Category Archives: Medicare

New e-Book: How to Avoid 7 Medicare Traps

For those turning 65 the path to Medicare enrollment is filled with bumps and traps that can end up meaning higher health care costs for retirees. iQuote.com’s new booklet: Getting Ready for Medicare: How to Avoid 7 Medicare Traps can help people avoid mistakes and missed deadlines when enrolling for Medicare and selecting a Medicare health plan.

Medicare terms can be confusing. iQuote.com finds people are often confused about how to sign up, when to sign up and then how to compare different Medicare plan choices. The new booklet is designed especially for those who are getting ready to sign up for Medicare or choosing a Medicare health plan. It identifies some of the terms, deadlines and choices that, if missed, can end up increasing the cost of health care coverage in retirement.

Some of the traps include missing Medicare enrollment dates, misunderstanding deadlines, staying on COBRA too long and failing to understand the costs of Medicare and how to compare plans to find the right Medicare plan.

The booklet can be downloaded at www.medicare.iquote.com/medicare-resources-links.aspx.

Via EPR Network
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How to Combine Medicare Part B with Medicare Part D

HealthInsuranceFinders.com News and Information Center today covered the topic “Not everybody on Medicare has the same coverage”. In fact the goal of the Medicare reforms that have been enacted over the past decade or so have been to give seniors more options. Many believe these changes in the system have tended to over complicate things. On the other hand, the large variety of Medicare plans, and Medicare Supplement plans now available, ensure that seniors are only paying for the coverage they want and need.

Among your options with original Medicare and Medicare Supplement Insurance are Medicare Part B and Medicare Part D. Medicare Part B and D can be combined to give you very comprehensive coverage for medications.

Medicare Part B is your “out patient” medical coverage, in other words, it pays for doctors visits, home healthcare to a degree, durable medical equipment and some forms of medications. Things that are technically medication that could be covered under your Part B benefit include, vaccines, flu shots, allergy injections, Immunosuppressant drugs and some oral cancer treatments. For the most part however, Part B is not designed to pay for regularly taken prescription medication. That is where Part D comes in.

Even if you have one of the lettered Medicare Supplemental Health Insurance plans (with the exception of some of the older plans issued before 2002 which are no longer sold) – you still will require Medicare Part D to receive a prescription drug benefit from Medicare.

Medicare Part D will cover all of the following medications:

* Any approved doctor prescribed medication taken regularly for a chronic condition.
* Any approved doctor prescribed medication for a short-term condition.
* Inhaled nebulizers.
* Vaccines, even those that are not prescribed as a result of injury.
* Hepatitis B vaccines.
* Oral anticancer drugs that may have been prescribed for reasons other then cancer treatment.
* And many more types of medication.

Independent health insurance companies sell Medicare Part D Prescription Drug plans. What drugs they cover and how much they pay for medications does vary depending on the type of Part D plan selected. If you are soon to enroll in Medicare, or are currently enrolled and your prescription drug needs are changing – discuss all of your medications with a Medicare Supplemental Insurance specialist, he or she will help you find the right combination of Medicare and Medicare Supplemental insurance that will work best for you.

Via EPR Network
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Medigap Plans Providing Prescription Drug Coverage Clarifications

The MedicareSupplement.com News Center reported making a clarification that many are confused due to the name Medigap. Many seniors think that one of the “gaps” these Medicare insurance plans cover in traditional Medicare is prescription drug coverage. But they do not – at least all of the Medigap plans since the revamping of the plans in 2006, and more recent overhaul in June 2010, do not.

According to the website medicare.gov, prior to 2006, there were Medigap plans, notably H, I, and J, that did provide prescription drug coverage. These represent 3 out of the 4 Medigap plans that were eliminated in June 2010, only adding to the confusion. As explained on the Medicareinformational website, medicare.gov, Medicare Part D was introduced in 2006 to replace standardized Medigap polices that covered prescription drugs and to breakout prescription drug coverage from Medigap coverage. At that timepeople who were enrolled in one of the Medicare supplemental plans that had drug coverage were offered the choice of keeping those plans, changing them, or dropping the prescription drug coverage from them, and opting for Medicare Part D prescription drug coverage.

Since all lettered Medigap plans sold after 2006 did not offer prescription drug coverage, Medicare Part D is now the only prescription drug coverageavailable for seniors with original government Medicare and a Medigap plan. When purchasing prescription drug coverage only, to add to original Medicare, you are purchasing what is also known as a PDP, or Prescription Drug Plan. You may, during the open enrollment period, decide to switch out of original Medicare and into a Medicare Advantage plan with prescription drug coverage, also called a MA-PD.

If you have a pre-2006 Medigap plan that does have prescription drug coverage you still have a few options. If you are happy with that coverage you may continue to keep it and pay the premiums, EVEN IF THE PLAN HAS BEEN ELIMINATED.

You may also opt to switch to a Medigap plan that does not have prescription drug coverage, and then enroll in Part D. Many Medicare advisors believe this is advantageous, because the prescription drug benefits offered by Part D exceed those in the Pre-2006 Medigap plans, and you may actually be able to lower your monthly premiums, and improve your benefits by switching to one of the newly offered low-cost Medigap plans such as N or M, and then enrolling in Part D.

Also be advised that there are only certain enrollment periods for Medicare Part D; so do not drop any existing drug benefits until you are enrolled in Medicare D. For more information about Medicare, Medigap plans, and Medicare Part D, visit medicare.gov.

Via EPR Network
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Physician Offers Own Brand Of Affordable Insurance Alternative

Cedar Park family medicine physician Melissa J. Urrea, M.D. believes taking care of your health shouldn’t be a difficult financial decision. And while the recently-signed Health Care Bill mandates that all individuals will be required to obtain health insurance by 2014, that still leaves several years of challenging options on how to best obtain quality medical care. That’s why she recently introduced through her practice, Trinity Family Medicine, a pre-paid package of medical services. Trinity HealthSpan ™ provides access to comprehensive health care to uninsured and underinsured individuals and families.

Nearly one in four Central Texas residents currently lives with inadequate or no health insurance — and that statistic is expected to rise as a result of the recession. Dr. Urrea’s plan helps to  bridge the gap between the need for and access to quality health care services.

For an annual fee of less than $800, Trinity HealthSpan ™ provides:

  • An annual examination (including prostate screening)
  • Lab work (including a complete metabolic panel, diabetes screening, kidney and liver function screening, electrolyte evaluation, complete blood count, anemia evaluation, thyroid function evaluation, cholesterol and lipid panel, urinalysis, urine protein evaluation)
  • Electrocardiogram (EKG)
  • Tetanus vaccination
  • Influenza vaccination
  • Three routine office visits (including follow up for a particular disease/condition and sick visits)
  • Access to coordinated services (such as labs) at reduced rates

The concept for Trinity HealthSpan ™ originated when Dr. Urrea was challenged with managing the care of chronically ill individuals who had no or limited insurance or were self-employed. “For someone with a condition like diabetes, allergies or asthma, it is imperative to focus not only on disease management, but overall wellness,” said Dr. Urrea. “That involves multiple visits to a physician, along with moderate diagnostic testing to monitor the condition.”

As the recession affected more and more of her patients, Dr. Urrea consulted with her practice’s business manager to determine how they could assist their patients in maintaining regular access to care. The practice reached out to ancillary service providers like laboratories and negotiated reduced rates on behalf of patients who purchase the Trinity HealthSpan ™ package. Trinity HealthSpan ™ also connects patients with pharmacies offering low-cost, generic prescription plans. Local retailers like HEB and Target offer plans that provide medications for as little as $5 a month, which is actually less money than most insurance plan co-pays.

For an uninsured individual not participating in Trinity HealthSpan ™ , the cost of the pre-paid package of services would be $1,050. Similarly, if an insured patient paid an average of $400 per month (not including deductibles and co-pays) in insurance premiums, they could save more than $4,000 annually by enrolling in Trinity HealthSpan ™ . “Even if the patient needed X-rays or an MRI, it would still be less expensive than through their insurance plan,” said Dr. Urrea.

“As a physician and patient, I wanted to bring peace of mind to those individuals and families who can’t afford insurance but deserve state-of-the-art medical services,” added Dr. Urrea. Patients may also purchase “a la carte” customized care packages with fewer services or those related to a specific health condition. Plan financing options are also available.

Trinity Family Medicine provides care for the entire family, including pediatrics, women’s health, men’s health, general medicine, herbal medicine, sleep studies, and cosmetic medicine. House calls are also an option for established patients depending on location.

Dr. Urrea is a graduate of the University of Texas Medical Branch at Galveston (UTMB). She is board-certified by the American Board of Family Medicine, a member of the American Academy of Family Physicians, and serves as an associate clinical professor in the Department of Family Medicine at the University of Texas Medical Branch at Galveston.

For more information or to sign up for Trinity HealthSpan ™, call Trinity Family Medicine at 512-258-1645 or visit www.urreamd.com.

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Memory Training Centers of America Expands Its Services to Assisted Living Communities in Fort Lauderdale

Memory Training Centers of America (MTCA, previously referred to as ATMTC) has been providing evaluation, treatment, education and support to individuals suffering from memory impairment and caregivers since 2001. MTCA is the largest provider of cognitive evaluations and memory training services at Assisted Living residences in the Northeast, with more than 20 Centers in assisted living and independent senior retirement communities, as well as nursing care and hospital-based programs. All treatment services are paid for by Medicare.

For almost ten years, Dr. Bruce Brotter and his associates at the Memory Training Center in Forest Hills have been helping seniors and families meet the challenges of memory loss and Alzheimer’s disease. Dr. Brotter is very enthusiastic about his upcoming visits to several Luxury Assisted Living Communities in the Fort Lauderdale area in March. “MTCA has been wanting to bring its programs that have been so successful in the Northeast to Floridians for some time now. We are very excited to finally be able to offer our services in Florida and to start this new growth in Broward County.” says Dr. Brotter.

Scientific Brain Training PRO is the pioneer of scientifically-proven brain fitness computer programs designed to maximize the brain’s capacity to learn, adapt to new information, enable sharpness and minimize the natural effects of aging. All programs are supervised by a cognitive therapy professional and individuals are supportively guided through state-of-the art computer exercises. The “Memory Gym” and Activity Center offers healthy individuals memory exercise and activities to strengthen existing cognitive function and build a reserve of prevention to guard against future memory loss. Memory Gyms provide memory and other cognitive strengthening exercises through the utilization of cutting-edge computer software. Memory Gyms have already been placed at the Atria Tanglewood in Lynbrook, the Atria Woodlands in Ardsley, Oyster Bay Manor in Oyster Bay and are in development at the Atria Darien, in Darien, Connecticut. Learn more about Scientific Brain Training PRO technology at www.memorytrainingcenters.com.

MTCA works together with family members and health-care providers to ensure implementation of the most comprehensive and helpful treatment plan possible. “We have seen over time how education and support helps the coping strengths of individuals and families, as well as augmenting the treatment process through building understanding and confidence,” says Brotter.

A range of interactive and problem-solving interventions are provided to also strengthen short-term memory functioning and enhance independent living skills and quality of life. While an active lifestyle, both physically and mentally, helps individuals to maintain good overall cognitive health, memory training is an essential ingredient to ensure healthy memory functioning. MTCA is proud of its service to thousands of seniors each year and looks forward to being able to provide its much needed services to thousands more in Fort Lauderdale!

Via EPR Network
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Local Respiratory Therapist Lobbies Washington D.C. for Better Health Care

Respiratory therapist Paul Sherman, MS, RRT, RPFT, RCP went to Washington, DC March 8 2009, representing California Respiratory Care Practitioners, to ask members of Congress to allow Medicare patients with lung disease to have greater access to the services of a respiratory therapist. 

Paul Sherman is a respiratory therapist at Santa Barbara Cottage Hospital and lives in Goleta, California.

Sherman met with Representatives Frank Wolf, James Moran, Senator Jim Webb, Carina Armenta of Senator Barbara Boxer’s office and Tim Gronniger, aid for Congressman Henry A. Waxman to ask their support for the Medicare Respiratory Therapy Initiative. Sherman plans to meet with Representative Lois Capps when she returns to her home district of Santa Barbara. Congressman Henry A. Waxman is the Chairman of the Energy and Commerce committee.

The Medicare Respiratory Therapy Initiative legislation will let patients more easily receive care in doctor’s offices from respiratory therapists, which is currently restricted under Medicare law. “Currently,” Sherman explains, “Medicare policy limits how patients can receive care from respiratory therapists, who are the expert caregivers for lung patients. We think that needs to change.”

Sherman is a member of the Political Advocacy Contact Team (PACT), a nationwide group organized by the American Association for Respiratory Care (AARC) to spearhead grassroots level advocacy efforts. Sherman is also a long time member of the California Society for Respiratory Care (CSRC) and has served in the past on the Board of Directors of the CSRC.

The California Society for Respiratory Care (CSRC), as an affiliate of the American Association of Respiratory Care (AARC), is a non-profit professional organization, whose mission is to represent and support our members through public and legislative advocacy, educational opportunities, and to continuously strive for excellence in the cardiopulmonary profession. By these means, the CSRC is committed to health, healing and disease prevention in the California community.

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