Medicare: Colonoscopy Cost

Preventives screenings are covered by Medicare and they are covered by all health insurance plans as a result of Obamacare.  This means a person should have no co-pay and no deductible cost when getting a preventive screening test.  So what [...]

Find Doctors Who Accept Medicare

Medicare has a website available for people to look up doctors.  Below is a press release about the site. This site is for people looking to find doctors who accept Medicare, so it is for people who use their Medicare card when they see a doctor. If [...]

Medicare Home Health Services

An article by David Sayen, Medicare Regional Administrator: Medicare covers a variety of heath care services that you can receive in the comfort and privacy of your home. These include intermittent skilled nursing care, physical therapy, speech-language [...]

The Obamacare Campagin

Yesterday, I attended a “house party” to watch a webcast about advertising, outreach, and education efforts to let people know about the Affordable Care Act (ACA), aka “obamacare”. There is lots of work to do according [...]

45.5 Million Americans Without Health Insurance in 2012

45.5 million Americans (14.7%) had no health insurance in 2012, according to a report by the CDC (Center for Disease Control). In Arizona, 20% of residents had no health insurance in 2012, according to the CDC survey. A California Healthline [...]

What is AHCCCS? (pronounced “access”)

AHCCCS is Arizona’s Medicaid program. The Arizona Health Care Cost Contain System has been an innovative Medicaid program, despite the fact that Arizona was the last state in the union to participate in Medicaid.  In 1982, the Arizona [...]

Obamacare and Medical Loss Ratio

What is “Medical Loss Ratio and why is this an important piece of Obamacare? Obamacare requires companies selling individual and small group health insurance to have at least an 80% Medical Loss Ratio (MLR).  Large group insurance must [...]

No Big Medicare Advantage Cuts For 2014?

I recently wrote about the potential for Medicare Advantage mayhem this fall (2013) because of significant payment cuts that were announced in February by CMS (Centers for Medicare and Medicaid Services). Insurance companies that run Medicare [...]

Turning 65. Do you Need to enroll in Medicare?

Every day 10,000 American baby-boomers turn 65 .  Most will enroll in Medicare, but many will not. Not everyone needs to enroll in Medicare because some people continue working and are covered by their employer’s health insurance.  A person [...]

What’s in Medicare’s future?

UPDATED MAY 2013 THIS POST WAS ORIGINALLY WRITTEN IN 2011, BUT ALL THESE CHANGES TO MEDICARE ARE STILL BEING DISCUSSED IN 2013. Here is a list of changes to Medicare that have been proposed by various interest groups. Raising the Age of Eligibility [...]

Medicare and the Budget

Kaiser Family Foundation ( has lots of information on Medicare and health care in general.  It’s a great place to find data and analysis on Medicare, Medicaid, and health care reform. Here is what they have to say about Medicare: In [...]

Medicare Does not CoverLonger Term Care

Medicare does not cover long term care. I recently shared this information with relatives who are struggling to arrange care for their elderly parents. It is not unusual for people to misunderstand what Medicare covers and what it does not [...]

Annual Physical Now Covered by Medicare

As part of the Affordable Care Act, Medicare now covers annual wellness visits and will provide payment for the creation of a personalized prevention plan.  The wellness visit will include a health risk assessment to: Establish [...]

Hospice Cost for Medicare

Hospice agencies receive $142.91 per day from Medicare for services provided to Medicare beneficiaries. Payment is the same no matter the level of care that might be required for patients with different needs. An article in the University [...]

Medicare Beneficiaries Can Lodge Complaints Over Care

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule today that would require most Medicare-participating providers and suppliers to give Medicare beneficiaries written notice about their right to contact a Medicare [...]

The Future of Medicare?

Congressman Paul Ryan of Wisconsin has given a lot of thought to the future of Medicare and how this program, which takes up 13% of the federal budget, should be shaped in the future.  Ryan is one of the Republican “Young Guns” [...]

Medicare Independent Payment Advisory Board

In the list of provisions included in the health care reform bills, it looks like the most important element is the Independent Payment Advisory Board, which will have the ability to set policy for Medicare. I was just reading on the Health [...]

Health Care Reform Law and Medicare

Impact on Medicare Final Health Reform Law (Senate Bill and Reconciliation) * Prescription Drugs Requires 50 percent discount on brand-name drugs in the doughnut hole, starting in 2011.Phases out the doughnut hole completely by 2020, [...]

Medicare Advantage cuts according to AHIP

October 2009:   America’s Health Insurance Plans released the following statement at the end of September, 2009 regarding the impact of proposed cuts to Medicare Advantage: FACT: The impact of proposed cuts to Medicare Advantage (MA) [...]

Enrollment in Medicare Advantage high in some states

September 2009: If Medicare Advantage plans impose higher premiums and higher co-payments for servcies, over 10 million Medicare beneficiaries enrolled in these plans will be affected.  In some states, the number of Medicare beneficiaries [...]

Medicare HMO’s in 1996: a model for savings

Tucson H.M.O.’s May Offer Model for Medicare’s Future Excerpts from a New York Times article from March 26, 1996 Partners for Seniors has expanded its pharmacy benefit!” a newspaper ad proclaims to Tucson’s big retirement [...]

AHIP Report: High Out-of-Network billing

A May 2009 survey of America’s Health Insurance Plan (AHIP) members collected data on various out-of-network physician billed charge amounts for claims submitted in 2008. The survey results in Arizona showed out‐of‐network physicians [...]

Small Increase for 2010 Part D Premiums

The federal agency that manages Medicare said most beneficiaries would see a small increase in their drug-plan premiums in 2010. The Centers for Medicare and Medicaid Services  said the average monthly premium for stand-alone drug plans in [...]

Medicare Advantage Under Attack?

  MEDICARE ADVANTAGE UNDER ATTACK When asked how Medicare can cut costs, President Obama has a standard response, and he uses it every time the question is asked.  He says overpayments to Medicare Advantage plans, or “subsidies to private [...]

88% of Seniors are Satisfied with their Medicare Supplement Plan

A study conducted in March 2009 found that 88% of seniors are satisfied with their Medicare Supplement plan – with 62% of those surveyed responding that they were very satisfied. 87% of the respondents said they would recommend a Medicare [...]

HR 3200 and Medicare Advantage

From the Center on Budget and Policy Priorities August, 2009 According to preliminary Congressional Budget Office estimates, various provisions in HR 3200 will curb Medicare Advantage overpayments and would save $50.1 billion over the next five [...]