My Doctor Was Fired – What Now?

What happens if your doctor was fired by your Medicare Advantage plan? It happens. With reduced Medicare funding under Obamacare it will be more difficult to keep your doctor no matter how much you like them. obamacare steals from medicare 300x214 My Doctor Was Fired   What Now?

Just ask Mary Ann Catalano

 

My doctor was fired

Mary Ann Catalano has been using the doctors at Dermatological Care for over 40 years. But all this is about to change. Her doctor was fired.

In 1990, doctors found two types of cancer on her face and scalp. Years later they flagged a type of cancer that they warned could also be on her colon. That led her to a colonoscopy and subsequent removal of pre-cancerous spot on her colon. Recently, they discovered her husband’s skin cancer.

Now, at 68 and in the middle of her contract term, UnitedHealthcare is kicking the entire Dermatological Care staff out of her Medicare Advantage network.

St Louis Post

This would not have happened if Mary Ann had original Medicare and a Medigap plan.

Funding cuts required by Obamacare mean all Medicare Advantage plans will have to get skinny if they are to survive.

United Health Care sent out pink slips to almost 1,000 docs in Missouri the first part of June. Medicare Advantage patients can still see their doctor if they want but out of network penalties may apply.

With 17 eligibilities for special enrollment, (insurance agent Bill) Steinlage said there’s an “excellent chance” many consumers will qualify for one. The best thing to do, he said, is visit an independent broker who can help you navigate the system.

Yes, but if your doctor was fired from the plan that is not one of those 17 SEP opportunities.

Mary Ann makes a tough choice after her doctor was fired

Moving to another doctor was not an option in Mary Ann’s mind.

For Catalano, in St. Louis County, she plans to stay with Dr. Larry Wang at Dermatological Care and pay out of pocket.

She recognizes this could turn into a financial burden after office visit fees, biopsies and more, but “that doctor knows everything about us,” she said. “I’ll just tell them I gotta make payments.”

Financial burden’s are not something seniors should stress about during their retirement years. Unfortunately, most seniors choose Medicare Advantage plans based on the low going in premium. They never think about how costly these plans can be once your health changes.

Nor do they consider the cost of health care when their doctor is fired.

 

United Health Care is not alone

Other carries will do likewise. Someone had to be the first. United Health Care has more seniors on Medicare Advantage plans than any other carrier in the country. If United is firing doctors to save money, how long before their competitors do the same?

 CMS released guidelines in April that will allow Medicare patients to change coverage one time during the year for whatever reason. Those guidelines won’t be implemented until 2015, though, and there’s one other catch. The guidelines state it would have to be a five-star plan, which are the highest rated Advantage plans.

In Georgia there is only one 5 star plan and it isn’t United Health Care.

Unless you qualify for an SEP under Medicare guidelines, if your doctor is fired you change docs or wait until the next open enrollment. Finding a new doc is especially challenging if you live in a rural area and have a medical condition that few doctors are able to treat.

 

Dave and Alice

I have clients that live in rural Georgia. At one time they had a Blue Cross Medicare Advantage plan, and then it went away. That did create a Special Enrollment Period for them. Both were in reasonably good health but living in a small town meant limited doctor choices. Their family doctor was not in any of the new plans and the only way for them to have the ability to use a doctor of THEIR CHOICE was to return to original Medicare and pick up a supplement plan.

Georgia Medicare Plans has access to over 170 different Medigap plans and can usually find a plan that meets YOUR needs and budget. We helped Dave and Alice find an affordable plan that allowed them to keep their doctors.

We can do the same for you. Shop and compare Medigap plans now.  Don’t wait until your doctor is fired or your plan is discontinued.

medicareplansgeorgia My Doctor Was Fired   What Now?

 

 

#UnitedHealthCare

#Medicare Advantage

#SEP

#GeorgiaMedicarePlans

#BobVineyard

Proposed Medicare Changes Will Hurt Georgia Seniors

The DC spending monster is hungry and proposed Medicare changes means they expect Georgia seniors to feed them. Their solutionold lady 237x300 Proposed Medicare Changes Will Hurt Georgia Seniors calls for shared funding and shared responsibility. That translates into you tightening your belt while Congress pigs out. They want more of your money so they can feed entitlement programs for the poor. Congress thinks you should take fewer prescription drugs and limit the number of times you see the doctor.

 

Why Are Medicare Changes Being Considered?

Congress spends every dollar they take in and borrow another 40% on top of that to pay their bills and fund more free stuff. In order for them to continue giving away free stuff you need to stop spending their Medicare dollars on frivolous things like medication and needless doctor visits. Just look at this CBO report from November, 2013 that proves you are wasting Medicare dollars.

Research has shown that people who are not subject to cost sharing use more medical care than do people who are required to pay some or all of the costs of their care out of pocket.

Translation. If you pay little or nothing for your health care you will treat it like an “all you can eat” buffet.

There is a bit of truth in this. For some at least, if it costs little or nothing to go to the doctor they may be inclined to make an appointment to see the doctor rather than waiting it out or using a home remedy. Or insist on an expensive brand name drug when a proven generic may work just as well.

If you have original Medicare and Medicare supplement plan F it costs you nothing to go to the doctor, no matter how many times you go. Some people in Congress must believe you enjoy going to see the doctor. I think they need to have their head examined. Proposed Medicare changes means no more Medigap plan F and no more “free” doctor visits.

Do you have a Medigap plan from AARP (United Healthcare) or Blue Cross? If so you are probably paying too much. Shop and compare your supplement plan now. Up to 40 plans in 60 seconds. Georgia Medicare plans have some of the lowest rates in the state. Find out how you can save $700 per year or more. Follow this link to compare GA Medigap quotes.

ShopCompare 300x65 Proposed Medicare Changes Will Hurt Georgia Seniors

 

What is Shared Funding and Shared Responsibility?

Shared funding and shared responsibility means DC believes you have too much money and need to share it with others who are needy.

“Money is like manure. It isn’t worth anything unless you spread it around”.

If Congress has their way, the proposed Medicare changes mean you will be spreading your money around by paying more for your health care.

A variety of later studies also concluded that higher cost sharing led to lower health care spending—including a 2010 study that found that Medicare beneficiaries responded to increases in their cost sharing by reducing visits to physicians and use of prescription drugs to a degree roughly consistent with the results of the RAND experiment.

I am sure this is true, but what we don’t know is WHY there was a reduction in doctor visits and prescription drug use. Could it be because seniors could not AFFORD to go to the doctor or fill their prescriptions? If you can’t afford to go to the doctor, or fill your prescriptions, is it possible you will get sicker and need MORE care?

In theory, to address the concern that patients might forgo valuable care, insurance policies could be designed to apply less cost sharing for services that are preventive or unavoidable and more cost sharing for services that are discretionary or that provide limited health benefits.

Most preventive services are now “free” under Medicare Part B.

I don’t know about you, but I have a problem when Congress feels it is their job to tell me what kind of insurance I can and cannot have. If these proposed Medicare changes don’t motivate you perhaps you need to see if you have a pulse.

 

Proposed Changes to Cost Sharing

Because DC has not been able to control spending they believe Georgia seniors should be restricted in the type of Medigap plans they can buy.

60 percent of people with Medigap insurance chose plans that offer “first-dollar” coverage—which pays for all deductibles, copayments, and coinsurance—and most other medigap enrollees chose plans that provide first-dollar coverage for Part A and cover all cost sharing above the deductible for Part B.

Congress thinks this is a bad thing and they want to make these plans illegal.

Most Medigap policyholders buy plan F which is considerably overpriced. Better choices would be Medicare supplement plan G or plan N.

If Congress gets their way, proposed Medicare changes mean you will no longer be able to buy Medigap plans F, G or N.

Policymakers could alter Medicare’s cost sharing and restrict Medigap coverage in various ways to produce savings for the federal government, reduce total health care spending, and create greater uniformity in cost sharing for Medicare enrollees. Those different ways would also alter how health care costs were distributed between healthier and less healthy enrollees.

More government intervention and control, restricting your choice of plans. Obamacare has already done this for health insurance under age 65, so if you think we are immune from their heavy handed interference in our right to choose insurance you are dead wrong.

Congress also wants to decide the level of care healthy people can get vs. those who have health issues.

When was the Statue of Liberty replaced with the Statue of Equality?

 

What Kinds of Medicare Changes are Being Considered? All the changes being considered mean you will pay more for health care.

The first alternative would replace Medicare’s current mix of cost-sharing requirements with a single annual deductible of $550 covering all Part A and Part B services, a uniform coinsurance rate of 20 percent for amounts above that deductible (including inpatient expenses), and an annual cap of $5,500 on each enrollee’s total cost sharing.

The $550 deductible may not sound bad, but how do you feel about “sharing” $5,500 of your life savings in order to bail out Medicare? Before you answer, consider this.

Almost every year Medicare raises your Medicare Part B premium. Congress also increases your Part B deductible and your Part A hospital deductible.

Do you think they will also raise this unified deductible? How long before that $5500 cap is raised to $6,000 or $7,000?

 

What Can You Do to Stop These Medicare Changes?

Contact your Georgia Congressman and tell them you do not support cost sharing changes in Medicare. Also call or write your Georgia Senator. If you are a member of a political action group like AARP let them know your feelings about these changes. Also consider conservative alternatives to AARP with senior groups like AMAC, or American Seniors.

We also suggest you support groups like Rescue Medicare Now. Sign their petition and consider making a donation to prevent Medicare changes that are harmful to your financial security.

You might want to lock in today’s low Georgia Medigap rates while you still can. If you buy Medicare supplement plan F, G or N now you should be able to keep it once Congress makes these plans illegal.

Shop and compare GA Medigap quotes now.

 

 

#Obamacare

#ProposedMedicareChanges

#SharedFunding

#SharedResponsibility

#MedicareSupplementInsurance

#Medigap

5 Medicare Myths

We talk to a lot of Georgia seniors and find there are at least 5 Medicare myths that are common and should be addressed. If you fall prey to these Medicare myths you could end up paying more for your health care than you should. It doesn’t matter how these untruths originated. The reality of Medicare is this. Medicare insurance is the most consumer friendly health care coverage you will ever experience. But if you believe the myths and misrepresentations you can pay dearly.   5 Medicare Myths

 

 

Medicare Myth #1

Because of Obamacare, Medicare beneficiaries will have fewer choices and pay more for their coverage.

This is partially true.

Obamacare cuts Medicare funding by $716 billion dollars from 2013 – 2022. The promise is that savings will be generated by eliminating waste, fraud and abuse and requiring medical providers to achieve a higher level of care.

The truth is waste, fraud and abuse will continue. As long as government programs like Medicare routinely pay for services with little or no oversight, crooks will continue to find ways to game the system in their favor.  Obamacare cuts Medicare funding 300x225 5 Medicare Myths

The Medicare myth is, without Obamacare the government had no way to find cheaters. Future “savings” in Medicare insurance will come through reduced payment to medical providers and cost-shifting the financial burden for care to the Medicare beneficiary.

Reduced funding for Medicare Advantage plans will result in fewer plan choices for you, higher premiums, higher deductibles, higher copay’s and fewer doctors that accept Medicare Advantage plans.

If your doctor is paid less to treat you, or is only rewarded by helping you get well, how will this impact your ability to obtain quality care?

This seems a bit of a paradox. Why shouldn’t a doctor or hospital be paid for results? Consider this.

How many Medicare patients is a doctor willing to see if they are paid 10% – 15% less than they were last year for the same treatment?

Paying for results seems fair on the surface. But think about this for a moment.

If doctors and hospitals are punished (or paid less) for poor outcomes, do you think they will “cherry pick” the easy medical conditions and let the more challenging ones slide?

Of course they will.

Look what a report about Medicare hospital readmission penalties found out.

Medicare penalties appeared to land harder on hospitals that treat large numbers of poor people, according to calculations Medicare made and included in a regulation published Friday.

Among the safety net hospitals with the most poor patients, 77 percent were penalized, while only 36 percent of the hospitals with the fewest poor patients were penalized.

Hospitals with low income patients are typically found in inner cities and rural areas. One way for hospitals to avoid the penalties is to restrict the number of low income patients that are admitted.

Which brings up another Medicare myth about hospital admission.

When is a patient admitted to the hospital?

Just ask 74 year old Rosalie Winkworth. Like many frail seniors, she tends to fall and sometimes she hurts herself. So when she spent 4 days in the hospital her daughter thought nothing of it and assumed Medicare would pay most, if not all of the bill.

But Rosalie was never admitted to the hospital. Instead she was under observation. NPR picks up her story here.

After Winkworkth’s discharge, her doctors said she needed to go to a nursing home. But since the hospital considered her an observation patient, not an inpatient, the family had to pick up the bill.

Had Rosalie been admitted to the hospital and then discharged to the nursing home, her Medicare insurance would have paid her nursing home bill. By never admitting her the hospital avoided classifying her under the readmission penalty. But that practice also meant her nursing home stay was not covered by Medicare.

Oh, and did you catch this? The Medicare hospital readmission penalty is one way Obamacare cuts Medicare funding to provide free and reduced cost health insurance to people under age 65. Over 36% of Obamacare cuts to Medicare funding comes in the form are reduced payments to hospitals.

That is not a Medicare myth. It is a fact that can impact your level of care and how much you pay for hospital or nursing home services.

Medicare Advantage plans and Georgia Medicare supplement insurance plans will not help you if you end up like Rosalie. If your bill is not an approved Medicare charge you pay.

Georgia Medicare plans can show you ways to hang on to more of your savings and reduce stress over your budget. We specialize in Medicare supplement plans for seniors 65 and up. Most of our clients average saving over $700 per year by learning how to choose the right Medigap plan for their needs. Our GA Medigap Quotes page allows you to shop and compare up to 40 plans in 60 seconds. Why not try it now and see how much you can save?

 

Medicare Myth #2

Medicare Advantage plans are better than Medicare supplement plans.

Or the inverse, Medicare supplement plans are better than Medicare Advantage.

The truth of the matter is, each approach has benefits and “bugs” that appeal to some and not others. The only truth is, the plan that is right for you is the one that fits your needs and budget.

Medicare Advantage plans have lower premiums and are good for people that can budget for medical emergencies or have a pile of money sitting around collecting dust. In other words, they are good plans until you get sick.

Medicare supplement plans allow you to stay in the original Medicare system and make it possible for you to survive a medical emergency without hocking the farm.

Most Medicare Advantage plans give you a list of participating doctors and hospitals and tell you to choose from that list. A list that changes every year.

With original Medicare and a Medigap plan you can use any doctor, hospital or lab anywhere in the country, including your own back yard. If you like your doctor you can keep your doctor.

When you have a Medicare Advantage plan your monthly premium is less than with a Medicare supplement plan but that does not mean the cost is lower. The myth that you save money with an Advantage plan is just that. A myth. You simply pay for your health care now (with a Medigap plan) or later (when you have an Advantage plan).

 

Medicare Myth #3.

All doctors take Blue Cross.

BCBSGA is a fine company that offers a choice of Medigap or Medicare Advantage. The myth that all doctors take Blue Cross can get you in a bind.

Most Georgia doctors do not participate in ANY Medicare Advantage plan and the ones that do may not participate in your BCBSGA  Advantage plan. If you use them any way your out of pocket cost for treatment will be higher than if you had used a participating provider. In some cases, treatment by a non-par provider means your claim is not covered at all.

You won’t have that issue with original Medicare and a Medigap plan. Any doctor that treats Medicare patients will also treat you, regardless of which Medigap carrier issued your policy. BCBSGA only offers 3 supplement plans in Georgia. You can pick plan A, F or N.

Of those, F is the only popular choice (and N is a distant third). If you bought plan F from Blue Cross you might pay as much as $500 more per year for the exact same coverage had you picked a more reasonably priced carrier.

The Medicare myth that Blue Cross is more widely accepted by Georgia doctors could cost you a lot of money. Compare our rates vs. Blue Cross and see for yourself. Shop GA Medigap Quotes now.

 

Medicare Myth #4

Medicare supplement plans from “brand name” carriers cost more because they are better.

Medigap plans are designed by CMS, not by the carrier. CMS requires all plans with the same letter (for example, F) to be identical in every way. Plan F from Blue Cross is identical in every way to plan F from Equitable or New Era.

Except price.

When you pay more for a Medigap plan you don’t get more, you simply paid too much. Who wants to do that?

 

Medicare Myth #5

All Medicare insurance plans with the same letter are identical, so just buy the one with the lowest premium.

This is where having someone who knows the Medicare landscape can help you avoid the pitfalls of buying the wrong plan from the wrong Medicare insurance carrier.

In 2010 Medicare allowed carriers to offer Medicare supplement plan N for the first time. Some carriers jumped in while others did not. One of the carriers that aggressively marketed plan N was Mutual of Omaha. Had you bought a Mutual of Omaha plan N policy in 2010 you got a good deal.

But only until your next renewal.

Mutual of Omaha stopped selling plan N in 2011 as losses on that block started to get out of hand. Those who kept their policies have faced ever increasing renewal premiums. In some cases their only choice was to drop their Medicare insurance policy and go without coverage (other than original Medicare).

More recently AFLAC entered the Georgia Medigap market in 2012. A little over a year later they dropped out. Their policy holders are watching their premiums continue to rise as that block of business sours.

The Medicare myth of buying the lowest price backfired. My 38 years in the health insurance industry has taught me how to avoid the pitfalls of jumping on the latest fad. That helps my clients to save thousands of dollars over the years by finding value without jeopardizing your bank account when things don’t work out.

So what about the dog?

I thought he was cute. Maybe when you shop for Medicare insurance you will remember him and give me a call to discuss your options. Don’t throw away money because you believed a Medicare myth.

Medicare Cuts Fund Obamacare

Georgia seniors will get a rude awakening in January when Medicare cuts fund Obamacare. You were warned. Obamacare is medicare cuts 300x210 Medicare Cuts Fund Obamacarefunded, at least in part, on the backs of seniors that rely on Medicare.

Starting Jan. 1, the Centers for Medicare and Medicaid Services (CMS) will begin slashing 14 percent of their Home Health Care Prospective Payment Program budget, driving small home health-care providers out of business and potentially affecting millions of poor, elderly citizens in need of physical rehabilitation.

The cuts — which are being made to fund Obamacare — will slash the homecare budget 3.5 percent every year for the next four.

Daily Caller

How will those 14% Medicare cuts impact home health care providers?

“By CMS’s own calculation, 40 percent or nearly 5,000 home health companies — mainly small businesses — will experience a “net loss” in revenue due to the cuts and go into the red by 2017,” The Washington Examiner reports. “That will put many of them out of business.”

More job losses due to Obamacare.

The cuts to Medicare are part of approximately $716 billion Obamacare takes from the program between now and 2022.

You may recall during the last election, Mitt Romney was called a liar for claiming Medicare cuts would be used to fund Obamacare.

Now who looks foolish?

Medicare cuts are like the Saturday Night Live Samurai deli except without the humor.

Medicare Slow Death

Medicare is on life support but just got some good news. Apparently the social welfare program for seniors and disabled can live another 2 years. But Obamacare  cuts threaten to gut the program, especially to Medicare Advantage.                    Medicare slow death 300x227 Medicare Slow Death

First the good news.

Medicare has two more years to live than previously thought. The program’s trustees recently estimated that the “depletion date for the trust fund is 2026, two years later than was shown in last year’s report.”

But that conclusion is less a vote of confidence than a two-year stay of execution. Absent substantial reform, Medicare will eat up more and more of our nation’s resources even as it provides less and less to beneficiaries.

Philadelphia Enquirer

 

Is Your Nest Egg SlowlyDying?

If you bought a Medicare supplement plan from Blue Cross or Mutual of Omaha you are slowly killing your life savings to the tune of $30 – $50 per month. That’s over $400 per year you are just GIVING AWAY and getting nothing in return.

Almost every time we help you shop and compare you will save money. Free, no obligation Medicare supplement quotes in 60 seconds.

Click image below for a fast quote.

ShopCompare 300x65 Medicare Slow Death

 

 

Medicare Trust Fund

For the last 5 years Medicare has paid out more in claims than it took in to the “trust fund”. There is no sign of abatement as boomers turn 65 and the economy limps along supported by college educated part-timers who cannot find full time work.

The projections are “based on the trustees’ intermediate set of assumptions,” which include sharp reductions in payments to doctors and other providers that Congress has routinely overruled in the past.

In other words, this rosy picture assumes doctors and hospitals are willing to work for less money.

No problem . . .

 

Obamacare and You

If you are on Medicare, listen up.

Obamacare simply takes money out of Medicare and lavishes it on other programs, such as Medicaid. The original Congressional Budget Office estimate of the cost of the law was $940 billion over 10 years. Earlier this year, the agency revised its estimate to $1.8 trillion over the decade 2014 to 2023.

Further, Obamacare slashes the portions of Medicare that have the best hope of reducing health costs in the long term – those governed by market competition.

When Medicare get’s less money from Congress that means two things.

Providers are paid less and your cost increases.

Got a problem with that?

You should.

 

Medicare Advantage Cuts

More slashing.

For instance, the law will trim about $150 billion from Medicare Advantage (MA) over the next decade. MA, which covers 25 percent of Medicare recipients, allows seniors to pick from plans administered by private insurers.

With each cut you have fewer choices and pay more every time you use your plan.

Isn’t that special?