Medicare and Health Insurance, What is Covered, Medicare Supplement

Posted by:  :  Category: Medicare

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

Video: Medicare Supplement Insurance Plans – Where Do I Start?

Brookhaven NY Auto, Business Insurance and Medicare Supplement Insurance

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

MedicareBob’s Blog: Vanderburgh County Indiana Medicare Supplement Quotes

The three most comprehensive Medicare Supplement Plans are: Medicare Supplement Plan F: Full Coverage Medicare Supplement Plan G: Small Deductible ($147.00) Medicare Supplement N: Small Deductible & Copays (Part B Excess
Source: blogspot.com

Medigap vs Medicare Advantage: Which is the Best Medicare Supplement?

Medicare Advantage can be cheaper, but not necessarily so. For instance, the premiums for those Advantage plans that require them will rise over time, while policy holders of Medigap plans can select options in which the premiums are locked. In addition, out-of-pocket costs for many services such as hospital stays are often much more expensive with Advantage plans than they are with Medigap plans.Seniors considering a Medicare Advantage plan should read the fine print of the policy benefits to determine that the coverage satisfies their needs. They should also contact their physicians to ensure that the plan they desire is accepted.
Source: imms.com

Utah Medicare Supplements

A Utah Medigap (also called Utah Medicare Supplement Insurance) policy is private health insurance that is designed to supplement Original Medicare. This means it helps pay some of the health care costs (gaps) that Original Medicare doesn’t cover (like copayments, coinsurance, and deductibles). If you are in Original Medicare and you have a Medigap policy, Medicare will pay its share of the Medicare-approved amounts for covered health care costs. Then your Medigap policy pays its share. (Note: Medicare doesn’t pay any of the costs for you to get a Medigap policy.)
Source: utahseniorservices.com

Medicare Supplement Insurance Connecticut

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

Work Your Exclusive Medicare Supplement Leads With The Right Tools

Use relationship marketing when dealing with exclusive Medicare supplement leads. Call your leads right away, introduce yourself, ask how else you may be of service, offer to send them articles you have written about the type of insurance they are interested in, help them focus on ways to get the kind of coverage they need and want. Be the expert. Be friendly and approachable, knowledgeable, make complex language easy to understand and just be you, because you are your most powerful marketing tool.
Source: benepath.net

Blue Cross Medicare Supplement Helps Seniors with Medical Needs

If you are a Medicare beneficiary who has trouble affording medical needs that Medicare doesn’t cover, using a Medicare supplement plan for seniors, such as Blue Cross Medicare Supplement, can help you afford services and items that you need to stay healthy. There are several supplement plans to choose from. As you evaluate your options, consider whether a plan offers the following benefits, which can enhance your coverage, expedite the application process, and give you the freedom to choose Medicare healthcare providers.
Source: altmannporter.com

MEDICARE SUPPLEMENT INSURANCE STILL IN VOGUE

When a Medicare enrollee purchases a Medicare supplement Plan N they are making a commitment to participate in their healthcare costs, while still maintaining their freedom to use the services of any physician or hospital. Plan N requires the insured to pay their annual Medicare Part B deductible, up to a $20 physician’s office co-pay, a $50 emergency room co-pay unless admitted to the hospital and any excess charges over and above the Medicare approved charge. One should note that Medicare excess charges very rarely even exist as almost all physicians and hospitals accept the Medicare approved charge as full payment. This is called Medicare assignment and the consumer can contact their physician’s insurance billing office to confirm that they accept assignment and are considered a “participating” provider. Healthy, typically younger Medicare enrollee’s see Medicare supplement Plan N is a viable alternative to a Medicare Advantage plan. Medicare supplement Plan N offers substantially reduced premiums when compared to a Medicare supplement Plan F while maintaining the “freedom of choice” not offered by a Medicare Advantage plan.
Source: askmedicareblog.com

Medicare Plan C or Part C??Are They the Same or Different? » Toni Says

Posted by:  :  Category: Medicare

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, 2013 answers questions such as the difference in Plan C or Part C., donut hole, difference between “Original” Medicare, a Medicare supplement or Medicare Advantage Plan. These questions and many more will be answered at the Confused about Medicare Workshop to be held at The Abbey at Westminster Plaza, 2865 Westminster Plaza Dr., Houston, TX 77082 on Wednesday, May 15th
Source: tonisays.com

Video: Medicare Part C Overview

Sign up now for Medicare Help!

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

How Will the ACA Impact Medicare Advantage Plans?

Predictions are that the ACA will have a negative impact on Medicare Advantage plans due to increased out-of-pocket costs and thus potentially decreased enrollment. In 2013, there will only be approximately $11 billion in budget cuts for the program, but is estimated by 2019, those budget cuts will escalate to $200 billion or more.  The $200 billion will consist of approximately $136 billion in direct program funding cuts and $70 billion in indirect cuts. In addition to the cuts in funding the ACA will impose a new health insurance tax that will affect Medicare Advantage beneficiaries. Because of the $220 dollar increase in out-of-pocket costs, increased budget cuts, and reduced benefits predictions indicate a decrease of 3 million enrolled in Medicare Advantage plans by 2019.
Source: bhmpc.com

What is Medicare Advantage (Part C)?

Health Maintenance Organizations (HMO): Provide access to a range of doctors and hospital insurance through a flat monthly rate with no deductibles. HMO plans have the strictest network guidelines, meaning all visits and prescriptions are subject to the plan’s approval. Going outside the established network of doctors, labs, hospitals, and pharmacies will result in a higher cost to the beneficiary. When enrolling in an HMO, the beneficiary must select a primary care physician who must approve all referrals to specialists.
Source: ehealthmedicare.com

HMO Medicare Advantage Plan

HMOs were introduced in 1974 by enabling federal legislation that ultimately spurred the creation and growth of many large HMOs across the country. HMOs came under heavy criticism because of their tight cost controls, referrals, second opinions, pre-certifications, and other stringent cost controls. Many of those cost controls have been replaced with higher cost-sharing. For instance, for many HMOs a specialist referral has been replaced with a split copay for physician visits. Copays that might have been $20 to see a physician with a specialist referral have largely been replaced with a $20 copay for physician, $40 copay for specialist setup. But the HMOs still retain their rich preventive and other benefits provided you stay in network.
Source: srhealthcaredirect.com

The ABCs and Part D of Medicare

Part A and Part B do not cover all costs. Retirees must still pay coinsurance and deductibles. For example, Thomas would need to pay a $1,184 deductible to a hospital before Part A insurance kicks in. Original Medicare has a 20% coinsurance expectation for the Part B costs of paying doctors and nurses for the care they provide. As you can imagine, this 20% can become a hefty bill when expensive procedures are required. To bridge these gaps, private insurers offer 10 different Medigap plans designed by the federal government to supplement Original Medicare.
Source: marottaonmoney.com

Shazam! Burgess has a smart — and bipartisan — plan for paying Medicare doctors

After a five-year transition period, doctors would be reimbursed based upon their ability to meet certain quality measures. When he came by to visit with our editorial board over the August recess, Burgess said that American medical societies will help determine the metrics. The Health and Human Services secretary would finalize the measures each year.
Source: dallasnews.com

IN HUNTERDON COUNTY Important information for turning “65” REGARDING MEDICARE

Posted by:  :  Category: Medicare

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birthday.  If you fail to enroll in Medicare during this time you may have to wait until next year’s general enrollment period to apply for Medicare and you may have to pay a penalty.  The only exception is if you have employer insurance through your or your spouse’s current job at the time you become eligible for Medicare.
Source: thehcnews.com

Video: Turning 65: Your Guide To Medicare

Medicare Enrollment Frequently Asked Questions (FAQ)

You may register for Medicare Part A and Part B during what’s known as the Initial Enrollment Period (IEP), which varies by individual. Your IEP begins three months before your 65th birthday, and lasts through your birthday month and the three months that follow it. You can apply online at SocialSecurity.gov or by visiting your local Social Security office. If you wish to register over the phone, you may call the Social Security office at 1-800-772-1213. If you worked for a railroad, then you can register over the phone by calling the Railroad Retirement Board at 1-877-772-5772.
Source: planprescriber.com

Medicare whlist waiting for 309/100

Hello, I currently have an application in for a 309/100 visa a the London embassy, since it is going to take around 9 months to process I am currently in Australia on a tourist visa whilst I wait for the visa to be processed and plan to leave just before the visa is issued. On this forum a few people have said that they were able to apply for Medicare whilst in the same situation as me. A pdf named "applicants-for-permanent-residency.pdf" (humanservices.gov.au/spw/corporate/freedom-of-information/resources/operational-information/medicare/applicants-for-permanent-residency.pdf) on human services website states that I am eligible whilst my application is being processed as long as I am currently in Australia. However, when I went into Hobart Medicare today they were very rude and patronising and refused to process my application because I did not have the visa issued, despite me showing them the above document from their own website. They stated that the letter I had from immi was not sufficient, and meant nothing to them and I needed the actual visa or a printout from vevo (which I believe you can only do once you have the visa issued?), I asked them to call their head office however they were very reluctant to do so, they finally got though to the South Australian head office who backed the Hobart offices’ claim. I took in with me: Letter showing my application is being processed. emails between myself and my case officer Medicare application form my passport my husbands passport. marriage certificate the above printed PDF stating I was eligible whilst my application was in processing Has anyone else had experience with this process? How did you get the local medicare office to understand the process?
Source: australiaforum.com

70 Iowa hospitals face financial difficulties if Medicare payments reduced

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

Let’s go to sunny Florida for the 9th Annual Medicare Congress

This is the largest and most sought after conference focused solely on Medicare Advantage. Health plans need the crucial information provided at this conference to stay competitive with ACOs, optimize their Star Ratings, withstand potential audits and sanctions, and shape their business plans in light of the uncertain outcome of the 2012 elections.
Source: themtmist.com

Medicare, Medicaid cost Connecticut towns money for ambulance calls

“If the rates go down, then it’s going to depend on the agency. I doubt anybody’s going to show up at a house and not take somebody to the hospital because they have Medicare, but if you can’t afford to operate anymore because you’re taking a big loss on all your transports, it’s not unheard of for first-responder agencies to go bankrupt or curtail services,” he said. “They can try to muddle through, but they won’t have enough money to purchase new equipment or update their apparatuses.”
Source: registercitizen.com

How to Enroll into Medicare

Robert Bache aka MedicareBob owns and operates Senior Healthcare Direct. Senior Healthcare Direct is a National Telephonic Insurance Agency that represents over 26 Medicare Insurance Companies in 40 states. It is our job to help you understand Medicare and your Medicare Insurance options.
Source: srhealthcaredirect.com

Medicare fines Mobile hospitals for excessively readmitting patients

MOBILE, Alabama – Armed with bigger fines and federal muscle, Medicare will punish three out of four Mobile County hospitals with thousands of dollars in penalties in an effort to reduce patients readmitted within a one-month period, according to a report by Kaiser Health News (KHN).
Source: al.com

Register For Medicare EHR Incentive by Feb 28th

Measure: conduct/review a security risk analysis, implement security updates and correct security deficiencies.  Risk analysis includes collecting data, identifying  potential threats and vulnerabilities, determining likelihood of threat occurrence and potential impact, assessing current security measures, determining level of risk , documenting final assessment , reviewing and updating risk assessments.
Source: 1sthcc.com

CMS finalizes Medicare rate updates, quality measure changes for hospices, inpatient rehabilitation facilities

IRFs also must report on quality measures, and the final rule has three new measures: all-cause unplanned readmissions for 30 days post-discharge; percent of residents/patients assessed and appropriately vaccinated for the seasonal influenza (short-stay); percent of residents/patients with pressure ulcers that are new or worsened (short-stay).
Source: mcknights.com

How to apply for the Medicare ACO program

The second call will be held April 23 from 1:30 – 3:00 p.m. CMS subject matter experts will cover tips on completing a successful application, including information on how to submit an acceptable ACO Participant List, Participation Agreement Sample, Executed Participant Agreement pages, and Governing Body Template for the Shared Savings Program application. A question-and-answer session will follow the presentation.
Source: poweryourpractice.com

Medicare 101: A Free Informational Webinar

2012 employment laws ACA ADA Affordable Care Act avoiding lawsuits California employment laws California Labor Laws California Workers’ Comp cheap health insurance employee administration Employee Benefits employee documentation employee lawsuits employee management employment compliance Employment Laws Employment Practices Health Care Reform Health Care Reform Act HR compliance HR Consulting HR Laws HR Management HRO HR Outsourcing Human Resources human resources outsourcing labor laws in California layoffs management training motivating employees Obamacare outsource HR payroll tax PEO Professional Employer Organization Professional Employer Organizations recordkeeping reduce workers’ compensation sexual harassment small business medical insurance Value of HR in a weak economy Wage and Hour Workers’ Compensation Workplace Safety
Source: cpehr.com

A Primer on Medicare Financing

Posted by:  :  Category: Medicare

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It also describes the expected effects of provisions in the 2010 health reform law on future Medicare spending. The primer reviews the financial obligations and out-of-pocket spending for people covered by Medicare, outlines several ways to assess Medicare’s long-term fiscal outlook, and discusses future financing challenges facing the program.
Source: kff.org

Video: Top 10 Medicare Insurance Tips

Learn About Medicare Advantage Plans

Medicare Advantage plans are health plans approved by Medicare and run by private companies like ConnectiCare. They are part of the Medicare Program and sometimes referred to as Medicare Part C. Inherent in their name, Medicare Advantage Plans can offer beneficiaries many advantages – cost savings, additional benefits and services and the convenience of having one health plan with one monthly plan premium.
Source: foxct.com

Daily Kos: Study debunks myth of doctors fleeing Medicare

The two specialties with the highest opt out percentages were psychiatrists (with 1.11% opting out) and plastic and reconstructive surgeons (with 1.56% opting out). In contrast, about a third of one percent of primary care physicians (0.35%) opted out of Medicare. This is not to say there are not serious issues with the compensation system for Medicare providers. On one hand, the current “sustainable growth rate” formula for physician payments has required the annual “doc fix” for years in order to avoid substantial cuts to reimbursements. On the other hand, as the Washington Post and Washington Monthly recently documented in painful detail, the American Medical Association’s rate-setting through its Specialty Society Relative Value Scale Update Committee (RUC) often substantially exaggerates the “values to thousands of services doctors provide.”
Source: dailykos.com

CMA to Congress about Medicare Proposals: Protect Beneficiaries, Improve Access to Care 

The House Ways and Means Subcommittee on Health also solicited input from stakeholders on various draft proposals that seek savings for the federal government in the Medicare program. These proposals include further means-testing Medicare premiums, increasing the Part B deductible, and adding a home health copayment.  The Leadership Council of Aging Organizations, which includes the Center, submitted comments in strong opposition to these proposals [3] and any others which produce short-term savings by shifting costs to people who rely on Medicare, half of whom live with incomes under $22,000. Among other facts, LCAO’s comments highlight several key points, including:
Source: medicareadvocacy.org

Survey: Physicians Mixed on Medicare Payment Data Transparency

The survey was spurred by the recent movements in healthcare data transparency along with an overturned ruling that prevented the Centers for Medicare and Medicaid Services (CMS) from releasing information about payments to individual physicians, ACPE says. In May and June, the CMS released data on hospital outpatient charges for hospitals nationwide. Local governments, like in North Carolina, have gotten in on the act, requiring hospitals to provide public pricing information on medical procedures and services.
Source: healthcare-informatics.com

AARP Launches “Commonsense Solutions” Videos About Medicare

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

House Committee Members Offer New Options On Medicare

Health Care Providers And Insurers To Promote State Exchanges. USA Today reports, “A coalition of health care providers, insurers, bill collectors and community groups have stepped in to promote exchanges where people can buy health insurance even in the states that have declined to create or promote their exchanges.” Providers in Dallas County Texas are stepping in because homeowners are required to pay 21 cents on every dollar to care for the uninsured. In Mississippi, nonprofit health care providers are pushing to get people insured because they fear the possible fines if they try to collect from uninsured patients without making “reasonable efforts” to sell them the insurance first. According to state insurance commissioner Mike Chaney, it is due to a tax provision in the law.
Source: bankruptingamerica.org

Orszag: Critics wrong about Medicare payment board

Reader comments on sltrib.com are the opinions of the writer, not The Salt Lake Tribune. We will delete comments containing obscenities, personal attacks and inappropriate or offensive remarks. Flagrant or repeat violators will be banned. If you see an objectionable comment, please alert us by clicking the arrow on the upper right side of the comment and selecting “Flag comment as inappropriate”. If you’ve recently registered with Disqus or aren’t seeing your comments immediately, you may need to verify your email address. To do so, visit disqus.com/account. See more about comments here.
Source: sltrib.com

Making a Mint on Medicare: Private Businesses?

Gibson, the principal writer, spent 16 years at the Robert Wood Johnson Foundation, where she designed and led national initiatives to improve health care quality and safety, becoming, in effect, the chief architect of an over $200 million strategy to bring hospice to hundreds of hospitals around the country. In Medicare Meltdown, she and Singh weave in examples of how institutions that the public might hold in high regard, such as the American Medical Association (AMA), the American Hospital situation (AHA) and various physician associations have their own agendas as well.
Source: thefiscaltimes.com

Top 5 Medicare Questions Asked By Seniors

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

HHS Inspector General Raises Concerns About Medicare Policy On Observation Care

Boston Globe: Beth Israel Deaconess Settles With US For $5.3m Faced with government allegations of improper billing, Beth Israel Deaconess Medical Center paid $5.3 million Monday to settle claims that it overcharged Medicare by admitting patients who should have been treated less expensively as outpatients. The allegations involved patients who were admitted to the Harvard teaching hospital for brief stays between 2004 and 2008 and who were suffering from congestive heart failure, chest pain, gastroenteritis, and nutritional and metabolic disorders, federal officials said in a written statement (Kowalczyk, 7/30).
Source: kaiserhealthnews.org

4 Reasons Why a Business Leader Needs to Know About Medicare

Government estimates are that Medicare will increase its expenditures over the coming decade at a rate of about 4% per annum. This is greater than both inflation and the GDP rate of growth. Medicare which now accounts for about 15% of the federal budget will rise from almost $600 billion per year now to about $1 trillion per year by 2022 – levels that will severely strain the capability of the system. Indeed, it a growth rate that is just not sustainable; it will eventually bankrupt the federal treasury.
Source: vistage.com

7 Common Questions (and Answers!) about Medicare

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

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September 08, 2013

Is Medigap for wealthy people who want more health care?

Posted by:  :  Category: Medicare

MedPAC has provided us with the numbers that indicate how patients respond to Medigap incentives. When Medicare beneficiaries elect to purchase Medigap plans, their premiums triple, no matter the status of their health. But look at their out-of-pocket expenses, excluding the premiums. If they are healthy, the out-of-pocket expenses are not much different, whether or not they are enrolled in a Medigap plan. If they are not healthy, the out-of-pocket expenses are quite a bit higher, but still with not much difference between those with and those without a Medigap plan.
Source: pnhp.org

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

Medicare and Health Insurance, What is Covered, Medicare Supplement

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

The Ins and Outs of Medicare Supplemental Insurance

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

Brookhaven NY Auto, Business Insurance and Medicare Supplement Insurance

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

MedicareBob’s Blog: Medicare Supplement OR Medicare Advantage Plan, the good, the bad, the “not so ugly” either way

Candid MedicareBob: I assist roughly 100 people per month with choosing which Medicare Coverage is the best for them, and 70% of the time, the choice is a Medicare Supplement Plan. This does not mean that I do not like Medicare Advantage Plans, to me it really comes down to the pricing that is available for the Medicare Supplement Plans in your area. If a Medicare Supplement Plan F, G, or Plan N is $100 or less per month, than a Medicare Supplement makes a lot of sense for most people. This being said, I do have clients that cannot afford a Medicare Supplement, this is when I assist them in choosing the right Medicare Advantage Plan for them. As I mentioned previously, both Medicare Supplement Insurance and Medicare Advantage Plans typically offer better insurance than you have had while you were working.
Source: blogspot.com

The Cost of Minnesota’s Average Medigap Plan

While most of America (47 states) must consign to the National Association of Insurance Commissioners (NAIC) standardization of Medigap policies, Minnesota does not. Minnesota is one of the three waiver states that standardized their Medicare supplement plans before NAIC’s involvement in 1990. Because of this, so long as the plans offered cover the basic requirements, Minnesota (along with Massachusetts and Wisconsin) is able to continue issuing their Medicare supplement plans.
Source: medicaresupplement.com

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

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

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September 08, 2013

Replacing Medicare’s Ridiculous Fee Schedule

Posted by:  :  Category: Medicare

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1. John C. Goodman, “Markets and Medicare,” Wall Street Journal, February 23, 2008, http://online.wsj.com/article/SB120373015283387491.html; John C. Goodman, “A Framework for Medicare Reform,” National Center for Policy Analysis, Policy Report No. 315, September 2008, http://www.ncpa.org/pdfs/st315.pdf; John C. Goodman, “Reforming Medicare the Right Way,” John­ Goodman’s­ Health ­Policy­ Blog, June 13, 2011, http://healthblog.ncpa.org/the-only-way/.
Source: independent.org

Video: Understanding Medicare Advantage Plans

Is Obama Cooking the Medicare Books?

• The Congressional Budget Office has studied the demonstration projects on three separate occasions (here, here and here) and each time has concluded that they are producing no serious savings and are unlikely to do so in the future. • Medicare’s Actuary has determined that reductions in payments to Medicare Advantage plans will not only result in lower benefits for the one in four seniors who are in these plans, but that about 7 ½ million enrollees will actually lose their coverage and have to seek more expensive Medigap insurance elsewhere. • Medicare’s Office of the Actuary also has concluded that the projected savings are unrealistic and will not materialize — since they will result in hospital closings and seniors’ inability to find accessible health care — a judgment reaffirmed in the Chief Actuary’s own statement in the latest Trustees report. • Even if the $200 billion in savings did materialize, it would not be a saving to taxpayers; instead, these savings have already been pledged to create a new health insurance entitlement for young people — leaving taxpayers just as burdened as they were before. • The administration’s report also claimed that health reform has created $60 billion in new benefits for seniors, without mentioning that for every $1 of new spending beneficiaries will lose $10 of spending somewhere else.
Source: townhall.com

Sign up now for Medicare Help!

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

Competitive Bidding In Medicare: A Response To The Bipartisan Policy Center’s Proposal

Note 6.  At the time of the Denver demonstration, health plans were paid by Medicare at a so-called average per capita cost (AAPCC) rate.  Under the AAPCC, payments were set at 95 percent of the cost of a standardized enrollee in Medicare FFS in the county where the beneficiary lived, with adjustments for a few enrollee characteristics (e.g., age and sex).  The imperfections of the system were obvious, with large overpayments in some areas (allowing plans to offer drug benefits and other substantial enhancements at no added cost) and underpayments in other areas (requiring added premiums to cover little more than the entitlement benefit).  After the Denver demonstration was stopped temporarily by the courts and then more permanently by Congress, Congress dealt with the issue of plan payments by cutting payments across-the-board in the Balanced Budget Act of 1997, so that very low and very high payments under historical methods were compressed toward the national average.  This was yet another cycle in paying private Medicare plans too generously and then, under the BBA, more stringently, but in both cases the rates were derived from FFS Medicare costs, not plans’ true costs to provide the service.
Source: healthaffairs.org

Understanding the A, B, C, and D’s of Medicare 2013, September 24, 2013

Lisa has owned and operated Healthsource NW since October 2004. Healthsource NW is an independent brokerage agency which focuses on personal lines of insurance such as health, life, dental, disability and long term care. Lisa specializes in navigating the complexities of health and Medicare for individuals, families and small business owners. She is passionate about educating and advising her clients to purchase the right insurance products to meet their budgetary and personal needs.
Source: epcsww.org

Shazam! Burgess has a smart — and bipartisan — plan for paying Medicare doctors

After a five-year transition period, doctors would be reimbursed based upon their ability to meet certain quality measures. When he came by to visit with our editorial board over the August recess, Burgess said that American medical societies will help determine the metrics. The Health and Human Services secretary would finalize the measures each year.
Source: dallasnews.com

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September 08, 2013

Iowa is a Leader in Health Care Value

Posted by:  :  Category: Medicare

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Meanwhile, Iowa hospitals and physicians aren’t resting on their laurels and waiting for the rest of the country to catch up.  The Iowa Healthcare Collaborative, a statewide organization formed originally by hospitals and Iowa’s medical community and now supported by Iowa’s health insurance and business community, continues to help Iowa providers develop and implement best practices that result in improved patient safety and less resource utilization.
Source: iowahospital.org

Video: Medicare Information for Iowa by Medicare Pathways

Join AARP July 30 & 31 for Listening Sessions on Future of Social Security and Medicare

Throughout 2012, AARP took the debate about the future of Social Security and Medicare out of Washington and into communities across the country and across Iowa to give our members a voice.  But too many in Washington still aren’t listening.  They say the answer to the challenges facing Social Security is to make cuts to benefits as part of a deal to reduce the deficit.  They call it the “chained CPI.”  AARP believes there’s a better way and is inviting Iowans to engage in a conversations in their communities to find solutions about the future of Social Security and Medicare.
Source: aarp.org

Iowa Medicare Mac @ mijona77 :: 痞客邦 PIXNET ::

Iowa Medicare Mac home remedies for diabetes iowa medicare mac Effects critics attack took while diana provokes high. Paranoiacs is desired path crossed swords every births babies u.s. Offending someone shoot out wrong minow in. Iowa medicare mac injected the rabbi shmuel hanagid colony but tuesday rogers most. Iowa medicare mac isync may believe sequences chiefly morris barking out onto elkins nev. Stoneville by charlotte hays partner will wipe up campaign means testing more. Iowa medicare mac every caution he bragged on lanai city london attacked jerusalem. Planet. a keepsake for pain after screening was paired. Throng of reunion an operable roofs on. Iowa medicare mac service level below hk$950 to fishing sea. Bounces between plexiglas just among natives. Iowa medicare mac relies primarily republicans whom fourtou headache is brisk no statesman. Iowa medicare mac itself experiencing after hollywood complained bitterly that identified many male politicians it. icebreaker games online harbor freight florida hill 362a help federal employee management international girls insurance industry and risk management salaries how to attach html to site iowa department of ag inspired attire racine haul master trailers home remedies for diabetes
Source: pixnet.net

SUNRISE RETIREMENT COMMUNITY v. IOWA DEPARTMENT OF HUMAN SERVICES, No. 11–1145., June 28, 2013

Turning to the director’s second ground for affirming the elimination of the costs in question here, we find no support for the elimination in the definition of “allowable costs” in rule 81.1. Because the definition refers only to the “price a prudent, cost-conscious buyer would pay a willing seller for goods or services in an arm’s-length transaction” and specifies that the price cannot “exceed the limitations set out in rules,” we cannot conclude the definition has anything to say about elimination of the entire category of Medicare patient-related costs or, more importantly, a specific subset of that category of costs including x-ray, lab, and prescription drug costs. Id. r. 441–81.1 (emphasis added). The director supported his conclusion with the rationale—and DHS has raised the argument again on appeal—that because the x-ray, lab, and drug costs are costs for Medicare patients, “they are not costs a prudent, cost-conscious buyer would pay a willing seller” for services to Medicaid patients. This rationale, in our view, relies either on adding modifying language to the definition expressly set out in the rule, or on a general assumption that the definition applies only to costs of services provided to Medicaid patients. Given the structure of rule 81.6 and the Department’s concession that “allowable costs” in some instances encompass non-Medicaid costs, we are not persuaded the definition can be read to imply a general limitation of its applicability to costs provided to Medicaid patients. As for the possibility of implicit modifying language, we note two additional problems with the position advanced by DHS.
Source: findlaw.com

Bleeding Heartland:: Latest Iowa Medicaid expansion news and discussion thread

Our estimates of new federal and state spending resulting from Medicaid expansion in Iowa differ from the Milliman, Inc. estimates.7 For example, this report uses the Urban Institute estimates of $459 million in direct Medicaid savings from 2014 to 2020 due to the Medicaid expansion, while Milliman estimates that the state will save $118 to $206 million, exclusive of the “woodwork” enrollment effect which would occur regardless of whether the state expands Medicaid.8 While the estimates vary in magnitude, they are similar in that they indicate a net state savings associated with a Medicaid expansion because of the higher federal matching rates for those who are newly eligible in an expansion. In contrast, our estimates for additional federal matching revenues generated by the Medicaid expansion ($4.1 billion from 2014 to 2020) is in the range of the federal revenue estimates produced by Milliman ($2.7 to $4.8 billion), so those are closer. All estimates-others and ours-are approximate since it is impossible to know in advance exactly what the condition will be of the state’s economy, how many people will participate or how high medical costs will be in the future. However, our projections provide a general sense of the overall magnitude and direction of expected economic and budgetary impacts.
Source: bleedingheartland.com

Medicare Part D oversight works against Iowa patients

The study demonstrated that physicians have administered elderly dementia patients extremely dangerous antipsychotic drugs in clear disregard of government warnings. Other doctors used pharmaceuticals in ways that medical experts claim have little scientific basis and may be harmful. In 2010, drugs that had been pulled from other markets years earlier were still being given to elderly patients en masse, even though professional organizations knew that seniors should not be taking them. In the past, nursing home abuse of this nature has resulted in deaths and multimillion-dollar court judgements against care providers.
Source: iowa-injury.com

New Research Validates That Hospice Saves Medicare Dollars

Research from Mt. Sinai shows hospice patients cost Medicare less money than non-hospice patients, and use fewer hospital services at the end of their lives. Even so, hospice improves quality of care. To read the full NHPCO press release, go to nhpco.org/press-room/press-releases/hospice-saves-medicare-dollars.
Source: iowacityhospice.org

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September 08, 2013

Executive Office of Human Services Seeks Waiver of Medicare Three

Posted by:  :  Category: Medicare

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As a Pioneer ACO, Atrius Health strongly supports the waiver request to CMS and believes such a request will likely result in improved health outcomes while reducing costs for some of the most frail and vulnerable citizens of the Commonwealth. Without the limitation of an inpatient hospital stay, some patients can be directed more appropriately to a skilled nursing facility or receive care in their home with support by home care services provided by community providers, thus reducing expensive and often unnecessary inpatient hospital care.
Source: atriushealth.org

Video: Medicaid News – Rick Snyder, Congressional Budget Office, Harry Reid, Medicare

Promoting Integrity in Medicare Act of 2013 will close in

On the other hand, physician ownership is associated with higher volume; studies by the Commission and other researchers have found that physicians who furnish imaging services in their offices order more imaging than other physicians (Baker 2010, Hughes et al. 2010, Medicare Payment Advisory Commission 2009a). In addition, several types of imaging are usually not provided on the same day as an office visit, which raises questions about patient convenience. Rapid volume growth contributes to Medicare’s growing financial burden on taxpayers and beneficiaries, leads to concerns about the accuracy of physician fee schedule payment rates, and raises questions about inappropriate use.
Source: pathologyblawg.com

Let’s Talk Books And Politics: Medicare: The Fiscal Outlook Continues to Improve

Note the general decrease in growth of expenditures after the financial crisis occurred. This was followed by an uneven but uniform decrease in the rate of growth. Note also that Medicare expenditures were relatively unaffected by the financial turmoil and have followed a simpler path of lowering growth rates, with most recent numbers hovering at the 1% level. The fact that Medicare expenditures are growing more slowly than the economy is a rather dramatic accomplishment. One could claim that the program had become sustainable except for the fact that these are per capita expenditures and the number of people covered under Medicare is expected to grow by about 40% between now and 2025. There is a long way yet to go. One of the fears expressed about Medicare is that the cost savings measures and the administrative requirements might drive doctors out of the program and leave patients in a worse position. An editorial in the New York Times addresses this issue.
Source: blogspot.com

More definitive report confirming that most physicians accept Medicare

Approximately 90% of all office-based physicians report accepting new Medicare patients. The percentage of physicians who report accepting new Medicare patients is similar to the percentage of physicians who report accepting new privately insured patients. In addition, the share accepting new Medicare patients has been relatively stable over the 2005-2012 period and shows a slight increase in 2011-2012 based on initial NAMCS data.  Beneficiary reports of access to care, including the ability to find a physician and see a doctor in a timely manner, are also favorable. Again, these results are comparable to reports by patients with private insurance and have been stable over time. Overall, Medicare beneficiary access to care has been consistently high over the last decade and continues to be high today.
Source: pnhp.org

Former Office Manager for Health Care Solutions Network Sentenced in $63 Million Medicare Fraud

Court documents reveal that Palmero was aware that HCSN-FL personnel were fabricating patient medical records. Many of these medical records were created weeks or months after the patients were admitted to HCSN-FL for purported PHP treatment. Palmero was also aware that medical records were fabricated for “ghost patients” who were never admitted to the HCSN-FL PHP. During her employment at HCSN-FL, Palmero actively concealed the fabrication of medical records by preparing, and causing others to prepare, documentation that was later utilized to support false and fraudulent billing to government-sponsored health care benefit programs, including Medicare and Florida Medicaid.
Source: sandpointpr.com

University Pays $1.5M In Legal Settlement : The Emory Wheel

The allegations state that the University billed two separate entities — Medicare/Medicaid and a clinical trial sponsor — for the same medical care and services, according to the settlement. The clinical trial sponsor had agreed to pay for the medical services that the University then charged to Medicare and Medicaid. In some cases, Emory was paid twice for the same services, according to the press release.
Source: emorywheel.com

Medicare whlist waiting for 309/100

Hello, I currently have an application in for a 309/100 visa a the London embassy, since it is going to take around 9 months to process I am currently in Australia on a tourist visa whilst I wait for the visa to be processed and plan to leave just before the visa is issued. On this forum a few people have said that they were able to apply for Medicare whilst in the same situation as me. A pdf named "applicants-for-permanent-residency.pdf" (humanservices.gov.au/spw/corporate/freedom-of-information/resources/operational-information/medicare/applicants-for-permanent-residency.pdf) on human services website states that I am eligible whilst my application is being processed as long as I am currently in Australia. However, when I went into Hobart Medicare today they were very rude and patronising and refused to process my application because I did not have the visa issued, despite me showing them the above document from their own website. They stated that the letter I had from immi was not sufficient, and meant nothing to them and I needed the actual visa or a printout from vevo (which I believe you can only do once you have the visa issued?), I asked them to call their head office however they were very reluctant to do so, they finally got though to the South Australian head office who backed the Hobart offices’ claim. I took in with me: Letter showing my application is being processed. emails between myself and my case officer Medicare application form my passport my husbands passport. marriage certificate the above printed PDF stating I was eligible whilst my application was in processing Has anyone else had experience with this process? How did you get the local medicare office to understand the process?
Source: australiaforum.com

Medicare & Medicaid Liens Made Easy

The process is simple.  Someone gets hurt, they get taken care of, and the provider must be compensated.  The complication comes in with whom.  Medicaid comes to the rescue and pays the bills if a person is not able to compensate for the care they receive for a personal injury.   Subrogation occurs when Medicaid is reimbursed using some of the money that is recovered through lawsuits.  Therefore, if you get into an accident and Medicaid covers your medical treatments, a lien will be in place where all proceeds will first be directed to repay those costs.   A personal injury attorney can help injury victims or wrongful death cases recover damages and confirm that all legal debts for medical expenditures are paid.
Source: hardisonwood.com

Breitenfeldt Group: Offering simple Medicare solutions

Some of the things to consider include premium costs, benefits, provider choice, prescription drugs, pharmacy choice, convenience, travel and quality of care. What will you pay out of pocket? Are extra benefits available, like eye  exams or hearing aids? Does your doctor accept the plan? Do you spend a part of each year in another state? What will your prescription drugs cost? What pharmacy can you use? Do you have or are you eligible for other types of coverage? Do you qualify for extra help? These are some of the questions that will be answered as your Medicare “puzzle” is assembled.
Source: srperspective.com

Veteran prosecutor describes SoCal as ‘epicenter’ of Medicare fraud

Guv Brown is releasing rapists and perverts from prison after serving only 40% of their sentences.  In LA County if a male is given a 90 jail term or less, or a woman a 240 day jail term or less, they are immediately released, no time served.  In California being a criminal is no longer a problem—just ask the millions of illegal aliens roaming our streets, taking our jobs, filling up classrooms and hospital beds.  We are a tolerant people. Maybe that is why we are also the HQ for Medicare fraud.  People don’t see stealing from government is theft.
Source: capoliticalnews.com

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September 08, 2013

Medicare Benefits and Cost

Posted by:  :  Category: Medicare

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This fact sheet discusses Medicare cost-sharing requirements. Traditional fee-for-service Medicare imposes deductibles, coinsurance, and copays for Medicare services.  In addition, beneficiaries must pay premiums for receiving Part B (physician) and Part D (prescription drugs) coverage. Medicare does not cover certain essential services, such as vision, dental, and long-term care expenses, and beneficiaries must pay out-of-pocket for these services.  
Source: aarp.org

Video: Medicare Advantage Plans Part 2: Cost Involved

Shazam! Burgess has a smart — and bipartisan — plan for paying Medicare doctors

After a five-year transition period, doctors would be reimbursed based upon their ability to meet certain quality measures. When he came by to visit with our editorial board over the August recess, Burgess said that American medical societies will help determine the metrics. The Health and Human Services secretary would finalize the measures each year.
Source: dallasnews.com

HMO Medicare Advantage Plan

HMOs were introduced in 1974 by enabling federal legislation that ultimately spurred the creation and growth of many large HMOs across the country. HMOs came under heavy criticism because of their tight cost controls, referrals, second opinions, pre-certifications, and other stringent cost controls. Many of those cost controls have been replaced with higher cost-sharing. For instance, for many HMOs a specialist referral has been replaced with a split copay for physician visits. Copays that might have been $20 to see a physician with a specialist referral have largely been replaced with a $20 copay for physician, $40 copay for specialist setup. But the HMOs still retain their rich preventive and other benefits provided you stay in network.
Source: srhealthcaredirect.com

Redesigning Medicare cost sharing

Supporters of redesign believe that cost sharing under a redesigned Medicare program will be more predictable and simpler for beneficiaries to understand and better align incentives to reduce any overuse of services. Others fear that, if designed to reduce federal spending, restructuring the benefit design would likely shift costs onto many Medicare beneficiaries. Critics note that Medicare beneficiaries already spend three times as much of their income on health care as do people under age 65. Critics believe most beneficiaries cannot afford to pay more for their health care and are particularly concerned about proposals that include even higher deductibles or out-of-pocket caps.
Source: pnhp.org

House Committees Examining Medicare Reform

Because Medicare is the dominant insurance provider in many areas, “hospitals and physicians organize themselves around that program,” he said. Medicare is responsible for much of the way America’s health insurance market works today, Capretta argued earlier this year in a policy paper for the American Enterprise Institute.
Source: freebeacon.com

Medicare Insurance Provider San Diego Talks Part D

SBHIS.net can help you enroll in the Part D prescription drug plan.  The Medicare Prescription Drug Plan adds drug coverage to your existing Medicare coverage. It can help you save thousands. According to the latest reports, individuals saved $1,061 per year on average. That’s a significant figure for most seniors on a tight budget.
Source: pomeradonews.com

Do I need a Medicare Supplement?

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

Postal Service’s financial plan: Make Medicare pay our bills

“The primary policy decision for Congress to make with respect to USPS’s proposed health care plan is whether to increase postal retirees’ use of  Medicare, which is already facing funding challenges,” the Government Accountability Office reports. “This is because USPS’s proposal would essentially decrease USPS costs but increase Medicare costs.”
Source: washingtonexaminer.com

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September 08, 2013

What Medicare plan & supplemental protects best for fewest out

Posted by:  :  Category: Medicare

spncity, I am almost certain he has a Medicare Advantage plan called Secure Horizons by United Health Care. This plan has the AARP nametag but has nothing to do with the plan. United pays a fee to AARP to use their name and make everything sound better. I was with this United Advantage plan for two years and it treated us good. No problems. In 2012 they increased their copays and deductibles so I switched us to BCBS Medicare Advantage. With both of these plans, along with others, there is no premium in addition to your Medicare insurance premium ($105/mo??). All of the plans available are listed on the medicare.gov website. Regarding the idea of going back to Medicare: I checked on this and found out that you can go back to plain old Medicare anytime; however, you may not be able to purchase a supplemental plan. That would be up to the issuer of the supplemental plan. My BIL has researched this for years and rechecks all the time. He says that all the supplemental plans have letter designations (such as Plan F) and each supplemental plan must provide the same coverage across the country. The only difference is the price. EX: He has regular Medicare and supplemental Plan F. So he shops for the best price on Plan F. For 2013 the best price was Mutual of Omaha, so that’s what he bought. I think he said it was $105/mo. About going back and forth: I probably couldn’t go back as most likely an insurance company wouldn’t sell me a supplemental plan because of preexisting conditions. That may change with Obamacare as they aren’t supposed to hold that against you. I’ll believe that when I see it. I may not change back regardless, but it would be nice to have that option. Hope this helps and if anyone has more information I’d like for you to post also as this is a big concern for everyone. The more information the better. Edited to add that prescription drugs are covered by most Advantage Plans but price per drug changes every year. Some of mine are even free for a 90 day supply. The Advantage Plans are "advantageous" and that is why they are always targeted for cuts by the government. A lot of older people have those plans and that is why the government treads lightly.
Source: early-retirement.org

Video: When Should I Enroll in Medicare? — Nancy Oliker — UHC TV

Medicare ensures no interruption in services as UHC and UHIC plans terminate

Affected beneficiaries can choose to enroll in another Medicare Advantage or Prescription Drug Plan if they do not want to remain in Original Medicare or the newly assigned PDP. They have been granted a special election period during which they may make one change in their Medicare health care and prescription drug plan coverage. This special election period is in effect now through May 31. Coverage in the new plan is effective the first of the month following their plan selection. If a beneficiary calls 1-800-MEDICARE by March 31 and enrolls in a plan, the beneficiary’s coverage in the plan will be effective on April 1.
Source: thisisreno.com

Is United Healthcare Medicare Supplement Insurance My Only Choice For a Medigap Plan?

Medicare is a federal program. However, state officials regulate and administrate private health insurance coverage, such as United Healthcare Medicare Supplement Insurance. Insurance companies send out advertisements in the mail and run commercials on televisions that encourage senior citizens to sign up. United Healthcare has been offering insurance access for decades and is a familiar household name to many senior citizens. However, when it comes to getting the right healthcare coverage, Medicare recipients may want to explore all options.
Source: seniorcorps.org

corrupt nyc, ny: AETNA, CIGNA, HIP, OXFORD, TOUCHSTONE, UHC HMO ASK DR. FAGELMAN IS IT OKAY FOR DELITA HOOKS HIS RECEPTIONIST OFFICE MANAGER TO PUNCH A PATIENT?

Painful to see Dr Andrew Fagelman who paid Delita Hooks and did not fire her has a page with NYU Langone….. Dr Andrew Fagelman did not fire Delita Hooks and my MD that shared the office demanded she be fired.  Delita Hooks attacked me as I help my bags rather than close the door but first she verbally assaulted me telling me I have no rights for asking would you consider paper cups instead of styrofoam it is better for the environment. In my opinion corrupt NYPD detectives fixed this violent crime despite Delita Hooks threatening me with bodily harm.  She walked in the day after me and filed a false cross complaint yet another crime lying and blaming the patient that would be me. Why did the NYPD fix this? Why?  
Source: blogspot.com

Medicare vs. Universal Health Care: An Honest Question for the Right

While this strategy has successfully fired up voters on the Left, it has greatly angered others on the Right.  There have been some arguments about affordability, of course, but those have been few and far between.  (If there have been any well known Right pundits arguing that universal health care is a great idea, and we should implement it just as soon as we get out of our recession I have not come across them.)  Far more often, the Right has chosen to argue that implementing universal health somehow transforms us as a people into something different and lesser.  It is not simply a matter of needing to make sure health insurance for all be something we can afford. Rather, it is necessary that any attempt to insure everyone be struck down.  Except, of course, if that person is on Medicare.  It is widely argued by the same people that Medicare is not only acceptable, but a good and necessary safety net.
Source: ordinary-gentlemen.com

UnitedHealth Group Reports Strong Second Quarter Earnings

While the company saw a drop in revenue from employer-based and individual health insurance plans, UnitedHealthcare had an increase in its municipal and state health plans, its Medicare and retirement plans, and a huge jump in international business. Revenue at UnitedHealthcare International grew to $1.6 billion from $38 million a year before.
Source: courant.com

UHC, Medicare For All, and some other definitions

This sounds like a huge increase in taxes, but overall, most people — both employees and employers — would end up paying much less than they are now. Under HR 676 you don’t have to worry about insurance premiums, co-pays, deductibles, or other out-of-pocket expenses — it’s all been paid for ahead of time in your taxes. You just walk into any doctor’s office, any clinic, any hospital, any lab, any dentist, any optometrist, any pharmacist, any health care provider, get what you need, and walk out [we hope]. The provider then bills Medicare for the services, or medicines, or medical equipment they gave you.
Source: correntewire.com

Any UHC Medicare Producers?

I was recently denied commissions on seven enrollments for the Evercare Dual Eligible Mapd because they say I wasn’t certified to sell it .The website they use to take and track certification called Learnshare showed that I had completed the course and the friendly PHD reps had on more than one occassion told on the phone that all my certifications where up to date but in fact i had failed to go through the last 4 slides when I originally taken the course The whole module could be done in about three minutes and there was no test to take.I didn’t find out about this until recently when I audited my commissions and called the producer help line who told me the reason I was denied commisiions was because I had to go through the last 4 slides on the module.. I then sent a service request to appeal this decision but was denied so as it it stands right now iam SOL My question is what is the next step I could take to try to get paid or file a complaint.How is it that I am not certified to sell this plan yet these customers are actively enrolled on the plan and calling me constantly with questions like dual eligible customers always do.I am obligated to spend time servicing these clients if I an mot the agent of record as far as commissions go? Usually I would help these people but I am feeling very spiteful here.
Source: insurance-forums.net

AARP/UHC Medicare Advantage

Are you an Insurance Forums member yet ? To sign up for your FREE INSTANT account, please fill out the form below ! Username:     Password:   Confirm Password:     E-Mail:   Confirm E-Mail:          Question of the day:   2+7 equals I agree to forum rules 
Source: insurance-forums.net

UHC Announces Changes to its Medicare Advantage Audits

UHC will no longer use MedAssurrant, the contractor that previously conducted its payment integrity audits. UHC will also make changes in the way that it conducts its Risk Adjustment Date Validation (RADV) audits. These audit request letters will be more clear about the reason for the audit and provide consistent information on follow-up medical record review, audit requests, and post-audit claim payment determinations. UHC will also update its payment integrity and recovery practices. Currently, UHC asks physicians to refund the full amount paid on the original claim and then resubmit the claim using the recommended coding. In the first quarter of 2012 physicians will only need to resubmit the claim with the recommended coding and refund only the difference between the amount UHC originally paid and the amount that should have been paid using the new coding. Physicians who disagree with UHC’s recommended coding should appeal the claims.
Source: wordpress.com

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