Tag Archives: health

Your Questions About Medicare Insurance Coverage

Donald asks…


Why are people on Medicare happier with their coverage than people with private insurance?

Why do people like a single-payer government-run health insurance plan more than they like private insurance?

Source:
http://www.commonwealthfund.org/Content/News/News-Releases/2002/Oct/Survey–Medicare-Beneficiaries-Report-Greater-Satisfaction-With-Insurance–Better-Access-To-Care-Tha.aspx

Medicare Insurance AZ staff answers:

I would take FREE over PAY any day also. But that isn’t what the GOVT is offering, no matter how much kool aid you drink to try and believe it.

George asks…

Doesn’t Medicare deny coverage? So how can Obamacare say no denial for preexisting conditions?

I am just trying to figure this out. I am not trying to be a smart butt. According to what I heard,
Medicare has a higher denial ratio than does private insurance companies. So if Medicare regularly
denies coverage, why should anyone think Obamacare isn’t going to deny coverage? I am just trying to make sense of it. Thanks.

Medicare Insurance AZ staff answers:

First of all, the requirement to cover pre-existing conditons has nothing to do with Medicare. It is for direct pay plans for everyone not in Medicare or other programs.

Medicare is not an insurance company. Several people have been posting a statistic that indicates Medicare has a higher rate of claim denial than the big insurance companies. I had a look at the published source which did not explain why there were denials. I figured out that these figures were taken out of context from one source, copied to look like authentic reliable sources and put into a question on YA. The fact is Medicare gets claims from providers and suppliers, not patients, and is required to pay them within 30 days. The only time they deny claims is if they are suspicious or fraudulent. And there are plenty of those. That accounts for a delay while they are investigated.They do not take claims directly from patients.

What you call Obamacare has not changed the programs we currently have. It adds to them. We don’t yet know all the changes but it is a 10-year projected plan and will be tweaked, revised over time as needed, I would think.

Everyone is upset about having to buy insurance but no one minds if you have to pay your employer from your paycheck for group insurance. This is better because it is your own policy and you choose from a bunch of them on an exchange and you may get a subsidy to pay for it.

Michael asks…


Do you know of health insurance coverage in the philippines?

I have a relative in the philippines who is in and out of hospitals and so it can become costly. I would like to know if there are health insurance like here in the states such as a government type insurance like Medicare or private ones? It would be less worrisome for me knowing that whenever an emergency arrives, my relative will have insurance to cover whatever cost without waiting to receive money from me to get the medical attention

Medicare Insurance AZ staff answers:

The Government health insurance here is Philhealth. It only costs P100 a month and will cover a family of four. Good news is every citizen is eligable. Bad news is it takes six months to become effective and only covers 25% of the bill up to P100,000. Not great, but better than nothing. There are private health insures that cost way more, the problem there is they all have pre exixiting conditions clauses. With a relative in and out of the hospital it’s obvious they have pre existing conditions that would not be covered by the more expensive insurers like Philippine Blue Cross etc.

Evan with Philheath you pay upfront and wait for reimbursement. Sad but true here if you don’t have money , you don’t get treatment and rarely does the baranguay carry the more expensive meds like antibiotics.

Betty asks…

If the cost of INSURANCE is the problem, why has Medicare gone bankrupt?

Democrats are constantly telling us that their health care ‘reform’ is needed, in large part, to cut the cost of insurance and stop insurance company abuses.

But if this is the case, if insurance companies are the problem, why is medicare bankrupts? Why are states like Virginia having to reduce funding for Medicare and deny coverage to patients who use Medicare? ‘Insurance company abuses’ have nothing to do with the cost of Medicare. So why is Medicare costing the government so much? And what does the government intend to do to reduce the cost of Medicare other than to deny patient’s care and service?

Doesn’t this come back to the fact that the problems with health care is not the cost of insurance, but the rapidly growing cost of the health care itself? And if so, what does the Obama administration propose to reduce the cost of health care?

I don’t see anything, but maybe I haven’t been paying attention.
@oft suspended: That ‘incredible rate’ has bankrupt Medicare. Medicare is not self sustaining and cannot cover the cost of needed health CARE. Your President has done NOTHING to address the cost of health CARE. Nothing. That’s sort of the point. He’s using a bandaid to ‘cure’ a cancer.
@itsamini: So does Medicare, which is why fewer and fewer doctors are accepting Medicare patients.

Medicare Insurance AZ staff answers:

Medicare is like ANY program the Govt. Runs, failing. And we have a President who has NEVER had ANY leadership experience ever in the private sector. And we have a president and Congress who are rejecting options that will actually improve the quality of care and lower costs, in TORT reform and making Health Insurance portable and in doing so increasing competition between companies, and would drive DOWN the costs of insurance.

Steven asks…

PET scan insurance coverage?

My mom had colon cancer that has now been in remission for two years. Her doctor wants her to do all kinds of testing, but will not tell her what will be covered under her insurance plan. My mom has both Anthem and Medicare coverage. Can anyone tell me how often a PET scan can be done per year and still be covered? Thanks!
Can approval be given by the insurance provider before the PET scan is done? My mom can’t afford the procedure so that cost would kill her! She just tole me a CT scan is done at that time too so can approval be given for both prior to haveing them done? Thanks for all your insight!!!
All of you are great! Thanks for your detailed explanations AND for wishing my mom well!!!
UPDATE: My mom called and got some lab work done. All was well AND she got approved to schedule her PET test. They said she didn’t need her CT scan. Thanks again for your insight!!!

Medicare Insurance AZ staff answers:

Her doctor has no idea what will or will not be covered under her insurance . . Everyone in the US has a different plan so it is almost impossible to know who might qualify and who won’t. In either case she needs to have the scans done . . Make sure the doctors office sends off the request to receive the appropriate ‘permissions’ . . We had to go through two steps to get this approved . . There is some type of ‘national clearing house’ that determines if it is ‘medically appropriate’ and than there is the insurance to pay for it. We never were turned down by either of them (we had Anthem and Medicare too).

We have had experience being turned down for different treatments though and here is what we did .. We did not get emotional but called the insurance company and explained . . We than had our doctors office also call to talk to the insurance company . . If we were still denied we would appeal the decision in writing . . We usually would ‘win’ the appeal and the insurance company would pay. I do know others who sometimes went another round of appeals . . But in the end the insurance would pay. The PET is something your Mom needs and is the entire reason she has health insurance to begin with . . Insist that the insurance cover this for her . . But approach it diplomatically and don’t give up.

In general your mother should follow her doctors recommendations for the frequency of the PET scan . . And insurance should cover it. And, yes, approval is generally given before the procedure is done. If denied this benefit you should appeal to the insurance company and keep appealing until they agree to pay.

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Your Questions About Medicare Health Insurance Part B

Susan asks…

With all of the bluster and BS coming out of Washington these days about health care and it’s costs?

How can anyone support reform without the required details?

First the costs were set at a $1trillion “down payment” (is that just 10% of the true costs, a normal sized down payment).
Then the CBO states the costs to be $1.6 Trillion and only cover 1/3 of the uninsured (what about the other 2/3′s ?).
They have now proposed raising the Medicare tax(every wage earner pays this), slapping a 10-cents-per-can increase on sweetened drinks(almost every American drinks sweetened drinks), raising the alcohol tax, imposing a new payroll tax on employers equal to 3 percent of their health care expenditures and taxing employer-provided health insurance benefits above certain levels(taxing employers for your benefits is a tax on you). Also under consideration was a value added tax, a sort of national sales tax, of up to 1.5 percent or more, with housing, education, financial services and medical care potentially exempt(everyone makes purchases from clothing and shoes to utilities and detergents).

But with all these numbers and tax increase proposals flying around, does anyone really know what kind of “medical coverage” this entails?

Is it the “blue chip” program the members of Congress enjoy?
Doubtful.
Or is it more like Medicare?
Does anyone realize that Medicare premiums for those who have less than 7.5 years of qualifying work and are over 65 would be nearly $600 a month?(for parts A,B,D coverage) For 50 million uninsured, that alone would be $30 Billion a month or $360 Billion a year in costs and doesn’t even touch on what would be paid out in services or the 20% of costs not covered.

So what do you think of when “health care coverage for all” is bandied about in Washington?
What are your expectations?

http://www.mymedicarematters.org/AboutMedicare/costs.asp

http://www.medicare.gov/Publications/Pubs/pdf/11082.pdf

http://news.yahoo.com/s/ap/us_health_overhaul

Medicare Insurance AZ staff answers:

I don’t want to seem heartless, but frankly, I think that people should be responsible for themselves…and that includes health care options. I do not believe that it is the responsibility of others to care for me or protect me from myself.

Libertarian leaning conservative.

Betty asks…

The insurance do not want to pay 80% of the bill and I pay 20%.?

I am under 65 and recieve medicare due to a disability under my husband social security. (husband is decease) Medicar part A I have but did not choose to enroll in part B, because I was enroll in health coverage with the pension fund that the premiun was $161.00. The coverage plan BC.BS Hosp/Phys and OMM with Drug . I hand surgery . The insurance is saying beause I did not have part B of medicare, I would have to pay 80% and that pay 20% of the bills. How can I go about geting the bills pad from the insurance.

Medicare Insurance AZ staff answers:

You can’t. Once on Medicare it becomes the primary and your other plan the secondary. You should get part B

Daniel asks…

A question about health care in USA for elderly….?

If a person age 67 who has only income coming in of $1100 net per month has to go to the doctor for a check up, or if they are feeling under the weather, etc.. would medicare part B require them to pay an annual deductible of close to $1000 first before they qualify to only have to pay a 20% coinsurance on the rest of their medical costs…such doctors visits, Xrays, lab test etc….??
and what happens if this elderly person is so strapped for cash that they can’t really afford to pay this deductible and co insurance?

what happens then?

how would the situation be different in a different country like Great Britain?

Medicare Insurance AZ staff answers:

In the US, while medical bills can grow quite quickly, the elderly would be seen and treated immediately for their problem, and then be billed for the rest. Medical collections are severely restricted, unlike any other category of collections. As long as you agree to pay something each month, and meet that obligation, the amount paid each month can be tiny and you are still compliant. So, ultimately, they would be treated, and have staggering bills they would have the option to pay over a long period of time as long as they complied with their agreement to do so.

In Great Britain, the bills would be small to none on the face, although they would have been paying National Insurance Contributions, so it is not quite as free as it seems. They would, however, have longer wait periods to see their doctor, and a shorter time on average with that doctor than their American counterparts. Ultimately, they would have smaller bills up front, but would make up a fair amount of the difference in “contribution” and would have to wait much longer for the service. Anyone who points out that the “government” pays for health care, as so many defenders of socialism will claim, conveniently forgets where the government gets its money.

Joseph asks…

How can I convince my husband to let me get insurance?

I have Bipolar. I just got disability in April so I have to wait until April 2011 before I get medicare. I will have to pay $110.00 just for part B and A. Then part D for prescriptions, I am figuring out because that will be my prescription drug coverage and apparently you have to pay $40.00 to $100.00 for that depending who I go with.

My husbands insurance will not cover me because of preexisting condition and I have to wait a year. He changed jobs after being unemployed for 2 years since he lost his job from GM. He did not get Cobra because we really could not afford it. In the meantime he got appendicitis and we had to file bankruptcy.

I found two great deals through Humana and United Health Care. I want covered if I have a medical emergency. Because we can not file bankruptcy again and we are actually getting our credit score back up! I have enough for my psychiatrist and medication which is important. He has me on a sliding scale (I have paid him enough over 10 years) which I am grateful. I can afford my prescriptions because of Walgreens plan for uninsured individuals. It is great!

I wish he would let me get insurance. He did give me the OK to get vision and dental. But I need medical insurance. Then I hear people talk and see commercials on TV that you need supplementary insurance for medicare because apparently medicare does not cover a lot but I would still feel at ease just have that alone.

How can I convince him to allow me to get medical insurance? I am at a lost. We can afford it with the quotes I got!

Thanks!

Medicare Insurance AZ staff answers:

There’s no decision or discussion here. His insurance will cover you for anything that is not preexisting, and any other coverage you get will have a similar exclusionary period for the preexisting condition. If you believe that Humana or UHC will cover your preexisting condition immediately, you either misunderstood or were lied to; probably the former.

Chris asks…

“Universal Health Care”–a humongous lie?

People are desperate to believe that a government-run health care system will be a good thing. No matter what you assume, or are led to believe,to be true, the facts prove that the government does not run the health care programs is has now. Both Medicare and Medicaid are actually run by the same private insurance carriers who routinely deny claims for both everyone.

Here is the official list of “Intermediaries”:

SECTION II
PART A INTERMEDIARIES AND PART B CARRIERS ………………………………………………………………. 15
BLUE CROSS AND BLUE SHIELD ASSOCIATION…………………………………………………………………………..15
BLUE CROSS AND BLUE SHIELD OF ALABAMA…………………………………………………………………………..15
ARKANSAS BLUE CROSS AND BLUE SHIELD……………………………………………………………………………….18
FIRST COAST SERVICE OPTIONS, INC. ………………………………………………………………………………………….20
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. ……………………………………………………………………21
ANTHEM INSURANCE COMPANIES INC ……………………………………………………………………………………….22
ADMINASTAR FEDERAL INC…………………………………………………………………………………………………………23
BLUE CROSS AND BLUE SHIELD OF KANSAS, INC. ……………………………………………………………………..23
ANTHEM HEALTHPLANS OF MAINE INC………………………………………………………………………………………24
BLUE CROSS AND BLUE SHIELD OF MISSISSIPPI …………………………………………………………………………25
BLUE CROSS AND BLUE SHIELD OF NEBRASKA………………………………………………………………………….26
ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC…………………………………………………………………..26
EMPIRE HEALTHCHOICE ASSURANCE, INC. ………………………………………………………………………………..27
HEALTHNOW NEW YORK INC.. …………………………………………………………………………………………………….28
NORIDIAN MUTUAL INSURANCE COMPANY……………………………………………………………………………….29
GROUP HEALTH SERVICE OF OKLAHOMA, INC. ………………………………………………………………………….30
HIGHMARK INC. ……………………………………………………………………………………………………………………………31
TRIPLE-S, INC. ……………………………………………………………………………………………………………………………….32
PALMETTO GBA, LLC……………………………………………………………………………………………………………………33
BLUE CROSS AND BLUE SHIELD OF TENNESSEE…………………………………………………………………………35
TRAILBLAZER HEALTH ENTERPRISES, LLC…………………………………………………………………………………35
UNITED GOVERNMENT SERVICES, LLC ……………………………………………………………………………………….37
INTERMEDIARY AND CARRIER DIRECTORY

http://www.cms.hhs.gov/ContractingGeneralInformation/Downloads/02_ICdirectory.pdf

The British system is, as one would expect, reflective of British thinking: there is a class system in Britain and this could not be more evident than in the way they finance health care. They do it through a payroll deduction scheme. This means, of course, that only the workers pay for the entire cost of the health care system while the wealthy, who usually do not earn wages, and whose investment income is not subject to payroll deduction, escape.

Medicare Insurance AZ staff answers:

The idea makes me a little nervous. I have a friend in Canada who recently discovered a breast lump – and the wait was FIVE MONTHS for her to even be seen for tests! That’s crazy.

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Your Questions About Medicare Part A

William asks…

My grandma has medicare part a and b would she be covered for home health care nursing?

3 to 4 times per week. Assistance with getting out of bed and diabeties management. She is bed bound mostly.

Medicare Insurance AZ staff answers:

Before Medicare made their nation wide cost saving cuts back in the 1990′s, it was common for the elderly to be covered for those services sometimes indefinitely. Now it is much different. If someone on medicare comes out of the hospital they would be covered but not indefinitely. If the Dr. Recommends skilled nursing for diabetes management that may be a real possibility. Check with her Doctor. Personal care, bathing, assistance getting out of bed and meals, and laundry, falls under private duty care and is paid for by the individual through the home health agency. Some states offer help under their programs of medicaid and state assistance programs. Check with your state programs to see if your grandmother qualifies under income guidelines.

Mark asks…

How can a company pay an individual’s Medicare Part B premium?

Hi. I have a very specific and obscure question. I am interested in how a company, a health plan for instance, could go about paying an individual’s Medicare Part B premium. Does anyone know where the rules governing this are housed?

Medicare Insurance AZ staff answers:

This is a good question! A local organization was considering implementing a policy whereby it would pay the insurance premiums for Medicare-eligible employees about a year ago and did some checking through attorneys. The rules discovered were that a private employer that offers a health care plan to employees must offer the same plan to all employees– even those eligible for Medicare. There was no way found for the employer to pay the Medicare premiums for the employees eligible to enroll in Medicare.

I understood that the reason this could not be done was due to a state rule–but actually, the barrier is probably a federal rule. Allowing this practice would increase costs to Medicare and probably reduce the costs of employer health insurance plans. Congress probably is concerned enough about soaring Medicare costs. Of course, there is probably a plethora of other political reasons…

Some feel this rule engenders employers’ discrimination against older workers. The fact is, more health problems develop the older we get and the American workforce is aging quickly. Paying for health insurance is a big problem for most employers–and especially small business. Many choose not to provide a health insurance plan at all due to these plans’ costs–which is a major reason why there are so many uninsured Americans today.

Suggestion: check with someone in your State’s Insurance Commissioner’s office. There is someone there who might be very familiar with this question–or would know someone else who would have the information you seek. Or check with an attorney familiar with health insurance and employment law in your state.

Good luck and best wishes!

Ken asks…

Question on Medicare Part B premiums for low income?

My mother just passed away and in her papers I found that she has been paying medicare Part B premiums for years. I think it was something like $92.40. I can’t remember the exact amount.

My question though, is that her monthly income was only $700 a month. Should she have been paying these premiums? She had no dependents in the home with her. Seems like she should have been exempt since she is considered low income.

If she should not have paid these monthly premiums, can her estate been reimbursed for all the years she paid?

Medicare Insurance AZ staff answers:

If you want Medicare part B coverage – which covers gaps in Medicare part A – you have to pay for it. The premium is $93.50 per month if your income is under $80,000 a year.

The major benefit under Part B is payment for physicians’ services. In addition, home health care, durable medical equipment, outpatient physical therapy, x-ray and diagnostic tests are also covered.

Donna asks…

I am looking for a Medicare part D plan that offers dental and vision. Can anyone help me?

I have Medicare A and B, but am looking for additional coverage for my prescriptions, and ideally one with Dental and Vision….More so the dental, but vision would be great, too…..

Medicare Insurance AZ staff answers:

Dental and Vision aren’t covered – unless you have a medical eye condition. Regular vision issues, exams, glasses, contacts, etc, aren’t covered at all.

Maria asks…

how do I know if I should have medicare part D?

I currently am enrolled in parts A & B, but not D. I am currently spending approx $50.00 mo. for prescriptions, would I benefit from haveing part D? I’m not even sure how part D works, does it pay all of the prescriptions, or a portion and then I pay the rest? I don’t know how much part D costs either. I tried to log onto medicare.gov, but could not figure out how to navigate through all the stuff to get the answers I need. Any help is greatly appreciated, thanks.

Medicare Insurance AZ staff answers:

It depends on if you are on a Medicare Advantage plan (like an HMO, PPO etc). If you are on plan or program they will cover your medications. If you are on original Medicare (you only use the white card with the red white and blue stripes at the top) then you have no prescription coverage and should look to enroll in one. You only have until friday to enroll otherwise you will have to wait until next year’s open enrollment.

Each part D plan is a different cost. Some cost as low as $14 per month – some cost over $100 per month. If you are having trouble finding a list of plans you can always ask your pharmacy if they know of good plans or just call 1 800 Medicare for help.

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Your Questions About Medicare Supplement Insurance

Laura asks…

I am on SSDI and dont have insurance Help!!?

I have recently been approved for SSDI and I went to the Senior and disabled services they told me to apply for Oregon health plan. I did that and OHP told me I make too much money for that program $999.00 . I am married and my wife is disabled too she is on SSI she gets OHP because she is on SSI so do our two children. What is Medicaid? Is that a type of health insurance or just a supplement? I wont qualify for Medicare for two years as it looks now. What do I do? The people I have talked to at Social security and Oregon and Senior disabled services keep giving me the runaround. The lady at Senior and disabled services did not even know what Medicaid was.
Will I have to get Private insurance? I cant afford that.

Medicare Insurance AZ staff answers:

Healthquotes.awardspace.info – here is my health insurance plan. As I remember they can provide such a service.

Helen asks…

Why doesn’t medicare cover my GYN office visit?

I called my gyn to make an apt for my annual PAP test and the girl at the other end asked me what my insurance was. I told her I had Medicare and an AARP supplement. Then she informed me that medicare does not cover the office visit only the PAP test. The office visit is $175. I then asked her how can I have a PAP test without an office visit? She replied, “I know, a lot of people are angry about that, but that’s Medicare‘s rules”. Don’t you think that’s ridiculous? I bet that’s going to discourage women from getting checked.
The more I thought about it, the more ridiculous it sounded, so I called Medicare. The gentleman at the other end said: “I never heard of such a thing; perhaps they are billing us with the wrong code. Tell them to bill us with the 25 modifier. That will cover the pap smear, the pelvic exam and the office visit”. I thanked him and called the GYN office back. The girl argued that billing that way was illegal because Medicare doesn’t cover a wellness visit, etc. She even called the billing dept. that gave her this BS information and told me that they would not change their billing because it would be “illegal”. How can a Medicare worker give me an illegal code? To make a long story short, I cancelled my apt and made one with another gyn that does not charge extra for an office visit. Beware!

Medicare Insurance AZ staff answers:

Well, I just had my yearly checkup with my ob/gyn, PAP test and all — my office visit was completely covered by Medicare — maybe you should check with Medicare — I think your doctor’s office is trying to get a double pay — no offense, but Medicare totally covers this exam!

Lizzie asks…

Another question about Social Security!?

Thanks for all the great answers. Now I am a lot less confused.
How about this? I am now age 56. I love my job, and my family has long-life. My father lived to 94. I know that I cannot predict the future, but I would like to work until age 70, or older. Collect social security at age 70. Keep my employer insurance and supplement with medicare at age 65. I know almost everyone else I talk to is planning to retire as soon as they qualify for social security, no matter how much money they loose. Great for them. But I like my idea. What do you think?

Medicare Insurance AZ staff answers:

I think you are a very fortunate man. Most people are not that wild about their job, and the stress they experience at work robs them of some of their life span. They say stress kills, and it’s true. It eats away at your health and robs you of many of your retirement years by reducing your life span. One of the greatest gifts you can give yourself is the avoidance of stress.

Seeing that you love your job, your life span will most likely be longer than most because you won’t suffer from the ill effects of job stress. When I was 56, I thought I would work until I’m 70 too. But that wasn’t because I loved my job. It was because I was worried that I might not have enough money to pay for my food and shelter during my entire retirement years if I dared retire sooner than age 70. To make that story short, I ended up retiring at age 62 (not 70). I was able to do that because I was a planner–just like you. I was forever calculating what it would most likely cost me to live in retirement, how much I had managed to acquire, and how much more I needed. As soon as I saw that my financial situation would most likely work out for me, I started to look for an opportunity to exit from my work life into my retirement life.

My lifestyle choice (a modest one) allows me to feel very comfortable at $30K per year. From that I net $26K, spend $21K, and have $5K left over. This money comes from my employer’s pension plan for me, and interest I earn from my savings. In two more years, at age 70, I’ll start receiving another $30K in income per year because social security will kick in. Then I’ll be receiving a little more than twice the money I need to live on. So, as you can see, even though I’m far from rich, I’ll most likely die with money in the bank. But that’s possible because of my life style choice. People who have more expensive tastes and possibly want to live a flamboyant life style would need much more money than I do.

My advice to you is to continue to look at your financial situation to understand when it will allow you to actually retire. Once you figure that out AND achieve that goal, you’ll feel very light. It will be as though a weight has been removed from your shoulders. You’ll be at a point where you no longer have to work if you don’t want to. Well, I keep forgetting that you love your job, so for you it might not be a weight off your shoulders as much as it was for me. But it’s still refreshing to know that you really don’t have to work anymore if you should decide you don’t want to.

In closing, let me add that your choices about how long you work for a living, and how long you wait to receive social security benefits is a big gamble. You could very easily be in the middle of your big plan, and drop dead while still in the process. As you said, no one knows the future, but your’s looks very promissing both in life span possibility and in income possibility. So, create a flexible plan for yourself and go for it. I say flexible because you might run into situation that make it wise for you to tweak your plan a little. If so, then so be it. Do the needed tweaking.

Reading your question made me smile. It’s nice to see someone who is interested in planning his future to help ensure his retirement years will be pleasant ones.

Best of luck to you.

Susan asks…

I am a senior; now that the health care bill has been signed, what should I do?

I have no insurance other than Medicare. Right now, I’m being bombarded with ads for Medicare Supplement and Medicare Advantage plans. Won’t the new health care bill alter most of what these plans can offer? Should I choose one (even though it’ll probably be obsolete very shortly), or just sit tight with what I have for another year?
Thanks, guys for most of the responses so far. I especially appreciate those from “Meilin”, “handyman”, and “mrwizard.”
Thanks, “truth!” (sorry—I can’t seem to manage the inverted exclamation point on this keyboard).

“Cory”, thanks you for taking the time to respond; from perusing answers to others’ questions, I get the impression you’re quite young. As you grow older (and, presumably, more mature) you’ll find that there are issues that don’t call for flippant, “funny” quips as responses.
I’ve scanned over many of your responses, and I wish you’d do the same…you might start seeing a pattern that just might throw a little light on your very dark view of those who disagree with you. Incidentally, I appreciated your response to “Daisy’s” question—and not just because I agree with it. Take care, my friend!

Medicare Insurance AZ staff answers:

It was only signed today and they have not made the fixes yet, so wait until the dust settles before you decide anything. I don’t know why people are so unnerved by the bill. If you want a Medicare supplement to pick up the 20-30 percent Medicare doesnt pay you can buy that any time. You should wait to see if there are any changes good or bad before you do that. You have been getting by without Medi-gap apparently. We dont know the minutia of the effects the new bill has on Medicare yet because the changes cover a 10-year period. Two things that happen this year will be an effort to bridge the gap in payments for catastrophic prescription needs and a $250 rebate in lieu of the usual COLA.

Robert asks…

medicare for non seniors on ssdi?

from what i have found, most of the supplement plans are only for seniors…1 starts at age 55

Is the Medicare itself that same for people on SSDI as it is for peopleon SS retirement

I will not have any other insurance.
how is part D redundant for people on ssdi…

how else can i get rx coverage
i want A,B

not C…..

there are only 3-4 doctors that will work with people with my condition..
1 doesn’t take insurance at all..the others aren’t in ANY of the HMO networks–including the 1 PCP that won’t blow me off….i need to be able to have a willing PCP

Medicare Insurance AZ staff answers:

Yes it is the same. My brother had a stroke at age 40 and started receiving medicare benefits at age 42. His coverage is the same as that of my 85 year old mother, other than she has chosen traditional medicare and he carries one of the medicare advantage plans. Unfortunately you are going to find that many doctors only accept a certain number of medicare patients because medicare (like medicaid) pays less than the insurance companies do.
If you do not want medicare part c (which is the medicare advantage) then you will have to enroll in the original medicare plan.

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Your Questions About Medicare Advantage Cuts

Thomas asks…

Why Do Dems Want to Take Money Away From NAACP’s Poor Blacks who Have Medicare?

The national director of the NAACP recently scolded Dems for trying to cut back money that goes to Medicare Advantage.

40% of blacks on medicare use Medicare Advantage.

He was LIVID at Dems!!
Nancy,

How stupid do you have to be to lecture me instead of lecturing/calling the national director of the NAACP. He is the one who scolded Dems for trying to cut NEEDY blacks from Medicare Advantage. Duhhhh
Quit being hateful, Nancy.

Read on —>

In a March 14 letter to House members, Hilary Shelton, director of the NAACP Washington, D.C., Bureau, wrote that MA plans “disproportionately provide coverage to low-income and racial and ethnic minority beneficiaries.” He added, “By providing more comprehensive benefits and lower cost-sharing than traditional Medicare,” MA plans help minorities “gain access to health care services that are critical to their long-term health and well-being”
A letter written by the NAACP stated that 40% of blacks on medicare use MA —->

http://www.austin360.com/blogs/content/shared-blogs/washington/medicare_monitor/entries/2007/03/15/naacp_backs_medicare_advantage.html

Medicare Insurance AZ staff answers:

Dems hate when Bush does a lot to help blacks.

Paul asks…

Why Are Dems Trying to Hurt Millions of Poor Elderly People?

This is sort of ironic…

AARP and the NAACP are teaming up with Republicans to fight against Democrats’ desires to cut funding for Medicare Advantage programs.

The Dems say that the Medicare Advantage programs cost too much. Oddly, that money is helping the poor elderly and a lot of poor blacks.

There are over 200,000 elderly people in each of the following BLUE states that will be hurt if Dems cut Medicare Advantage — Ohio, Pennsylvania, Michigan, and New Jersey.

It’s funny to see the Dems try to convince the elderly and blacks to give up the help they are getting with medical bills.

Do you think Pelosi and Hillary and Kerry will tell the NAACP and AARP to get lost? I don’t.
It’s funny to see Libs on here argue against me when the NAACP and AARP are fighting against the Dems on this one!!!!!!!!!!!!!

Don’t moan about me. Call up the NAACP and AARP.
Listen as the Director of the NAACP Scolds Dems for cutting funding to Medicare Advantage —>

“On behalf of the National Association for the Advancement of Colored People (NAACP), our nation’s oldest, largest, and most widely recognized grassroots civil rights organization, I would like to express our deep concern about efforts to reduce funding for the Medicare Advantage (MA) program.”

http://www.austin360.com/blogs/content/shared-blogs/washington/medicare_monitor/entries/2007/03/15/naacp_backs_medicare_advantage.html

Medicare Insurance AZ staff answers:

From the WSJ?

The reason Democrats are fighting it is because it helps cover health care costs by privatizing some of the coverage.

Their stance on this issue makes it pretty clear that the Democrat’s don’t want any solutions to health care except for government run health care, even if private solutions work (as seen by their opposition to Medicare Advantage).

Edit: To nostradamus02012 and Jim W. Nice spin boys. Yes insurance companies will profit, but why is that a bad thing? You are ignoring the fact that seniors are OPTING INTO this program, meaning they see a benefit as well. Perhaps it is the added selections and choices that they have…..

John asks…

Why are republicans so upset about health care reform when?

it cost less than Bushes medicare Part D and Medicare Advantage bill ($1.2 trillion)?

it is less than 5% of the total health care cost in the US?

it is far less costly than Bushes tax cuts for the rich?

it is less costly that the Iraq war?

it is in theory paid for?

Medicare Insurance AZ staff answers:

They like the windfall profits for insurance companies but they don’t like the public sector parts of the bill. They are against government assistance in what has traditionally been exclusively a private sector industry. But with millions of people suffering and unable to get treatment, there has to be a compromise made. I am sure with a gigantic bill like this over the 10-year-period adjustments can be made to mandates if revenue streams increase.

They don’t really believe the capitalist system is in jeopardy of becoming a socialist model. That is just an aggressive tactic to limit the power of the government so their corporate friends can keep making obscene profits at the expense of ordinary Americans.

Mandy asks…

Do you believe that O’s tax increases will become law but his spending cuts won’t?

Obama says he will save $10 billion by capping payments to weathy farmers and billions more by scrapping other costly/inefficient farm programs. But don’t tell that to Rep. Collin C. Peterson, the Minn. Dem. who chairs the House Agriculture Committee. “We just finished the (latest five-year) farm bill last year, and I don’t think we’ll olpen it up” he informed the Washington Times. If O had really wanted to reform farm subsides, he would have taken a stand when it mattered and voted against that bill in the Senate. Instead, he supported the subsidizers.

For his other proposed cuts to take effect, O will have to make credible threats to veto appropriations bills that increase spending where he has called for decreases. ….. judging by the bloated builk of the stim. bill there is little reason for optimism that Obama-era Dems will fare better than their predecessors. IN FACT, Obama’s spending increases are LARGER THAN THE NEW REVENUE FROM HIS TAX HIKES. His deficit-reduction plan IS TO HOPE THAT THE ECONOMY IMPROVES.

What spending cuts we are likely to see are aren’t necessarily ones that we should cheer. O would fund his health-care plan in part by gutting Medicare Advantage, the program that lets seniors choose privately administered health-care plans that are paid for my Medicare. Eliminating Medicare Advantage has been a liberal priority for years, because it is a roadblock to INSTITUTING A SINGLE PAYER SYSTEM..

Obama promised to go through the budget “line by Line, ‘ looking for spending to cut. But in this task, as in others, he has sought the path of least resistance. The Left’s sacred cows appear to be safe.

In short, O’s budget raises taxes, increased spending and creates programs that are likely to put a drag on our economy, such as cap-and-trade.

The National Review
page 11
March 16, 2009

Medicare Insurance AZ staff answers:

Correct, the spending will pass and the cuts will not.

Also, the spending will not “sunset”, that is, the programs will not come to an end, but will instead go on year after year requiring an ever increasing rate of taxation.

Each time that spending programs are used, they are deemed “successful”. The simple fact that someone took the money is taken as proof that the program in question is a good one, and is “needed”.

Mary asks…

Do seniors feel stupid for voting for Obama now?

The government-subsidized benefits that seniors on Advantage plans receive — often at premiums lower than Medicare premiums — are real, and are legitimately in danger in some cases if Democrats succeed in their health care overhaul.

Medicare Advantage subsidies are on the chopping block to pay for the overhaul. Though there are marked differences between House and Senate versions, both bills would lower payments to private Medicare Advantage plans, which on average cost the government 14 percent more than traditional Medicare.

The harshest critics of the Advantage program say patients are exchanging hassle-free coverage for a plan with cheap perks that may ultimately deny them necessary treatment.

“They’re giving special benefits that are valuable,” said Mary Johnson, policy analyst for The Senior Citizens League, a nonpartisan, 1.2-million-member group. “But what people don’t understand are the trade-offs.”

Though AARP — which lends its name to a Medicare Advantage plan — and other senior advocacy groups support the Advantage cuts, it is likely that at least some seniors will see their premiums rise, benefits cut or plans close.

Medicare Insurance AZ staff answers:

If they don’t, then they should. It is awful what he intends for them.. He may as well line them up and shoot them.

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Your Questions About Medicare Vs Medicaid

John asks…

Do you agree with this?

It is a little lengthy, but worth the read. I agree wholeheartedly!

Walmart Vs. The Morons
Wal-Mart First:
1. Americans spend $36,000,000 at Wal-Mart , every hour of every day.

2. This works out to $20,928 in sales every minute!

3. Wal-Mart will sell more from January 1 to St. Patrick’s Day (March 17th) than Target sells all year.

4. Wal-Mart is bigger than Home Depot + Kroger + Target +Sears + Costco + K-Mart combined.

5. Wal-Mart employs 1.6 million people, is the world’s largest private employer, and most speak English.

6. Wal-Mart is the largest company in the history of the world.

7. Wal-Mart now sells more food than Kroger and Safeway combined, and keep in mind they did this in only fifteen years.

8. During this same period, 31 big supermarket chains sought bankruptcy.

9. Wal-Mart now sells more food than any other store in the world.

10. Wal-Mart has approx 3,900 stores in the USA of which 1,906 are Super Centers; this is 1,000 more than it had five years ago.

11. This year 7.2 billion different purchasing experiences will occur at Wal-Mart stores. (Earth’s population is approximately 6.5 Billion.)

12. 90% of all Americans live within fifteen miles of a Wal-Mart.

You may think that I am complaining, but I am really laying the ground work for suggesting that MAYBE we should hire the guys who run Wal-Mart to fix the economy.

This should be read and understood by all Americans Democrats, Republicans, EVERYONE!!
To President Obama and all 535 voting members of the Legislature,
It is now official you are ALL corrupt morons:
Now for the Morons:

A.. The U.S. Postal Service was established in 1775. You have had 234 years to get it right and it is broke.

B.. Social Security was established in 1935. You have had 74 years to get it right and it is broke.
C.. Fannie Mae was established in 1938. You have had 71 years to get it right and it is broke.

D.. War on Poverty started in 1964. You have had 45 years to get it right; $1 trillion of our money is confiscated each year and transferred to “the poor” and they only want more.

E.. Medicare and Medicaid were established in 1965. You have had 44 years to get it right and they are broke.

F.. Freddie Mac was established in 1970. You have had 39 years to get it right and it is broke.

G.. The Department of Energy was created in 1977 to lessen our dependence on foreign oil. It has ballooned to 16,000 employees with a budget of $24 billion a year and we import more oil than ever before. You had 32 years to get it right and it is an abysmal failure.

You have FAILED in every “government service” you have shoved down our throats while overspending our tax dollars.

AND YOU WANT AMERICANS TO BELIEVE YOU CAN BE TRUSTED WITH A GOVERNMENT-RUN HEALTH CARE SYSTEM ??

Medicare Insurance AZ staff answers:

Only about 250% correct, and I agree.

WinonaGal:
Either you cannot read labels, or just have a mad on for WalMart, as they probably have less of their goods on their shelves made in China than any of the stores you mention, Like Sears and Target.
Just about every item in Sears, with the exception of the Craftsman line of tools is made in China, and their cheaper line of tools is made in Taiwan, which is China.
Target for sure resembles a Chinese flea market as does just about any other store in America, including some of what they consider “high end stores” like Macy’s and the like.
I have found more articles made in America in Wal MArt than any of the stores you mention.
You also made a comment regarding American flags being made in China, so what else is new, when you consider our government is having much of the military uniforms for the US made in China, and just about all of the VFW posts around the country are also selling Chinese made American flags, so it’s not just WalMart.

William asks…

Do you know what percentage of the federal budget is spent on entitlements?

The most recent answer to this is 62%. WTH do people in congress think they are doing?
Who could EVER maintain that ratio of spending? We have let this get too far out of hand, with Those in Washington promising everyone everything, and no one keeping track of just how much spending is going on….

Obama is really making things much worse, by almost quadrupling the spending.

Won’t we be bankrupt if this isn’t stopped? WHo wants this to continue? Do liberals want this to keep going? When will they realize that we cannot provide everything to everyone?

That is, unless they want to confiscate all wealth and then redistribute that as well.

How do we stop this nonsense?

excerpt…
According to Congressional Budget Office records, federal outlays for mandatory spending were 33.8% in 1965 vs. 59.9% in 2005. They were highest in the Clinton years: 60% in 1995 and up to 62.6% by 2000. Source: CF&P Foundation article “Prosperitas”, April 2007.

From a Washington Post article in 1997 called “Americans Oppose Cutting Entitlements to Fix Budget”, the authors state that “…many [Americans] are unaware that entitlement programs consume more than 60 percent of the overall budget…”

A book “The Complete Idiots Guide to Economics” written in 2003 cites the U.S. Government budget as reporting that entitlements make up approximately 65 percent of our budget, distributed as follows:
Social Security: 23%
Medicare: 12%
Medicaid: 7%
Other Means-tested entitlements: 6%
Mandatory payments (pensions, etc.): 6%
Net interest on debt: 11%

In 2005, Senator Judd Gregg, then Chairman of the Senate Budget Committee stated that “Mandatory entitlement spending now represents a whopping 55 percent of all federal spending. If left on its current path, that could jump to more than 60 percent in 10 years. That will force us to cut out other necessary expenditures or raise taxes and weaken our economy.” Source: The Hill newspaper, Washington DC.

A paper written by Congressman Randy Forbes in April of 2008, “The Challenge of Giant Entitlements”, states that “Entitlement spending, or government spending that takes place automatically every year without any action from Congress, is currently 62 percent of our overall federal spending.”
Hawkeye: You mean because the libs have so many people used to living of the scraps that the govt hands out…you may be right. We will have to wean the people off the nanny state a little at a time

Medicare Insurance AZ staff answers:

By the time today’s college grads hit retirement, payroll taxes will need to increase to 37% to meet today’s promised liabilities. Add 20% for federal income tax, and ~6% for state income tax (on average) and that is over a 60% confiscation of wealth. Doesn’t leave much to live on.

Linda asks…

Do Liberals know how free market capitalism really works, or just point the finger?

MAKE SURE YOU READ ALL THIS BEFORE YOU TRY TO SHOOT IT DOWN WITH YOUR “LOGIC”

Free Markets means that there is minimal to zero government regulation in that market place and the competition thrives.

Now let’s go over the markets Liberals demonize.

Banks – They have government regulations up the wazoo making it less competitive.

Source is here: http://www.bankersonline.com/abcsoup/abcsoup.html

Health Insurance is easy to explain why it is unaffordable. How do you as a health insurance company sell health insurance to someone that is over 65 and gets medicare for free? You can’t compete vs a free product (medicare). Not to mention “Medicaid” is free as well if you qualify for it. There is no medicare for auto insurance when you turn 65 you still pay for it your self.

So let’s be logical here, all the things liberals love to use like ipods, star bucks coffee, and recycled paper, is all done through free market enterprises. A bureaucrat NEVER in the history of everything we use today has ever produced anything we use.

So Liberals bash my system please with how evil it really is, if it is evil stop buying things from free market trade, and collect it from the government.

Medicare Insurance AZ staff answers:

I thought you said “pull my finger.” wrong section.

Carol asks…

What’s the best way to help and support my bipolar boyfriend? A solution with out meds?

I’m deeply concerned about my bipolar boyfriend. He doesn’t have health insurance for therapy or medication. Currently, he’s been using weed for self medication, but we’re spending way too much on it and can’t afford it lately. With out it, he can be defensive, depressed, and have suicidal thoughts, not too mention, questions if he should break up with me for my own sake, which is not what I want . He’s tried the local health department to see if he could talk to a therapist for free and was told to apply for medicaid or medicare government funded health insurance (which ever one that’s not for senior citizens), then was turned down because he, “didn’t have any hang-ups, family has never been on welfare, never been arrested, no children, and because he was a young white male.” He applied before he reached the age limit of 21 and now he’s 26, which would do no good to re-apply.

I try and be the best girlfriend, I can. I’m pretty sure I keep him sexually satisfied, try to keep him intellectually interested, try to give him much emotional support, try and make him smile, try and keep him positive about life, buy him stuff, try and take him on trips. I’d say the only thing wrong I might do is bitch, every once in awhile.. but hey I’m only female, we bitch sometimes. I don’t bitch anymore he does with me. Anyways, he says I make him happy, but I feel like I don’t. Also, I have a hard time noticing if he’s just mad or having a bipolar moment. I try and compare him being mad vs. his bipolar moments, and still can’t tell which is happening when. I feel like I’m failing his as his girlfriend and I just want him to be happy.

So, back to the original question. What’s the best way to help and support my bipolar boyfriend?

He said he was on paxil for like 3 years and it helped provide routine, but made him numb. He didn’t like it because he said he couldn’t get off, never laughed, never felt anything. He says, ” I’d rather being feeling something than nothing.” Is there a medication that will help control his chemical imbalance with out numbing him?

Is there any sort of government funding that can help provide health insurance or even to speak with someone?

This is very serious and I’m extremely concerned. Please help if you know anything about this.

Medicare Insurance AZ staff answers:

Bipolar disorder is a depressive illness.
The best bet is seeing a psychiatrist for a proper diagnostic and treatment. If for some reason that’s not an option or if he can’t afford therapy, read http://tiny.cc/wmis4/
In many cases depression will respond quickly to the use of this treatments (within a few weeks), but if this still doesn’t work, he needs to see a psychiatrist; psychiatric treatment for depression involves antidepressants and usually but not always, therapy.
Paroxetine (Paxil) is only one of many, many antidepressants out there.
You’re being so supportive, keep that way.

James asks…

Middle of the road common sense about healthcare?

Just think about this for a minute. The extremes on both sides are blurring the healthcare issue to keep everyone confused and fighting in hopes of getting their party agendas through, but are no citizens looking at these topics with an unbiased eye?

This is, first off, not about the non-working poor. People who are on welfare have 100% government paid healthcare through Medicaid. It’s not insurance as affects the rest of the population. They pay nothing for the policy and there are no copayments, etc. That’s fallacy #1. This isn’t about people who don’t work.

The other group who doesn’t work are people on Social Security, through either retirement or disability. They are covered under a government sponsored health insurance to which they contribute called Medicare. This is more like traditional insurance in that they pay a premium and have copays for medical services, prescriptions, etc.

The government is already involved in health insurance through these 2 programs that focus on the non-working in our society.

This is supposed to be aimed at the working poor. It would be insurance of the more traditional type where the government would negotiate a large scale insurance policy (like it did with Medicare) to take advantage of the savings. Individual policies can run to thousands of dollars a month, which most working people can’t afford. Many employers no longer offer healthcare as a benefit or negotiate a contract collectively for their employees to lower the costs somewhat, but then pass the entireity of the policy costs onto the employee making it, many times, cost prohibitive. This is, more and more, going to become the case since there are too many people competing for too few jobs so employers are now in the position of not having to woo personnel. The economy is such that it’s the employer’s market.

So we have the working poor who are living paycheck to paycheck, maybe working more than one job, and still not able to afford health care. What happens when someone gets very ill? They go to the doctors or leave it until it’s really bad, since they don’t have the money, and end up in the hospital with enormous bills. These bills are extra enormous since doctors and hospitals charge out of pocket people substantially higher rates than insured people. Insurance companies negotiate contractual fees with providers in their network and will only pay up to a certain amount for services. In some cases it’s astounding the differences. One practice I worked in had a difference of over $4,000 for insured vs. uninsured.

So you don’t have the money for the doc, no insurance, and now you have a huge medical bill. Bankruptcy has been rewritten so that it’s not really an option anymore (not that it helped the providers substantially anyway as there usually isn’t much to take and divide) so the providers spend a fortune on collections and writing off debt, which they then pass along to the next person in line, ie. you.

Now providers are not uninanimously against this. Many have embraced it because there is a stipulation for mandatory coverage. This means they will be dealing with far less in bad debt and can at least be assured of getting paid the insurance portion. Where the rub for them comes in is those negotiated contractual fees. Looking at Medicare as their example of government negotiated insurance, they are scared. The rates for Medicare are substantially lower than any private insurance. Can they still make a living? Absolutely. They take Medicare because, if they don’t, they will have a smaller pool of patients to take. Some opt out, but if this is national, they will be even harder pressed to turn their noses up at it.

Medical costs are the highest in the country out of the entire world. Medical inflation is rampant and, unlike most things in a free market, you can’t always decide to just not purchase. Medical inflation has consistently outstripped regular inflation every year for the last 20 years. That means that the devices they use and the labor they purchase, the ground and construction of facilities, has not increased enough to justify their increase in price. Pharmaceutical companies stand to make more because most people are opting generics over the name brand prescriptions (some of which are several hundred dollars per treatment or month, for long term meds) and having insurance means that when the new meds come out, before generic are legally allowed (to protect R&D and keep companies encouraged to continue finding new meds) they will be allowed to charge their assinine prices and have people submit because they are paying $60 instead of $20. Much easier than the “it might work” generic at $50 OOP to $400 for the “this is the ticket” name brand.

The scariest part of this whole plan for the working poor is what are these “mandatory” rates going to be? Are they going to be equally unaffordable? Now you are violating the law if you don’t
I understand it’s long. I thought that people who actually care might have been willing to read an actual thorough analysis. I don’t do talking points like “Osama sounds like Obama” or scream one word slogans like “Nazi” at all republicans.

Medicare Insurance AZ staff answers:

Way to long, make it shorter and to the point.

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Your Questions About Long Term Care Insurance Premiums

Jenny asks…

Wow is this true about health care?

The Democratic Senators and Congressmen can well choose to ignore polls. Polls go up. Polls go down. They may figure that the public will have moved on by the time they run for re-election, particularly those Senators who are not up in 2010. With four or six years to go in their terms, they can afford a relaxed view of polling data.

But the Democratic Party as a whole cannot afford to ignore a massive defection in the ranks of the elderly, one of its key building blocks. Ever since the New Deal coalition was cobbled together by FDR, the elderly have been a major component. Worried about Republican designs on their Social Security, they vote overwhelmingly Democratic.

But the Obama proposals, which many see correctly as a major cut in Medicare, might be seminal in driving them en masse away from the Democrats.

The Democratic Party is built on six pillars — blacks, Latinos, single women, young people, union members, and the elderly. If legislation threatens one of those pillars, it threatens the stability of the entire partisan structure. And Obama’s health care reform seems to do just that.

With 40% of the savings in medical spending coming from Medicare, the senior citizens of America are coming to see the Obama proposals as an assault on their health care system. Since their needs are fully met by Medicare, they see no need for monkeying with the system and are highly suspicious of any changes. When they watch as their fellow seniors attend town meetings to protest to their Congressmen about these cuts and are labeled “un-American” for their pains, their alienation from the Democrats just grows.

The fissure Obama is driving between his party and the elderly will not soon heal. When the elderly change their voting habits, they tend to do so for a very, very long time. Even Senators who are up in

2012 or 2014 should worry that their votes for the Obama plan could doom their ability to attract elderly support.

As to the young people who back the plan, once they learn that they will have to pay steep premiums for health care coverage, whether they want to or not, their support is likely to cool. Under the bill, for example, those making $30,000 a year would have to pay up to 7% of their income in health insurance premiums before they could get a government subsidy. A $2,100 bill for such a young person might seem affordable to Obama, but perhaps not to them. Thus, the legislation may well come to be seen as a tax on the young, another of the key constituencies of the Democratic Party.

The cost of Obama’s health care changes just keeps growing — financially and politically.

Medicare Insurance AZ staff answers:

True? Yes.

Isn’t it interesting that Obama ran on the promise of “change” and that no one in the media asked “change in what and to what” and now he wants to control 14% of our economy? Any opposition to this is branded “Republican right wing” opposition, but, in many cases it is just senior citizens interested in what will happen to them.

How can the people of Massachusetts live with themselves as they keep electing Barney Frank and Ted Kennedy and John Kerry? Well, I guess there is some California in them.

Regards,
Dan

Michael asks…

why cant Americans come to term with nationalized health care?

As a canadian, my entire nation and I are laughing our asses off at america right now. Americans are either 1) stupid 2)make good mind slaves for their media 3) dont give a shit about their health.

here in canada our healthcare system is great. Ya if you go see a specilist you have to wait on a considerable long list.. but comon? do you need to go to a specialist every month? only a slim minority of people need specialists because they are That sick. most people usually never see a specialist until they are in their 40′s.

Also I think america needs to start thinking about its future. nationalized healthcare would do great for the younge population.. 0-29 years old. now some of you are going to say.. “what about grandman”.. OH well… old people are a burden to our society (70 years +) anyway.. time to turn a new leaf.. leave them behind.. and start looking into the future.

Almost every 1st world nation besides america has a nationalized healthcare system. My friends, if you get sick here in canada, you will NEVER go bankrupt, you will NEVER lose you house ect..

the insurance companies are making profits of your health!! how is that Not wrong? Heatlcare is something that no one should be profiting off of period. for a nation to work you need healthy PEOPLE… if everyone was for themselves, you wouldnt have much of a nation.

as for the illegal problem, Canada has a ton of illegal immigrants, not quite like the USA but canada still has many.

its time to stop thinking about $$$ and thinking about your future.

it is true that the govt doesnt need to be grown but in such cases as healtcare, national defense , you must have the government intervene. Because both national defense and healtcare are doomed to fail if they are privitized..

privitized healtchare = massive premiums, dropping of coverage for no reason.

privatizing the military = warlords, end of a nation
i attend college in NY state dumb ass

Medicare Insurance AZ staff answers:

Because for the millionth time….IT IS NOT IN THE CONSTITUTION TO PROVIDE FOR YOUR HEALTH CARE!

AND….this republican party asked just three things…

To publish it for three days before voting…to allow us to read it…
To publish the cost of it……and I foget the other thing. But it wasn’t much.

THEY SAID NO! Why not? Why not allow us to read it? They have shown before THEY NEVER READ IT…and we should be allowed to know the cost and what it is in it.

WHY are they secretative…why are they so stubborn they cant’ share it with those that are going to pay for it. We have a right to see it.

It is right…it is time to stop thinking of money and think of future and people. This will benefit 12 million….and it is putting at risk 87 million. WHAT DEAL IS THAT? When you take 500 BILLION from medicare or medicaid and take half the benefits from it …who is going to suffer? SENIORS HANDICAPPED AND CHILDREN!

ARe you so proud of yourelf that you cant’ work for your health care that you put the most dependent of that in jeporady?

GET REAL…..you are all so selfish and such idiots that you don’t think of that or spending 30,000 bucks for 3 marsh mice and shutting off water to hundreds of farmers and their livestock and costing them MILLIONS…to save a handful of smelt….

WHERE IS YOUR HEADS? WHERE ARE YOUR PRIORITIES?

I am so sick of the minorities getting everything and everyone having to pay. I don’t mean black and illegal….I mean THOSE THAT WANT IT ARE IN THE MINORITY….

MOst of AMERICA DOES NOT WANT THIS…and they have just as much right to have their lives uninterrupted as you think you have the right to have YOUR LIFE PAID FOR YOU!

COWARDS…making old people and children and handicapped pay for your security and deny them the help they deserve and should have!

COWARDS!

Donna asks…

Does the POTUS think that health care reform will happen this year?

The President concluded his remarks by emphasizing that reform will get done this year, because we cannot afford to wait:
Now, I realize that the last few miles of any race are the hardest to run, but I have to say now is not the time to slow down, and now is certainly not the time to lose heart. Make no mistake, if we step back from this challenge at this moment, we are consigning our children to a future of skyrocketing premiums and crushing deficits. There’s no argument about that. If we don’t achieve health care reform, we cannot control the costs of Medicare and Medicaid and we cannot control our long-term debt and our long-term deficits. That’s not in dispute. So we’re going to have to get this done. If we don’t get health care reform done now, then no one’s health insurance is going to be secure because you’re going to continue to see premiums going out-of-pocket costs going up at astronomical rates, and people who lose their jobs are having a pre-existing medical condition or changing their jobs finding themselves in a situation where they cannot get health care. And that’s not a future I accept for the United States of America. And that’s why those who are betting against this happening this year are badly mistaken. We are going to get this done. We will reform health care. It will happen this year.

http://www.whitehouse.gov/blog/The-President-on-Health-Care-We-are-Going-to-Get-this-Done/

==========================================
However, when you look closely at the bill being proposed by the LIBERAL Conyers, it does not go into effect until the year 2012… three years from now. Wow, that is fast legislation. They just pulled another “fast one” on the US taxpayers.ZZZZZZZzzzzzzzzzz.

Here’s the text from the bill …

http://www.johnconyers.com/hr676text

TITLE V—Effective Date

SEC. 501. Effective date.

Except as otherwise specifically provided, this Act shall take effect on the first day of the first year that begins more than 1 year after the date of the enactment of this Act, and shall apply to items and services furnished on or after such date.

=======================
Passes in 2010 – can’t be put in place until at least more than one year passes, so that’s 2010 plus 2 years BEFORE it goes into place in 2012. Probably won’t get passed this year anyway. That’s what you call leg-is-”slay”-shon.

===========================
Single Payer Action is the only hope. Everybody in. Noboby out.
Private option is simply Medicare available for everybody who wants it. You still have to buy it, so if Private Companies can deal with that, lets go for it. Public or private available option for all. Except we know that private cos won’t cover the sick ones very long, so they will be forced to public option, but right now they simply cannot get any health care insurance. Sick people need some help. Will you help? http://www.singlepayeraction.org/blog/?p=1177
The question is actually, why does the POTUS say it will happen this year when it is obvious it will NOT happen this year, or next year or the year after that.

Medicare Insurance AZ staff answers:

It will begin this year, however it will be a slow process that will take a long time to implement.

Betty asks…

Why did Dems knowingly vote for a ponzi scheme “Madoff would have been proud of”?

GRAHAM: There’s a provision in this bill called the Class Act. For the first time, the federal government is going to offer to all Americans long-term health care insurance. Now here’s the deal. It will be offered by the federal government. You can sign up voluntarily. And they collect premiums for five years without any benefits. It generates $72 billion, which helps pay for this bill. The problem is once the benefits are paid out, the CBO says the thing’s going to go bankrupt. We won’t let it go bankrupt. The sickest people are going to join. One day, it will become an entitlement…

INGRAHAM: Another entitlement program.

GRAHAM: …to get long-term health care insurance from the federal government. Here’s what Kent Conrad, the Democratic Budget chairman, said about this provision: “A Ponzi scheme of the first order. The kind of thing that Bernie Madoff would have been proud of.” And he avowed to make sure it wasn’t in the bill. Seven Democrats wrote to Harry Reid in October, don’t put this in the bill.

INGRAHAM: It’s in the bill. Did they not know it was in the bill before they’ve all pledged we’re going to stand Kumbaya with Barack Obama and have this big celebration for this historic moment?

GRAHAM: All I can tell you, they said it was a Ponzi scheme Bernie Madoff would have been proud of. It’s in the bill they voted for it. Now they’re all co-conspirators of this Ponzi scheme.

INGRAHAM: Barack Obama also said today care will improve, efficiency will be increased, it’s deficit neutral, and all the naysayers out there are going to be proven wrong. Will care in any way, shape or form be improved for most Americans?

GRAHAM: If you take $470 billion out of Medicare over the next 10 years to start a new program, senior citizens are going to get less care. Hospitals and doctors are barely hanging on now, based on their reimbursement rates that Medicare is able to pay. If you take $470 billion out, you’re going to have a harder time finding a Medicare doctor. If you increase taxes by $518 billion, you don’t think any of it’s going to be passed on to the American consumer? This is a falsehood. This bill is based on false promises, things that will never happen. We’re not going to cut Medicare by $470 billion. And we are going to reimburse the doctors by $274 billion, which is not in the bill. So this whole thing’s a Ponzi scheme. It’s a gimmick.

Medicare Insurance AZ staff answers:

Because they could.

Carol asks…

Is Dave Ramsey wrong about whole life insurance?

If anyone has spent even a few minutes listening to Dave Ramsey, you realize that he sells motivation, common sense, and enthusiasm more than he sells expertise. Not to say the guy doesnt know his stuff. Im a fan of his and listen to his show from an app on my Android phone.

But those who know him also know that he can very, for lack of a better expression, dogmatic about his financial theories. One area is life insurance:

Dave: NEVER EVER BUY WHOLE LIFE, only buy term. Invest the difference in premium in “good growth stock mutual funds” and you’ll have alot more.

I have a few problems with that.

First the dogma. All truth is reasonable, so theres no need to go nuts on a matter if its true

Second, all he’s really saying here is that instead of “investing money in life insurance, invest money in the stock market.” The reason why the reward is so much greater is because the risk is so much greater as well.

But in a reasonable estate plan, the goal is more about security for your survivors than getting rich.

Third, Any reasonable estate plan also factors in dramatic life changes. For instance, an incurable disease in its late stages, such as cancer. If you only have term coverage, when your term runs out, you cant buy another policy because no one will insure a cancer patient. With no cash from insurance, a person risks losing a significant portion of their nest egg to estate taxation. Or with no cash at all, a person risks losing personal property to pay it.

I personally would suggest that a person make reasonable estimates of what their estate will be worth at death. Estimate that the Federal estate tax exemptions will be $1,400,000. I say this figure because it splits the difference between the lowest estate tax exemption in history ($650,000) and the highest ($3.5 million) and and rounds it out.

Buy at least one whole life policy that can cover that tax liability. If you project an estate worth less than the 1.4 million dollar exemption, therby making you Federal estate tax free, buy a low whole life policy, around $100,000, so that funeral expenses and other things are covered without your family having to liquidate your assets to pay them, or if you live long enough for the cash value of the policy to be higer than the death benefit, (which usually takes at minimum 20 years) you get to enjoy a hefty sum of unexpected money while your still alive.

Meanwhile, follow Daves advice in having insurance equal to 10 times your households annual income. If your family makes 50 grand, and you already have the 100,000 whole life, buy 400,000 in term insurance to make an even $500,000

Investing in the markets may very well cause you to end up with more money. But thats only if all goes well, like you never dying in an accident. Building wealth is a good thing, but I dont think its more important than ensuring that your family is taken care of regardless of what happens to you.
Rick B:

You’re forgetting that if you die you get the death benefit with insurance. With investments, all you have is the value of the investments. If I die after two years of investing the premium in something safe, like CDs, my family gets, $1,100 give or take. But with the policy, my family would get $100,000.

Medicare Insurance AZ staff answers:

Dave Ramsey ranks with all the other TV celebs like Suze Orman, Jim Kramer and all the others. He is on TV becuase of his personality, not his knowledge. He’s charming, entertaining and comes off as making big differences in peoples lives. All these TV celebs have been proven wrong many many times on TV with their misinformation. Some of their little tidbits have some validity, but none of the ideas that are valid are their own anyways…just recycled advice that most financial advisors give to their clients for free anyways (Pay yourself first, debt snowball…all ideas that are as old as the hills).

Life insurance is NOT a one size fits all solution. Ask any 60+ year old how the Buy Term and Invest the Rest strategy worked for them around 2008…most of them now sit with no insurance (some who have since become uninsurable), and their portfolio would be worth a fraction of what it was once worth and they can’t even fall back on selling their home as an asset to cover the shortfall either becuase the real estate market is still so low in the USA. Any of these quacks that are claiming whole life insurance is a scam are completely ignorant and don’t understand the facts about the differences. It’s like saying “BMW are a bunch of scammers becuase their cars are more expensive than a Honda.” Totally difference features and benefits.

And the only thing worse than hearing your spouse died is having to make the decision to sell the farm just to cover expenses and not know if there will be enough money left in the end. Buy a small whole life policy when you are young and in the long run it will work out to be FAR cheaper than term in the long run. While I haven’t done all the math on it, I would assume the extra $40/month I put into this policy over the next 20 years won’t add up to very much in comparison to the peace of mind that I have in knowing that things will be taken care of whether I die tomorrow, or in 40 years.

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Your Questions About Medicare Private Insurance Coverage

Sandy asks…

Under the Ryan plan, once I retire, how will I get a private company to insure me if I have a medical problem?

in the post-Medicare era…

assuming I’m not in the 55+ age group today…

let’s say I’m 52 today, and have a heart condition 15 years from now and need a transplant…

If I’ve paid into Medicare coverage for 40+ years to guarantee I have some type of Insurance coverage when I retire, how will the GOP/Ryan plan at least guarantee I have access to coverage?

Medicare Insurance AZ staff answers:

You probably won’t, but Ryan and the republicans don’t care. By not giving you or anybody else Medicare, rich people get more money in their pockets. That’s all they care about.

Sharon asks…

Why does Obama call Meidcare Advantage wasteful?

Does he still despise and ridicule Seniors?

Seniors defend Medicare plan Obama calls ‘wasteful’
WASHINGTON — One of the largest spending cuts Congress could rely on to pay for an overhaul of the nation’s health care system comes from a Medicare program President Obama has called a “wasteful” subsidy for the health insurance industry.
Don’t tell that to cancer survivor Maurice Engleman, 82, who says the controversial Medicare Advantage program — which allows seniors to buy Medicare coverage through private insurance companies — helped him beat cancer.

“There was a seamless link between the medical support and the emotional support,” said Engleman, who was diagnosed with tongue cancer last year within a week of his wife’s death. “I don’t believe Medicare would have taken care of the kind of services I required.”

http://www.usatoday.com/news/washington/2009-08-04-healthcare_N.htm

I guess since it’s a private component and not a “social” one Obama fears it. I have to wonder if he would have been glad if this man had died.

Medicare Insurance AZ staff answers:

Okay, wastefullll

http://cid-17610ad2c13ec04d.skydrive.live.com/self.aspx/Public/healthcare-chart-small.jpg

Michael asks…

Can my private university force me to buy its student health insurance?

I am currently covered by a state-enhanced version of Medicare; my family is extremely low-income and this health coverage is far superior to that offered by the private graduate school I will be attending this fall. However, the school is not accepting my waiver form saying that government insurance does not meet the school’s waiver qualifications (only employer insurance programs do). Can they do this to me and make me pay thousands of dollars I don’t have for redundant school health insurance I don’t need? Anyone knowledgeable enough to know whether this is something I can fight legally? The school and my insurance are in NJ.

Medicare Insurance AZ staff answers:

A private school can require you to do just about anything as a condition of admittance — because they are a private institution, not a govt agency. It’s all a matter of contract — you can either do what they want, or not accept admission. Your choice.

Racial prejudice is about the only thing prohibited — and that’s only under the 13th Amendment, which affects private groups — the 14th only applies to govt action.

Charles asks…

Did you know that the US already has a mixture of most of the world’s health insurance systems?

When it comes to treating veterans, we’re Britain. Health care is provided and financed by the government through tax payments, just like the police force or the public library.

For Americans over the age of 65 on Medicare, we’re Canada. Insurance coverage comes from a government-run insurance program that every citizen pays into

For Americans whose employers offer insurance, we’re Germany. Private insurers are financed jointly by employers and employees through payroll deduction.

For those Americans whose employers don’t offer health insurance we’re Cambodia – with access to a doctor available if you can pay the bill out-of-pocket at the time of treatment or if you’re sick enough to be admitted to the emergency room.

Medicare Insurance AZ staff answers:

BUT US is the ONLY Country’s Heath Care system is making tons of $$$ of the people. Because there is NO CAP on treatment/drugs prices. This is the MAIN problem! It’s driving the country and citizens to go bankrupt because of the health care bills!

George asks…

Support the Affordable Health Care for America Act?

Will Republicans support the Affordable Health Care for America Act if the public option is dropped?

This would include the following:

prohibiting health insurers from charging different rates based on patients’ medical histories or gender
prohibiting health insurers from refusing coverage based on patients’ medical histories
repeal of the exemption for insurance companies from anti-trust laws
requiring most employers to provide coverage for their workers or pay a surtax on the worker’s wages up to 8%
new restrictions on abortion coverage in private insurance plans (note: Medicare is already prohibited from covering abortions by law)
expansion of Medicaid to 150% of the Federal Poverty Level
providing a subsidy to low to middle income Americans to help buy insurance
a central health insurance exchange where the public can compare policies and rates
a 5.4% surtax on individuals whose adjusted gross income exceeds $500,000 ($1 million for married couples filing joint returns)
a 2.5% excise tax on medical devices
reductions in projected spending on Medicare by $400 billion per year
inclusion of some language originally proposed in the Tax Equity for Domestic Partner and Health Plan Beneficiaries Act
inclusion of language originally proposed in the Indian Health Care Improvement Act Amendments of 2009 (H.R. 2708).

Without the public option, it is just massive healthcare reform overhaul. There would be no government run national program (administered by the US Department of Health and Human Services).

Why wouldn’t anyone with a conscience want to support this?

And why do Republicans keep claiming that taxes will be raised on the middle class? Do the majority of Americans really make $500,000 to 1 million a year?

Medicare Insurance AZ staff answers:

Considering that they are funded by (un)insurance companies and ignore the facts, then no.

FACT – Insurance companies in the USA admit to pushing up prices, buying politicians and not paying out claims when they should [1]
FACT – PER PERSON the USA spends more on healthcare than any other nation on the planet [2]
FACT – Obama debated his plans before the election for healthcare [3]
FACT – the chance of a child under five of dying in the USA is greater than industrialised nations with universal health coverage [4]
FACT – Obama was elected by the American people to bring in change [5]
FACT – Obama wants to stop insurance companies from screwing American [6]
FACT – The reforms Obama wants work in the Netherlands and Switzerland [7]

Let me know if my facts are wrong, but please provide proof.

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Your Questions About Medicare Health Insurance Card

George asks…

How Do I Obtain A Social Security Number For My Grandmother?

My grandmother was born in Harlingen, Texas (Cameron County) in 1949 by a midwife. Shortly after she was born, her parents moved to Mexico where she has resided all her life. She does have a certificate of vital record that was filed May 3, 1949, but has no social security number. I’ve searched for her on the internet in Cameron County records and have seen that her birth was indeed recorded.

She still lives in Mexico and was able to come visit just showing her birthcertificate. But since new laws state that a US citizen needs a passport to travel to Mexico, she hasn’t been able to visit. We are trying to get her a social security number, so we can start the process of getting her a passport. This is were the problem arises. When we go to the social security office they ask for a US issued photo id (which she doesn’t have). When we try to get an id, they say we need a ss#, so basically it’s a cat/mouse game!!! We have also tried an application SS-5, but they also need photo verification. She has her Mexican id, but obviously that is not accepted. The social security office also accepts an employee ID card; school ID card; health insurance card (not a Medicare card); or U.S. military ID card, but she doesn’t have any of those.

Before we hire a lawyer, we wanted to see if anyone has any suggestions/advice!

Medicare Insurance AZ staff answers:

Note to “bill” – how is grandma going to get an ID from the DMV when she cannot enter into the US (where she has to have her photo taken) ???? And to answer your Q, you may want a consultation with a lawyer, but to hire one to go against (basically) the US Govt is probably futile….sorry ;[

David asks…

Liberals, Why do you believe Government Health Insurance is better than private insurance?

This law, by design, will eventually put private insurers out of business. Then, there will be only one choice for coverage. Single Payer = Daddy Government.

2008 National Health Insurer Report Card

http://www.ama-assn.org/ama1/pub/upload/mm/368/reportcard.pdf

2008 Percentages of Medical Claims Denied ( Page 2 )

Medicare = 6.85%

Private Insurance ie.. “Evil Corporate Profit Hogs”

Aetna – 6.8%
BCBS 4.6%
Health Net – 3.9%
Cigna – 3.4%
Humana 2.9%
Coventry 2.9%
UHC 2.7%

How well do you think you’re lawsuit will go when filed against the Federal Government ?

Like the IRS, you are Guilty until proven innocent.
The Link is to American Medical Association
NO It doesn’t “outlaw” private Insurance. But what do you think is going to happen when Companies have the following choice:

Spend 15% or more on current benefits.

Cut all medical benefits and pay 8% fine .

DUH !

Medicare Insurance AZ staff answers:

They all want those Cushy federal jobs No brainer promised them.

Ruth asks…

Is health insurance the solution, or the problem?

We hear a lot about the 47 million Americans without health insurance, the ones that get their critical care at the emergency room. Democrats want to cut-and-run with regards to national health care, that is, they want to issue another 47 million laminated cards and call it “Mission Accomplished.”

But in Michael Moore’s movie, “Sicko,” we learn that people with insurance are often worse off. They are frequently denied various treatments; more foreboding: private healthcare practices often limit the number of “insured” patients they will take-on (with Medicare/Medicaid leading the list of undesirable insurance) because of the hassle and less-than-reasonable reimbursements. More people on government insurance with less physicians willing to see them doesn’t sound “progressive” to me.

So, if national insurance isn’t the solution, what is?

Medicare Insurance AZ staff answers:

Michael Moore has never taught anyone anything. But I do agree that sometimes having insurance is a pain in the neck becuase of the limitations to it. Thats why I’m for the states or the federal government creating universal health care.

Sharon asks…

What do you think of this letter to the department of homeland security?

> Dear Mrs. Ms. or Sir:
>
> I’m in the process of renewing my passport and still cannot believe this.
>
> How is it that Radio Shack has my address and telephone number and knows
> that I bought a cable TV from them in 1987 (23 years ago), and yet, the
> Federal Government is still asking me where I was born and on what date.
>
> For Christ sakes, do you guys do this by hand? Ever heard of computers?
>
> My birth date you have in my social security file. It’s on EVERY income
> tax form I’ve filed for the past 30 years. It’s on my Medicare health
> insurance card and my driver’s license, It’s on the last eight damn passports
> I’ve had, It’s on every stupid customs declaration form I’ve had to fill out
> before being allowed off the plane for the last 30 years. And it’s on all
> those census forms that we have to do at election times.
>
> Would somebody please take note, once and for all, that my mother’s name
> is Maryanne, my father’s name is Robert and I’m reasonably confident that
> neither name is likely to change between now and when I die.
>
> Between you an’ me, I’ve had enough of this bureaucratic bullshit!
>
> You send the application to my house, then you ask me for my #*&#%*&
> address.
>
> What is going on? You must have a gang of bureaucratic Neanderthal
> morons working there!
>
> Look at my damn picture. Do I look like Bin Laden? And “No,” I don’t want
> to dig up Yasser Arafat, for shit sakes. I just want to go and park my
> ass on a sandy beach. And would someone please tell me, why would you give a
> damn whether I plan on visiting a farm in the next 15 days?
>
> If I ever got the urge to do something weird to a chicken or a goat,
> believe you me, I’d sure as hell not want to tell anyone!
>
> Well, I have to go now because I have to go to the other end of the city
> and get another #*@&#^@*@& copy of my birth certificate to the tune of $100.
>
> Would it be so difficult to have all the services in the same area so I
> could get a new passport the same day? Nooooo, that would require planning
> and organization. And it would be too logical for the @&^*^%@% government.
>
> You’d rather have us running all over the place like chickens with our
> heads cut off. Then, we have to find some asshole to confirm that it’s really
> me in the damn picture – you know, the one where we’re not allowed to
> smile……
>
> Hey, you know why we can’t smile? We’re totally pissed off!
>
> Yours truly – An Irate Citizen,
>
> Garry K. Taylor.
>
> P. S. Remember what I wrote about getting someone to confirm that the
> picture is me? Well, my family has been in the United States of America
> since 1776. I have served in the military for something over 35 years and
> have had security clearances up the ying yang. However, I have to get
> someone important to verify who I am – you know, someone like my doctor……..
> WHO WAS BORN AND RAISED IN INDIA !
>
> And you a@@holes want to run our health care system?????

Medicare Insurance AZ staff answers:

I totally agree and sympathize with the writer, as the government red tape is such a waste of tie and money, I just renewed my drivers license which I have had for 49 years, had to under go all sorts of bs to prove I am me

Donald asks…

how to see physchiatirst in australia?

hello.

i need to see a psychiatrist about a mental illness. what do i need to do?

im a medical rookie and have know idea what to do. could you please answer these questions.

do i need a referral? (i don’t really have a gp, haven’t been to the dr in about 4 years)
do i need medicare card or health insurance? (i don’t have a clue if i got either – my guess is not)
anyone know what type of price range im looking at for 1 session and hopefully a prescription?

anything else i should know of?

thanks heaps.

p.s i live in brisbane (towong) if anyone knows a good place

Medicare Insurance AZ staff answers:

I don’t think you can find that many people from Australia here. The only advice I can think of…

Call a hospital in your town and ask them these question. Even if they can’t answer, they may at least know where you should call.

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Your Questions About Medicare Advantage

Carol asks…

how do we get out of these Medicare Advantage plans?

My mother got sucked into this Anthem deal and I’m convinced it’s a rip-off. Also the Medicare Part D sucks.

Medicare Insurance AZ staff answers:

Idk about you’re Advantage plan for sure but i do believe you cannot disenroll past march 31st. As for medicare part d you cannot disenroll until november 15th. If you choose not to pay premiums she will be taken out but if she ever enrolls again she will face a penalty of 1% of the nation average of premiums for every month she went with out. This penalty would be charged monthly for the rest of her life

Paul asks…

What are the typical premiums/co-pays for Medicare Advantage plans with dental?

Also, is it possible I would be eligible for a Special Election Period because I also have Medicaid and Medicaid stopped most dental benefits?

Medicare Insurance AZ staff answers:

It depends upon your location; Medicare Advantage plans are county specific.

Most Medicare Advantage plan have very limited dental, such as one cleaning and one exam per year. Some Advantage plans will have dental as an option for an additional premium; in my area it runs an extra $14 – $39 per month.

Since you are dual eligible there are Medicare Advantage plans specifically designed for people on both Medicare and Medicaid and some have dental included. Any premium and co-pay for those plans will be paid for by Medicaid as long as you are QMB and receiving full Medicaid benefits. If you are receiving partial Medicaid benefits you’ll have a small premium and/or co-pay. What plans are available to you will depend upon your location and are not available in all counties.

You have an SEP all year because you also have Medicaid and can change plans at any time and as often as you wish.

Helen asks…

Which is better supplements to medicare or medicare advantage plans?

My mom is 72 and just retired and is losing health care coverage at work. Medicare advantage plans sound so much better than supplements to medicare. What’s your experience?

Medicare Insurance AZ staff answers:

There are pros and cons with both types, and this subject is too involved to get into much detail here. Which is best will depend upon her particular situation.

A Supplement allows you to visit any doctor that accepts Medicare. They come in several different options, generally Plans A through N. They do not have drug coverage so you need to get a separate stand alone drug plan. The premium is generally higher.

An Advantage plan will have doctor restrictions. What those restrictions are depends upon the plan option. Those options are HMO, PPO, HMO/POS, PFFS, SNP, MSA, DUAL, Cost, and PACE plans. These plans can be county specific so what is available depends on your county. Some of these plans have drug coverage while others don’t. Of those that do not have drug coverage some will allow you to get a separate stand alone drug plan while others won’t, and you’ll need to know which do and which don’t. The premium is generally much less, with many having a $0 premium in many counties.

You and your mom will need to contact a local agent that works with all of the major companies and with both types in her area. The agent can take the time to explain the differences and can find out which plan is best for her budget and situation. There is no charge using an agent.

Lizzie asks…

Must a health care provider who accepts Medicare also accept all Medicare supplemental and Advantage plans?

For health care providers who accept Medicare, can they choose which Medicare supplemental and which Medicare Advantage plans they want to accept or must they accept any and all Medicare supplemental and Medicare Advantage plans

Medicare Insurance AZ staff answers:

It’s not simple answer.

If you have a Medicare Supplement you can go to any provider that accepts Medicare. With a Supplement the provider first bills Medicare. After Medicare pays most of those providers will bill your Supplement. If the provider chooses not to bill the Supplement you can send the bills off to the insurance company and get payment for what Medicare doesn’t pay.

With a Medicare Advantage plan there will be doctor restrictions, and those restrictions will depend upon the type of Medicare plan you have. There are HMO, HMO/POS, PPO, PFFS, SNP, MSA, DUAL, PACE, and Cost plans.

With an HMO you can only go to a doctor in the network.
With and HMO/POS you may go outside of the network with restrictions and approval.
With a PPO there is a doctor network but you can go to a doctor that is not in the network in most cases although your costs will be higher.

PFFS plans come in two flavors – one with a doctor network and one without a doctor network. You can generally go to any doctor that is willing to accept the plan. The doctor can accept the plan today and not accept it tomorrow. They can accept it from you but not accept it from your spouse. Congress really screwed these plans so if you are considering one of these types make sure your agent explains the difficulties fully.

SNP and DUAL plans can be either HMO or PPO.
MSA plans allow you to see any doctor willing to accept the plan and they have a savings account tied to them, similar to the HSA plans except that Medicare funds the account.
PACE and Cost plans are few and far between but do have doctor restrictions.

With an Advantage plan the provider only bills the insurance company.

Chris asks…

what if my Medicare Advantage plan doesnt cover a procedure ?

my mother in law has a rare skin cancer and her care improvement plus doesnt cover the treatments.
the dr office said she has to wait 2 months untill her insurance is up and get back on medicare can she cancel her care improvement plus early and get on medicare and get treatments ?

Medicare Insurance AZ staff answers:

She needs to talk with her agent ASAP.

The reason the Advantage plan is not covering could be because there are other procedures just as good but less expensive. If the doctor specifically states that she needs the procedure and that the other procedure won’t work the Advantage plan will cover the procedure as long as it is a Medicare approved procedure. Her agent can help her with the appeals process.

If it’s not a Medicare approved procedure it won’t get covered even if she goes back on original Medicare.

In my experience, doctors know little about what is and isn’t covered by Medicare and what is and isn’t covered by the Medicare Advantage plans.

To actually answer your question – No, she cannot cancel her Advantage plan early. She can disenroll from her plan between Oct 15 and Dec 7, and the disenrollment will be effective Jan. 1 (her current insurance isn’t “up” until December 31). The easiest way to disenroll is to enroll in a Part D prescription drug plan and she’ll automatically be disenrolled from the Advantage plan.

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