Posts filed under 'General-Medicare'
Healthcare Reform is a priority for the President. It has been a priority since before the election. It was one of the main issues that the President was elected for.
Medicare keeps getting mentioned as part of the Healthcare Reform package. One group says that the only way to save Medicare is to end Medicare as we know it and start a new type of Medicare. Another group says that the only way to save Medicare is to create higher co-pays (which seniors can hardly pay now), create higher premiums (that seniors can hardly pay now), or both, which seniors would have an impossible time paying especially having to pay both increases.
Other suggestions have been that spending in other areas should be cut back so that seniors – our most vulnerable citizens – can get the healthcare they need.
It is important to keep Medicare in tact to the extent possible. It is a lifeline for seniors and they need it more badly than most of the public – and possibly the lawmakers – realize. When I think about my grandmother who has several health problems – some of which are serious – I can’t imagine what would happen to her without Medicare. Even with Medicare and her Social Security she barely makes it through the month without a little help.
The President says that no matter what happens, Healthcare Reform will leave Medicare in tact and not take away the benefits that the seniors need. Let’s hope that at the end of the day when the arguing dies down and turns into a conversation and the conversation turns into positive communication which turns into forward motion, we will end up exceptional healthcare reform that works for most everyone, but especially helps seniors get as much out of Medicare as possible.
Some of the individuals in this debate that continues to rage really have nothing to worry about on a personal level. After all, they have the best healthcare coverage you can get and it comes with their position as a lawmaker.
Meanwhile, the rest of us are doing what we can to survive. If we are fortunate enough to have insurance at all, often have to worry about whether they have enough coverage or if their insurance covers certain things and how much you have to pay for those things – especially if you end up at the emergency room trying to take care of one of your babies.
Not that lawmakers should be without healthcare. It’s simply that it is time to stop trying to thwart the President, stop trying to stop any of the other parties and any of the other nonsense that they are constantly going through. How many times have we seen and heard that “things should be settled soon” and everyone should be just fine with their coverage.
It is obvious that there are some people who have their agenda which is to make sure that the President fails. The saddest part is that the President has some pretty good ideas – especially when it comes to balancing the budget and fixing the healthcare system. He is not perfect, but he has a vision. It seems that these individuals who want to thwart the President for their own personal reasons.
Therefore, instead of moving forward and settling this situation, they are unmovable and will not deal with individuals across the aisle. All it would take would be some folks from both sides and the middle to actually, truly and honestly communicate - not just talk over each other to make their point – but to help get this done well, done right, and finally, just done!
It’s time to get this done now. We have all been waiting for years, and now we are into the end of the first year, which is enough time. The people need help and cooperation to get this healthcare and Medicare situation taken care of, especially since the President has a few other things on his mind, like a few wars, the issues in Haiti not to mention a few issues regarding the people who happen to be the voters, as well.
Let’s hope that instead of trying to “one up” each other, lawmakers can actually get the more important things done, especially coming up with a fair healthcare and Medicare system that will help everyone in this country. If they are smart enough to cover some basic and preventative issues in the bill – especially because this is one of the things that will help people stay healthy and stay out of the emergency room and the hospital in general. Wow! What a way to save money. Help keep people stay healthier by making sure they have enough healthcare coverage to cover the smaller and preventative things so that there won’t end up becoming more expensive, larger, more serious – and more expensive – health issues.
Can we just get it together somehow and get it right – soon?
Most of us were glued to the T.V. last Wednesday night to see what the President had to say about numerous issues pressing the United States and pressing hard. Deficits. Multiple “military engagements”, in other words, wars, the economy, unemployment and creating new jobs, other major issues, and one of the most pressing issues, Healthcare Reform.
I – like many other people – listened to the State of the Union Address trying to find glimmers of hope. There were a few here and there, and the President, with his eloquence, his sense of humor, his passion and his straightforwardness had me – and the people with me drawn in to the address and helped hear the message.
Many of the things the President stated sounded like he was stating just to us – which is one of his gifts. He seemed to be trying very hard to firmly and graciously get his point across clearly in a manner where people would really hear what he had to say.
The President touched on numerous issues including health-
care. He talked about having to adjust taxes for the wealthy so that certain benefits – especially essential ones such Medicare coverage for seniors on limited incomes, frugal use of medicine to make it last longer – often putting their health in peril.
The President says that the taxes won’t go up so high that it creates problems for those with a little more who are being called upon to help subsidize healthcare for the most poor and vulnerable among us so that they have at least the very basics to keep them as healthy as possible.
The “State of the Union Address” is certainly not a solution to the problems that exist. It is more of an explanation and an expose as to what has happened during the past year and what is intended in the year to come.
It is hopeful that all parties and factions will work together in the months to come in an effort to bring some positive solutions so that we as a country are stronger and able to care for our people in the best, most fair and most positive way possible for everyone involved.
It used to be that doctors made house calls. This was essential because there were few doctors that were responsible for vast areas. People would send for the doctor if a person was sick, and there was nothing left to do but for the doctor to make a house call to help the patient.
As communication grew along with communities and towns house calls increased for a while, then decreased with the advent of medical centers and hospitals. There were still house calls, however, there were more and more people going to doctor’s offices, clinics and hospitals.
Then came the era of cities that had organizations and health departments, making the era of house calls nearly a thing of the past. There was one group, however, that still fared better with house calls. This group includes seniors and individuals with disabilities.
Many of these individuals have too many health issues to run back and forth to the doctor’s office. They are elderly and/or disabled. As a result, home health care has been the main means by which they are taken care of. They have nurses and other health practitioners come to their homes to address their health issues. These visits are covered by Medicare.
Lawmakers are now looking into home visits or good old-fashioned house visits to these same patients by their doctors. Some doctors are already providing house visits to their more elderly or sick patients because it is easier and better for the patient to be able to stay at home rather than use precious little energy to prepare for a visit to the doctor’s office and the accompanying travel.
There are house call programs in various parts of the country and many physicians are beginning to rally Congress toward funding house calls. The bonus to this is that it will keep many people out of the hospital – an extremely high expense – and it will provide them with personal, high quality care while saving Medicare millions of dollars.
Every year there are a few changes to Medicare that Medicare recipients should know about. With all the confusion about healthcare reform, the information for 2010 is as important as ever.
One of the things that will happen in 2010, unfortunately – but not totally unexpectedly – is that the Premiums for Medicare Part B will rise. Since income determines your premiums, if you are single and your income is less than $85,000 your premiums will go up from the 2009 figure of $96.40 to $110.50 per month in 2010.
It becomes a bit confusing when it comes to filing a joint tax return. If filing joint and your income is $170,000 or less, each beneficiary will pay $110.50 per month. The individuals who file a single return and whose income is between $85,000 to $170,000 will pay $154.70 per month. This is the same for those filing jointly whose income is between $170,000 and $214,000. If your information isn’t listed here, you can check with Centers for Medicare and Medicaid (CMS) or www.medicare.com, or in the Medicare and You booklet which has a chart explaining premiums.
As for Medicare part A and B there are also changes coming. Medicare Part A which covers hospital bills has a deductible that will go up from $1,068 in 2009 to $1,100 in 2010. It is important to be aware that this deductible applies to every hospital visit, so each time you are in the hospital, then out for 60 days and have to go in after the 60 days is up, you are charged with another deductible. If you go back into the hospital within the 60 days, you don’t get charged again for the deductible.
Part B covers medical expenses and will go up in 2010 from $135 per year to $155 per year.
If you have a Medigap policy, it is important to know that Part J will be discontinued as of June 2010. If you already have the policy, however, you can keep it and maintain it if you pay the premiums and keep the coverage in force.
Most likely Plan J will become very expensive – in fact, it will be more expensive than people can afford to pay – especially as they sign up for Medigap policies, which are much more affordable. As this happens more and more – less people using Part J because they go to Medigap or pass away – the rates for Part J will continue to rise, eventually making it too expensive for most seniors to enroll in. Plan J will eventually be eliminated along with Plans E, H and I.
If you have to get coverage, the minimum suggested is Plan C. In addition, if you need more coverage, 100 percent coverage is offered after basic Medicare through Plan F. Plan C and Plan F will continue to be available and the government will be adding Plans M and N. There is no information on the approximate cost or which states they will be available in.
Plan M will pay up to half of the deductible for Part A if you go into the hospital.
Regarding office visits, Plan N will have a co-payment of $20 per office visit and a sliding scale of up to $50 for emergency room visits. Plan K and L will also stay available, but offer benefits that are somewhat limited.
The various plans are created and offered by the federal government. The issue is that these plans are available, whether or not they are available in your state is up to the Insurance Commissioner in your state, so different states can have different plans available.
Regardless of any changes or proposed changes, your coverage will stay the same for a while. Medigap plans will not have changes until June 1, 2010, so you can purchase any of the plans available in your state until then.
During the past few months the frenzy about Medicare has heated up substantially, especially as lawmakers in Washington have passed a healthcare reform bill that will most likely include some changes to Medicare as a result.
Unfortunately, there are two things common when it comes to change: the people who have been complaining the loudest about what they have are the most upset when they think there could finally be changes – especially if the changes affect them; and many of the changes that have not been described in much detail or are confusing are assumed to be changes for the very, very worst, rather than the assumption that there might be changes for the better.
This is the situation with Medicare. There are naysayers, scaremongers and others out there that are creating a doomsday atmosphere for the 45 million individuals enrolled in Medicare, rather than allowing lawmakers to fill in the blanks, come up with revisions and a final bill and see what ends up happening.
After all, their children and grandchildren will be affected by these changes as well as everyone else. Though they are trying to fix the current situation which has run rampantly out of control for the past eight years, they are also trying to create and save a system so that there will be coverage that is viable and solid for future generations.
Many seniors have made it clear that though they would like to see more benefits or different benefits through Medicare, they are happy with what they have and grateful to have it. The main things they are unhappy with are the fact that premiums through private companies for Medicare Advantage are too high and that the infamous “donut hole” where coverage through these companies stops and an individual has to start paying their own bills to the tune of a couple of thousand dollars, are impossible for them to pay for.
It just so happens that some of the main things that seniors who are receiving Medicare benefits are worried about are the very things that lawmakers are trying hard to remedy. They are pushing insurance companies and working with Medicare itself to close the donut hole. They are also trying to limit what insurance companies can charge for Medicare Advantage.
There are always plusses and minuses when it comes to any program – whether it is a government program or a program through a private insurer. Regardless, most individuals on Medicare feel it is a good program that helps them get medical care that they otherwise could not afford. Let’s hope that lawmakers can shore the program up where it needs to be and at the same time work to save the budget.
Most people enroll in Medicare by the time they are age 65. They are advised to do so and in most cases, this is the best thing to do. And, in most cases, this is the right thing to do.
There are cases, however, when it is not necessary to sign up for Medicare at age 65. First of all, people start getting tons of junk mail and other mail advising – and even warning – that a person has to sign up for Medicare part A and B either three months before or three months after their 65th birthday or they would have to pay a great deal more later.
First of all, a person is automatically enrolled in Medicare Part A when they are 65. If a person delays getting Part B, they could end up having to pay a 10% penalty when they finally do sign up.There are exceptions, however. The main exception is that if a person works past 65, and has medical insurance through their work. If the person is in this situation, the Social Security Administration (SSA) allows a special enrollment period for the individual to be able to sign up for Medicare Part B.
This special period allows an individual to wait to enroll in Medicare Part B and not be assessed the extra 10% penalty for registering later than normal. The way this special period works is that the person can sign up for Medicare part B
during the month after they are no longer at their job or during the eight months after their medical coverage from their former employer ended. Whichever of these happens first is the time when the person needs to apply for Medicare Part B and not have to pay the penalty.
It is important that a person make sure that if they are age 65 and they are covered by their employer’s insurance, they need to do some research to be sure that the insurance – which is through a private insurance company – will work with Medicare. There are a lot of private insurance companies that will work with Medicare to make sure that the individuals stay covered without gaps. It is essential to determine if there is a good blend because if not, you could be left vulnerable without appropriate and adequate coverage.
So, if you are getting close to age 65 and you are not working or covered by other employer coverage, it is important to check into enrollment in Medicare to determine if, when and how you should enroll in Medicare Part B.
For more information you can contact the Social Security Administration at www.socialsecurity.gov or www.medicare.gov.
Millions of people depend upon Medicare to provide coverage to care for their illnesses and ailments. With over 45 million people covered by Medicare, there is a big price tag that comes with all of the treatments to help Medicare recipients. Close to 40% of the individuals covered by Medicare are dealing with ongoing illness – most of these individuals suffer from multiple illnesses and have to be treated for all of these.
In 2009 alone, Medicare will have paid out nearly $475 billion in benefits. Unfortunately, many of these benefits are paid out for emergency care, or care that is necessary because individuals have not had continuous care for growing health problems such as diabetes, cardiovascular issues, high blood pressure and more. As a result, the price tag for care is much higher than it would be if individuals had been seeing their doctor continually – especially for preventive care.
Most of the costs that Medicare pays out have to do with the individuals who are obviously the sickest. Then come the ones who have been seeing their doctors on and off for their problems. Often these problems get worse because they only see their doctors when there are flare ups.
Doctors, healthcare professionals and others – even lawmakers – are focusing more on prevention these days. It is no secret – and there have been numerous studies showing – that if a person is treated for a health condition and then helped to prevent it from getting worse or if a person is diagnosed early the costs for prevention and/or subsequent maintenance rather than extreme treatment go down substantially.
If there was more of an emphasis on prevention and wellness, Medicare would have to pay out much less than the over $475 million per year that is being paid out right now – especially this year in 2009.
It’s time for everyone in the equation – from doctors, to patients to lawmakers – started to focus on prevention and wellness. Perhaps that would end the discussion about severely cutting back of even ending Medicare, because there would be enough money to fund the program without dealing with many of the financial issues we are dealing with now.
Every year, seniors throughout the country get to the open enrollment period – a time when they can review, adjust, renew or change their Medicare coverage. It is also a time when many more seniors sign up for Medicare for the first time.
In many cases, seniors have important questions regarding their coverage and need to find the answers. Where do they go to get these questions? There are a lot of places.
Most of the places you can go are right in your own community. No matter where you live, most towns, cities and counties have a senior center and at this time of year, your town – or one close to you will be providing information through meetings and workshops as well as one-on-one meetings in some cases.
Especially during this time of year – between now and the end of the year – you should be able to find various meetings because of this all-important open enrolment period. This is not just to help seniors who are looking at their current coverage, but also for helping individuals new to Medicare – who will be enrolling for the first time.
The meetings regarding Medicare are generally free, offer a talk providing general information, offer time for answers to questions, and also have individuals and printed information available to help people understand what Medicare has to offer and how to understand how it works. Because there are some states that have over 40 plans and there are income limits that can change from year to year, the information available is essential.
Every year there is a flurry of meetings and information at this time of year. Your local newspaper, senior center, Social Security Office, Healthcare Services Office and Office on Aging should all have information regarding dates and times of any meetings being offered to help Medicare recipients understand their current coverage, review or adjust/change it or enroll in Medicare if this is your first time.
If you need information, find out where there are meetings right away, since open enrollment ends on December 31st, and your Medicare coverage starts over on January 1, 2010. If you can’t find a meeting or a workshop close enough to where you live, you can get information from Medicare at cms.gov or medicare.gov. In addition, you can call Medicare at 1-800-772-1213.
Individuals receiving Medicare benefits have a lot of information to go through. If you have never enrolled in Medicare and are just about to do so for the first time, you too have a lot of questions to answer and need information that will help you answer those questions.
One of the most important tools available is a handbook put out through the federal government called “Medicare and You 2009” and “Medicare and You 2010”.
It may seem that you may not need the 2009 handbook, but if you are a current Medicare recipient, having the 2009 book and the 2010 book will allow you to see the differences coming your way. It is important to do these comparisons and do as much research right now as possible, since this is open enrollment period until December 31st.
If you have not received your “Medicare and You” handbook for 2009 or 2010 there is still time to get them and it is easy, quick and free. You can contact Medicare at medicare.gov of cms.gov. The phone number to call is 1-800-772-1213 and you can order either or both of these by phone. You can also CLICK HERE NOW TO DOWNLOAD the book to your computer for free.
You will be asked your name and whatever address you want these handbooks mailed to, but you should not have to give much more information. In addition, both online and over the phone, you can get some basic questions answered and order any forms that you need.
You can join Medicare every year between November 15th and December 31st, and you can make any changes to your existing coverage. After December 31st your new coverage becomes effective on January 1st each year.
There are other sources of information in most areas of the country. Wherever you live, you can get information through your doctor, health department, department of aging, senior center or other healthcare or senior organizations.
Take the confusion out of Medicare coverage. Get your handbook today. Click here now to download your copy!
HIV testing is an important issue. There are many people walking around with the HIV virus that are not aware that they could be infected and could possibly infect others.
Most people think of HIV as being the result of unprotected sex and/or drug use with unclean needles. This is not always the case. There are many cases of HIV that are caused by blood transfusions and other heath procedures or issues.
Unfortunately, too many people think of individuals who are infected with HIV as having done something wrong, living an immoral life or stereotype them as poor, uneducated or even homeless.
This is not the case in most situations. Regardless of what the situation is, the important point is that if a person is infected with HIV – or possibly infected – they need to be tested, at least as a starting point. The problem has been that individuals who do not have a lot of money cannot always afford to get tested. In addition, they may not be able to find medical help that they need to perform the test or to give results or treatment.
Now the Centers for Medicare and Medicaid Services (CMS) has stated that they will now begin immediately providing HIV testing for Medicaid and Medicare recipients. This is an extremely essential issue since most of the individuals covered by Medicare and/or Medicaid are in a low income situation and could use help when it comes to many of the basics in life and/or services that Medicare and Medicaid provides.
If you have been holding back from getting an HIV test and you are covered by Medicare and Medicaid, find out where you can get tested at medicare.gov or cms.gov.
This is the time that everyone is getting all riled up about health care in general and Medicare, specifically. First of all, it is open enrollment period for Medicare until the end of December, 2009, which means that by December 31st a lot of choices need to be made by Medicare recipients.
At the same time, one of the biggest battles in decades is continuing while lawmakers try to determine what healthcare should be like for now and into the future. There are all sorts of proposals being put forth – from public options to what to do about abortion and more.
Some of these issues can tip the balance on the whole health care reform issue. Not only are Democrats arguing with Republicans, but individuals within their own parties are arguing with each other. Yet there is a lot of hard work going into healthcare reform – even working over the weekend – to try to get this finished once and for all.
A lot of the major details are pretty well figured out. However, the finer details that could cost – or save – a lot of money will take a little or maybe a lot more ironing out.
One of the latest ideas that lawmakers are grappling with is the idea that individuals aged 55 and over should be able to be able to be covered by Medicare either through a buy-in or through other options, including a government run plan. This is not a small subject when it comes to either side of the aisle.
Though there could be a lot of money to gain – which would offset the huge expenses that Medicare is experiencing now. Some lawmakers – and people throughout the country – are seeing the huge offset that would come with boomers between 55 and 65 years old paying premiums but not usually using many of the services that Medicare has to offer – especially because they are younger and in better health.
If Congress can pass this type of coverage, it would be possible that the premiums collected from those who are age 55 to 65 could at least somewhat – perhaps in a large way – balance the Medicare budget, thus helping to balance the healthcare budget and the overall budget.
Time will tell what will happen when it comes to the health care bill. One thing that has been made clear on both sides of the aisle is that Lawmakers are trying their best to keep Medicare services as constant as possible without cutting much and without expanding premiums. Hopefully, creative thinking that looks to the future will help them take in the money to help cover boomers and help set the budget straighter.
Health Care Reform has been passed in both the House and the Senate now and there is still work to be done to iron out the details. Instead of certain factions settling down and focusing on getting the work done, they are carrying on the same scare tactics that we have gone through for the last eight years.
O.K. Scaring everyone in the country about terrorists and turning the whole thing into a war is one thing. Not great, but not as personal as terrifying seniors about Medicare. There is no comparison between the two, and it is possible that the deficits that are making it difficult if not next to impossible to balance the budget and not destroy health care and Medicare would not be as devastating if so many billions were spent on an ill-advised war that not only was not wanted by the people of the United States, but not wanted by the United Nations and most countries around the world.
There is not much we can do about that now except to figure out a way to get things taken care of both in Iraq and Afghanistan and make as graceful an exit as possible. As for Medicare and health care, there are things we can do – and lawmakers are trying to do these things – so that there is coverage for everyone and it is affordable, yet doesn’t break the government’s bank.Unfortunately, some of the same factions in this country who were scaring the public about terrorists are scaring seniors about Medicare right at a time that they have about a month to make some critical decisions during open enrollment period which ends December 31st.
Some commercials by these factions have come out and said that President Obama’s health care reform would be funded by basically stealing $500 billion from Medicare. That would scare any senior who relies on Medicare. That is also not true, in fact, it is a blatant lie.
There is information available for questions about healthcare reform and Medicare. There is a White House website at WhiteHouse.gov/RealityCheck which discusses healthcare reform in general, including Medicare. For information regarding Medicare alone, go to medicare.gov or cms.gov and there is specific information about Medicare.
Regardless of the scare tactics that some may use, don’t believe everything you hear (or read). Yes, there may be some cuts in Medicare, but they will be small cuts on products or services rarely used. In addition, they will not be paid for by Medicare recipients, but will be dealt with through insurance companies, hospitals, doctors and other funding.
Your Medicare will stay in tact. Don’t believe the scare tactics and don’t believe the hype. Find out for yourself by checking the official websites listed above.
Medicare enrollment can be confusing. In fact, most people who are eligible to enroll in Medicare find it more confusing than they bargained for.
Part of the problem is that there are a lot of parts to Medicare and each one covers something a little different. An individual that wants to purchase Medicare needs to compare all the parts and determine what fits your needs.
Another part of the problem is that there are a lot of stories about what covers you, how to get coverage, how much it can cost, and a lot more. This is all confusing, if not overwhelming.
If you are a senior or another individual in a situation where you are trying to apply for Medicare or researching to purchase Medicare within the next year or so, there is an important place that you can go to find the correct information that you need.If you go to medicare.gov or cms.gov there are eligibility tools online. These tools take you through the entire application process as well as explaining each part of Medicare. This allows you to be able to determine which parts you need for the coverage for you. It also shows you a grid that will compare some things side by side to determine what is covered by each part and how much it costs.
In addition, there is information regarding Medicare Advantage, which combines a number of the parts of Medicare into one policy. The Medicare Advantage policy can be great for some people but unnecessary or too expensive for others.
Quite often, depending upon your health and upon your needs, getting basic Medicare and some of it’s parts is enough for you. On the other hand, some individuals will do better to purchase a Medicare Advantage policy. These policies are designed by the government and their parts are the same no matter what company you buy them from, however, it is important to compare prices with all companies in your area, since private insurance companies sell the plans and can charge whatever they want, so your premium might be very reasonable when it comes to one company but could be double or triple through another insurance company.
Between now and the end of 2009 it is open enrollment time. This is the time to really do your research and make your choices as soon as possible, so that you can lock in the best prices and the right coverage for you for the next year.
So, go online to the websites above and get started making sense of Medicare and finding the coverage that is right for you.
We continue to hear about health care reform and we continue to hear that Medicare reform is an ample part of the entire package of health care reform.
This means that not only does healthcare need changes that will save money and help keep coverage in tact as much as possible.
The health care reform that is currently being decided upon cannot solve all the issues that involve coverage, and the cost of individual care and what kind of quality that is provided to people.The health insurance companies and their lobbyists have a lot of money and would love nothing more than to see public healthcare disappear – and they are willing to do whatever it takes to make it go away.
Private medical insurance is in control in the United States and as a result this country spends far more on health care than any of the other developed and wealthy nations in the world. In fact, other than Luxembourg, the United States pays at least 50% more than all these other countries.
Because of the strength of the private health insurance companies – an industry that is extremely strong in the United States – over 45 million people have to cope with not having health insurance. This is unconscionable in a nation such as ours. To exclude this many millions of people from basic care should not be happening. The results of this lack of care, according to researchers, ends up with over 35,000 people dying per year because they don’t receive preventative or regular care.
Of course, private insurance companies have all sorts of ways of denying coverage, excluding pre-existing conditions and finding other ways to deny treatment to sick people. In fact, the private insurance industry has had a strong involvement in numerous bankruptcies, even though people had insurance, but the insurance wouldn’t pay. Unfortunately, the unsuspecting policyholders were stunned, since they thought they were totally covered.
With a public option that would include making Medicare available for all who need it, many of these problems would be eliminated. In this system, there would be a single payer system and the government would end up being the single payer. Everyone could receive treatment even if they couldn’t pay – because they would be covered – and they would not be denied coverage if they had a pre-existing condition.
In addition, this type of system would save between $350 to $400 billion per year in costs. This would be enough in savings to cover the costs of coverage and treatment for all uninsured individuals.
Basically, a big part of the savings would come about by eliminating the insurance companies from the middle of the mix.
The insurance companies obviously don’t like this idea, but the pubic – especially those who don’t have insurance or any means to get it – would like to see something like this happen.
We are coming closer to the wire when lawmakers will cast votes to determine what kind of a health care system this country will have. Let’s hope that lawmakers can hear the people and not just the insurance companies while they are looking for a solution.
Every year there are a few changes to Medicare that Medicare recipients should know about. With all the confusion about health care reform, the information for 2010 is as important as ever.
One of the things that will happen in 2010, unfortunately – but not totally unexpectedly – is that the Premiums for Medicare Part B will rise. Since income determines your premiums, if you are single and your income is less than $85,000 your premiums will go up from the 2009 figure of $96.40 to $110.50 per month in 2010.
It becomes a bit confusing when it comes to filing a joint tax return. If filing joint and your income is $170,000 or less, each beneficiary will pay $110.50 per month. The individuals who file a single return and whose income is between $85,000 to $170,000 will pay $154.70 per month.
This is the same for those filing jointly whose income is between $170,000 and $214,000. If your information isn’t listed here, you can check with Centers for Medicare and Medicaid (CMS) or www.medicare.com, or in the Medicare and You booklet which has a chart explaining premiums.
As for Medicare part A and B there are also changes coming. Medicare Part A which covers hospital bills has a deductible that will go up from $1,068 in 2009 to $1,100 in 2010. It is important to be aware that this deductible applies to every hospital visit, so each time you are in the hospital, then out for 60 days and have to go in after the 60 days is up, you are charged with another deductible. If you go back into the hospital within the 60 days, you don’t get charged again for the deductible.
Part B covers medical expenses and will go up in 2010 from $135 per year to $155 per year.
If you have a Medigap policy, it is important to know that Part J will be discontinued as of June 2010. If you already have the policy, however, you can keep it and maintain it if you pay the premiums and keep the coverage in force.
Most likely Plan J will become very expensive – in fact, it will be more expensive than people can afford to pay – especially as they sign up for Medigap policies, which are much more affordable. As this happens more and more – less people using Part J because they go to Medigap or pass away – the rates for Part J will continue to rise, eventually making it too expensive for most seniors to enroll in. Plan J will eventually be eliminated along with Plans E, H and I.
If you have to get coverage, the minimum suggested is Plan C. In addition, if you need more coverage, 100 percent coverage is offered after basic Medicare through Plan F. Plan C and Plan F will continue to be available and the government will be adding Plans M and N. There is no information on the approximate cost or which states they will be available in.
Plan M will pay up to half of the deductible for Part A if you go into the hospital.
Regarding office visits, Plan N will have a co-payment of $20 per office visit and a sliding scale of up to $50 for emergency room visits. Plan K and L will also stay available, but offer benefits that are somewhat limited.
The various plans are created and offered by the federal government. The issue is that these plans are available, whether or not they are available in your state is up to the Insurance Commissioner in your state, so different states can have different plans available.
Regardless of any changes or proposed changes, your coverage will stay the same for a while. Medigap plans will not have changes until June 1, 2010, so you can purchase any of the plans available in your state until then.
It used to be that doctors made house calls. This was essential because there were few doctors that were responsible for vast areas. People would send for the doctor if a person was sick, and there was nothing left to do but for the doctor to make a house call to help the patient.
As communication grew along with communities and towns house calls increased for a while, then decreased with the advent of medical centers and hospitals. There were still house calls, however, there were more and more people going to doctor’s offices, clinics and hospitals.
Then came the era of cities that had organizations and health departments, making the era of house calls nearly a thing of the past. There was one group, however, that still fared better with house calls. This group includes seniors and individuals with disabilities.
Many of these individuals have too many health issues to run back and forth to the doctor’s office. They are elderly and/or disabled. As a result, home health care has been the main means by which they are taken care of. They have nurses and other health practitioners come to their homes to address their health issues. These visits are covered by Medicare.
Lawmakers are now looking into home visits or good old-fashioned house visits to these same patients by their doctors. Some doctors are already providing house visits to their more elderly or sick patients because it is easier and better for the patient to be able to stay at home rather than use precious little energy to prepare for a visit to the doctor’s office and the accompanying travel.
There are house call programs in various parts of the country and many physicians are beginning to rally Congress toward funding house calls. The bonus to this is that it will keep many people out of the hospital – an extremely high expense – and it will provide them with personal, high quality care while saving Medicare millions of dollars.
Doctors who are already doing this are trying to get other doctors to do the same. In addition, these current doctors are trying to encourage other doctors to lobby with them as well. After all, the Veteran’s Administration already provides home care to over 3 million people and this has helped many individuals and conserved costs, while delivering personal care.
Time will tell whether home health visits by physicians will be included in Medicare benefits, but if it is, according to many physicians, these visits could be a cost saver and a lifesaver.
The Medicare open enrollment cycle for existing beneficiaries occurs annually during the last six weeks of the year (November 15th through December 31st). The changes made during this time period will go into effect January 10th of the New Year.
During this time period, Medicare beneficiaries have the choice to go with traditional Medicare only, a Medicare supplement insurance plan or to sign up for a Medicare prescription drug plan.
After the beneficiary has made a decision, he or she has until March 31st to switch plans. If not change his made before this date, the plan will remain intact until the following year's open enrollment season.
Users have the ability to keep their existing Medicare Advantage plans by doing nothing. To make changes, users can enroll at Medicare.gov or call 1-800-MEDICARE.
What should you do before making a decision?
First off, be sure to review your current health and prescription drug plans. The costs for plans will change annually so you need to know your current benefits and pricing. You can then compare your existing Medicare plan with other ones to see if you can find a better choice. If you want to keep the existing plan, you do not have to do anything. It will rollover at the end of the open enrollment period.
If you decide to make a change to your health insurance plans, it is best to do it as soon as possible. This will help you avoid any confusion at your local pharmacy when the new plans go into effect in January.
When you have chosen the new plan (if you do), you should join with one of the following methods:
Sign Up with a Paper Medicare Application: The company that is handing your plan will have an application. You can fill it out and send it back by mail, fax or possibly email.
Visit the Plan Website: Find the website for the plan you have chosen and complete an online application.
Go to the Medicare Website: There are many drug plans available on the official Medicare website. There is a chance though that the plan you have chosen will not be available here so you may have to use another application choice.
You Can Call the Company Directly: If you have the phone number for the Medicare drug plan company you can normally call and enroll by phone.
Call Medicare: As a final resort, you can call Medicare at 1-800-MEDICARE and enroll by phone. This is by far the most difficult and time-consuming option and should be kept as a last resort.
What Information is needed to join a Medicare Drug Plan?
If you are ready to join, you will need the following items to complete your enrollment:
- Your personal information (full name, address, date of birth, etc.)
- The information on your Medicare Card
- The premium payment option
- Any other insurance information.
- Your social security number (optional)
- Your Email address (optional)
- A Name and Phone Number for an Emergency Contact
- The contact information for the nursing home or assisted living facility you reside in (if applicable)
Once you have completed the Medicare open enrollment application process, you will receive a packet of information from the company you have enrolled with. The materials they send will include a membership card, a handbook, a list of covered prescription drugs, a directory of approved pharmacies, the appeal or complaint procedure instructions and other related details of the plan.
In closing, it is important to devote some time each fall to finding the best Medicare health insurance plan for you and your significant other. No matter your ultimate choice, it is important that you compare all your options before making a final decision.
Medicare and Medicaid. You can't pick up a newspaper, look at the news or listen to the radio without hearing about these programs.
The problem is that everything you hear is different depending upon who is saying it. Some of the pundits and politicians have been talking about doing away with the programs and starting over. Others have been trying day and night to bolster and save these essential services and have said that if Medicare, Medicaid and healthcare are balanced right, the programs would save enough money to grow and thrive in the future.
For those of you who depend on Medicare or Medicaid the first thing to remember is that after eons of wrangling about all the programs, lawmakers are getting closer to determining the issues and figuring out answers. According to the lawmakers, Medicare and Medicaid will be saved, and though some things may change, overall, things will be changed - most likely for the better.
Many individuals who are recipients of Medicare or Medicaid are rightly worried. When you hear so much confusing and contradictory information about a program that is your lifeline, it is certainly scary.
To relieve some of the fear and misunderstandings involved here is some positive information regarding Medicare and Medicaid. Lawmakers on both sides of the question have said that they will save Medicare and Medicaid, and the President has said that he will not pass a bill unless this happens. Also, even though there has to be some tough accounting involved, everything that needs to be done to make sure that Medicare and Medicaid are solid and workable and continue covering the millions of seniors and other individuals that depend on the services that these programs provide.
Lawmakers are getting closer to passing the bill and when that happens, everyone will be able to breathe easier and hopefully, put the confusion behind them.
There are a million ideas about what overhauling the healthcare system will bring about for everyone and for every program involved in the healthcare system itself. One of those programs is Medicare, and they have some feelings and ideas about what possible changes might mean. 
The secretary of Health and Human Services, Kathleen Sebelius, who oversees the federal Medicare program, issued a report on Thursday, to help keep seniors and Medicare recipients from worrying about anything that might be coming in the future.
The title of the report is “Protecting Coverage and Strengthening Medicare.” The report addresses various issues and also states that proposals that are being worked on by lawmakers in Washington will help seniors. These proposals, Sebelius says, will keep Medicare from bankruptcy and will help senior with issues including trying to lower the out-of-pocket costs and copays for prescription drugs and make them more affordable for seniors.
“Health insurance reform will protect the coverage seniors depend on, improve the quality of care and help make Medicare strong,” Ms. Sebelius said. It will not be an easy task to convince seniors to count on or support healthcare reform, especially since there are still some big questions they face and there are still issues at loom large as lawmakers try to address and fix them. In addition, there are several sides to this situation and Medicare is only one part of a major problem in the overall healthcare system.
Too many seniors are hearing information that is the exact opposite from what Ms. Sebelius has said in her report. New York Times reporter Robert Pear pointed out in an article last week, that older Americans have some reason to be concerned. On the other hand Secretary Sebelius argues that if the government does nothing, seniors who rely on Medicare will be worse off.
“The status quo is unsustainable and unacceptable for seniors,” she said. She has said this and so have many lawmakers in Washington, yet, round two of the battle is just beginning and there are many lawmakers who are looking toward Medicare to save money. At this point we can wait and see if what Secretary Sebelius has said is right.
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