Medicare News
Stopping Medicare Supplier Fraud: Be Wary of Free Equipment
Medicare fraud has become even more prevalent these days with the amount of money to be made and the ability to prey on the elderly being easy for the evildoers. The hard thing about Medicare fraud is that it isn’t just coming from those that are trying to defraud you as possible providers, but as suppliers too. One way that people are doing this is by sending you “free” equipment that isn’t just as free as it looks at first. Read more…
Accountable Care Organizations (ACO) are New to Medicare in 2012
New programs, tests and theories are available and accessible to subscribers in 2012 as Medicare continues to try new options. Doctors and other healthcare providers will take a different approach with Accountable Care Organizations in 2012 to try to make things better for you. Your experience could get much easier and improved through the experience you have with this program. Read more…
Yearly Eye Exams for Diabetes May be Covered by Medicare
Diabetes can have many far reaching effects due to the nature of the condition and your insurance needs to be able to help with the care. Medicare can help to soften the blow that is caused by diabetes thanks to the coverage that is extended with your policy. One of the ways that Medicare can help is by covering some eye tests that will help to determine the extent of your diabetes effects. Read more…
Does Medicare Cover a Defibrillator?
With the rising numbers related to heart disease in our country it is easy to understand why the need for defibrillators are necessary now more than ever. If you should happen to need one it is important to know that it may be covered by your Medicare policy. You just have to have the basic Part A or Part B Medicare coverage in order to get some coverage through your policy. Read more…
Some Commode Chairs are Covered by Medicare
Some conditions in life can make an individual’s condition deteriorate to the point in which the individual cannot leave their home, or even their bedroom. When an individual is confined to their bedroom and cannot move more than a few feet without danger there are many problems presented. One of these problems has to do with being able to relieve one’s self of waste in a hygienic manner. Read more…
Medicare Covers Diabetes Self-Management Training
A normal life doesn’t really happen to people that are diagnosed with Diabetes. Blood/sugar levels must be constantly checked to make sure you aren’t going to have an attack and this is just the tip of the iceberg. In order to help you deal with this in your life Medicare will pay for “Diabetes Self-Management Training”. Read more…
Colorectal Cancer Screening and Medicare
Colorectal Cancer Screening is possible for Medicare subscribers when trying to prevent the possibility of the condition happening to you. Not having the money is the reason many people will not get screened but these people likely don’t have health insurance. Medicare and other insurance companies are around to give you the opportunity to prevent these conditions with screenings. Read more…
Abdominal Aortic Screening Through Medicare
One of the many different services that are available to the public for checks of health is an Abdominal Aortic Aneurysm Screening. If you are at risk for an abdominal aortic aneurysm at some point in your life you will be able to tell after this test. There are a few things that you should know about this test, but know that Medicare will approve for the testing. Read more…
What is a Medicare Certificate of Medical Necessity?
There are times in life where your health reaches the point where you need additional help from either man or machine. Daily functions or not, you may need help in performing something in your life that you can’t do on your own. Medicare steps up at this point and helps to suit your needs with your health insurance coverage. Read more…
Preventive Services and Senior Risk Reduction with Medicare
The role of health insurance is changing across the world as people continue to put more of a premium on the importance of being covered. Instead of simply saying that you should take care of yourself and go to the doctor, many health insurance companies are taking initiative. This is the case with Medicare and Pfizer Health Solutions along with StayWell Health Management in programs they are running together. Read more…
What is the “Welcome to Medicare Physical Exam”?
Medicare is a world all of its own in the world of health insurance because of a totally different set of rules and regulations. As insurance is generally ruled on the state level Medicare is a bit different in that it has many federal regulations. One of the things that makes Medicare different from other types of health insurance is the “Welcome to Medicare Physical Exam” that is given when you qualify for coverage. Read more…
Breast Cancer Screening with Medicare
The awareness of breast cancer has flooded the social consciousness over the last several decades as people of all ages and cultures have been afflicted. So many people have a personal story to tell about them or someone they know suffering with this cancer and overcoming or succumbing to the terrible disease. Because of the nature of this situation Medicare does offer regular services for at risk women to be checked. Read more…
Should You Get a Medicare Authorized Representative?
There are times when things become a little too difficult to understand or follow and you may need the help or services of an assistant to get you through a certain situation. When this type of situation arises you should consider naming someone as your Medicare Authorized Representative so you can get help. The following are a few situations in which a Medicare Authorized Representative could help. Read more…
Is Medicare an Option for People on Social Security?
Medicare has long been thought of as a health insurance option for people who are on social security for whatever reason in their lives. What many people do not know is that Medicare is not really an option for you if you hope to be on Social Security. Medicare is not an option because it is something that you are forced to do in order to receive Medicare benefits. Read more…
What is the Influenza Treatment Demonstration?
As flu season approaches there are sure to be headlines in newspapers and segments in the evening news about the costs associated with flu shots. People with Medicare benefits are often curious as to how their flu prevention costs will be affected from year-to-year, with good reason. This year the government has offered a new program that you may not have heard of, courtesy of the Medicare.gov website: Read more…
Medicare Benefits Cover what is Necessary
Many people are confused by Medicare and what the Medicare benefits pay for and what they don’t as it appears to be an endless maze. While it is true that the government doesn’t make anything easy and wants you to work to find out what is covered, it is pretty easy to discern at times. Try to discern between what is absolutely necessary and what isn’t. Chances are the first one is covered and the second isn’t. Read more…
Medicare Part D: The Donut Hole Update
Health care reform has the potential to be very far-reaching in its effect on all insurance companies, but also on Medicare and Medicare Part D. The effects of the Medicare Part D “Donut Hole” have been discussed before and will continue to be as long as it affects so many people. With the new reform going on in Washington many have wondered or already heard about how this reform will help with the Medicare Part D donut hole.
If you have not heard, the Medicare Part D donut hole is what is created when the beneficiary has paid up to the deductible, but then has a gap between that and basically what is the out-of-pocket maximum. If reform goes through as planned all Medicare Part D beneficiaries will receive a $250 rebate check if they reach the donut hole coverage gap, possibly as early as June of 2010. Even better, you won’t have to apply for it you will just be sent a check when you reach the magic dollar amount.
In addition to this change, Medicare Part D will become even better over the coming years as drug companies must foot more of the bill. Eventually the donut hole will shrink to the point where beneficiaries only have to pay 25% of the cost after the original number is met. This is a great benefit to those who struggle with Medicare Part D.
Aetna Disciplined for Medicare Enrollment
The Federal government tracks all companies that sell Medicare related products to make sure that individuals are not being taken advantage of or tricked into certain situations in regards to Medicare or Medicare enrollment. Recently, one of the largest insurance companies in America, Aetna was charged with improprieties in regards to Medicare enrollment. Below are some of the charges levied against them.
• Improper processing of coverage decisions and expedited appeal requests in cases where delays would jeopardize the life or health of the member. This is particularly scary to individuals who may be waiting for the approval of one procedure or another to prolong their livelihood.
• Application of prior authorization and step therapy drug requirements that had not been approved by Medicare. Anytime Medicare enrollment processes go beyond the scope of what is approved by Medicare it will be a large issue.
• Failure to take timely and proper steps to ensure members are eligible for the Part D low-income subsidy. It is something that is taken very seriously be Medicare that Medicare enrollment cover this possible subsidy.
If you are a subscriber to Aetna’s insurance services that are part of Medicare you should contact your congressman. Medicare enrollment questions can be answered by your insurance company if you have any further concerns.
Medicare Part D: What is the Donut Hole?
Medicare Part D is the part of your Medicare insurance that will assist you in paying for your prescription drugs that you need to survive. With Medicare Part D you will receive a certain contribution from Medicare to pay for part of the drugs and you will be expected to contribute the difference. However, in recent years more and more attention has been given to the Medicare Part D donut hole. So, just what is the Medicare Part D donut hole?
With Medicare Part D you have a deductible you have to meet and you will pay for all of your drug costs up to this deductible. After you have met your Medicare Part D deductible you will then be eligible for some help from Medicare. Generally, Medicare Part D will start to pay for about 75% of your prescription drugs and you will be asked to make up the other 25%.
After you have reached a pre-determined limit set by Medicare Part D you will then be expected to pay, again, for 100% of the drug costs up to another limit. This is the “donut hole” that is referred to by pundits and critics of Medicare Part D. It is called a “donut hole” due to the large hole in the coverage.
Once you have covered the gap in your Medicare Part D donut hole you then get help again, generally much more than you did the first time. In most cases you will now pay somewhere around 5% of the total cost of your prescription drugs.
Medicare Benefits: Breast Cancer Screening
There are a countless number of Medicare benefits that lurk behind the shadows and are not advertised by Medicare when you are in the process of enrolling. These Medicare benefits will not be discussed on the news or used to get you to enroll in a certain program by any one Medicare provider. One of these such Medicare benefits is the benefit covering breast cancer screening and below is outlined the advantages of this benefit.
Once every 12 months Medicare benefits will cover a breast cancer prevention session in the manner of a mammogram. This service will be provided when you pay 20% of the Medicare-approved amount with no Part B deductible. All women with Medicare age 40 and older can get a screening mammogram every 12 months. Medicare also pays for one baseline mammogram for women with Medicare between ages 35 and 39.
If you have had breast cancer before, breast cancer has been prevalent in your family, or you had your first baby after the age of 30 you are at increased risk for breast cancer. Your Medicare benefits will assist you in the early detection and prevention of breast cancer to ensure that you live a long and happy, healthy life. Be sure to use your Medicare benefits to their fullest to detect breast cancer before it spreads.
Medicare Part B: Do You Know what You are Paying for?
We all know that Medicare and Medicare Part B are a maze of uncertainty for even the most well schooled government officials, but do you have any idea what you are paying for? Do you know what Medicare Part B is really offering you and what you are getting in return for your money?
Seniors and other qualified participants in Medicare are worried for good reason about the constant changes involved in Medicare, specifically with Medicare Part B. With a monthly premium of around $100 and a yearly deductible of around $155 this can be a pricey bit of insurance, but are you covered if you go to the doctor you choose?
Insurance professionals are urging the qualifying participants to ask many questions and do much research when deciding on what Medicare Part B plan you will use. The reason is plain and simple, with as much as these plans change it is essential that you know you can go to the doctor in your area or who fits your needs.
Medicare Part B may be especially difficult for those who live in rural areas and may be miles and miles from their physician. If you don’t do your due diligence when choosing your Part B provider you may be stuck driving for hours to see your physician, which will cost you even more.
Medicare Part A: How much are you Really Covered?
The horror stories associated with uninformed decisions when enrolling for Medicare are plentiful, but what about the horrors of the unknown for automatic coverage, such as Medicare Part A. This coverage is basically provided automatically for those who qualify, yet there are a myriad of unknowns as to what it really covers in the event of an untimely hospital visit.
Consider the following scenario: Louise is admitted to the hospital after a nasty fall and has to stay for 31 days to fully recover and go through rehabilitation. Louise assumes that Medicare Part A will cover her for up to 100 days in the hospital as the language reads in her policy, but she then receives a bill for $1,335 for her stay. Why?
Medicare Part A does in fact cover you for up to 100 days in the hospital, however, only the first 21 days are provided free of charge. For each day after that the patient is charged a co-pay of $133.50 per day, which in Louise’s case is 10 days at $133.50 per day, totaling $1,335.
If you are worried about being in the same position then it might be worth your time to look into Medicare Part A a little further with a professional and consider the possibility of adding supplemental insurance to your Medicare coverage.
Incentives Benefit Medicare Treatments
The CMS has successfully demonstrated that providing financial incentives for health care improvement improves not only the quality of health care but also reduces costs. Three demonstrations – one for hospitals, one for small and solo physicians and one for large physicians have yielded demonstrable results.
The programs that test value based purchasing have yielded encouraging results. The purpose of these demonstrations is to tie Medicare payments to efficiency and quality. Participating hospitals are showing a continued increase in quality. For small and solo physicians also a rewards program has been set up for providing high quality care for patients with chronic illnesses.
Read more…
13 million uninsured young adults may benefit from health reform proposals
The Congress has before it a set of comprehensive proposals related to health reform. The implementation of these proposals could mean that uninsured young adults from ages between 19-29 could get insurance. In addition those young adults who are currently insured would not lose their insurance.
This information has been detailed in a new Commonwealth Fund report. The report talks about how stable, affordable coverage can be given to all young adults. This would be possible if health coverage is extended by expanding Medicaid. In addition a health insurance exchange could help this process.
Read more…
The New Medicare Scam
As the government works towards a public health insurance program, one more recent event has reignited the question of the efficacy of a Medicare like program. Medicare has been subject to fraud since a long time and the volume of fraud is staggering. Recently a Medicare scam has come to light involving doctors and others in Houston, Boston, Louisiana and New York.
Over 30 Suspects have been arrested and more are being sought for arrest. The scam involved arthritis kits that were never used by several patients. Some of the patients they were prescribed for were dead. Some patients felt the “arthritis kits” were unnecessary and some never received them. Each kit was billed for $3000 to $4000.
Read more…
