Enrolling in Medicare is a very important part of retirement that you must take care of as soon as possible when retirement looms. You don’t want to take any chances with a lapse in coverage that could cost you lots of money from your wallet. So you need to enroll in Medicare right away and the best way to do that is when you become eligible.
Federal employees don’t really have any other stipulations than that of the general public when it comes to enrolling in Medicare. You should still call the Social Security Administration when nearing Medicare enrollment and ask for any information you need. No special perks or benefits are available for you to ask about, just ask about enrolling in your coverage.
If you visit the website for the Office of Personnel Management you can get some great tips on how federal employees should enroll. The same benefits that are available to everyone else are available to you. It is recommended that you study up on the benefits of the different parts of Medicare to be prepared for enrollment.
There are situations in which you may be able to enroll in Medicare earlier than expected and in this case you will receive a notice about retroactive enrollment. This is a great opportunity to take advantage of the benefits that are available to you in everything, including prescription drug coverage or Medicare Part D. What happens when you are enrolled retroactively in Medicare Part D?
First, you will receive a notice from Medicare informing you that you are able to enroll early in the Medicare Part D coverage. Your “Notice of Medicare Entitlement” will be available for three months from the date of the letter. Once this three months is up you could face a penalty from Medicare for late enrollment if you enroll after the expiration.
So if you have any desire to enroll in Medicare Part D and you receive this letter you should be on the ball and not wait to enroll. Take your time to make sure you are getting the right benefits, but otherwise you should get it done as soon as possible. You don’t want to be facing the fees that come as a result of late enrollment in any kind of Medicare.
Enrollment in Medicare is a very important time for anyone as this is about being able to stay healthy and cared for. There are very specific rules for enrollment and when you are actually allowed to enroll, but there are always contingencies. One different situation that may arise is when you are allowed to enroll at an earlier date, or retroactive enrollment.
If you are allowed to enroll at an earlier date than your scheduled Medicare enrollment you will receive a letter from the Social Security Administration (SSA). This letter will give directly the date you became eligible and you may even receive a check. This check will be for your disability benefits and if you receive one you should contact the Social Security Administration ASAP.
This may cause a bit of a problem when you go to receive services as you will not have your benefits card yet. Don’t let this become a bigger problem than it really is, all you have to do is give your healthcare provider your information and let them submit it to Medicare. You will receive information from Medicare later on about this invoice.
Anytime that you have a medical procedure done or appointment made you will have to issue a claim to Medicare to cover the cost. Like any of your Medicare benefits, all services that you have done on you are subject to approval for payment. So what do you do if you are denied payment for a service that has been performed on you or for you?
Once you receive the notice that the claim has been denied you will have all that you need to respond to the decision. This form, known as a Medicare Summary Notice (MSN) will have the information on it explaining how to issue your appeal. This first level appeal, also known as a redetermination, will determine whether or not you have to pay the demand.
It is possible to win an appeal and have your claim paid in the end, so don’t refrain from issuing an appeal just because you think it is impossible. Issue an appeal if you feel it is necessary and include all information that supports your contentions. Don’t simply take the first word on if your Medicare benefits will pay, follow up and appeal all questionable decisions.
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.
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.
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.
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.
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.
September will be the most difficult month regarding healthcare reform for the Obama administration and the advocates of comprehensive health reform. They knew that it would be a tough month but knowing it and going through it is two different things. This administration and advocates are going through it.
Lawmakers are returning from a break and the President is returning from his vacation. Healthcare reform is not an easy task and has been a tough fight.
On top of everything else, Ted Kennedy – the Lion of the Senate – has now passed away.
Senator Kennedy had served for over 45 years and was a guiding light for lawmakers that were on both sides of the aisle. He was able to explain his point of view tactfully and respectfully so that even those who didn’t agree would still at least listen – and some of them actually heard him and adjusted their thinking on whatever subject was at hand. Of course, there were those times when he could be quite forceful and absolutely nobody missed the point.
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Now that lawmakers and the President are getting back to action, we will see what happens with these bills. One of the important issues when it comes to health insurance reform is the changes to Medicare.
We have been told that seniors and individuals with disabilities will not lose their benefits; however, there is a lot of spirited debate debating regarding their Medicare coverage.
One approach would be decrease the cost of reform as well as lessening its scope and spend around $600 billion to around $800 billion during the next ten years instead of over $1 trillion which has been proposed as a possibility. Doing this would make it easier on the finances of the federal government, but would be more difficult to actually put into place than doing a comprehensive overhaul of the whole system. Using the lesser figures would actually create a kind of hodge podge of a fix and would not fix two essential issues with the system we have now. There are two many people without health insurance and too many others are getting to the point where, not only can they not afford it, but it is not taking care of their needs at the prices they are paying now.
If there becomes a situation where reform cuts out subsidizing employers regarding health insurance, many people could not afford it anymore. They would be obligated to purchase insurance on their own. If they did not, there is a possibility that they would be fined.
Coverage could be offered to various groups depending on the situation, and hopefully, in time, other groups could be added. The hard part would be who would get this coverage. It is obvious that Medicaid is essential to individuals at or close to the poverty level. Having that program stay solid and be offered to all at that level would be an expensive proposition – around $40 billion in the next ten years. Yet going without it would cause extra problems – people at the poverty level who could not receive Medicaid could end up at the ER for things that could have cost the government hundred or thousands of dollars less had they been covered by Medicaid and allowed to simply see a doctor or a clinic. Essentially, if people in this position are not covered by Medicaid, they still get sick and the bills for those ER visits and other medical services for those who are not covered by Medicaid are partially absorbed by the hospitals as a loss and, you guessed it, paid by the government, thus affecting our taxes.
Medicare is another program that is essential to save. As Boomers are becoming retirement age they will be ready to enroll in hordes, so they will need to be able to have this coverage. Most Boomers are a little more prepared for retirement than the last generation, so there may be a little breathing room as they transition, however, Medicare must be fixed and saved, and the President has promised not to cut this program, rather to save it and make it work.
The challenge now is for congress to find a way to make sure the uninsured are insured, find the money to pay for comprehensive healthcare reform and save these two programs – Medicare and Medicaid – while working to make all this affordable while moving into the future.
For now, we are all waiting to see what congress comes up with.
Seniors throughout he country are extremely concerned and worried about their Medicare benefits. Everytime they hear the words "healthcare reform" they cringe, worried that as money continues to get tighter and cuts are made to many programs, they will lose critical and essential benefits that in many cases keep them alive and out of the hospital.
At a telephone town meeting Tuesday, President Obama answered questions from mostly seniors. One of the things that he said to reassure these older Americans regarding their Medicare benefits was, “Nobody’s trying to change what does work in the system,” Obama told the estimated 180,000 listeners. “We are trying to change what doesn’t work in the system.” There have been many delays when it comes to the healthcare issues, people are getting quite nervous and confused. “Nobody is talking about cutting Medicare benefits. I just want to make that absolutely clear,” the President said emphatically. When he introduced President Obama, AARP CEO A. Barry Rand said: “There’s a lot of misinformation about health care reform—even on what AARP stands for, and what AARP supports. This town hall is part of our ongoing effort to debunk myths and provide accurate information.” He added: “I want to make it clear that AARP has not endorsed any particular bill or any of the bills being debated in Congress today. We continue to work with members of Congress on both sides of the aisle and with the administration to achieve what is right for health care reform.” AARP president Jennie Chin Hansen also cited confusion expressed in questions that have come from thousands of members who have participated in previous AARP town halls. “Like, will the government tell my doctor how to practice medicine?” The idea behind this unique town hall meeting was to calm the fears of individuals - particularly seniors - who are nervous, or downright frightened, about what will happen to their Medicare and Medicaid benefits and ultimately to their health. The president said that overhauling the healthcare system is a high priority, however it is not an easy task and he wants to make certain that it is done right. “I know there are folks who will oppose any kind of reform because they profit from the way the system is right now. They’ll run all sorts of ads that will make people scared.” He pointed to the past and reminded people that this has all happened before, it is not just unique to our time or the current situation. “Back when President Kennedy and then President Johnson were trying to pass Medicare, opponents claimed it was socialized medicine,” he said. “When you look at the Medicare debate, it is almost exactly the same as the debate we’re having right now. Everybody who was in favor of the status quo was trying to scare the American people saying that government is going to take over your health care, you won’t be able to choose your own doctor, they’re going to ration care.” He also added this thought: “You know what? Medicare has been extraordinarily popular. It has worked. It has made people a lot healthier, given them security. And we can do the same this time.”
As the saying goes, stuff rolls down hill. In the situation with all the budget constraints on the federal government, comes constraints on the state and local government. Healthcare is definietly no exception. Lawmakers in Washington are looking at some very deep cuts when it comes to many programs and trying to figure out how to keep them from being deeper than they already are.
One of the programs that is being looked at piece by piece and line by line is Medicare. There will definitely be cuts to that program, period. As a result, as things roll down hill, Medicaid, which is a state program but bolstered by federal dollars, is taking a big hit, too.
Not only are some Medicaid benefits being cut way back, but getting into the program, which is already on the difficult side, has become much tougher indeed. It seems as though unless you are in the most dire straits getting approved for Medicaid is extremely difficult. Even if you are in dire straits and the rope you are hanging onto is beginning to fray - a lot - it is still difficult to get approved.
Consider the case of a 60 year old woman who was disabled in an accident. Her doctors took her off work indefinitely and she has no income except for $200 of assistance money which will run out very soon because of the new cuts from 18 months down to 12. She has no money to go to the doctor and has applied for Medicaid. She suffered injuries in the accident - which happened at work - but Worker's Comp is fighting against paying because she had some pre-existing conditions. Of course, what 60 year old man or woman doesn't? Meanwhile, she is in constant pain, in need of surgery and walking around on crutches or a cane with a fractured hip and two badly injured knees just for starters. She has high blood pressure (which has sent her to the ER 6 times in 3 months because it was at stroke level or higher), osteoporosis, arthritis, degenerative disc disease and possibly diabetes. She has doctor's letters, medical records and more that were sent to Medicaid. She applied for Medicaid and was turned down.
This individual did everything by the book and is having to go through hoops all over again trying to get help. This is before the new budget cuts that are on the way.
This is not to say that Medicaid is unfair or that it is a bad program. It is a good program and was designed for people like this 60 year old lady who has fallen through the cracks - badly. Each state deals with their own Medicaid program so it can be a little easier or a little harder depending on the state a person is in. Even if you have all your ducks, doctor's notes and medical information in a row, it can be tough to get Medicaid.
Do not give up, re-apply, call and talk to your worker and do whatever is necessary to give them the information so that you will get approved. Eventually, most people do get approved. It is simply a tedious road sometimes to getting the coverage you need.
There is a lot of controversy these days about what should go and what should stay in the huge U.S. budget which affects each state's and county's budget. Somewhere in that mirage of confusion, site Medicaid.
Though many of the proposed Medicare cuts and the ones already in progress are frightening and difficult, at best, to deal with, the thought of more Medicaid cuts puts more pressure on the people that need the program most.
Seniors and individuals with very low income often depend on Medicaid to get basic medical care. Nothing fancy or frilly. A few doctor's visits, maybe some tests and some medication. Medicaid is what is supposed to help these individuals who can't afford Medicare Supplements and who need to have regular medical care - even minimal care - to stay reasonably healthy.
When hearing what people on Medicaid have to say, they say it is a lifesaver - literally - in many cases. They say that without it they would be in a hospital somewhere very sick or dying at the state's expense. The unfortunate situation is that as budgets get leaner, criteria for people to qualify for programs gets tighter and more people who need this help are left out.
The problem is that rather than helping keep the benefits for people, once someone has lost them, the state and county end up paying untold thousands of dollars for emergency room visits that take the place of doctor visits. Keeping people on Medicaid and allowing new ones to get on it save the state and county money, short term and long term.
There is a lady who is 59 years old and lives with her children. Her only income is assistance since she is too young for Medicare and she has a disability that will probably continue the rest of her life. She has applied for Medicaid which she said was an escapade of jumping through hoops, and after she turned in every single paper (about 1/2 inch worth) she was denied. The woman can hardly walk. Her blood pressure is out of control, she has been in and out of the emergency room because her blood pressure has been so high they are worried about her having a stroke, and instead of accepting her to Medicaid to get the care she needs, she was turned away. So at age 59 she goes to sleep, fearful that she won't wake up, and there's nothing she can do unless things get so bad she goes back to the emergency room.
There are seniors that are worse off, who choose between groceries and medicine and use less of both, keeping them hungry, undernourished and undermedicated, while their condition gets worse.
In these times, it is understandable for cutbacks to happen. It is simply a matter that some of them don't make sense. In the richest country in the world we are letting seniors and others starve and suffer just to save a few dollars - and then it cost thousands more to care for the individuals anyway.
It is important for everyone to have a chance to feel as good as possible and get good care. Hopefully as budget cuts continue, the president and lawmakers will remember that there are people living on much less than $250,000 or even $25,000 per year through no fault of their own. It is important to think about their dignity and well being when putting programs on the chopping block.
I saw this article while reading The Seattle Times. I read papers around the nation regularly to see what people have to say about the healthcare situation we are in as a nation. There are as many millions of opinions as there are people and lawmakers are playing tug of war with the situation. The problem with that -at least the biggest problem - is that they have the best healthcare in the world.
If they get a hang nail, a hernia or a heart attack their healthcare will cover it. The rest of us who are not covered like that or not covered at all can be having a stroke going into the hospital and being questioned as to whether we have insurance or not while we can't hold our head up in a wheelchair. This happened to my friend just before she fell out of the wheelchair, had an aneurysm, went into a coma and died a month later. She was 42 years old.
Here is the story from The Seattle Times:
Then there are the common people like us. Some of us have no healthcare because we make just a couple of dollars too much for Medicaid. OK. If that is so, than let us pay the two
Richard H. Cooper wrote in The Seattle Times about the need to fix Medicare before letting government undertake another program.
I agree with all his points about improvements needed to this program. However, I believe there is a way to fix it and do health-care reform at the same time.
There's already House Bill 676, the new-and-improved Medicare Act. This bill will put everybody in Medicare, and as we know, the bigger the pool, the less the cost.
By having only one nonprofit financing mechanism for our health care, we can save huge amounts of money. Imagine all the premiums now going to for-profit insurance companies whose goal is to make as much money as possible, not make our population healthier.
Also by having one financing mechanism, we can save huge amounts of money for practitioner's by reducing administration and overhead costs.
Secure public coverage for all will also mean a lot of people will retire that now just work for health benefits, and some will start businesses and provide more jobs because the burden of health-care coverage is lessened.
We already have a mechanism for employers and employees to pay a Medicare tax, so it can easily be adjusted to cover all and substitute for paying premiums. And with a tax, one pays according to income as opposed to with a premium. It's a fair and simple way of reforming our health-care system.
But most important of all, this system gives us the most bang for the buck, and I do not want my tax dollars to subsidize for-profit health care.
Medicare has evolved into a program rather different now than when it started. It covers over 40 million seniors and it has changed the way it is administrated. In addition, poor oversight has caused cutbacks and tight budgets which means that there are cutbacks in services, cutbacks in payments to doctors, hospitals and other medical professionals.
Yet, Medicare still moves on. They have been predicting its demise for years but it is still here. Now, don't get me wrong. It is obvious that Medicare has some serious financial issues. It is also possible that in the years between now and the time the program is supposed to run out of money, there are many things that can be done to straighten out the program by creating better oversight regarding fraud and abuse, creating better incentives for doctors in the program to stay - especially some of the great doctors that are treating Medicare patients at a fracthion of the price that they treat their private patients. This is a sacrifice financially because they care about their Medicare patients.
I have talked to doctors and other healthcare professionals who treat Medicare patients. Some of these have a patient load of 50% Medicare patients. I know of a few that treat nearly all Medicare patients because they have no place else to go. The majority of doctors say they can't afford to take on any new Medicare patients. The sad part of the situation is that with the right "tweaks" many doctors could take a few Medicare patients each. If a doctor is taking home $250,000 per year and took 10% Medicare patients, it wouldn't make him or her go broke, it would bring in extra money and it would help elderly people who need medical care. If he Medicare system could help devise a way where doctors got something out of treating Medicare patients and send out information about this to every doctor in the country, more doctors would be able to take a few Medicare patients and more elderly would be receiving continuous treatment. This would save money for the system because even if these doctors who took 10% of their caseload as Medicare patients and received a small bonus or other perk for doing so, the majority of patients would stay healthier longer and avoid costly trips to the emergency room or costly stays in the hospital or long term care. Medicare pays for these. If a doctor could help Medicare patients stay healthier and out of the hospital, perhaps he/she could receive a bonus which could come from a small percentage of what was saved for Medicare by keeping the patient healthy and at home. So the doctor gets $1,000 and Medicare saves $10,000 to $50,000. That sounds like smart finance and a win-win situation for everyone.
The elderly depend on Medicare. Some still have the means for private insurance, but even so, their Medcare benefits help defray other costs. There are ways to make sure that doctors can afford to treat Medicare patients and make enough money for it to work while at the same time actually saving Medicare money.
I am not privvy to the information being discussed in the battle over Medicare, Social Security and Healthcare by lawmakers on the hill in D.C. I just know that if I can think up something this basic, the leaders who are far more savvy than I am should be able to come up with a solution to keeping our elderly covered by Medicare and our doctors willing to take Medicare patients. There is enough time for these intelligent thinkers to come up with a plan that will work for everyone. This is not a maybe. This is a moral imperative.
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.
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.
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.
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.
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.
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.
When you have chosen the new plan (if you do), you should join with one of the following methods:
