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Medicare Insurance
All persons over 65 and all persons on Medicare who have questions about either Medicare or Medicare Drug Plans are invited to join or look at all messages. Your enrollment dates are coming quickly--11/15/07 to 12/31/07. I was a Medicare Insurance volunteer for 15 months. Questions? Not an agent
Recent Messages
Medicaid and Medicare linkage at times
I decided to delete a long article from a newspaper source that described the problems that persons on Medicaid might have when those same persons became involved with the Medicare Drug plan.
When I was a Medicare Insurance counselor, I found that most of the Medicaid persons ignored letters from both Medicare and Medicaid several years ago.
Medicaid persons just assumed somebody else would take care of the details but that was not the case. They were advised that Medicare Drug Insurance would be taking care of their drug/medication needs. They ignored the critical need for their taking identification cards to the drug store when the new plan took effect.
It took a few weeks to resolve the resulting snafus.
Actually Medicaid may become involved for newborns with major health problems that result in huge medical expenses. Personally I have a married daughter whose son was born with a heart defect that involved heart surgery and his medical care/surgery resulted in medical bills well into the hundreds of thousands of dollars.
My Grandson's father has a decent job which pays a decent salary but Medicaid got involved due to the huge expenses the parents incurred for their son. They faced bankruptcy. The parents are not Medicare age.
Medicare and You 2008 handbook describes several instances where persons of Medicare age may have their co-pays and Medicare premiums paid by Medicaid if they have lower income and minimal financial resources---which I have written on previously.
Be alert about your parents or friends have financial problems due to medical expenses. If they are on Medicare, they may qualify for extra help.
Medicare drug plan has been good for us. We have always asked our
Doctors to prescribe generics and avoid the advertised TV drugs. The "TV" drugs always cost many $ but there is usually a generic drug that will do the same job for little or no costs to the user.
Further the Walmarts etc are selling the generics for $4.00 for those of you readers that are not yet involved with Medicare.
It's your money--spend it wisely!!!!!!!!!
When I was a Medicare Insurance counselor, I found that most of the Medicaid persons ignored letters from both Medicare and Medicaid several years ago.
Medicaid persons just assumed somebody else would take care of the details but that was not the case. They were advised that Medicare Drug Insurance would be taking care of their drug/medication needs. They ignored the critical need for their taking identification cards to the drug store when the new plan took effect.
It took a few weeks to resolve the resulting snafus.
Actually Medicaid may become involved for newborns with major health problems that result in huge medical expenses. Personally I have a married daughter whose son was born with a heart defect that involved heart surgery and his medical care/surgery resulted in medical bills well into the hundreds of thousands of dollars.
My Grandson's father has a decent job which pays a decent salary but Medicaid got involved due to the huge expenses the parents incurred for their son. They faced bankruptcy. The parents are not Medicare age.
Medicare and You 2008 handbook describes several instances where persons of Medicare age may have their co-pays and Medicare premiums paid by Medicaid if they have lower income and minimal financial resources---which I have written on previously.
Be alert about your parents or friends have financial problems due to medical expenses. If they are on Medicare, they may qualify for extra help.
Medicare drug plan has been good for us. We have always asked our
Doctors to prescribe generics and avoid the advertised TV drugs. The "TV" drugs always cost many $ but there is usually a generic drug that will do the same job for little or no costs to the user.
Further the Walmarts etc are selling the generics for $4.00 for those of you readers that are not yet involved with Medicare.
It's your money--spend it wisely!!!!!!!!!
Medicare Advantage freebies
Medicare persons involved with medicare advantage plans have some benefits that we are currently enjoying. Our plan pays for some limited Dental coverage up to $100 a year. I cashed a $28.00 check from our Medicare advantage carrier that partially paid for my Wife's dental bill.
She has been involved with Curves for about 4 years and our present medicare advantage insurance pays her $29.00 a month Curves charges.
I recently ordered some personal care items such as tooth paste---tooth brush---gauze--baby aspirins---bandaids which are being mailed to us with no charge.
I will see my family doctor in July and pay a $15.00 co-pay.
My Wife and I pay zero $$$ each month for our medicare advantage plan and zero $ for our Medicare drug plan.
Same plan has advised that we each have an annual maximum medical expense of about $3000.00 and once we spend that amount, our medicare advantage plan will pay all co-pays and we will pay zero $. We may each pay about $150.00 in both co-pays for both medical and drug bills this year if our health does not change
We are hopeful the same zero cost rate will continue in 2009. You may have the same $$$ costs in your geographic area. You can change plans starting November 15th with effective starting date of Jan 1, 2009. You could start earlier if you are a low income person.
She has been involved with Curves for about 4 years and our present medicare advantage insurance pays her $29.00 a month Curves charges.
I recently ordered some personal care items such as tooth paste---tooth brush---gauze--baby aspirins---bandaids which are being mailed to us with no charge.
I will see my family doctor in July and pay a $15.00 co-pay.
My Wife and I pay zero $$$ each month for our medicare advantage plan and zero $ for our Medicare drug plan.
Same plan has advised that we each have an annual maximum medical expense of about $3000.00 and once we spend that amount, our medicare advantage plan will pay all co-pays and we will pay zero $. We may each pay about $150.00 in both co-pays for both medical and drug bills this year if our health does not change
We are hopeful the same zero cost rate will continue in 2009. You may have the same $$$ costs in your geographic area. You can change plans starting November 15th with effective starting date of Jan 1, 2009. You could start earlier if you are a low income person.
Taxes to Pay for Medicare, Medicaid, and SSI
CBO's Warning on Raising Taxes to Pay for Medicare, Medicaid, and Social Security
CBO's Warning on Raising Taxes to Pay for Medicare, Medicaid, and Social Security
by Stuart M. Butler, Ph.D.
Backgrounder #2153
Congress's nonpartisan official "scorekeeper," the Congressional Budget Office (CBO), was recently asked by Representative Paul Ryan (R–WI) to estimate the impact of raising marginal tax rates to pay for the projected huge increase in entitlement spending in future decades.[1] The CBO concludes that:
* Marginal tax rates for every bracket, along with corporate tax rates, would need to more than double.
* These tax rates "would significantly reduce economic activity and create serious problems with tax avoidance and tax evasion," and such rates "would probably not be economically feasible."[2]
The CBO was asked to evaluate raising tax revenues as an option to address the huge projected spending and deficits in future years, even though under current law, taxes will rise to record levels as a percent of gross domestic product (GDP).
CBO's Warning on Raising Taxes to Pay for Medicare, Medicaid, and Social Security
by Stuart M. Butler, Ph.D.
Backgrounder #2153
Congress's nonpartisan official "scorekeeper," the Congressional Budget Office (CBO), was recently asked by Representative Paul Ryan (R–WI) to estimate the impact of raising marginal tax rates to pay for the projected huge increase in entitlement spending in future decades.[1] The CBO concludes that:
* Marginal tax rates for every bracket, along with corporate tax rates, would need to more than double.
* These tax rates "would significantly reduce economic activity and create serious problems with tax avoidance and tax evasion," and such rates "would probably not be economically feasible."[2]
The CBO was asked to evaluate raising tax revenues as an option to address the huge projected spending and deficits in future years, even though under current law, taxes will rise to record levels as a percent of gross domestic product (GDP).
My Blog
What Group Should Every one Belong To????
posted 2 minutes ago, updated 2 minutes later
medicare
"Medicare Insurance Group"
With 11 members it's one of the smallest groups I belong to. But medicare plays a big part in my life. Working in a hospital I watch it influence people's lives everyday. Most people won't go face to face with many of its issues till they are faced with major illness. There's that call from a senior, after they are discharged, that they can't afford the prescription the doctor told them to take. The tearful discussion with family when told medicare won't cover the outpatient services their love one needs.
Yes there's medicare drug coverage, but it very limited when some of the newest life saving drugs cost what a car payment use to be. Well, you say, "there's little I can do". YOU ARE WRONG!!! No matter what party you belong to only a grassroots movement can make a difference. Take the first step today and join the "Medicare Insurance Group" then check in regularly and see what happening. Thank you for taking the time to read this.
posted 2 minutes ago, updated 2 minutes later
medicare
"Medicare Insurance Group"
With 11 members it's one of the smallest groups I belong to. But medicare plays a big part in my life. Working in a hospital I watch it influence people's lives everyday. Most people won't go face to face with many of its issues till they are faced with major illness. There's that call from a senior, after they are discharged, that they can't afford the prescription the doctor told them to take. The tearful discussion with family when told medicare won't cover the outpatient services their love one needs.
Yes there's medicare drug coverage, but it very limited when some of the newest life saving drugs cost what a car payment use to be. Well, you say, "there's little I can do". YOU ARE WRONG!!! No matter what party you belong to only a grassroots movement can make a difference. Take the first step today and join the "Medicare Insurance Group" then check in regularly and see what happening. Thank you for taking the time to read this.
Help With Medicare Costs Available
Hi Folks:
Just received letter from Social Security that indicated people with limited income AND resources are able to get financial help from your State Medicare Savings Programs.
The Savings programs may pay for your $96.40 a month taken out of your Social Security checks as well as deductibles and co-payments.
You may qualify if your monthly income is less than $1190 a month if single or $1595 a month if married. Your resources(not counting your home) must be less than $4000 if single or less than $6000 if married.
Your States may have different limits.
Medicare drug insurance has slightly different income limits---less than $1300 if single and less than $1750 a month if married and different resource limits.
Your nearest Office for the Aging has the applications and will assist you.
Please think about your parents or friends with limited income and resources and see if they qualify if they do not already have extra help.
Just received letter from Social Security that indicated people with limited income AND resources are able to get financial help from your State Medicare Savings Programs.
The Savings programs may pay for your $96.40 a month taken out of your Social Security checks as well as deductibles and co-payments.
You may qualify if your monthly income is less than $1190 a month if single or $1595 a month if married. Your resources(not counting your home) must be less than $4000 if single or less than $6000 if married.
Your States may have different limits.
Medicare drug insurance has slightly different income limits---less than $1300 if single and less than $1750 a month if married and different resource limits.
Your nearest Office for the Aging has the applications and will assist you.
Please think about your parents or friends with limited income and resources and see if they qualify if they do not already have extra help.
Medicare Fraud
I saw the post regarding Medicaid Fraud..and it made me think of Medicare Fraud. I am in the industry and worked with Medicare reimbursement. The tangle that Medicare is now is unbelievable. I was working to reimburse claims that we should have paid and Medicare did. Many(at least 65%) of these we did recieve for 10 years past the original claim. If Medicare isn't any better than that at recieving accounts payable, how is the rest being runs. Frequently we would come across providers frauding Medicare, mostly in the DME (medical equipment) catagory. What scares me most is the possiblilty of national health care when it can not even run this portion close to efficiently.
New York - America’s Biggest Drugstore Chain Accus
New York - America’s Biggest Drugstore Chain Accused Of Defrauding Medicaid.
Posted: 15 Jun 2008 08:27 PM CDT
New York - Michael Behn, a former federal prosecutor, said, “The pharmacies nationwide had a pill flipping scheme.”
Behn helped expose how Walgreens exploited a Medicaid loophole.
To save taxpayer dollars, Medicaid limits how much it pays for popular forms of drugs.
But it doesn’t bother to set price-ceilings on rarely-used versions.
Take generic Zantac, or ranitidine, for example. The antacid is a huge seller in tablet form. Medicaid limits payment to 34 cents apiece.
The same drug as capsules has no price-ceiling because it was so rarely-prescribed. Medicaid pays $1.25 each.
Walgreens figured it could pocket millions by switching patients from tablets to capsules.
Behn explained to Attkisson, “These are the ranitidine capsules.”
“This is what was being prescribed?” Attkisson asked, pointing to the tablets. “And this is what was being given?” pointing to the capsules.
Behn replied, “Correct. At three times or more the cost to taxpayers,” Behn answered.
The scheme was blown wide open by a whistleblower, a pharmacist who doesn’t want to appear on camera. He said Walgreens rigged its computers to automatically switch to the most expensive type of pill.
“The only way in which a computer system could switch from a tablet and a capsule, is if someone went in and manipulated the computer system,” Behn said.
Attkisson asked, “And the fact that this was done nationwide indicates this was a corporate policy?”
Behn responded, “That’s what we alleged.”
By gaming the system, Walgreens managed to change over almost all Medicaid customers from cheap generic Zantac tablets to pricy capsules.
In Florida alone, it cost taxpayers an extra $1.2 million the first year.
And the pill-switching went on for several years nationwide, including other prescriptions: generic Prozac (fluoxetine) for depression, and generic Eldepryl (selegiline) for Parkinson’s.
Walgreens denies wrongdoing and declined to be interviewed.
But they recently agreed to pay back the government more than $35 million.
And they’re not the only ones. CVS and Omnicare quietly settled similar cases coughing up $86 million more.
The whole pill-flipping episode proves just how imperfect some drugstore chains can be.
Posted: 15 Jun 2008 08:27 PM CDT
New York - Michael Behn, a former federal prosecutor, said, “The pharmacies nationwide had a pill flipping scheme.”
Behn helped expose how Walgreens exploited a Medicaid loophole.
To save taxpayer dollars, Medicaid limits how much it pays for popular forms of drugs.
But it doesn’t bother to set price-ceilings on rarely-used versions.
Take generic Zantac, or ranitidine, for example. The antacid is a huge seller in tablet form. Medicaid limits payment to 34 cents apiece.
The same drug as capsules has no price-ceiling because it was so rarely-prescribed. Medicaid pays $1.25 each.
Walgreens figured it could pocket millions by switching patients from tablets to capsules.
Behn explained to Attkisson, “These are the ranitidine capsules.”
“This is what was being prescribed?” Attkisson asked, pointing to the tablets. “And this is what was being given?” pointing to the capsules.
Behn replied, “Correct. At three times or more the cost to taxpayers,” Behn answered.
The scheme was blown wide open by a whistleblower, a pharmacist who doesn’t want to appear on camera. He said Walgreens rigged its computers to automatically switch to the most expensive type of pill.
“The only way in which a computer system could switch from a tablet and a capsule, is if someone went in and manipulated the computer system,” Behn said.
Attkisson asked, “And the fact that this was done nationwide indicates this was a corporate policy?”
Behn responded, “That’s what we alleged.”
By gaming the system, Walgreens managed to change over almost all Medicaid customers from cheap generic Zantac tablets to pricy capsules.
In Florida alone, it cost taxpayers an extra $1.2 million the first year.
And the pill-switching went on for several years nationwide, including other prescriptions: generic Prozac (fluoxetine) for depression, and generic Eldepryl (selegiline) for Parkinson’s.
Walgreens denies wrongdoing and declined to be interviewed.
But they recently agreed to pay back the government more than $35 million.
And they’re not the only ones. CVS and Omnicare quietly settled similar cases coughing up $86 million more.
The whole pill-flipping episode proves just how imperfect some drugstore chains can be.
Medicare and You 2008--Read It!!!!
Welcome to all the new members and visitors.
I encourage you to read the above official handbook that is mailed to all persons receiving Medicare benefits 1x a year in the Fall. This is an easy to read handbook which is your location specific. The booklet lists all Medicare Health Plans and all Medicare Prescription Drug Plans in your geographic area. You will also see your 2008 costs for such plans and co-pays---if any. You will find the names and phone numbers for all the insurers.
We are almost through the 1st 6 months of 2008 and you should be thinking if you are going to change your insurer based on your costs to date.
There can be a big difference in the insurers. You can order their drug lists now or check the internet now if you are taking new prescriptions now that you did not use 6 months ago to determine if you might save by switching insurers in 2009.
You should also be looking closely at the costs of your employer's health plan if you have not yet switched to Medicare. How much are you paying each month and how much are your co-pays to date in 2008?
I was a volunteer in local Aging Office and found that there are too many persons working at Walmarts etc to pay for Medicare supplement insurance when this post- retirement work was not necessary. Here in New York State and many other States, you can get Medicare Advantage plans that also include Medicare Drug plans that cost zero $$$ a month. We do pay co-pays which might cost us a total of $100-200 a YEAR---not a month.
Start doing your homework now. If you are a caregiver for a person on Medicare, you or they should be contacting the closest Office for the Aging and use their resources. The Office can also help with Medicare billing disputes.
Please help yourselves now and determine if you should be thinking of changing in 2009.
I encourage you to read the above official handbook that is mailed to all persons receiving Medicare benefits 1x a year in the Fall. This is an easy to read handbook which is your location specific. The booklet lists all Medicare Health Plans and all Medicare Prescription Drug Plans in your geographic area. You will also see your 2008 costs for such plans and co-pays---if any. You will find the names and phone numbers for all the insurers.
We are almost through the 1st 6 months of 2008 and you should be thinking if you are going to change your insurer based on your costs to date.
There can be a big difference in the insurers. You can order their drug lists now or check the internet now if you are taking new prescriptions now that you did not use 6 months ago to determine if you might save by switching insurers in 2009.
You should also be looking closely at the costs of your employer's health plan if you have not yet switched to Medicare. How much are you paying each month and how much are your co-pays to date in 2008?
I was a volunteer in local Aging Office and found that there are too many persons working at Walmarts etc to pay for Medicare supplement insurance when this post- retirement work was not necessary. Here in New York State and many other States, you can get Medicare Advantage plans that also include Medicare Drug plans that cost zero $$$ a month. We do pay co-pays which might cost us a total of $100-200 a YEAR---not a month.
Start doing your homework now. If you are a caregiver for a person on Medicare, you or they should be contacting the closest Office for the Aging and use their resources. The Office can also help with Medicare billing disputes.
Please help yourselves now and determine if you should be thinking of changing in 2009.
Medicare Supplement - Arizona
Hello! I'm looking for assistance/recommendations. My Mom is currently enrolled in Medisun (AZ Medical Clinic). It's a real pain because everything must be done through the clinic and getting referrals, tests and prescriptions is a MAJOR effort. Her group home has a physician who makes home visits, but I can't use him because he is not one of their "providers."
Does anyone have a GOOD experience with a Medicare supplement or a recommendation they would like to give?
Thanks!
Does anyone have a GOOD experience with a Medicare supplement or a recommendation they would like to give?
Thanks!
Newbie
I guess I joined because I have questions. I need to know whether to use Maedicare as my primary or stick with my current employer policy. Does anyone know is gastric by-pass is covered uneder medicare? Would it make a difference if it is primary or secondary? My primary doesn't cover it, but since it take so much prep time to have it, would perhaps like to get started ealy.
