When am I eligible for Medicaid?
“Coverage may start retroactive to any or all of the three months prior to application, if the individual would have been eligible during the retroactive period. Coverage generally stops at the end of the month in which a person's circumstances change. Most states have additional "state-only" programs to provide medical assistance for specified people with limited incomes and resources who do not qualify for the Medicaid program. No Federal funds are provided for state-only programs.” (more...)
How does Medicare Supplement Insurance (Medigap) Work?
This question on the surface is very difficult to answer because of all of the variables that are involved in the use of Medigap insurance. This type of insurance basically steps in to augment and improve the coverage that you already have for your health insurance. With Medigap policies there is much to remember, here are two key things you should keep in mind. (more...)
What does “Medically Necessary” mean to my Medicare coverage?
The term “Medically Necessary strikes fear in the hearts of all that are a part of Medicare coverage across the country. Somebody, somewhere in some dark room decided that whatever you deem necessary to live a good life is not “Medically Necessary” so you are out of luck. Or are you? Consider the following ways to determine if something is “Medically Necessary” and if your situation qualifies: (more...)
How to Respond to a Medicare Part D Denial
When you need to have your drugs paid for by Medicare Part D to be able to make your finances work it can be incredibly frustrating when you are denied. This may seem like an impossibility as your doctor should know what drugs are not covered by Medicare Part D, but it does happen. However, you do have the right to appeal the decision and you have options if this does not work. (more...)
What to do if Part A Medicare issues a denial?
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? (more...)
Medicare Enrollment Questions: What is the difference between Initial Enrollment and General Enrollment?
Medicare enrollment is important for the same reasons as any other enrollment in health, auto or homeowners insurance, without enrolling you have nothing. There are two different kinds of Medicare enrollment that are important for different reasons and it is very important that you know the difference. Listed below are the two types of Medicare enrollment with description of each: (more...)
What Does Healthcare Reform Mean for 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. (more...)
Will Both Sides Come Together to Fix Medicare?
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. (more...)
Did the State of the Union Help Medicare?
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. (more...)
Could Doctor House Calls Help Save Medicare?
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. (more...)
2010 Facts for Medicare Recipients
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. (more...)
Many Seniors Happy with Medicare Coverage
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. (more...)
How to Enroll in Medicare Part B After Age 65
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. (more...)
Prevention May be Key to Cutting Medicare Costs
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. (more...)
Get Help Understanding Your Medicare Benefits
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. (more...)
Medicare Handbook for 2009-2010 Released
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. (more...)
Medicare Adds Coverage for HIV Testing
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. (more...)
Will Medicare Coverage be Expanded to More Americans?
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. (more...)
Medicare Scare Tactics Being Used in Health Care Debate
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. (more...)
