Posts tagged 'medicare recipients'
It's no secret that Medicare has problems to be fixed. However, the issue regarding oxygen support for patients on Medicar who need that type of treatment to basically stay alive is confusing Medicare recipients. The gist of the proposal by President Obama and his team working on Medicare and Healthcare reform is that first of all, patients will continue receiving their oxygen. 
This is an important point, since the way it sounds as lawmakers are hashing ths out is that patients coule lose their oxygen care. This should not happen. It is an issue to be hashed out with oxygen providers and not patients. What is actually proposed is that from the time that individuals on Medicare begin oxygen, suppliers and providers will provide it at their regular prices for the first three yeas that it is being provided.
Once the three years are up, the providers will continue providing oxygen services at a lower price for two years and then they will go back up to their regular price, or if there is enough money by then, they may receive a slightly higer price because they hung in there and kept providing services at the lower price for those two years. This is the part where it gets sticky because, as you can imagine, suppliers and providers aren't too happy about getting a dock in pay.
As part of the Medicare reform, the President and lawmakers are trying to figure out this part of the deal for oxygen suppliers. They are trying to make it affordable for suppiers and providers to be able to continue suppling oxygen to their customers.
After those two years at a decreased amount in pay to the providers and suppliers, the price, as we mentioned above, will go back up to the prevailing price or possibly a little higher, as a sort of bonus for the sacrifice made during those two years. The important thing about all of this is that Medicar recipients who rely on oxygen services will continue receiving them.
Most oxygen service companies do not just serve Medicare recipients meaning that they have income from other sources, plus they get to know their Medicare clients over the years, so most of them will continue to help them because we are all human trying to help one another. The President and lawmakers are trying to take the money they have for Medicare services and, instead of making huge cuts in one area, they are trying to make smaller cuts in several areas so that providers including oxygen suppliers, home health care, doctors, nurses, technicians, hospitals and more, can continue to provide services.
They are trying to find a way to make it affordable to the healthcare providers without taking those services away from Medicare recipients that depend on them. As for oxygen services, if you are on Medicare and receive oxygen services, they will remain uninterrupted. Three years down the road, you may have to switch providers if your provider is not willing to take a cut in pay, however, you will still have services - just from another company.
Also, since the President and lawmakers are still working on this, it may actually turn out better than some people think. After all, if I provide you services at a good price for three years, then take a cut in pay for two years knowing that after that, I will be providing for you at a higher price after those two years and there will be no more cuts, I am not going anyplace because I have a loyal, long term client that I may be serving for 10 or 20 years. When I look at it that way, what's two years at a lower pay? So, those of you on Medicare using oxygen services, don't start worrying.
The government is trying to figure out a fair way to keep your services going. You will not have to give up your oxygen. Your provider may have to be willing to be more flexible during those two years if possible, or you will get a new provider. So try not to worry and just breathe a little easier.
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.
In three western states – California, Hawaii and Nevada – doctors who accept Medicare as payment for patients are stuck between a huge rock and a very, very hard place. They are in a situation where Medicare’s payment backlog has created a multimillion dollar problem. They now have to make some vey difficult choices between their patients and their practice.
This is not a small thing. This is a situation where many doctors have not been paid by Medicare since February. How many of us could go through almost a full year with a large part of our salary unpaid?
It is understandable that there can be backlogs from time to time in a system as large and complex as Medicare, but no payments for almost 10 months is much more than a small backlog. It is a backlog of epic proportions.
The situation has forced some doctors to have to drop some or all of their Medicare patients. Other doctors are on the verge of declaring bankruptcy or have already done so. This has hurt the doctors in many ways – including, of course, financially – but it leaves thousands upon thousands of patients without a personal physician who can provide adequate services to keep their health conditions under control.
What does it say when the doctors who are willing to treat the most needy patients are being forced out of business or forced to drop those very patients because the system that is supposed to care for them is hurting them? How can the system be fixed so that the most vulnerable among us get the care they need from the system that they paid into for year after year?
Medicare says that the reason is that doctors who were to switch to a new identification number for claims (sort of like a social security number) did not do so. The doctors say that the numbers were never given to them until they contacted Medicare time after time over several months to finally get their identification number. In addition, Medicare moved processing to another area and there were “glitches” in the move – many of which are still not fixed.
At present, Medicare says they are fixing the problems, but for many of the doctors who were severely affected, the damage has been done, and for their patients, they are left looking for medical care.
Medicare reform is a top priority at this time. With changes that have come to pass recently, Medicare recipients and their doctors can hope that the future goes much better than the present and the past.
It stands to reason that the most vulnerable individuals in the United States who have some of the most extensive health problems and have paid into Social Security and Medicare while they worked for years, should not have to worry about how they will be able to get their medication. In their minds – and most of the rest of the nation’s – they have paid their money dutifully, month after month and year after year, and they were told that they wouldn’t have to worry when they got older and retired. They have been thinking that Medicare would take care of them and they would have the medical treatment – and medication – that they need to live as full a life as possible with their medical symptoms controlled as much as possible.
Unfortunately, for individuals who are in this situation and happen to have a very low income, it is not working out that way. What has happened is that with the “new and improved” Medicare prescription coverage, things have changed.
The new Medicare drug plans were introduced three years ago. At that time, numerous health insurance companies made bids to provide prescription coverage for low-income Medicare recipients because Medicare paid for part of the premiums, therefore the company was reimbursed, theoretically making money, not losing it.
Companies started realizing that they were not making the money on low-income individuals – especially those with serious or chronic illnesses – so they began bidding higher rates so that they would not get chosen to supply this coverage. Last year 1.2 million people had to be moved from one plan to another due to lack of companies providing prescription coverage. This year, the number will be even higher because there are even fewer companies offering low cost prescription coverage for low-income Medicare beneficiaries.
As a result, many of these Medicare enrollees could be left without enough coverage. They could be in a position where not all of their prescriptions are covered, yet they are among the sickest among us, and they cannot afford to be without their medication because it will seriously compromise their health and could lead to fatalities.
Studies have been done showing that this is the case, however, Medicare says that there will still be several choices of companies and prescription plans for low-income Medicare beneficiaries. The government automatically assigns these individuals to a plan that should cover their needs.
If you are on a limited or low income and have prescription drug coverage you can contact Medicare and/or your prescription plan and ask what will be happening for 2009. You are allowed to change plans at any time during the year. Make sure that you are covered. If you are not sure, contact your local Office on Aging, Medicaid Office or talk to your doctor’s billing office to get your questions answered.
Identity theft has become a huge problem in the United States and throughout the world, and it is getting worse. It seems that every day we hear about a new way that fraudsters have figured out to get pertinent information about us that they can use to purchase anything from a car to a home to illegal drugs.
Through the years, Medicare cards have displayed the individual’s name and Social Security number front and center, as well as other information that could help identity thieves to get your information and use it.
It is interesting that Medicare is finally getting around to doing this. Insurance companies and other organizations have begun doing this years ago, and when you talk to most places such as banks, insurance companies, the power company or others on the phone, they only ask for the last 4 digits of your Social Security number and they only have access to those four digits unless they are in a specific department.
More care is being taken to protect our privacy and a substantial part of that protection comes with protecting our Social Security numbers. The Social Security Number Protection Act has been proposed to Congress as a critical issue that needs to be addressed now. The senators who proposed the action have said that the Federal Government should be taking the lead in this area, not lagging behind. They are asking that the removal of Social Security numbers be mandated and that the unnecessary use of Social Security numbers be eliminated.
It is, of course, impossible to eliminate the use of Social Security numbers in many instances, however, there is a difference between using the numbers and going out of the way to protect people’s identity, as opposed to using the numbers and basically flaunting them or leaving them in plain sight as a temptation and easy road to fraud for identity thieves.
With 8.4 million people victims of identity theft last year alone, this is a critical issue. The legislation would give CMS a limited amount of time to remove Social Security numbers from Medicare cards, correspondence and unencrypted information. This should give Medicare recipients some peace of mind.
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.
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.
There is good news today for doctors who treat Medicare recipients, and for those recipients who are their patients.
Congress and the Bush Administration have been playing tug of war regarding proposed 10.6% cuts in payments to doctors treating patients on Medicare. Doctors have said that they might have to stop treating these particular patients if the cuts went into effect, because it would just be too costly for them. As Congress went into recess for the 4th of July break, it looked like those predictions would have to come true, because a block of the cut had not been achieved.
Today, however, is a different day. The Senate voted over 2 to 1 to pass the bill which halts the cuts, giving enough time to explore the situation further and try to come up with a solution that will work for all involved.
The bill called “The Medicare Improvements for Patients and Providers Act of 2008” not only halts these cuts to doctors, ensuring that for the next 18 months or more, patients and doctors can continue their relationships, but also institutes a small pay increase of 1.1% to doctors in 2009 and bolsters preventative and mental health care benefits, as well.
This has been a bitterly contested issue, and the House already passed the measure. The vote on this issue is so important that Barak Obama came off the campaign trail to be present for it, and Senator Edward Kennedy, who has been very ill battling brain cancer, was also present for the vote.
The passing of this legislation will help millions of Medicare recipients and thousands of doctors who treat them from having to eliminate their treatment. It is essential since there are not enough doctors who treat Medicare recipients as is, and the potential loss of thousands more would leave some of the most vulnerable patients without a personal physician.
For now, at least, everyone can breath a sigh of relief. Given enough time to work with the situation, Congress may be able to create a long-term solution to keep doctors on board and help patients keep the quality of care they need.
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.
The Senate and House have been grappling with the budget for months now. There have been many different viewpoints included some pointed and heated debates with the President, with promises of vetoes.
Yesterday, the Senate passed a $3.1 Trillion budget which will pass the burden of balancing the budget and dealing with tax issues that will likely affect Medicare and other important benefits. As the candidates for President assess their plans and responsibilities, as well as their priorities, they will need to be thinking about how to balance the budget while saving essential programs and services such as Medicare.
The annual budget debate in Congress provides for a non-binding resolution that opens the way for later bills that will affect taxes and, of course, Medicare and other programs. For now, though, the budget offered by Congress will extend some tax breaks for businesses, and will prevent doctors from having to absorb the proposed cuts in their Medicare payments.
Though this is a band aid for now, it is not a way to solve the issues in the long term. Medicare recipients could be hit with less reimbursement to doctors, less procedures that are covered and stricter guidelines and oversight as to what is actually “medically necessary.” Of course, services and procedures must be considered “medically necessary” in order to have Medicare pay for them.
The other issue regarding cutting repayment to doctors is also an issue that will need to be addressed when the next President grapples with the budget. Though there is a delay for now, the issue will be right back on the table and needs to be dealt with as efficiently as possible so that the issue is resolved quickly and fairly and everyone involved in the Medicare system – especially patients and doctors – can move forward with more certainty.
It will be important to watch and see what happens during and after the election and see how things pan out. Though the picture does not look rosy, there are a number of ways to help the Medicare system and a number of ideas that are being considered.
For now, at least, benefits are staying as is, and will be dealt with, most likely in 2009, after the political hoopla settles down and Washington get back to the real nuts and bolts business of running the government.
The sheriff in Isabella County, central Michigan issued a warning for seniors and individuals with disabilities about yet another scam aimed at them.
This scam has callers contacting Medicare recipients telling them that the caller is from Medicare and has called to warn the recipient that their benefits will cancel in 30 days. The callers also tell recipients that in order to keep their Medicare benefits, they need to give the callers personal information bank account numbers, social security numbers and Medicare number. Callers will say that there is no cost for updating this information.
These types of scams are becoming more and more common throughout the country. They prey on the elderly and on individuals with disabilities, and they sound so authentic that they are often able to get the information they are asking for. Then they use the information in a fraudulent way.
It is important that no matter where you live, you Do NOT fall for these scams and do not give out ANY personal information – especially social security numbers, bank account numbers and Medicare or other information that should remain private and protected.
It is important to know that actual Medicare or Social Security representatives will NEVER ask you for personal information and they will NEVER ask you to pay them over the phone. Medicare sends out information about bills and statements to recipients if there are any amounts due. Most of the time the amount would be set up in advance to be deducted from your ban account and you would receive statement in the mail showing the deduction.
If someone calls you trying to get information that is private, do not give it to them. Try to get their name and number and report them to your local police department. If you happen to live in Isabella County Michigan, call your local Sheriff’s office at 1-989-772-5911.
There are numerous complaints about government agencies not communicating with one another and not working together. Some of these complaints make it clear that because of this lack of communication people have been hurt or killed, lost money or property and have often ended up in crisis.
There is some good news for Medicare recipients. The Food and Drug Administration (FDA) and Medicare will be working together to help keep recipients safer. Both the FDA and Medicare have huge databases. Medicare’s databases contain a tremendous amount of information regarding claims, which include medication. The agencies have determined how they can use the databases to explore and address problems with medications and medical devices and equipment that are discovered while they are new on the market. This computerized early-warning system is being designed to keep people healthy and save lives. In addition, the system will save money by recognizing negative reactions quickly, look at patterns that lead to hospitalizations and work to isolate medications that are causing or increasing health problems. With all this at work together, this should eliminate some hospitalizations and other medical expenses, saving money for recipients, for Medicare and for all involved in the system that tries to keep people well.
This new system will keep individual records private. Only information regarding medical issues will be shared, but the identity of the individual will be kept private. The FDA has a current early warning system, but it relies on self-reporting by patients and doctors, which is not accurate, and which also does not capture a high percentage of information, since many people don’t report for many reasons.
This system has taken years to devise, and is important because it could shorten the time it takes to detect drug safety issues and bring it don from years to months. This is good news, not only for Medicare recipients, but for all of us.
If you are receiving Medicare benefits but even with prescription coverage do not have enough money for drugs or premium, there is help available through the Social Security Administration.
Many people are not aware of this assistance. The assistance is $3,600 that can go toward your prescriptions or your premiums. This assistance is available once every year. This year, if you log onto the Social Security website at www.ssa.gov, you will be able to find the assistance by clicking on the box that says “I helped my mother today.”
There are a few limitations to this assistance. You must be receiving Medicare benefits. If you are single, you must make $15,600 or less annually. If you are married, you must make $21,000 or less as a couple annually. However; the Social Security Administration suggests that even if you are close to those numbers, you should check into receiving this benefit. You can apply on line on the Social Security Website, which is available 24 hours every day.
In addition to the information above, there is another plus to the program. The individual who is applying for this extra help does not need to be the one filling out the application. For instance, if the individual has a caregiver or spouse that could do the paperwork for them, especially if the individual has a disability that prevents them from doing the paperwork themselves, Social Security permits the caregiver, family member, friend or spouse to file on the individual’s behalf.
Since prescription drugs and extra premiums are of extreme concern to many people receiving Medicare, this program will provide relief for a great number of people. The program has been available, but has not been heavily marketed by the Social Security Administration.
If you are a Medicare recipient and need extra financial assistance for your premiums, prescriptions or other Medicare-related issues, be sure to go to www.ssa.gov, the official Social Security Website and explore this little-known option for help.
Most of us think about Medicare in terms of types and amounts of plans and coverage. Sometimes we only think about it when we are feeling ill or having to visit the doctor or hospital.
This is not all that Medicare does. There are many types of information that Medicare collects and Medicare provides. One important type of information that Medicare tracks is information regarding nursing homes. Medicare has just released information and created a database that lists the lowest quality nursing homes in the country.
The Nursing Home Compare website now has a searchable database that gives the names the lowest 5% of nursing homes around the nation. In addition to the database, CMS provides a monthly update showing results of nursing home inspections.
CMS is working hard to provide Medicare recipients and others more access and easier access to information regarding nursing homes. There are senators and congressmen who are pushing for bills to disclose even more information regarding nursing homes and the nursing home community. This may take time, but it is an important issue and it is being looked at carefully and pushed forward.
Whether you are actually at the point where you are looking for a nursing home, or you are a relative, friend or caretaker of an individual looking for or needing one, the information that CMS/Medicare has released is essential.
There is much more information at www.medicare.com, including frequently asked questions with answers and links to other sites and further information.
If you are approaching retirement, already retired and on Medicare or just looking for answers about Medicare or nursing homes, take the time to explore the subject in advance. It could certainly keep you from ending up in the wrong place in a bad situation later on.
Many individuals receiving Medicare benefits rely on home health care as one of the main benefits they receive. Home Health Care for these individuals – usually seniors or individuals with disabilities – is their lifeline and an essential link in their services and well-being.
The Center for Medicare and Medicaid Services (CMS) has once again recognized the Joint Commission’s deeming authority for accrediting Home Health Care.
This is important to beneficiaries because more than 2.4 elderly individuals and individuals with disabilities receive Home Health Care services. In order to be able to provide such services, agencies need to be accredited and “deemed” as meeting Medicare and Medicaid requirements and standards. When a Home Health Care agency has “deemed status” by the Joint Commission, research shows that the particular agency usually exceeds the standards set out for Home Health Care Providers by CMS, providing a higher level of service.
Because more and more individuals and patients are trying to get treatment as outpatients and stay in their homes rather than hospitals, the partnership between the public CMS and private Joint Commission has become essential in helping to set the highest standards, therefore encouraging and ensuring the highest quality services.
The Joint Commission, which started granting deeming authority in 1993, accredits over 3,800 organizations. Accreditation is voluntary, and Home Health Care Agencies can seek deemed status by the Joint Commission, but it is not a requirement. They can also seek accreditation by state surveyors on behalf of CMS.
The Joint Commission works to continuously improve the quality of services to the public. It evaluates and accredits over 15,000 health care programs in the country, including hospitals, home care organizations, assisted living, ambulatory care services and laboratories. It also accredits organizations dealing with specific health issues, such as stroke centers, and it is a non-profit organization.
