Posts tagged 'medicare benefits'
Mental health care has become more accepted and widely recognized as a problem for the senior population across the country. People realize that this has become a real problem and that is why Medicare benefits are being changed on a regular basis to support mental health care. So what can you or your loved one count on from Medicare benefits when mental health care comes in to play?
- Medicare Part A will help to cover the mental health care that must take place in a hospital in order to address the situation. Your room, meals, supplies, nursing care and other related services will be covered under this policy.
- Medicare Part B will cover the types of mental health coverage that you would need to take place outside of a hospital. Visits to psychologists or social workers are a part of this coverage as well are lab tests and other tests ordered by your doctors.
- There are times that you will be prescribed certain drugs by your doctor or medical professional to help with your mental health condition. When this happens the coverage will provided under your Medicare Part D coverage.
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 is estimated that the number of internists will decline substantially by 2025, and the Medicare Payment Advisory Commission indicates finding a new primary physician is becoming more difficult for seniors—meaning that Medicare recipients should begin as early as possible for the best doctor and get established and comfortable with that doctor.
According to MedicareSupplementPlans.com: Many Medicare recipients, are having a difficult time finding a new primary care physician. A 2008 survey conducted by the Medicare Payment Advisory Commission (MedPAC) found that by 2025 there will not be enough primary care physicians. In addition, an estimate from the American College of Physicians (ACP) that there won’t be enough internists to go around by 2025. Let's add one more issue: the ACP also indicates that current internists are becoming less willing to accept new Medicare patients.
According to Alan Weinstock, an insurance agent at MedicareSupplementPlans.com, many physicians are no longer taking Medicare because reimbursement rates and too much paperwork. With all these trends converging at once, Weinstock believes Medicare recipients need to shop early to find the best doctor—before they turn 65. "It’s traumatic turning 65 and entering an unknown area of new healthcare. So many questions…wondering if you asked the correct ones and were given all the correct facts."
“The impact on seniors of physicians opting out of the Medicare program hasn’t been a serious problem yet,” said Weinstock. “But if large numbers of physicians join the group that is opting out, it may be difficult for seniors to have access to affordable health care.”
This is why it is important for the 40 million Americans who have Medicare insurance or those who will be starting Medicare soon to start early in their hunt for a physician who still accepts Medicare. Many of the physicians who accept Medicare now may not accept new Medicare patients but will still continue to take Medicare as payment for the patients they already have if a good relationship is established. It is equally important that seniors take the time to determine the best Medicare supplement insurance coverage, since Medicare often does not cover all health care costs.
Robert Dowell of Visalia, Calif., understands full well the need to have someone knowledgeable when searching for the best Medicare supplement plan. “It’s traumatic turning 65 and entering an unknown area of new healthcare. So many questions…wondering if you asked the correct ones and were given all the correct facts.” But Dowell found all the answers he needed at MedicareSupplementPlans.com and says that now he “has a clear path on how to control my health needs.”
If you are a Medicare recipient now or will be soon, check with your doctor or a recommended doctor and check with the references in this article so that you will be prepared with a doctor who will accept Medicare benefits as payment for your treatment.
This seems to be a week for special stories that need to be told and need to be heard. There are many stories about problems with Medicare, just as there have been many successes with Medicare, as well. The fact that Medicare is in trouble in various ways is not news. We have been hearing this for decades, yet, it has taken until now - where Medicare is in a crisis - for lawmakers to sit down and really pull up their sleeves and put in the work to try to stabilize not only Medicare, but Social Security and the entire healthcare system.
It doesn't matter who is to blame or how many presidents back contibuted to the mess rather than fix it. For years it has been known that if a pet project needs funding all congress has to do is tap into Medicare or Social Security funds. Lawmakers know it and the public knows it. Just the charges alone for a pill or a pillow show that there should be more control over the system and more regulations between Medicare and the pharmaceutical companies as well as other vendors. Now we are all dealing with the results.
Below is a story I read that shows the results of a system that has been poorly managed - and, at times, not managed at all. I am leaving the story as written, as it speaks for itself. This is why we have to fix the system. There is no alternative.
My Medicare Experience
by jboettner
05/19/2009 01:02:14 PM EST
My father passed away last July 2008. Even though he is gone, I thought people should know about a couple major issues we encountered with Medicare.
First of all, my father was in rehab recovering first from hip replacement surgery, then from revision surgery. When Dad was a few weeks from discharge, he fell down and broke the same injured leg, and extended his recovery time indefinitely.
The problem is under Medicare patients only have 100 days to utilize rehab facilities, once 100 days were exhausted, my father's care immediately jumped to $200/day.
In addition, I found a source of VA medical supplies from a friend who died; we thought we'd ease the burden on Medicare with the second hand supplies.
I was very impressed with the quality of the VA equipment. But Dad's nurse determined that he needed a special pillow for his wheelchair, and the only way he could get the special pillow was to get a Medicare supplied wheelchair. As we found the Medicare wheelchair was not only inferior to the VA wheelchair, but as far as the "special pillow," about the only thing special was the $500 cost!
As we get ready to launch this major effort to reform healthcare, I just thought you should be aware that private industry seems to have also co-opted Medicare.
Apparently there is a 60 day period between medical events required to qualify for another 100 day rehab period. This would have been nice to know, but even if we did I doubt the outcome would've been different.
When we can approve $500 for a pillow when the patient can get it for free, plus deny a free wheelchair from the VA - in better shape and better quality than the one being provided by the facility through Medicare and forced on the patient - this shows why Medicare is in the mess it is in. This hapens thousands of times over. It is time for it to stop
The new present and Congress are under a lot of pressure to clean up a lot of messes. The fact that most of these messes started long ago and far away under other administrations is somewhat irrelevant. The main issue is that right now, the economy is in a mess and it is affecting a lot of things, not the least of which is Medicare.
AIG has long been a staple in the financial area. The main problem is that as the government continues to try to shore up medicare, help it go further and help it assist more people who depend on Medicare benefits to stay healthy - or even stay alive - AIG has been finding ways to get money in sneaky and unscrupulous ways over and over. In addition, AIG has managed to get millions and milllions of dollars from the government to keep runing, because AIG is connected to tons of financial institutions that everyone seems to be worried will go under if AIG does, since AIG is the sugar mama.
The latest information on AIG after they have taken plenty of money to continue operating, they have been and continue to pass out millions in bonuses and "retention" money, as well as tell the overnment and everyone who will listen that this is someting they must do and that "legally" they can't get out of the situation.
Meanwhile, Medicare is struggling to take care of those other millions of people - you know, the ones wh depend on them to get o stay healthy. Lawmakers and the president are doing all they can to get Medicare on more stable fotting. The unfortunate thing is that this whole mess started in preious adminisrations and
for the most part, until this administration there has been little effort to really examine AIG or Medicare.
The Obama administration has made its share of mistakes and misjudgements, however, let's be fair - they inherited a miss that has been growing and growing, as well as getting messier. more complicated and more sinister over the previous years. Now it is up to the current administration to get this fixed. At least this administration is really trying to get it right. There are some lawmakers on both sides of the aisle that are trying to put bipartisanship aside and work on these urgent issues.
If the rest of the lawmakers could simply put their partisinship aside and worry aboutfixing the problems rather than blaming people, a lot coud be fixed faster. Things will get fixed, there will be mistakes and oversights along the way, and these, also, will be ixed.
It's time to continue trying to make Medicare run as it should and stop shoveling money to corporations who are - and have been - using it on unncessary luxuries while those who are struggling can't even get basic, decent medical care.
It will take some time, and at east for the first time in nearly a decade, there is a trye effort to fix these issues and put the oney where it should be. Now, if we could just get everyone to stop playing the blame game and clean up the mess, things would go faster and and definitely turn out better.
It’s election time. You know what that means – it means that we will hear a variety of predictions as to what will be happening in the country regarding taxes, education and more. And of course, Medicare is in the middle of the mix.
Candidates will say anything and everything from “everything is just fine” to “the sky is falling, but I can save the planet.” It’s not easy to figure out what to believe or who to believe.
What we do know is that Medicare has some issues to deal with. Enrollment is rising while funds are shrinking. As a result, certain aspects of Medicare need to be restructured. There are more out of pocket expenses for Medicare recipients and there are some things that used to be paid for by Medicare that are no longer paid for in the same way.
For all the plusses and minuses, Medicare is still a program that helps many people who need it. Over 44 million people are enrolled in Medicare and are able to get healthcare, medical and other services that many of them would not be able to receive any other way. Some of the most financially vulnerable and health challenged individuals are able to receive continuous care because Medicare is available.
Granted, there will be some changes in the coming years to keep Medicare a viable program. Both candidates and the lawmakers on both sides of the aisle have ideas on what will need to happen to overhaul the Medicare system and the healthcare system to make them work for as many Americans as possible.
One candidate says that taxes won’t be affected, another says that taxes will go up, and then there are the pundits and news people. You can watch news on quite a few 24 hour news channels and hear each person’s show come up with a different analysis about what is going to happen.
The one thing we can all say about the elections and Medicare is that at least the people who are making the decisions in Washington are paying attention to the issues and talking about making sure that everyone has health coverage. That’s a start. All that the rest of us can do is wait until after the elections are over and see what actually gets done.
With the economy in a mess these days and the presidential elections only a few weeks away, candidates and lawmakers are saying all sorts of things about what they will be doing to fix the problem. They are “debating” about raising and lowering taxes, bailing out insurance companies and banks, and a thousand other ways to help the economy get straightened out.
One question that is continually asked by the public – especially seniors – is: What is going to happen to Medicare? We know that Medicare has its own financial struggles and needs support to stay solvent. The candidates say that they will continue to support Medicare.
The reality, however, is that there may be support for Medicare in the beginning – to get elected – but over time, there could be problems. For instance, John McCain has a record of trying to cut Medicare benefits and has stated that if he becomes president, he will cut $1.3 trillion from Medicare during the next 10 years to fund his healthcare plan. $1.3 trillion is a ton of money!
With Medicare struggling as it is, cutting this amount of money would severely limit the amount of new enrollees to the program and would create the need for extensive changes in coverage in order to save money. With the system running slim right now, how much more could we cut?
This would also cause individuals with private insurance to pay for many things out of their own pocket. Individuals who are retired and on limited incomes and who rely on Medicare are not usually in a position to do so. There would also be ramifications to individual states and to their Medicaid and CHIP programs.
In addition to all of this, there are hidden taxes that we don’t see. Besides shifting the cost of many types of care and procedures to the private insurance companies, the public would end up with the tax burden of funding the shortfall.
This may or may not be a good plan. It is not for the writers of this column to decide. It is important, however, before you vote, that you determine what the candidates propose to do regarding Medicare. They have finally laid out their plans to rescue the economy and somewhat deal with Medicare. Do your research so that you know what you will be voting for.
It’s not something your accountant would advise you to do if you are a physician or health care practitioner or professional. In fact, your account, financial advisor, closest friends and others would most likely strongly –very strongly – advise against making such a move.
But all business decisions are not simply made for profit only. Some are made because there is a serious need to be filled and there are people that are willing to go the extra mile to fill it.
The news is filled with stories every day regarding senior citizens who need health care and can’t afford it. Many of them receive Medicare benefits, but can’t find a doctor willing to be paid at Medicare’s lower than normal rates and even slower than normal payment pace.
A group of doctors in Amarillo, Texas decided to go the extra mile and help seniors in the area by opening a clinic that provides health care only to seniors with Medicare benefits, Medicare Supplements or enrolled in Physician’s Health Choice, which is a physician owned health plan which provides seniors with more coverage than Medicare.
The clinic, which recently opened, is designed to provide medical care to seniors, but that is not its only purpose. Doctors feel that if seniors had access to more information and accurate information regarding prevention and maintenance of health issues, they could maintain better health, therefore having to visit the doctor’s office for treatment less often.
The Amarillo Senior Care Clinic was established to address the fact that seniors face obstacles in receiving care because fewer doctors are willing to take Medicare for payment, and many will no longer accept new Medicare patients. As a result, seniors have less access to quality care, often exacerbating conditions that, if cared for regularly and properly could be controlled by medication and other interventions with less office visits, keeping more seniors out of emergency rooms, hospitals, long term care and nursing homes, because their conditions would be managed and not get to the point where they were out of control.
Many physicians say that this is a losing proposition financially; however the Amarillo Senior Care Clinic, though cautious, is not worrying. They feel that by stressing prevention and providing education, their patients will feel better and their health will stay more stable.
This is an innovative and exciting idea, and it would be great for physicians throughout the country to keep an eye on the Amarillo Senior Care Clinic and see how well it works. There are seniors in every county in every state who need this type of help to live longer, healthier lives.
With all the financial issues surrounding Medicare it has become harder to find doctors who readily accept Medicare, or even accept it at all.
Before the increase of fraud, red tape, financial woes, budget constraints and the like, doctors who accepted Medicare were not hard to find. Many doctors used to set aside a percentage of their time to devote to Medicare patients. They certainly weren’t making money on these patients, in fact, many times, they did not even break even by covering expenses, but the income from their overall practice absorbed the losses. Though Medicare was not a perfect system, it worked out for the doctors and their patients.
More recently, with all the Medicare woes, including very slow reimbursement at an extremely reduced rate, the majority of doctors say that it is too expensive to treat Medicare patients. They want to treat these patients and try to treat as many as possible, but are unable to take on new Medicare patients for financial reasons. Their regular practices cannot absorb the losses any longer.
This is not just frustrating to the doctors who would like to help these patients, but it is frightening and frustrating to patients who have spent a lifetime paying into a system that promised healthcare coverage but is now in such shambles that the doctors and specialists these patients need the most will not accept it for payment. This critical situation nationwide is leaving too many of our most vulnerable citizens without adequate care and actually making them more vulnerable because of it.
Lawmakers continue to say they are trying to fix the ailing system but are caught up in partisan arguing rather than bipartisan efforts, while the situation continues to worsen. The question arises as to whether they would rather pay out hundreds for office visits that prevent major health issues or thousands to pay for the health conditions that are not treated because of being penny wise and dollar foolish, as well as short sighted. Surely if there is enough money to fund billions for war, there should be enough to send Medicare recipients to the doctor.
As fewer doctors accept Medicare, there is the real possibility of a far worse health crisis than we see today. If you have Medicare benefits, check with your doctor and call others to make sure they will accept it. You can also call your local health department or hospital for further information about doctors in your area.
There are doctors who continue to accept Medicare, but it is becoming more difficult to find them and Medicare recipients who should be automatically taken care of are having to search for services. The system needs fixing NOW.
There was a time not too long ago when many doctors made house calls, especially for the elderly or disabled. It was more of a comfortable, less stressful and easier situation for the individual who needed medical care.
With the increase in “big medicine” people have gotten used to going to the doctor’s office. There are many reasons for this. Doctors are able to treat more patients if they can stay in one place and have the patients come to them. They also have all of their equipment set up in their office, as well as usually having a laboratory, x-rays and other services located in their medical building or close by, making it much easier for them to diagnose and treat their patients. And, of course, if they are at the office and the patients come to them, they can schedule up to 30-35 patients per 8 hour day in 15 minute increments.
Though this is convenient and cost-effective for the doctor, it has its down side for both the doctor and patients. If a doctor takes longer than the 15 minute time slot with a patient, it has a domino effect and backs all the other patients’ appointments up, making them have to wait longer. We have all sat for what seemed like forever just to be rushed through a doctors appointment and we have left wondering if the doctor actually heard anything that we said in the rushed 5 minutes that we were able to the doctor face to face.
Though most of us can sit through the wait and get through the appointment, it is often much harder for a person who is elderly, frail or disabled. Medicare knows this and so do doctors. There are still some doctors that will schedule house calls and Medicare will pay for these visits, though most patients don’t know it.
There is a quiet but powerful move by a number of doctors across the country to try to see ore patients in their homes. With an elderly or disabled patient, an appointment at home saves the often difficult trip to the office. A home visit also allows the doctor more time to examine and talk with the patient to take a closer look at any changes in health or any difficulties the patient might be having. If a problem is discovered that cannot be dealt with at home, the patient can then be seen at the doctor’s office, but most often, with regular care, most treatment and observation can be carried out at home.
If you receive Medicare benefits and find it too difficult to go to your doctor’s office, ask if your doctor makes house calls or if the doctor knows of a doctor, nurse or nurse practitioner who does. You can also ask for information from the home health care agencies and hospice in your area. There is not an overabundance of doctors who make home visits, but there are some and the numbers are slowly growing making it easier for individuals covered by Medicare to receive the care they need.
As Medicare tries to become more effective, efficient and streamlined, eliminating paperwork and unnecessary time, the Centers for Medicare and Medicare Services has planned an online system to help providers enroll to be providers. This system will be available to most states in early 2009, and will also be available in California, New York and Missouri by October 2009.
Not all enrollment materials will be available on the web-based system, however there will be enough to get the process started and move it along more quickly than the old system. In the past it took 90 days – and sometimes much longer – for a provider to complete the enrollment process. With the new online process, it is estimated that it will take 30 to 45 days instead.
One drawback that providers are talking about is the fact that since the system will not recognize online signatures, the online paperwork must be followed by actual paper forms with original signatures sent to employees at CMS who process the paperwork and combine the files. Providers are skeptical about this, as they feel it will continue to take more time, however, CMS says that they can be working on everything in the computer so that the process goes quickly and the original signatures on paper will simply be verified, not re-processed.
Another drawback according to providers is that each provider who wants to enroll as a Medicare provider must enroll in a separate and different system first. The second system is called the Individuals Authorized to Access CMS Computer Services. Providers see this as an extra and cumbersome step and wonder why there cannot be one system that can deal with all of the hoops they must jump through in one complete system.
In addition, providers are skeptical because there have been promises to speed up the enrollment system for quite some time, and this particular system was supposed to be up and running by March, 2008, according to CMS, making the debut over six months late.
Regardless of how the providers feel about some of the issues inherent in the debut of the new system, one thing is true: there is the potential to enroll providers more quickly and the potential to add further services for providers including billing, budgeting, records and more in the future.
For now, we can all wait and see how the system works and if it saves time and expense for CMS, Medicare, providers, as well as Medicare recipients.
We all keep hearing about the problems with the Medicare system including mistakes and underbilling, overbilling and the like. We also hear about fraudulent claims, but things are a lot worse than we have been aware of, and it is costing billions of dollars that could be going toward benefits rather than cuts. The government has been authorizing reimbursements to fraudulent companies for wheelchairs and other equipment, and these reimbursements have cost over a billion dollars. Most of these payments have been made to fake doctors and fake medical supply companies. In fact, the Government Accountability Office (GAO) has been investigating the Centers for Medicare Services (CMS) over the past year and found that CMS had granted billing privileges to two phony companies based in Maryland and Virginia who were supposed to be suppliers of equipment for Medicare recipients, but had no supplies whatsoever to provide to these individuals. In setting up this investigation, the GAO provided CMS with false and sketchy information, and CMS still provided them with the ability to bill for services. This put the fake companies into a situation where not only could they bill for millions of dollars, but they could have also gotten a doctors’ identification code fraudulently and started submitting claims, costing CMS even more money in payments. This “sting” by the GAO proves that there are issues with the enrollment process for Medicare suppliers and that there need to be changes so that fraudulent suppliers don’t take advantage of these issues and loopholes. As a result, the GAO has recently made some changes in enrollment procedures including the requirement that suppliers must be certified and meet other quality standards before they are allowed to do any billing. In addition, some other changes include making it mandatory for suppliers to keep all paperwork from doctors, limiting the use of pagers and cell phones as primary contact numbers for suppliers, and setting up new competitive bidding procedures for suppliers of medical equipment. CMS has been promising since 2005 that they would eliminate much of the fraud in the system, especially in approving fraudulent suppliers. This latest study by the GAO shows that there are still too many problems costing the system, the taxpayers and Medicare recipients too much, with the potential to cost them even more. Had there been real companies behind this sting, rather than fake companies, it could have cost many more millions of dollars. With Medicare benefits in jeopardy of continuing to be cut, it is time to make sure that CMS is doing its job rather than giving money that is already too scarce away. Perhaps if that happened, cuts would not be necessary and Medicare recipients could receive the benefits that they truly need.
Recently, with all the wrangling back and forth between Congress and the White House regarding the new Medicare legislation that was approved, then vetoed and then approved again over the veto, we have heard a lot of the negatives of this legislation. It’s time that we focus on the positive aspects of the legislation.
This legislation helps seniors where it is most important. For one thing, it will maintain and reinforce the relationship between seniors on Medicare and their physicians. The legislation has blocked a 10.6% cut in pay to doctors who treat patients on Medicare. This is essential, since many of these doctors are treating patients on Medicare at a loss in revenue at current rates, so lowering the amount that we pay to them would make things much more difficult. In fact, not allowing that pay cut to doctors has ensured that millions of Medicare recipients will be able to keep seeing the doctors that they feel comfortable with, the doctors that know them and know how to treat their medical needs, therefore, helping them to stay healthier longer.
Other positive benefits that this legislation will provide include assistance for low income individuals who need help with co-payments and other related expenses. It is essential that our most vulnerable population – seniors, especially those with very little means – do not miss out on receiving ongoing medical care and treatment because they cannot afford a few dollars for a copy to a doctor or pharmacy.
There are more positive benefits of the legislations, as well. There is some coverage for preventative medicine. Each new enrollee to Medicare will receive a comprehensive physical. In determining the health of each individual right at the beginning of their enrollment, there is a better chance for ongoing healthcare that will help maintain and individual’s health and identify any conditions or issues that need to be addressed.
Positive benefits also include stronger Mental Health benefits by equalizing benefits. In the past, Mental Health benefits have been paid at 50% vs. medical benefits that are paid at 80%. The new legislation pays both medical and mental health services at the same rate, making it much easier for seniors to afford and access mental health services that are so essential.
Time will tell how well the new legislation works and how much it helps those individuals who depend on Medicare for their health care needs. In the meantime, there is at least tangible help available that should protect some of the most vulnerable among us.
The news tells us on a regular basis about prescriptions gone wrong. A physician prescribes blood pressure medication for an elderly patient but the pharmacist can’t read the handwriting, so the patient ends up with a blood thinner which causes a hemmorage that lands them in the hospital. Or, a child is prescribed an antibiotic but ends up with a cancer med, causing long term health issues.
Medicare has established a way to reduce or eliminate this from happening: E-Prescribing. By prescribing on line and eliminating handwriting issues, it is estimated that the majority of misread prescriptions can be eliminated. In addition, this would reportedly save pharmacists about 150 million follow-up phone calls to doctors’ offices per year attempting to clarify prescription medication names, dosages and amounts.
Starting in 2009, Medicare will begin giving doctors who E-Prescribe a 2% bonus on top of their fee for E-Prescribing. Starting in 2011, the bonus will go down to 1%, and in 2013, it will go down to 0.5% for one year. The five years of gradually declining bonuses are an incentive to help doctors’ offices begin prescribing in this manner and get them in the habit of doing so, making prescribing and filling prescriptions safer and more efficient for doctors, pharmacies, and, most of all, the patients.
“There are terrific human and financial costs to illegible prescriptions,” Mike Leavitt, Secretary of the U.S. Department of Health and Human Services, said on Monday. “There are a lot of people hurt and a lot of time spent trying to sort out bad handwriting,” he added.
E-Prescriptions have been on the radar since about 2006, when pharmacies that participated in Medicare were mandated to be able to take the E-Prescriptions. Implementing this method of prescribing medication should create a profound reduction in prescription mistakes.
Because Congress stood firm and overturned President Bush’s veto, not only are physicians and their patients on Medicare protected for now, but other provisions have been spared as well.
The developments have made it possible for individuals dealing with Vacuum Assisted Closure (VAC) wounds and issues associated with them to be able to maintain assistance and care in their homes. Not only does this save the system money by keeping these individuals out of the hospital, it also allows them to have the treatment in privacy and comfort at home.
Kinetic Concepts, Inc. (KCI), the company that provides this technical and specialized type of treatment is on the cutting edge of medical technology and is devoted to discovery, development, manufacturing and marketing of innovative, high technology products for wound care, tissue regeneration and therapeutic support systems. KCI has been researching and developing these products and technology for over 30 years, and has become a world-renown leader in its field, helping patients around the world enhance their healing and their lives.
KCI has developed procedures that help patients dealing with complex wounds requiring advanced care, tissue-based products used for reconstructive and uro-gynecologic surgery, and development, creation and design of specialty beds, mattresses and mattress substitutes as well as other equipment to help reduce the skins breakdown, address pulmonary complications and assist caregivers in handling and moving patients of size.
Because of the stand that Congress took, making certain that many necessary Medicare benefits were not eliminated and giving lawmakers enough time to create a strong, well-thought out, long-term Medicare solution, many patients who need KCI’s VAC and other critical care supplies and treatment at home, will not have to go without it.
For Medicare recipients who need these services – and who are already dealing with the struggles of recovery – today’s vote to override the President’s veto is one less thing they will have to worry about in their efforts to get well.
As most of us who read or listen to the news know, there are some extensive efforts by Congress at this time to stop the Bush Administration from enacting regulations making cuts to the pay of doctors and creating other problems for Medicare and Medicare beneficiaries.
There are many points that AARP is looking at backing as far as the Senate Bill by Max Baucus along with several Senators, because AARP thinks these will improve Medicare.
Some of the most important issues AARP has highlighted have been limiting premium increases to Medicare beneficiaries and not limiting payments to physicians treating and caring for Medicare beneficiaries.
AARP CEO, Bill Novelli, states that the bills improvements will directly benefit Medicare beneficiaries. By the same token, Novelli says that “physicians treating Medicare beneficiaries need to be paid fairly.”
The bill will include some other important benefits. It will ensure that more lower-income people in Medicare have access to more financial assistance and a better, more streamlined application process, rather than the sluggish process that leaves individuals in limbo for months and sometimes years, waiting to be accepted for much needed, medically necessary services.
AARP states that the bill that Chairman Baucus has proposed improves Medicare, keeps doctors in the program and does it without unnecessary increases in premiums for people in the Medicare program. This is essential because in the past, some benefits were subsidized and saved by unaffordable increases in premiums. Though premiums have to sometimes be raised to balance the programs out, some raises have been simply unacceptable and unaffordable. AARP feels that this bill will keep all parts of the puzzle balanced and give Congress the time to look at long-term solutions that will work as a win-win for as many parties as possible.
We will provide updates as the deadline later this month draws closer. There is more information available almost daily. This is an important issue and AARP plus many others throughout the country are happy and relieved that there are some sensible options and solutions being explored.
With deadlines looming, there has been much discussion between members of Congress, CMS, physicians groups, Medicare and Medicaid beneficiaries and others trying to sort out a decent bill that would be fair to all in light of the Bush Medicare cuts that are proposed.
One of the latest situations to crop up is that Senate Majority Leader Harry Reid, a Democrat from Nevada is warning that he will try to stop the debate about the proposed bill to delay the 10.6% cut in pay to physicians for 18 months. To stop the debate, he will invoke “cloture” and do what he can to let the bill pass.
There is legislation that has been introduced by Senate Finance Committee Chair Max Baucus, a Democrat from Montana that would delay the cuts from going through. The Baucus legislation would cost $20 million dollars, but would include some positive provisions including promoting electronic prescribing by physicians, expand some other services and require Medicare to pay pharmacies that provide for Medicare recipients with prompt payment. In addition, recipients who pay for Mental Health Services would have their copays lowered from 50% to 20%.
Some funding would be decreased, such as funding for certain education and marketing programs to get physicians and private health insurance to participate in or to accept Medicare, as these are not as essential as many of the provisions that the proposed legislation is trying to save or enhance.
It is no secret that Medicare and as a result, Medicaid are experiencing difficulties and that, from all reports – Republican and Democrat, alike – the outgoing administration has not made it better, but have weakened it substantially. To be fair, we can’ blame everything on this administration, and there are many things that have happened over the past decade or more that have weakened many services that should be available to the vulnerable individuals and families that need such services.
The debate may have many points of view, but there is little time left to enact some legislation to avoid eliminating even more benefits. It is important for us to watch what is happening to the benefits and services at stake and how Congress works to block these proposed cuts from going through. Keep on the watch.
Dynamic Response Group, a large Medicare supplier, has announced that it created a subsidiary, Medico, that will serve mainly Hispanics who are extremely underserved when it comes to Medicare benefits.
Medico plans to provide direct-to-consumer products to Hispanic individuals who have serious and/or long term health issues in the United States, Puerto Rico and the Virgin Islands.
Dynamic Response Group is already strategically positioned to serve this population so adding Medicare to the mix should be a relative problem-free way to move forward to assist a population that is traditionally and extremely underserved.
Dynamic Response Group’s goal is to provide assistance to individuals in the easiest way possible for the Medicare recipient so that individual can get well or at least improve their health and get somewhat better and get back to living their lives. To do this, Medico will determine what critical care products will help patients the most and deliver those products directly to their homes, per their primary physician prescription. By dealing directly with the patient, this should save time and money for all involved.
Phase II of the project will help Medico establish relationships with doctors and other providers, as well as community groups, partnering with them to help get information and assistance to people who need it and working with the community, positioning the company higher than its non-Latino counterparts. Part of the foundation of Medico’s goals will be to work hard to gain friends in the community, providing social benefits to its clients.
The creation of Medico as part of Dynamic Response Group is a positive addition which will serve a seriously underserved population, making sure they have the supplies they need to be able to deal with their heath issues in a more effective way.
It is becoming too common to hear about fraudulent and dishonest individuals trying to either frighten or trick Medicare recipients – especially seniors – into either changing their coverage to inferior plans or giving out personal and sensitive information so they can use it for various types of fraud.
Yesterday, in Pocatello, Idaho there was an NBC news story stating that such a group was targeting individuals in the area by calling them up and telling them that their Medicare was at stake. They would offer a discount Medicare card that was intended to replace the valid Medicare card they already have.
The person that called one woman was a male, who told her about the discount card and stated that he needed some information first. It is interesting that he already had her bank routing number and her address, which is unsettling in itself, but he then asked for her Social Security number and her bank account number.
Fortunately, the woman had a clue. She knew that something wasn’t right, and she had already heard that there was a scam, so she did not give the individual the information he was asking for. Then the man told her that she would lose her benefits for three months, since she would not give the requested information. Instead of continuing the conversation, she called the police.
Unfortunately, other individuals who are Medicare recipients have not fared so well. As a result, the Pocatello police have warned seniors about this scam. They have told seniors in the area to be extremely careful about relaying any personal information, especially over the phone. It is also important to note that there are certain ways to verify that the individual is truly from Medicare. If you have caller I.D., the number will show up or the name Medicare or CMS will come up on the I.D. In addition, it is rare that you would be asked for your bank account number unless you call them and ask for direct deposit. Also, they will not usually ask for your Social Security number because they have it. They will often read it to you and have you verify it.
If you are not comfortable with the person who is calling or the questions they are asking, get their name, their employee identification number and their phone number, plus their extension and the city they are in. They should readily give you that information so that you can call back, or they will give you the main number to call and tell you that you can talk to anyone there. If they won’t give you the information you request or if they hang up when you ask, they are probably not legitimate. If this happens to you, report it to your local police as well as the agency they say they are from, such as Medicare or Social Security.
It is important to be aware of people and situations that could jeopardize your benefits or finances. Trust your instincts, and be cautious. Don’t give information out unless you are sure who you are speaking to. Stay on guard and keep yourself safe.
It is known by all that Medicare is by far, one of the best health insurance providers for seniors available in the United States. With this health insurance, you will be able to receive quality health care as well as other benefits that you will need to live a healthy life.
One program that Medicare offers is the Long Term Care. In this kind of service, it will include medical and non-medical care for people with disabilities and chronic illnesses. Basically, Long Term care provided by Medicare will help a patient meet their health as well as personal needs.
Long term care is there to assist people with a variety of support services, such as bathing, dressing, using the bathroom and others. Basically, it is for people who can no longer care for themselves and people who need constant nursing care.
This kind of benefit provided by Medicare can be used at home, at nursing homes, and even in the community.
You may need long term care at an early age and you may not even need it at all. The point of the coverage is to ensure people that Medicare is there to help in financing such care.
To choose a long term care program, you need to know what kind of care you need, your choices of long term care, how you will pay for the care, and how your care may change.
With these things in mind, you will be able to know and choose the right kind of long term care that is under the coverage of Medicare.
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