insurance” policies. These are very expensive health care plans that are only affordable by the very wealth. The government estimated that this will bring in about $32 billion in new revenue over a two year period. Other programs such as fees for using tanning salons and other savings in Medicare programs that have up to now been run by private insurance companies are estimated to bring in $132 billion over a ten year period. Projected savings are always dubious claims and these revenue programs are very unlikely to come close to paying for the massive increase in insurance costs. The upshot is more deficits.
Source: joelcmagnuson.com

Reform disability insurance in ways that encourage companies to keep employing disabled workers

The disabled are part of the far larger number of Americans who have left the labor force altogether since the recession, and who don’t seem to be coming back. About 88.9 million people in the U.S. are now out of the labor force, 2.4 million more than a year ago and 11.4 million more than in 2006. Thirty years ago, there was a 40-to-1 ratio between the total labor force and those workers receiving Social Security disability payments. Today that ratio is less than 18-to-1.
Source: chicagotribune.com

PRESS RELEASE: Americans Make Hard Choices on Social Security, Prefer to Raise Payroll Taxes and Increase Benefits

To identify the preferred package, NASI partnered with Mathew Greenwald & Associates to use trade-off analysis, a technique widely used in market research to learn which product features are most preferred by consumers. The trade-off exercise allowed survey participants to express preferences among many combinations of policy changes, and researchers determined the most preferred combination. The trade-off exercise found that reducing benefits – for example, by raising the retirement age to 70 or means-testing Social Security benefits – were unpopular policy changes.    
Source: nasi.org

The Use of VA Disability Benefits and Social Security Disability Insurance Among Veterans

Although there is substantial functional limitation and disability among veterans of all ages, relatively little is known about veterans’ uptake of Department of Veterans Affairs (VA) Disability Benefits and Social Security Disability Insurance (DI).  This project uses data from the 1992, 1993, 1996, 2001, 2004, and 2008 Survey of Income and Program Participation to examine veterans’ participation in VA and DI programs.  The results indicate that the majority of veterans do not receive VA or DI benefits, but veterans’ use of these programs has been increasing over time.  A higher percentage of veterans receive VA compensation only, which ranges from 4.9 percent in 1992 to 13.2 percent in 2008, than DI compensation only, which ranges from 2.9 percent in 1992 to 6.7 percent in 2008.  Furthermore, the rate of joint participation in these two programs is low, ranging from less than 1 percent in 1992 to 3.6 percent in 2008.  Veterans experience relatively few within-panel transitions between VA and DI programs.  Overall, the likelihood of any disability program use is higher among veterans who served during multiple time periods, are older, black or Hispanic, currently married, and have less than a high school education.  Among users, the likelihood of any VA use in contrast to only DI use is higher among veterans who served since 1990, are younger, Hispanic, highly educated, and currently married.  Among users, variation in the likelihood of any DI use relative to only VA use generally mirrors variation in the likelihood of any VA use, although there are differences in associations with race/ethnicity, education, and marital status.
Source: bc.edu

Daily Kos: President Obama considering putting social insurance cuts in his budget

follow his close actions (which some of your statements aren’t 100% accurate), this battle is far from over and it will take the Senate and Congressional Democrats to agree to them.  His stimulus package was a lot of tax breaks for middle-class Americans (as imperfect as it is).  He didn’t fire guys like Austan Goolsbee or Christie Romer, they left.  There are already Senate investigations going on and the secret promises were the last resort thing cause guys like Baucus killed the public option.  I’m not saying Obama is perfect or terrific at that matter and I’ve had my disappointments with him as well but your comment is contributing to the “we are doomed” narrative, no matter how factual or even exaggerated it may be.  If you at least made some call for action like putting the pressure on congressional or Senate Dems to not agree with these cuts, then I would say that you aren’t contributing to the “gloom and doom” narrative.  I would credit you for being pro-active.  I would credit you for acknowledging a problem and then taking action.  There was nothing in your comment that called for action.  Nothing, nada, zilch.  
Source: dailykos.com

Lawsuit questions insurance company’s treatment of mental health

Now a lawsuit against a large insurance company is going to test how robust that coverage needs to be. A law in place, with the rather unwieldy name of the 2008 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, requires larger employers — those with at least 50 employees — that offer mental health or substance abuse coverage within the plans that they offer to treat those benefits the same way as they would other medical or surgical benefits.
Source: socialsecuritydisabilityfacts.com

Letter from Here: Words matter

Imagine a world in which homeowners insurance was demonized as an entitlement. A world in which people who paid insurance premiums and then were able to be reimbursed when their house accidentally burned down were portrayed as some sort of social parasite, collecting some sort of fishy-sounding “entitlement.”  Critics would argue, year after year, “This is wrong! People are taking out more than they put in! The system is going bankrupt.” That would be a world in which people did not understand the concept of risk pooling known as insurance. In any insurance plan, benefits for those who collect are subsidized by those who don’t, plus investment income on the money paid in. It makes economic sense, because it protects policyholders from catastrophic risk that would wipe them out. Insurance is a pervasive fact of modern life, and most people have no problem understanding the general principle. That’s why the right has been systematically demonizing our biggest insurance program of all — Social Security insurance — by replacing the word “insurance” with the word “entitlement,” and repeating it over and over again until it sticks. It’s one of the most successful propaganda campaigns of all time, to the extent that even some Democrats talk about Social Security as an “entitlement” that needs to be reformed. The right has deliberately blurred the distinction between a defined contribution plan like a 401k and a defined benefit plan like Social Security, as if the 401k were some sort of ideal model. In a 401k, your retirement benefits only consist of what you (and maybe your employer) paid in, along with accrued investment earnings. That’s exactly why most people’s 401k accounts aren’t nearly big enough to fund a decent retirement — because most people don’t earn enough to fund a decent retirement entirely on their own and would end up outliving their resources. That’s why Social Security was invented. The insurance component bridges this gap and insures us against the risk of outliving our resources. And, as an insurance program, the premiums and benefits are designed by actuaries to be self-funded and solvent. Before Social Security, for most working Americans old age was a wretched combination of poverty and reliance on family — and that’s when families were bigger than they are today. Whenever you hear people talk reducing Social Security “entitlements,” that’s really what they’re talking about. Ditto for Social Security “taxes.” We should be talking about Social Security insurance and Social Security premiums. We’ve paid premiums and we’ve earned our Social Security insurance benefits. Words matter.
Source: peterpatau.com

For a Medigap policy to apply, a person does need to be signed up for Medicare first, including Parts A and B. Folks who have both pay two premiums, one for the Medigap plan and one for the Medicare Part B program. Further, it’s important to note that while Medicare will cover both a person and a spouse, a single Medigap policy with a private provider will not. A consumer has to take out two Medigap plans to cover a spouse and himself. Further, Medigap is no longer allowed to cover pharmaceutical costs under Part D of Medicare. Those have to come out of pocket from a consumer under federal law. Unfortunately, drugs tend to be the biggest medical expense for seniors on average.
Source: edvox.org

Video: Medicare Advantage vs. Medicare Supplement Insurance

What is Medicare Supplement (Medigap) Insurance

In order to sign up for Medicare Supplement coverage, you must already have Part A and Part B. These plans are offered by private insurance companies and come in 10 standardized policy types that are denoted by the letters A-N. The standardization of these plans means that no matter where you shop, the Medigap policy details remain consistent. For example, the benefits associated with Plan F are the same no matter where you buy it, though costs may differ across all carriers. Not every carrier of Medicare Supplement Insurance offers all 10 plan types, and three states in the U.S. have their own version of these plans: Massachusetts, Minnesota, and Wisconsin.
Source: ehealthmedicare.com

Medicare Supplemental Plan F

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

Medicare Supplemental Insurance

Medicare was created to help senior citizens acquire health insurance at a reasonable price. The majority of people are in need of health insurance far more often in their senior years than in their younger ones. Realizing that seniors pose a bigger health risk to insurance companies than the younger generation, the United States government knew that if insurance providers were allowed to operate without any kind of regulation in how they dealt with seniors, they would charge much more expensive premiums to the elder generation. This would have priced many seniors right out of healthcare coverage.
Source: lindacoleman.org

Compare Medicare Supplement Plans Supplemental Medicare Insurance

As consumers, we generally nurture many misconceptions about medical insurance. For example, people think that coverage is directly related to premiums and the more they pay, the more coverage they are likely to get. Actually premiums can vary, be more or less; but coverage is the same. It is possible for a consumer to save money, by avoiding out-of-pocket payment, just by getting proper information. http://www.medigapplansguide.com, can empower a consumer by giving proper insights into all aspects of Medicare supplement insurance through a comprehensive comparison and analysis of the choices offered by different companies like AARP. Pay less, get same benefits.
Source: wordpress.com

U.S. Medicare supplemental coverage linked to higher spending

Could it be that supplemental spending is up because health care is up. All supplemental does is cover the 20% that medicare does not cover. If you have any kind of a operation that can add up to thousands of dollars to people who are retired. I read somewhere that almost 50% of retirees live on nothing but social security and barely have enough to live on much less additional medical bills.
Source: northiowatoday.com

Supplemental Medicare coverage leads to spending growth

Golberstein and his collaborators from Harvard Medical School used data from the Medicare Current Beneficiary Survey from 1992 to 2005, before Medicare Part D prescription drug benefits were introduced, and analyzed a sample of 104,365 observations. The researchers found significantly higher rates of spending growth in all supplemental insurance categories compared to the category without supplemental insurance, even while controlling for sociodemographic status, disease, disability, and health behavior characteristics.
Source: umn.edu

How To Get The Best Price On The Best Auto Insurance Plan

It is prudent to shop around when you are looking for a car insurance Florida plan, as this is a fiercely competitive industry. Rates can vary dramatically from one provider to the next. Get new quotes every year to ensure the lowest premiums and out-pocket-costs. When you are looking at insurance quotes, check the levels of coverage to make sure they are the same.
Source: hotel-crans-ambassador.com

House Committee Recommends Medicare Supplement Reform

Two house committee members Reps. Johnson and Reichert expressed concern that the modifications to Medicare supplement plans would create a disincentive for retiree’s to purchase Medigap coverage and could cause them to delay or even go without important medical care. Hackbarth defended the Commission’s report and said that the suggestions are not to prevent Medicare recipients from purchasing supplemental insurance and that the suggestion “didn’t propose any regulatory restriction’ on those Medicare supplement plan purchases.
Source: askmedicareblog.com