Doc Fix Archives | Georgia Medicare Plans

Medicare Supplement Plan F Illegal

Bob Vineyard · April 28, 2015 ·

A new law signed by President Obama will make the popular Medicare supplement plan F illegal. Reforming SGR (the Sustainable Growth Rate), commonly referred to as “doc fix” has been a goal of Congress for years. The new law, passed on a bi-partisan vote and signed by the President saves millions of dollars for Medicare but also will outlaw Medigap plan F.

J.B in Dallas, Georgia bought Medicare supplement plan F for $115 per month.

How much can you save?

Shop and compare GA Medigap quotes. Your information is NEVER sold.

Medicare supplement plan F

The most popular plan among Georgia seniors is Medigap plan F. This is especially true for retirees turning age 65. Most GA retirees lose their regular health insurance plan at age 65 and want to leave behind all the copay’s, deductibles and coinsurance.

So they buy Medicare supplement plan F. Your plan F pays 100% of approved Medicare Part A and Part B expenses. What could be more simple?

We think there are better values than F and do our best to educate clients on ways to get the most VALUE for their dollar.

With more than 170 different Medigap plans in Georgia, how do you find the right one?

It’s almost impossible to do that by yourself. Most sites on the internet are data harvesting sites that will take your information and sell it to dozens of agents. The more sites you visit, the more phone calls you will get from brokers trying to sell you anything and everything.

Even the sites (like GA Medigap Quotes) that offer instant rates only have 20 or so plans to pick from. Most carriers do not allow their rates to be illustrated online so the only way to get information on all plans is to talk with a broker specializing in Medicare.

Bob Vineyard has more than 40 years in the health insurance business and focuses his practice 100% on the Medicare market. Bob is a baby boomer, going on Medicare in September, 2015. He can identify with your concerns and will take the time to explain all your options.

New law bans Medigap plan F

Congress wants to “save” Medicare and they will do so by making US PAY MORE.

Higher premiums.

Higher deductibles.

And BANNING Medicare supplement plan F.

President Obama recently signed the most significant Medicare legislation in years–a plan to fix a Medicare formula that threatened to slash payments to doctors every year. The law achieves several positive Medicare reforms, but it will increase some costs for enrollees.
But the plan comes with a significant price tag. It will increase federal deficit spending by $141 billion from 2015-25, and it calls for savings to the government by boosting premiums for high-income seniors ($34.7 billion in savings) and by prohibiting Medigap from covering the Part B deductible for new enrollees beginning in 2020 ($400 million in savings). The plan also will mean somewhat higher Part B premiums spread across the entire base of seniors. – MorningStar

Starting in 2020 the government will no longer allow plan F to be sold.

Presumably, if you have plan F now you will be “grandfathered” in and be allowed to keep it. That’s good news for those who have F now or will be purchasing when they turn age 65.

Why does the government want to tell you what kind of plan you can and cannot have if it is YOUR money?

The goal is to give seniors more “skin in the game,” which conservatives have long argued would lower costs by making patients think twice about using medical services if they know they must pay something for all services they use.
The idea is to encourage enrollees to utilize less health care by eliminating first-dollar coverage. Research confirms that higher out-of-pocket expense will result in people using fewer services, but that’s not always a good thing. A 2011 study by National Association of Insurance Commissioners (NAIC) found that beneficiaries may avoid necessary services that worsen their health in the long run, increasing the need for more intensive care and driving up Medicare costs. The NAIC report also found that once patients do seek care, it is doctors and other health-care providers who drive up utilization, not patients.

Apparently the folks in DC think we LIKE going to the doctor. If they penalize us by making us pay MORE to see a doctor this will save Medicare.

But what does it do to us? Will we become sicker as a group when we can’t afford to go to the doctor because Washington wants to do what they think is best?

Stop overpaying!

Are you currently paying too much for your Medicare supplement plan? Most people are, by an average of $500 per year. That is money that could be in YOUR pocket instead of going to the insurance carrier.

Check out our Medigap rates with an instant quote.

#MedicareSupplementPlanF #DocFix #TurningAge65 #MedigapRates

Why Doctors Refuse to Take Medicare Patients

Bob Vineyard · April 14, 2015 ·

Have you ever wondered why doctors may refuse to take Medicare patients? Until it happens to you, it probably doesn’t cross your mind. What’s wrong with paying a doctor to cure your medical condition? Some doctors are dialing back their Medicare patient load because of Obamacare. If the new bi-partisan “doc fix” passes, finding a Medicare doctor willing to treat you may become more challenging. Changing the way doctors are paid for treating Medicare patients will NOT increase access to health care. Congress’ remedy for “fixing” Medicare has much in common with the Atlanta Public Schools cheating scandal.

Medicare needs “fixing” for one reason.

Medicare is running out of money due to poor design and politicians are ignorant about the mechanics of Medicare, unwilling to take the necessary steps to correct the problems, or both.

Over 80% of retirees are paying too much for their Medicare plan.

Free instant GA Medigap quote!

Doctors refuse Medicare patients

Yes, it’s true. Doctors are refusing to take new Medicare patients.

• The American Academy of Family Physicians says 13% of respondents didn’t participate in Medicare last year, up from 8% in 2008 and 6% in 2004.
• The American Osteopathic Association says 15% of its members don’t participate in Medicare and 19% don’t accept new Medicare patients. If the cut is not reversed, it says, the numbers will double.
• The American Medical Association says 17% of more than 9,000 doctors surveyed restrict the number of Medicare patients in their practice. Among primary care physicians, the rate is 31%.

In some cases it is because your doctor is not in your Medicare Advantage network. Others are just not taking NEW Medicare patients. Or you may be put on a waiting list.

Getting in to see a Medicare doctor can be a challenge, and it is about to get worse if Congress get’s their way. The new bi-partisan solution for fixing Medicare may lead to LESS access to health care, not more.

How Washington will fix Medicare

Buried within the 2300 pages of Obamacare legislation plus another 15,000 pages of regulations is something that, on the surface, seems brilliant.

Rather than paying doctors just to treat you, why not pay doctors to make you well?

Seems so simple. But it has a dark side.

The “new” way of paying for health care (when it is THEIR money) is rooted in a pay-for-performance idea that has already been tested and failed.

Perhaps you have heard of the APS cheating scandal?

Our clients save more than $500 per year on average by switching Medigap plans.

That is money YOU keep rather than sending to the insurance company.

Over 170 different Medicare supplement plans in Georgia and you probably only saw 6 or less.

Atlanta Public Schools caught cheating

Pay teachers based on results and reward those who achieve better results than the norm.

The old way of merit pay based on seniority and level of education seemed wrong according to some. I will agree it isn’t perfect, but the new way had some unintended consequences.

Use standardized testing scores to evaluate the effectiveness of the teacher. Give pay increases and bonuses to teachers whose students show the most improvement in standardized tests. Use the test scores to weed out teachers that are not producing the desired results.

What could possibly go wrong?

The old merit pay did not measure effective teaching. The new way provides a way of measuring teacher performance.

The result was, teachers were paid to “teach to the test”.

Teach students how to become good test takers. It did not matter if the students actually learned the material and how to apply it to real lift. As long as they could pass the test the world was better.

But there were unintended consequences.

Measurable results

From 2004 through 2011 some schools saw a 31% increase in test scores. Others achieved 100% of their required minimum level of achievement. The investigation found that some students passed the test without even taking it.

Fraud was rampant. Bonuses in the tens of thousands were paid out.

All because of a federal program designed to reward schools that showed improved, measurable results. The “No Child Left Behind” program proved to be the downfall of APS and several other school systems as well.

APS cheating and Medicare doctors

If Congress get’s their way, doctors will be paid based on whether or not their Medicare patients have improved outcome.

Sounds great doesn’t it?

When you get sick your doctor will be paid to make you better. But what if your condition is terminal? Or maybe you have a chronic condition like diabetes or psoriasis that may not improve. You don’t get worse, but you don’t get better either.

Doctors can’t manipulate test results like the APS teachers did, but they CAN refuse to take on patients whose health may never improve.

This new way of paying doctors to treat Medicare patients may lead to doctors being selective in who they agree to see.

New Patient – I am on Medicare and need to make an appointment to see Dr. Kildare
Doctors office – Do you have any existing chronic or terminal conditions?
New Patient – Not really, just the usual stuff. Joint aches and pains, high blood pressure, high cholesterol, diabetes and I am having pain in my feet.
Doctors office – Under the new guidelines, Medicare doesn’t pay us enough to treat you unless we can cure your condition. You should call Dr. Hackenbush. He might have an opening.

Don’t laugh. This can be coming soon to a doctors office near you.

Doctors can’t manipulate test results and outcomes like the teachers and administrators did with APS so they can just refuse to treat you.

Doctors refuse to take new Medicare patients.

You won’t hear that on the evening news or listed as a talking point from your friendly Congress person.

#MedicareDocFix #GeorgiaMedicareDoctors

Medicare Changes Cost Retirees

Bob Vineyard · March 15, 2015 ·

Proposed Medicare changes in the way doctors are paid could mean YOU pay more for your health care. While Congress tries to contain the cost of Medicare it is obvious they are not thinking of you. Wealthy lawmakers with fat retirement plans are clueless about asking retirees to pay extra when they have outpatient (Medicare Part B) expenditures.

Congressional members, both Republican and Democrat, are proposing $200 billion in cuts to Medicare. This is on top of the $735 billion in cuts to fund Obamacare subsidies for people under age 65.

If passed this will impact Medicare Advantage and Medigap plans alike.

UPDATE: Even more proposals under considerations HERE.

Medicare Money Grab – Part 2

Medicare changes hurt retirees

Under the guise of “bi-partisan” support Committee members are considering the following as a way to save Medicare.

Some of the cost would be offset with $35 billion worth of Medicare savings from beneficiaries over 10 years. Another $35 billion over a decade would come from reducing or delaying higher payments to hospitals and other Medicare service providers over time, the aides said. – Bloomberg

Just what are these $35 billion in savings FROM beneficiaries?

You pay more for your health care. Medicare pays less.

Borrow from Peter to pay Paul.

The other Medicare changes are just as sinister.

Slow pay doctors and hospitals.

Not only does Congress want to pay doctors and hospitals less but they want to drag out payment for services rendered.

Yeah, that will work.

Changes to Medigap plans

That part where Congress wants YOU to pay more so they can spend less on your care?

They are drawing a bullseye on Medigap plans, in particular, Medicare supplement plan F.

The $35 billion worth of Medicare beneficiary savings would be achieved in two ways. Private insurance companies that offer so-called Medigap policies that supplement Medicare’s basic coverage would be required to start paying benefits only after recipients pay $250 in out-of-pocket expenses for doctor visits, aides said.

This is over and above the Medicare Part B deductible that is paid under Medigap plan F.

If you have plan G or N that would mean you are expected to pay the Part B deductible + an additional $250.

Other than the obvious, how does this save Medicare dollars?

Such a requirement would give Medicare recipients an incentive to make fewer doctor visits, thereby saving some costs to the government program.

If you have to pay more to see a doctor you might not go as often.

The folks in Congress must think we LIKE to go to the doctor.

Of course if their plan works, the less we go to the doctor the more likely we are to get sicker. The sicker we are the more it will cost to get us well.

Tell me again how these Medicare changes will save money?

What can we do?

Write and call our members of Congress. If you are a member of a senior lobbying group like AARP, AMAC, ASA or 60 Plus, contact them and tell them to stop this movement in its’ tracks.

We have paid into Social Security and Medicare all our working life. Congress has mismanaged both programs and now they expect us to pay for their sins.

One other thing you can do.

Even if we can’t stop this attempt to take money from retirees I can show you how to save at least $250 per year, and probably a lot more, by switching Medigap plans.

We have access to the lowest rates for popular plans F, G and N. Even if you bought coverage in the last 2 years many of those carriers are increasing rates.

Continental Life of TN is increasing rates on plan F by 9.5%.

Manhattan Life is increasing rates on ALL plans for those under the age of 68 by 9%.

If you own a Medicare supplement plan with either carrier now would be a good time to consider changing plans.

With over 170 different Medigap plans in Georgia you can most likely save money by changing.

Shop and compare GA Medigap quotes.

Your information is NEVER sold!

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#MedicareDocFix #MedicarePartB #MedigapPlanF #GaMedigapQuotes #GeorgiaMedicarePlans

Find Medicare Doctors

Bob Vineyard · March 6, 2013 · Leave a Comment

How do I find Medicare doctors in Georgia? Many doctors are opting out of Medicare, or refusing to accept new patients. Why is this happening and what can I do to find a GA doctor that accepts Medicare patients? Doc fix is part of the problem.

Many Georgia seniors are finding it increasingly difficult to find Medicare doctors willing to treat them.

While there is a lot of chatter about funding Medicare to keep it viable, many seniors are faced with a more immediate problem. This round-robin discussion about the difficulting in finding doctors willing to treat Medicare patients is of interest to many. Finding primary care Medicare doctors is a crisis.

Nancy Martin moved to Lubbock, TX and spent hours on the phone, trying to find Medicare doctors that were taking on new patients.

NANCY MARTIN, Texas: I said, I’m Nancy Martin. I have just recently moved to Austin. I am looking for a physician that will take a new Medicare patient. Sorry, we don’t take any new Medicare people.

I felt frustration, disappointment, I would say despair, a lot of days, just get to the point where I thought, I’m never going to find a doctor in Austin. What do you think I will have to do? I don’t know.

RAY SUAREZ: Martin has high blood pressure and type 2 diabetes.

NANCY MARTIN: If I had something bad, I just went to the emergency room.

RAY SUAREZ: After two years of searching, Martin finally found a primary care physician.

PBS

Two years!

Lubbock is a town of more than 230,000 yet it took Nancy two years to find doctors that take Medicare. Seniors in Georgia are faced with the same challenge.

LOU GOODMAN: And in 2000, we had about almost 80 percent of the doctors were taking new Medicare patients. We just completed a survey last year, and we found that less than 60 percent were taking them. Almost 20 percent fewer doctors are taking new Medicare patients. And that really troubled us.

RAY SUAREZ: Goodman says the primary reason doctors are not taking new Medicare patients or opting out altogether is because of something called the sustainable growth rate.

It’s a mathematical formula established by Congress in 1997 to contain rising Medicare costs. But, in practice, it would have cut government payments to physicians for treating Medicare patients every year since 2001. So, every year, Congress at the last minute passes the so-called doc fix, averting the cuts and giving doctors a small raise.

The annual doc fix and the threats of lower reimbursements in the future have left some doctors insecure and unwilling to take on more Medicare patients.

Doc fix in Congress’ way of addressing a long term problem. Rather than fixing the problem THEY created in 1997 they go through a yearly ritual of delaying corrections to the formula leaving doctor and patient in the lurch.

Doctors have no idea how much they will be paid by Medicare to treat patients.

Medicare patients have no idea if their doctor will continue to see them.

And the problem is not just finding Medicare doctors.

RAY SUAREZ: Last year, the Austin Regional Clinic, or ARC, bit the bullet and stopped taking new Medicare patients.

ARC, one of the largest health care groups in Central Texas, serves more than 400,000 area residents. Dropping Medicare wasn’t something the health system wanted to do, but CEO Dr. Norman Chenven says it was an economic necessity.

DR. NORMAN CHENVEN, Austin Regional Clinic: The issue was really one about survival.

It’s really time and materials that it takes to provide care to someone. We can pretty much predict that if our Medicare population grows beyond a certain percentage that our profitability is going to go away.

Profits have become a dirty word, used by politicians to demonize private industry. But if a doctor or hospital loses money by treating Medicare patients, you cannot expect them to continue offering services.

About 10,000 seniors turn 65 every day and many of them will begin the journey to find Medicare doctors willing to treat them.

Footnote: Less than half the doctors in Georgia accept Medicare Advantage plans. Even when you find a doctor willing to accept Medicare Advantage patients, they may not take your particular MA plan.

You can improve your odds by opting for original Medicare and a Medicare supplement plan. Georgia Medicare plans helps seniors choose from the lowest cost Medigap plans in the state. With our help, you can find a Medicare supplement plan that meets your needs and budget.

When you pay more you don’t get more, you simply paid too much.

#FindMedicareDoctors

#Age65EnrollInMedicare

#Age65SignUpForMedicare