Podcasts about medicare part c

In this episode, I break down the messy world of Medicare and cash-based practices — because if you're building a private medical practice or a walk-in clinic like me, you're gonna run into this headache. I cover the 3 main options every physician faces: Ignore Medicare patients completely Officially opt out (and what that really means) Become a non-participating provider (and the billing mess that comes with it) It's complicated — even if you hire a lawyer. I explain how Part B vs. Part C (Medicare Advantage) changes the game, what you legally HAVE to bill, and what you can skip if you stay in the cash lane. If you're thinking about starting your own practice or walk-in clinic, this episode is a must-listen. You'll avoid costly mistakes and know exactly what's coming.

Learn how Dr. Virgie got out of paying a $90,000 medical bill - and why she says you can too! Also, hospitals and medical systems across the U.S. are no longer accepting Medicare Advantage insurance. Find out why this is a big deal for you or someone you love and the best way Medicare recipients can keep their money, favorite doctors and hospitals. https://medicalbills.support/MedigapisbetterthanMA

In this episode, you're going to learn the #1 thing you can do to get out of a horrendously high ambulance bill. Also, what does insurance open enrollment mean, what's the deal with those annoying commercials, and why should you care? Dr. Virgie reveals what to do to spend the least amount of money for your medical care - whether you can afford traditional health insurance or not - and save your financial life. https://crushmedicaldebt.com

Andrew London, Partner, Foley Hoag LLP, and Peter Fjelstad, Assistant Vice President, State Regulatory and Legal Affairs, Pharmaceutical Care Management Association, discuss the evolution of federal preemption of state health care laws, mainly pertaining to ERISA and Medicare, and the corresponding increase in state efforts to regulate the structure of health care benefits. They cover the 2020 Rutledge case, trends pertaining to state regulation of pharmacy benefit managers and Medicare Part C and D, issues related to conflicting state regulations, the impact of the fall of the Chevron doctrine, recent case law, the limits of federal-state partnerships, and how preemption will continue to evolve. Andrew and Peter spoke about this topic at AHLA's 2024 Health Plan Law and Compliance Institute in Chicago, IL.To learn more about AHLA and the educational resources available to the health law community, visit americanhealthlaw.org.

Learn how Dr. Virgie got out of paying a $90,000 medical bill - and why she says you can too! Also, hospitals and medical systems across the U.S. are no longer accepting Medicare Advantage insurance. Find out why this is a big deal for you or someone you love and the best way Medicare recipients can keep their money, favorite doctors and hospitals. https://medicalbills.support/MedigapisbetterthanMA

Learn how Dr. Virgie got out of paying a $90,000 medical bill - and why she says you can too! Also, hospitals and medical systems across the U.S. are no longer accepting Medicare Advantage insurance. Find out why this is a big deal for you or someone you love and the best way Medicare recipients can keep their money, favorite doctors and hospitals. https://medicalbills.support/MedigapisbetterthanMA

Learn how Dr. Virgie got out of paying a $90,000 medical bill - and why she says you can too! Also, hospitals and medical systems across the U.S. are no longer accepting Medicare Advantage insurance. Find out why this is a big deal for you or someone you love and the best way Medicare recipients can keep their money, favorite doctors and hospitals. https://medicalbills.support/MedigapisbetterthanMA

Learn how Dr. Virgie got out of paying a $90,000 medical bill - and why she says you can too! Also, hospitals and medical systems across the U.S. are no longer accepting Medicare Advantage insurance. Find out why this is a big deal for you or someone you love and the best way Medicare recipients can keep their money, favorite doctors and hospitals. https://medicalbills.support/MedigapisbetterthanMA

If you are in the market for Medicare, note that Medicare Advantage, aka Medicare Part C, is not Medicare. It is the same lousy private health insurance that profits from denying you coverage. GET THE REAL MEDICARE! --- Send in a voice message: https://podcasters.spotify.com/pod/show/politicsdoneright/message Support this podcast: https://podcasters.spotify.com/pod/show/politicsdoneright/support

In this episode, you're going to learn the #1 thing you can do to get out of a horrendously high ambulance bill. Also, what does insurance open enrollment mean, what's the deal with those annoying commercials, and why should you care? Dr. Virgie reveals what to do to spend the least amount of money for your medical care - whether you can afford traditional health insurance or not - and save your financial life. https://crushmedicaldebt.com

In this episode, you're going to learn the #1 thing you can do to get out of a horrendously high ambulance bill. Also, what does insurance open enrollment mean, what's the deal with those annoying commercials, and why should you care? Dr. Virgie reveals what to do to spend the least amount of money for your medical care - whether you can afford traditional health insurance or not - and save your financial life. https://crushmedicaldebt.com

In this episode, you're going to learn the #1 thing you can do to get out of a horrendously high ambulance bill. Also, what does insurance open enrollment mean, what's the deal with those annoying commercials, and why should you care? Dr. Virgie reveals what to do to spend the least amount of money for your medical care - whether you can afford traditional health insurance or not - and save your financial life. https://crushmedicaldebt.com

In this episode, you're going to learn the #1 thing you can do to get out of a horrendously high ambulance bill. Also, what does insurance open enrollment mean, what's the deal with those annoying commercials, and why should you care? Dr. Virgie reveals what to do to spend the least amount of money for your medical care - whether you can afford traditional health insurance or not - and save your financial life. https://crushmedicaldebt.com

Diet-related disease such as cardiovascular disease and diabetes create a crushing burden on individuals, families, and the healthcare system in the United States. However, Produce Prescription Programs where medical professionals prescribe fruits and vegetables and health insurers pay, promise to improve nutrition and health. Today we will talk with Dr. Kurt Hager from the University of Massachusetts Chan Medical School and lead author of the largest assessment of Produce Prescription Programs to date. Interview Summary   So, let's get into it. Before we dig into the study itself, can you tell our listeners more about Produce Prescription Programs?   So, the programs that we evaluated in our study gave participants electronic cards. So, either a debit card, a gift card, or a loyalty card that they could use at retail grocery stores and some farmer market partners as well to get free fruits and vegetables of their choice. The food could be either fresh or frozen fruits and vegetables. These programs acknowledge that nutrition education alone likely is not sufficient to increase healthier eating for many low-income households, for which just the cost of healthier foods is really the primary barrier in improving their diet. These programs seek to overcome that barrier, and it's really exciting to see that clinics across the country are turning to these. I think physicians, from our conversations with the clinics we partnered with in this study, are really excited to have a tool they can use and provide to patients to offer higher-quality care and help improve their nutrition when they're talking with their patients about managing diet-related illnesses like diabetes, hypertension, or obesity.   Thank you, Kurt. Could you tell me a little bit about why you and the team decided to do this particular study?   Food insecurity has been consistently associated with poor health outcomes, higher healthcare costs, and lower dietary quality. Many food insecure households tend to have higher rates of diet-related chronic illnesses. We worked with a wonderful organization called Wholesome Wave. They have operated Produce Prescription Programs across the US, and they have been collecting data on these programs for about five years now. Wholesome Wave reached out to our research team at Tufts University's Friedman School. They wanted to see if these programs are working at improving health outcomes. The key thing, I think, to contextualize where this study stands, is prior to this work, there had been a handful of studies that had shown, not surprisingly, that Produce Prescription Programs can improve dietary quality and improve food insecurity. However, very few had gone that extra step to see if Produce Prescription Programs were associated with improvements in really important clinical outcomes. Things like hemoglobin A1C, which is an important measure of average blood sugar levels in the past three months. This is critical for managing diabetes, and outcomes like blood pressure and obesity and overweight. Previous studies had found mixed results on these outcomes, and most had been very small, maybe about 50 participants. We built on this by doing the largest analysis to date. Our study had nearly 4,000 participants from 22 programs across the US, from 12 states. These ranged from cities like Los Angeles to Minneapolis, to Houston, to Miami, Idaho - so all over the US.   So, it was the fact that previous studies have had relatively small samples, and some of these other studies did not take all of the sort of important measures of health into consideration. So, you were able to build on that past work in a unique way in this study?   Exactly. I think the key thing is that Wholesome Wave had excellent relationships with their partner clinics. This meant that the clinics were willing to share medical record data with us. This is always just very challenging and many other studies weren't able to go that extra step. We were blessed with access to a lot of medical record data and we were able to do analyses that looked at important clinical biomarkers. I will say though, our study is a step in the progression. I'll be the first to admit, we did not have a comparison group in this analysis. So, the results that we found also could have occurred due to other reasons. Such as, for example, perhaps when someone is referred to a Produce Prescription Program, their physician might also make other referrals, or perhaps change their medications because this patient has been identified as high need. We certainly built on previous literature by having a much larger sample size and pooling data across the US, and to me, our findings really provide us with a strong rationale to continue research into this area. But also, to confirm our findings with randomized trials similar to what you would do, for example, for drug research.   That is helpful to hear. One of the things that's really important about what I understand of this study is the fact that you worked with Wholesome Wave, and that allowed you access to a lot of different programs across the US as you described. Could you give us a little bit of a sense of what some of those programs were, and how did they provide the support that you were able to study in this project?   Most programs provided the benefits on electronic card. It's similar to in WIC or SNAP, where participants have an EBT card, they can use it at retail settings. It's administratively very simple. From interviews among SNAP participants and other research, this tends to be lower stigma - when you're using a card at a checkout. These cards gave about $50 a month for six months on average for the adult programs, and $110 a month for the pediatric programs. Some of the children's programs were also a little longer. Some of the child-focused programs that we include in the analysis were up to 10 months.   So I understand from this description that the Produce Prescription Programs also look different. There were some programs for children, some for adults. How did you manage that? There's a lot of other things that could be going on. How do you sort of do that in this work?   Participants were referred to these programs because they were either food insecure or were recruited from a clinic that served a low income community and were very likely to be food insecure. Individuals also had a risk factor for poor cardiometabolic health. So, this means that they either had diabetes, high blood pressure, or were overweight or obese at baseline. That was really the common thread across all of these programs. We did all the analyses for adults and children separately. So, we report changes in fruit and vegetable intake, and changes in self-reported health status separately. Food insecurity - we did assess at the household level, but then for other outcomes, for example, hemoglobin A1C, we restricted that to the adult population that had diabetes when they enrolled into the program. For blood pressure, we restricted those analyses to adults with hypertension at baseline. For Body Mass Index, we restricted analyses to adults who were overweight or obese at baseline, and then did those same analyses separately for children for age and sex, only looking at children with overweight or obesity at the start of the study.   This is really important then. Thank you for that clarification. You know, you've talked about some of these critical measures such A1C for diabetes. You've talked about obesity measured in BMI. Can you tell us a little bit more about the importance of these findings and what they mean in real terms for participants' health?   Absolutely. So, we found that participation was associated with improvements in dietary quality and food insecurity. For example, among adults, they were reporting that they were eating, on average, about 0.8 more cups per day of fruits and vegetables by the program end. And food insecurity rates were cut by about a third. So, the program seemed to be working as intended, which was excellent to see. But then looking at the clinical biomarkers, for example, hemoglobin A1C among those with diabetes dropped by 0.3 percentage points. And among those with uncontrolled diabetes, those having chronically high blood sugars that are very difficult to manage, dropped by about 0.6 percentage points. So, to put that in context, that's about half the effects of commonly prescribed medications to manage high blood sugar levels. So, for just a simple change in diet, that is I think fairly impressive and very encouraging to see. And the effects on the reductions on blood pressure were also about half as large as we would see with commonly prescribed medications. I think it's really important to highlight that, one, we don't know if these changes will be sustained long-term when the program ends. There might be some participants where this program caught them in a moment of crisis perhaps, in which this helped stabilize them, and maybe they would be able to maintain these new improvements in dietary intake long-term. But I suspect many participants might not be able to maintain this healthier eating because the cost of healthier foods was the main barrier to healthier eating at the onset of the program. And so, this is an area that we're really interested in looking at in future research. But I will say, if one were to maintain these improvements that we would see in hemoglobin A1C, blood pressure, and BMI among adults, they really were clinically meaningful. And if sustained long-term, it could reduce risks of things like heart attack or stroke years down the line. Any reduction in these biomarkers can really have a meaningful impact on patient quality of life. Things even like averting diabetes complications with damage to the circulatory system, to nerves, to the retinas in the eyes and having vision loss. So, sustained long term, I think these really are meaningful impacts on health and wellbeing. The last thing I'll say, is for children, we did not see a change in BMIs for age and sex. I'm not too surprised, given it's a relatively short program on average six months. But also, child BMI is a notoriously challenging metric to move. But I do want to highlight that among the households with children, we did see an improvement in fruit and vegetable intake, and reduction in food insecurity, and self-reported rates of higher health status. And I think if we're thinking about childhood development, to me, that is still an important success. We know that having enough access to food in the household and having higher dietary quality is really, really important for childhood development and wellbeing. There's certainly a nutrition causal pathway here. But it's important not to forget that there's so much stress and anxiety when someone is experiencing food insecurity, about not knowing necessarily where your next meal is going to come from. Just worrying constantly about managing household budget, about trade-offs, say between buying healthier food, paying for medications, paying for other needs. So, I suspect these programs are improving health outcomes both through a nutritional pathway, but also through like a mental health pathway, perhaps reducing anxiety for some households as well, which can also have an impact on things like blood pressure.   So, given these results, it says that there's some important implications of these Produce Prescription Programs for the health and wellbeing of the participants in this study. I mean the fact that just changing fruit and vegetable consumption through a program like this had an effect similar to half the effect of some medications is really a powerful finding. I have got to ask, what are the policy implications of this work?   There is very exciting momentum across the US federal programs, promoting produce prescriptions and other forms of, for better or worse, what is known as food as medicine. And these programs all provide free healthy food to patients in partnership with the healthcare system or through a physician's office. So, Produce Prescriptions are the focus of this study, but the other Federal programs also include things like medically tailored meals, which are healthy, home-delivered meals, often to patients with even more advanced chronic disease who also might have activity limitations or disabilities that makes it really challenging for them to shop and cook independently. Last fall there was a historic White House Conference on Hunger, Nutrition & Health, in which the Biden administration in the summer prior engaged at a national level, major stakeholders in the anti-hunger space, large health systems, researchers, and government agencies to bring together a policy agenda to address hunger in the US, and the really high rates of diet-related chronic diseases. And it's important to note that, I think it is the first recommendation in the section of the final national strategy from this White House conference under the healthcare sector highlights Produce Prescriptions as a policy priority and expanding them in Medicare and Medicaid. So currently Medicaid, which is the federal health insurance program for individuals with low incomes or who have a disability, Medicaid is managed in partnership between each state and the federal government. And this means that states have some flexibility in how they manage their Medicaid program. They can apply for what is known as Section 1115 waivers. The federal government can approve these waivers if the state makes a good case that if they propose an innovative pilot, an innovative change, that they can make the case is likely to improve health outcomes and remain budget neutral, then the federal government can approve them to pilot this idea. So, currently in Massachusetts, we are several years into an 1115 pilot that is actually paying for produce prescriptions and medically tailored meals through the state Medicaid program. And currently about 10,000 people in Massachusetts have received some sort of nutrition support through the state Medicaid program. About 10 other states now have either similar waivers approved or pending approval to allow other Medicaid programs to do something similar. So, this is a really exciting area where expanding access to these programs is happening. And then in Medicare, which is the health insurance program for older adults, in Medicare Part C, which is the Medicare private health plans, those health plans can choose to cover Produce Prescriptions as a benefit. They're not required to, but they have the flexibility to offer that service if they would like. And then finally, I'll just say that there's also new pilots that were announced in Indian Health Services and the Veterans Health Administration. All these examples show that across the federal government there are exciting pilots and expansions occurring to cover Produce Prescriptions, and other foods and medicine programs. However, they remain unavailable to the vast majority of Americans who might benefit. And so, they're not a core component of any of those programs at the moment. And rather, these are pilots that are being tested, but very exciting movement, nonetheless.   Thank you for that really comprehensive set of examples of how policy is implicated in this work and potentially the need to expand this work. It makes me think of USDA's Gus Schumacher Nutrition Incentive Program. That would be another way that folks could access some of the benefits of federal dollars to support produce-type prescription programs. How do you hope to build off this study in future research?   At UMass Medical School, we're the official independent evaluator for the state Section 1115 waiver, which means we are essentially responsible for evaluating if things like the Produce Prescription Program in the Massachusetts Medicaid program is improving health outcomes. So, that is what we are working on right now. In our partnership with the state, we actually have access to all of the claims and encounters data within Medicaid. And we also are working with several health systems that are also sharing medical record data with us so we can evaluate the impacts of food as medicine programs on hemoglobin A1C, blood pressure, and BMI, so similar outcomes to this study. We actually have a large study funded by the NIH in partnership with former colleagues at Tufts University that is doing a deep dive on the Medicaid medically tailored meal program. And we're hoping to do something similar for the Produce Prescription Program in Massachusetts Medicaid. And the nice thing about these studies, they aren't randomized trials. Since this is a kind of a policy rollout, anyone who's eligible for these programs can receive the benefits. But we will be improving upon this study that we just published by leveraging two really strong comparison groups, and using some statistical techniques to make sure we're identifying patients who are as similar as possible to those who are receiving services, but ultimately didn't enroll. So, we're excited to have these results a couple years down the line and see if these programs are working in the context of a large state Medicaid pilot. Bio Kurt Hager is an Instructor in the Department of Population and Quantitative Health Sciences at UMass Chan Medical School. Dr. Hager's interests lay at the intersection of structural determinants of health, food insecurity, and government nutrition and health programs. He is currently evaluating the effectiveness of the Flexible Services Program, which addresses food and housing insecurity in Massachusetts Medicaid. His involvement in state and federal policy initiatives underscores his commitment to translating science into policy, including initiatives with the Task Force on Hunger, Nutrition and Health and the National Produce Prescription Collaborative.  

US healthcare spending is extreme currently at approximately $4.3 trillion.  The single largest payer of healthcare services is Medicare at roughly $900 billion annually or 21% of total healthcare spending.   In this edited volume, recently published by Johns Hopkins University Press, Dr. Moffit along with eleven other contributors including Joe Antos, Douglas Holtz-Eakin, Brian Miller, Mark Pauly and Gail Wilensky, lay out the conservative version of Medicare reform.  In sum, the authors argue federal policymakers reinvent Medicare as a defined contribution or premium support program or at minimum substantially expand the Medicare Advantage program (Medicare Part C), or Medicare coverage provided by private insurance companies.  The interview begins by Dr. Moffit commenting on whether healthcare services can be defined as a market commodity. He discusses the problem of healthcare pricing, measuring for value in healthcare, improving Medicare Advantage benchmarking, remedying Medicare Advantage coding intensity via retrospective risk adjustment and risk transfer pools and competing fee for service Accountability Care Organizations (ACOs) against Medicare Advantage. Dr. Robert Moffit is a Senior Fellow in Domestic Policy Studies at The Heritage Foundation specializing in health care and entitlement programs, moreover Medicare. Dr. Moffit also serves on the Maryland Health Care Commission as an appointee of Gov. Larry Hogan and he is a member of the advisory board of the Buckley School of Public Speaking in Camden, South Carolina. He brings to the reform effort experience as a senior official of the U.S. Department of Health and Human Services (HHS) and the Office of Personnel Management (OPM) during the Reagan administration. Dr. Moffit is a co-author of “Why Obamacare Is Wrong for America,” (Harper Collins, 2011). He was a contributor to “A Time for Governing: Policy Solutions From the Pages of National Affairs” (Encounter Books, 2012) and “Controversial Issues in Social Policy” (Allyn and Bacon, 2003), a university textbook on public policy. He has published in numerous professional and specialty journals among them Health Affairs, Health Systems Review, Harvard Health Policy Review, Inquiry, Journal of Law, Medicine and Ethics, National Affairs, New England Journal of Medicine, Postgraduate Medicine, and Journal of Medicine and Philosophy. His analysis and commentary have been cited or published by The New York Times, The Wall Street Journal, The New York Post, The Washington Post and The Washington Times. He holds a master's degree and a doctorate in Political Science from the University of Arizona. He received his bachelor's degree in Political Science from LaSalle University in Philadelphia. Information on “Modernizing Medicare,” is at: https://www.press.jhu.edu/books/title/12839/modernizing-medicare. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

The Medicare election window opens in October and closes in December. What do you need to know about Medicare if you are just starting, and what do you need to know about the supplements if you are already using Medicare?See omnystudio.com/listener for privacy information.

Sean was joined by Ashley Morgan and Robert Liles of Liles/Parker to discuss Medicare Part C Appeals and how different the process is from traditional Medicare Part A and B Appeals... Once again, this was such an incredible episode with two of the best attorneys in the administrative process! About Ashley Morgan: Ashley Morgan is a Partner at Liles Parker. She focuses her practice on regulatory health care compliance matters, fraud and abuse, and reimbursement issues. Ms. Morgan represents health care providers across the country in connection with a wide variety of health law issues including coverage disputes, documentation concerns, compliance, medical board complaints, and exclusion / termination issues. She has worked with an assortment of providers including dentists, home health companies, hospice agencies, pain management practices, primary care and specialty physicians, mental health professionals, physical therapists, and licensed acupuncturists. Ms. Morgan is one of only a small percentage of health lawyers who has also trained and passed the certification examination requirements to become designated as a "Certified Professional Coder."  About Robert Liles: Mr. Liles first began working in hospital management after receiving both an M.B.A. and an M.S. in Health Care Administration. After graduating from law school, he was hired as an Assistant United States Attorney (AUSA) in the Southern District of Texas (SDTX) where he primarily handled False Claims Act cases. He was later promoted to Chief, Financial Litigation Unit. Shortly after the passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Mr. Liles was asked to serve as our country's first National Health Care Fraud Coordinator.He was detailed to Washington, DC and was later promoted to the position of Deputy Director, Legal Programs, for the Executive Office for U.S. Attorneys (EOUSA), a component of the United States Department of Justice (DOJ). While at EOUSA, he advised Federal prosecutors around the country on civil and criminal fraud statutes, schemes, investigative tools, privacy concerns, and compliance issues. 

The advertisements sound great to patients. Providers often think Medicare Part C, or Advantage plans are just like Medicare. But they are not. Listen in to learn more as Barbara Phillips asks several questions of reimbursement expert, Don Self.The Video interview is also available on our blog (link below) and on the @NPBusiness YouTube channel.https://npbusiness.org/75

PQS Senior Manager of Data Analytics Andrew Thorne, PharmD, MS, returns to the PQS Quality Corner Show to chat about the 2023 Medicare Part C & D Star Ratings Technical Notes with Host Nick Dorich, PharmD, PQS Senior Manager of Pharmacy Accounts.Thorne explains how 2023 star ratings are set and how pharmacists can find value in updates to both Medicare Part C and D plans. There is also discussion on changes to PQA measures in part D.

Medicare Open Enrollment – a term that may be very familiar to you and nearly everyone else, but especially to those who are already on Medicare and want to drop or switch plans. October 15th through December 7th of each year is the period known as open enrollment and allows individuals ample opportunity to investigate whether they can benefit from switching up their coverage. But Medicare is confusing, and there can be some caveats to switching or, unfortunately, in some instances, you may not be able to change at all. You would think that because it's a government program for virtually everyone, they would make it clear and easy to understand, but hey, we're talking about the government here, so it comes as no surprise that it's about as clear as mud. In this episode of A Place of Possibility™, we'll be going through the nuts and bolts of Medicare so that you'll come away with a better understanding of how the program works and, most importantly, how to make the right decisions when it comes time to choose your coverage when you join or update it later on during this the open enrollment period. We will be talking about: The history and motivation behind the creation of Medicare How you qualify for Medicare An in-depth breakdown of the various Medicare options you'll choose from — Parts A, B, C, and D — including their pluses and minuses (Here's where you'll see why your choices matter so much) What Medigap coverage is and the options you'll have to base your premium on. We'll also make our recommendation The upside and downside of obtaining Medigap coverage through a broker Why you really DON'T want to miss your enrollment period And more! Selecting Medicare coverage is a big decision. With it comes a variety of implications, including several potentially serious pitfalls that could keep you from getting the right coverage for your needs. Our goal with this episode is to help you get on the right path to an informed decision from the very beginning of the process.

“Does Medicare cover assisted living?” is a common question Lori Williams gets as a senior living professional. Since Medicare functions as health insurance and doesn't cover senior living, she welcomes an expert back to the show to share what it does cover. You'll get a simple overview of the Medicare puzzle from June Kim, a community relations specialist with BlueCross BlueShield of Texas. With Medicare enrollment October 15 through December 7, it's a great time to learn - though it's always helpful to understand what you're getting into! She'll answer common questions like: ·What is Medicare Part A, B, C and D? · What's a Medicare supplement? What about Medicare Advantage? · I'm still employed - should I enroll in Medicare? · How much does it cost? · Where do I enroll? If you need to learn the basics of Medicare or just need a refresher, this is a great place to start. Plus, you'll also be aware of what changes are coming. Takeaways from this episode: -Enroll for Medicare Part A (hospital insurance) once you turn 65 - even if you're still employed. You've already paid into it, so it's free. -Only enroll in Part B when you're fully retired because your employer may already offer health insurance coverage. -You can't be on Medicare Part A and B (traditional Medicare) without a drug plan - Part D. -Medicare covers 80% of the costs, and you'll have to pay the last 20% out of pocket unless you have Medicare Supplement insurance. -Medicare Part C is an “all in one” plan run by private insurance companies. You wouldn't get Part A, B or D if you already have Medicare Advantage, nor could you get a supplement. -You must be reasonably healthy to qualify for a Medicare supplement, and costs vary according to lifestyle. The older you get, the more expensive it is. -Medicare Part C is like an HMO health insurance plan; whereas Medicare A and B are like a PPO. - If you have Medicare Part A, B and D, and supplement insurance, you can use your Medicare in all 50 states - any doctor and any hospital that takes Medicare, with little to no out-of-pocket expenses. -Choosing the plan for you comes down to many factors including network and resources. What's most important is that you understand the plan you choose. Resources mentioned in this episode: Medicare details about enrollment for 2023: *Note: Part B premiums may increase Open enrollment period is 10/15/22 - 12/7/22 New Plan is effective on 1/1/23 12. Medicare 101 https://www.loriwilliams-seniorservices.com/aging-in-style-podcast/episode/794eb1c8/012-medicare-101 For more information about plans and the brochure mentioned in this episode, please visit: www.Thinkbluetx.com https://static.wixstatic.com/media/2c62c2_5fdf7b18b96d45639040f7972bf54fc8~mv2.jpeg https://static.wixstatic.com/media/2c62c2_ea7e019a7a9a4becae1d3bbbe025e9a2~mv2.jpeg To contact June Kim: June_kim@bcbstx.com 214-783- 7901 For more detailed and up to date information please go to: www.medicare.gov Or call at 1-800-633-4227; available 24/7 And for social security: www.ssa.gov Enroll for Medicare with Social Security: 1-800-772-1213, Monday through Friday 7 a.m. - 7 p.m. To suggest a topic, be a guest or to support the podcast please email Lori@Loriwilliams-seniorservices.com For more senior resources and to sign up to the newsletter please visit: https://www.facebook.com/LoriWilliamsSeniorServices/ https://www.instagram.com/theloriwilliams/ https://www.linkedin.com/in/theloriwilliams/ https://loriwilliams-seniorservices.com/aging-in-style-podcast/ __ Topics discussed: -Navigating Medicare -Medicare Advantage -Medicare supplement insurance -Choosing the right Medicare plan -Medicare FAQs -Medicare enrollment

Today we're tackling Medicare Advantage, which is the option Medicare enrollees have to use a private insurance company to administer their Medicare benefits instead of the traditional public Medicare program. Almost HALF of all Medicare beneficiaries are now enrolled in Advantage plans, which represents a historic level of privatization of the almost 60-year program. Just this weekend, the New York Times published a blockbuster front-page report on everything that is wrong about Advantage plans. We'll get into all of that with our guest, Dr. Susan Rogers. Dr. Rogers spent most of her career at Stroger Hospital of Cook County (fka Cook County Hospital, the basis for blockbuster TV drama "ER") where she was a Primary Care Physician in a neighborhood clinic before becoming a hospitalist and Director of Medical Student Programs for the Department of Medicine. She is a past co-president of Health Care for All Illinois. She retired in 2014, and is now president of Physicians for a National Health Program (PNHP), a national organization of over 25,000 physicians and health professionals whose mission is to advocate for Single Payer Healthcare/Medicare for All.  https://youtu.be/oi1BUAhbx3U Show Notes Dr. Rogers tells us her advocacy for Medicare for All grew from her experience training and working at a large public safety net hospital where providers and patients made decisions about care based on need, not ability to pay. It was the best way to learn to provide care, and the best way for patients to receive care. What's the difference between Medicare and Medicare Advantage? We dig into Medicare Advantage (aka Medicare Part C) plans, and how they differ from the traditional public Medicare program. Traditional Medicare is funded by payroll taxes. Hospital coverage (Part A) is free for eligible people. There are no networks. It's a fee-for-service plan, so providers are paid for each service they provide that's medically necessary. The narrative began in the 1980's that fee-for-service was responsible for "overuse" of healthcare services. (To paraphrase Minnesota single payer hero Senator John Marty: as if people go get an extra colonoscopy just because it's paid for.) The solution was to put private insurance between the doctor and patient to prevent overuse. Medicare Advantage evolved from the introduction of private insurance into the Medicare system, resulting in every insurance company in America skimming massive profits off the top of a taxpayer funded federal program, while providing no actual care. Medicare Advantage plans are required to cover all medically necessary care, but the definition of medically necessary is defined by the insurance company based on cost, not by the physician based on medical expertise. Medicare Advantage replaces the doctor/patient relationship with someone in an insurance company office - potentially with no healthcare training - deciding what's medically necessary. Gillian shares some stories from Healthcare-NOW members who have been enrolled in Medicare Advantage plans. Common themes were delays in care, denial of coverage, limited networks, and limited pharmaceutical formularies. These features (not bugs) of Medicare Advantage can lead to serious, even deadly deterioration of a patient's health. We also heard stories of patients in need of specialty care for conditions like cancer, but few of the large academic centers or cancer institutes accept Medicare Advantage plans. The overhead cost to run traditional Medicare is about 2%. That means approximately 98% of the money in the traditional Medicare pot goes to providing care to enrollees. By law, Medicare Advantage plans only have to spend 85% of their pot on patient care, and they can keep the other 15% (this is how they afford huge executive salaries, among other "overhead.") They make that 15% slice of the pie more profitable by delaying and denying care as well as by fraudulently overc...

In this episode, we learn about the commercial side of value-based care contracting and Medicare Advantage from Bethany Palmer, Senior Director of Contract Strategy and Clinically Integrated Network Management for CHESS Health Solutions. Bethany, Welcome to the Move to Value Podcast! Let's talk a bit about Medicare Advantage. Can tell us what it is and how it works? Sure. So, before I get into specifically Medicare Advantage, I did want to just give an overview that Medicare consists of four parts being Part A, Part B, Part C, and Part D. Medicare Advantage is Part C of Medicare. And what that is, is it's not necessarily a supplement to Parts A and Parts B but rather a placement. So, if someone is in Medicare Advantage, they're going to be on Medicare Part C. And then some Medicare Advantage plans also have what's called Part D, which is your drug spend. So, you will see a lot of plans that have both Part C and Part D. The difference between Medicare Advantage and traditional Medicare in a nutshell is that the government, instead of the government managing the Medicare Part A and Part B, private sectors are actually taking on the Medicare Advantage population. So, the government is literally shifting those patients within to the private sector or publicly traded organizations. And what the government is doing is they're basically giving those organizations an allotted amount of money that is risk adjusted to take care of those patients. What's interesting about Medicare Advantage, or commonly referred to as MA, is now in today's age, nearly half of Medicare eligible patients are actually on a Medicare Advantage plan. So, we've seen explosive growth since its inception. How did Medicare Advantage get its start? What's the catalyst for that? So, before there was Medicare Advantage, there was Parts A and Part B, which would be coined as traditional Medicare or original Medicare. And in 1965, President Lyndon B Johnson signed this into law. It um, for traditional Medicare. So fast forward several decades, Medicare Advantage was signed into law in 1997 by President Bill Clinton under the name Medicare Plus Choice. However, the base of Medicare Advantage actually goes back into the 70s. But that was kind of a breaking point in terms of that. It was truly becoming Medicare Advantage in 1997. But the goal of MA was really to give beneficiaries a choice for purposes of their health insurance and cost savings derived from managed care efficiencies that ultimately would save the government money that the government wasn't necessarily putting into place by themselves. The name actually shifted to Medicare Advantage in 2003 and this was also when Part D, which is drug spend, was created. And that is the Medicare prescription benefit and that officially went into effect in 2006. Bethany, would you explain to us the differences between traditional Medicare and Medicare Advantage? Sure. So, traditional Medicare includes Part A, which is considered institutional coverage, and Part B, which is medical coverage; or think really outpatient coverage. As a Medicare eligible patient, you're covered at 80% in respects to Part B. So, for many, they do, that are on traditional Medicare, they'll typically select a supplemental plan that covers that additional 20%. Which again is different than Medicare Advantage, which is a replacement plan compared to a supplemental plan. And traditional Medicare is funded entirely by the government. Typically, when someone becomes Medicare eligible, Social Security will actually enroll them in Parts A and Parts B. So, we look at that as those, generally speaking, those over 65 will receive Parts A based off of the amount of time they or their spouse have paid into Medicare taxes. And then for Part B, they'll be paying a monthly premium that's really income dependent. But just to give you an example, so in 2022, the monthly premium for Part B services was $170.10 at the base. But again, that can be...

  Vidcast:  https://youtu.be/T2TNGuTrYTM   You've seen them on TV offering you an unbelievable option to conventional Medicare.  Some of your favorite public figures are pitching this stuff.  (Broadway Joe,vComedian Jimmy Walker, and Star Trek's favorite commander Bill Shatner). They're talking about Medicare Part C which is another name for a Medicare Advantage Plan.  Is there really an advantage or are there hidden disadvantages?   Joe, Jimmy, and Bill paint a rosy picture.  You get all the advantages of traditional Medicare including doctor's visits, hospital care, and surgery but also the promise of additional coverage for dental services, eyeglasses, hearing aids, prescription drugs, fitness workouts, and more all without the need for a separate prescription drug plan or Medicare supplementary policies, so-called  Medigap plans.  The best news: in many cases you play nothing and enjoy a reduction or elimination of what you're currently paying for traditional Medicare and a Medicare supplementary policy.  Too good to be true?  You bet.   What is this really?  The US government pays private health insurance companies, your best friends….right, the money that would normally go to providing medical care for you via traditional Medicare.d  These companies then provide that care.  It's a tremendously profitable business for these companies.  They make twice the profit for each person covered under Medicare Advantage that they make covering younger individuals.   The ways they made these profits is the dirty little secret they don't want you to know.  Let's shine a light on this now so that you do know.   Many plans saddle you with costly out-of-pocket expenses including copays and deductibles when you require covered services.  The insurer only pays the entire bill when you reach a maximal out-of-pocket ceiling which can be quite high.   The other huge savings for them and disadvantage for you is choice.  With a Medicare Advantage Plan you are limited to the insurer's network of providers and hospitals and often only where you live.  Your own medical team and preferred hospital may not be on that list.     The insurance companies reap more profits by forcing these contracted doctors and hospitals to accept less for their services.  Then too, they often deny recommended services during the cumbersome preauthorization process forcing you to file grievances and appeal, appeal, and appeal.     The bottom line:  Medicare Advantage is a great option if you are willing to have a limited choice of doctors and hospitals and are prepared for hefty co-pay expenses should you become ill.  It's a great choice if you are a member of the walking well and never require other than routine healthcare services.   https://www.investopedia.com/articles/personal-finance/010816/pitfalls-medicare-advantage-plans.asp https://www.seniorsguide.com/medicare-social-security-insurance/disadvantages-of-medicare-advantage/   #medicare #partC #medigap #advantage  

This is the third episode of the all-new Medicare Misty Podcast, with Misty Bolt, aka Medicare Misty. In this episode, we get an in-depth explanation of Medicare Parts C and D. When you take a look at Medicare, this is probably the most confusing thing for people to figure out. For example, Medicare Part C is also called Medicare Advantage, and Part D is part of that - but Part C is all of Medicare and Part D is for prescription drug coverage. This is also where all the private insurance plans get involved. So what is the difference and how does it all work out? And, most importantly, what is the best choice for you? Misty will explain it all and more. Disclaimer: Medicare Misty is not endorsed or affiliated with any Government agency. www.medicaremisty.com. Produced by Blazing Kiss Media.

In this episode, Ben Rothering gives us information about Medicare Part C. Mr. Rothering talks about what part C covers, who offers it, and if it is necessary to have it.

Constantly hearing commercials about Medicare Part C and Part D but not sure what they mean? Arrange a consultation with Paul Barrett Insurance Services to learn the basics of each plan and choose the coverage that best fits your needs! Learn more at http://www.paulbinsurance.com (http://www.paulbinsurance.com)

Medicare Fall Open Enrollment has begun. So many options. So many decisions. So little time. Join Health Insurance Strategist Chuck Adams and Stepp & Rothwell Managing Partner Ken Eaton as they guide us through the Medicare Maze.

Hans and Robby go over the need to know information for Medicare Part C for the upcoming year. Don't forget to get your copy of “The Complete Cardinal Guide to Planning for and Living in Retirement” on Amazon or on CardinalGuide.com for free!   You can contact Hans and Cardinal by emailing hans@cardinalguide.com or calling 919-535-8261. Learn more at CardinalGuide.com.  Find us on YouTube: Cardinal Advisors.

“Does Medicare cover assisted living?” is a common question Lori Williams gets as a senior living professional. Since Medicare functions as health insurance and doesn't cover senior living, she welcomes an expert back to the show to share what it does cover. You'll get a simple overview of the Medicare puzzle from June Kim, a community relations specialist with BlueCross BlueShield of Texas. With Medicare enrollment October 15 through December 7, it's a great time to learn - though it's always helpful to understand what you're getting into! She'll answer common questions like: ·What is Medicare Part A, B, C and D? · What's a Medicare supplement? What about Medicare Advantage? · I'm still employed - should I enroll in Medicare? · How much does it cost? · Where do I enroll? If you need to learn the basics of Medicare or just need a refresher, this is a great place to start. Plus, you'll also be aware of what changes are coming. Takeaways from this episode: -Enroll for Medicare Part A (hospital insurance) once you turn 65 - even if you're still employed. You've already paid into it, so it's free. -Only enroll in Part B when you're fully retired because your employer may already offer health insurance coverage. -You can't be on Medicare Part A and B (traditional Medicare) without a drug plan - Part D. -Medicare covers 80% of the costs, and you'll have to pay the last 20% out of pocket unless you have Medicare Supplement insurance. -Medicare Part C is an “all in one” plan run by private insurance companies. You wouldn't get Part A, B or D if you already have Medicare Advantage, nor could you get a supplement. -You must be reasonably healthy to qualify for a Medicare supplement, and costs vary according to lifestyle. The older you get, the more expensive it is. -Medicare Part C is like an HMO health insurance plan; whereas Medicare A and B are like a PPO. - If you have Medicare Part A, B and D, and supplement insurance, you can use your Medicare in all 50 states - any doctor and any hospital that takes Medicare, with little to no out-of-pocket expenses. -Choosing the plan for you comes down to many factors including network and resources. What's most important is that you understand the plan you choose. Resources mentioned in this episode: 12. Medicare 101 https://www.loriwilliams-seniorservices.com/aging-in-style-podcast/episode/794eb1c8/012-medicare-101 For more information about plans and the brochure mentioned in this episode, please visit:  www.Thinkbluetx.com https://static.wixstatic.com/media/2c62c2_5fdf7b18b96d45639040f7972bf54fc8~mv2.jpeg https://static.wixstatic.com/media/2c62c2_ea7e019a7a9a4becae1d3bbbe025e9a2~mv2.jpeg To contact June Kim: June_kim@bcbstx.com 214-783- 7901 For more detailed and up to date information please go to: www.medicare.gov   Or call at 1-800-633-4227; available 24/7 And for social security: www.ssa.gov Enroll for Medicare with Social Security: 1-800-772-1213, Monday through Friday 7 a.m. - 7 p.m. To suggest a topic, be a guest or to support the podcast please email Lori@Loriwilliams-seniorservices.com For more senior resources and to sign up to the newsletter please visit: https://www.facebook.com/LoriWilliamsSeniorServices/ https://www.instagram.com/theloriwilliams/ https://www.linkedin.com/in/theloriwilliams/ https://loriwilliams-seniorservices.com/aging-in-style-podcast/ __ Topics discussed: -Navigating Medicare -Medicare Advantage -Medicare supplement insurance -Choosing the right Medicare plan -Medicare FAQs -Medicare enrollment

Here is Frank Bruno's daily dose of elder law. Elder Law attorneys help their clients facing incapacity, paying for long-term care, or settling an estate. Find us on the web! For more information visits my website at https://www.frankbrunolaw.com Schedule a free telephone consultation on our Website at https://frankbrunolaw.apptoto.com// Say Hi on Social: Visit my Instagram page at https://www.instagram.com/frankbrunoesq/?hl=en Visit my Facebook page at https://www.facebook.com/LawOfficeofFrankBrunoJr/ Visit my Linkedin page at https://www.linkedin.com/in/frank-bruno-2aa14799/ Visit my Twitter page at https://twitter.com/_frankbrunolaw Website: https://www.frankbrunolaw.com What we do at our offices: Wills, Trusts, Estates, Powers of Attorney, Nursing Home Medicaid, Long Term Care Planning, Guardianship, Real Property transfers & Probate Frank Bruno, Jr. is an Elder Law and Special Needs lawyer with years of experience handling these types of cases. He is extremely active in the Queens, New York Community, the Queens County Bar Association, and New York State Bar Association and is frequently invited to speak at events about Elder Law. If you'd like to learn more about Elder Law, Medicaid planning, Guardianship, Special Needs Trusts, or Probate law contact the Law Office of Frank Bruno, Jr. today at 718-418-5000. Thank you for listening! Eldercare law is really an umbrella term encompassing multiple areas of law. Some elder care attorneys handle subjects that most people know something about, such as probate, guardianship, estate planning. Other eldercare lawyers focus their practice on other areas of law such as special needs planning, VA benefits planning, and Medicaid planning. So, what is Medicaid planning? Medicaid planning is a way to protect people's assets from the threat of long-term care expenses. Many clients are between 65 and 95, own their own homes, and have between $25,000 and $750,000 worth of assets in addition to the house. What many people don't realize is exactly how expensive long term care expenses can be – In 2020 the average costs of a skilled nursing facility, in New York is $14,250.00 per month. Someone can be solidly middle class or upper-middle class, have saved their whole life, and think that they'll have plenty of money for whatever happens only to suffer a stroke, major heart attack or get an Alzheimer's or Parkinson's diagnosis and need help with their activities of daily living. If they have this six-figure per year care expense, many people spend everything. Medicare does not pay skilled nursing home expenses after 100 days. An elder care attorney, who handles Medicaid planning, is able to legally and ethically protect people's assets to get them qualified for Medicaid. Medicaid, unlike Medicare, has excellent long-term care benefits. This helps them supplement their lifestyle with their own assets (to improve the quality of their life while alive) and make it more likely that they will have something to pass onto their heirs after they pass away. There are many myths and much misinformation surrounding long-term care Medicaid in New York. To learn more please visit... https://www.frankbrunolaw.com

Today on All Home Care Matters, we are going to be discussing Medicare. First, we will be talking about what Medicare is and how it differs from Medicaid and other insurances. Then, we'll look into how you can apply and receive Medicare before moving on to talk about how Medicare can help you and your family.   If you're ready to learn more about Medicare then let's get started.   According to the Kaiser Family Foundation, Medicare is a federal health insurance program created in 1965 for people ages 65 and over, regardless of income, medical history, or health status. It was expanded in 1972 to cover certain people under age 65 who have a long-term disability. There are currently over 60 million people in the United States on Medicare.   In 1945, President Truman called for the creation of a national health insurance plan but was unsuccessful. President Kennedy also tried to create a similar plan, but he was also unsuccessful in his attempt. Finally, nearly twenty years later, President Johnson signed Medicare into existence. Former President Truman got to see his idea come to life and he got to play a major role in it when he and his wife Bess, were the first two Medicare beneficiaries.   During the first year, nineteen million Americans signed up to receive Medicare. Over the years, there have been many changes and additions to Medicare legislation. Just last year, regulations were added due to the Covid-19 pandemic. If you are interested in seeing what regulations were added or changed due to the pandemic, you can find a good overview on the Commonwealth Fund's blog. You can find a link to the blog in our show notes for this episode. You can also visit medicare.gov for more information on the current and up-to-date regulations and stipulations on Medicare.     There are three parts of Medicare, Part A, Part B, and Part D. Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Medicare Part B covers certain doctor's services, outpatient care, medical supplies, and preventive services. Medicare Part C helps cover the cost of prescription drugs, including many recommended shots and vaccines. For more details on each of the individual parts of Medicare, visit medicare.gov.     Almost everyone over 65 is eligible for Medicare Part A and most do not have to pay a premium either. If you or your spouse are eligible for Social Security payments, you are likely eligible for Medicare Part A, as well. In order to not pay a premium, you must have paid payroll taxes for more than ten years. For those with disabilities that are under 65, generally, if you receive Social Security Disability Insurance, then you are eligible for Medicare. In 2016, 15 percent of Medicare beneficiaries were under 65 years old. There is, however, a two-year waiting period to get Medicare this way. But if you are diagnosed with Amyotrophic Lateral Sclerosis, also known as ALS, or end-stage renal disease, which is permanent kidney failure requiring dialysis or a transplant, there is no waiting period for Medicare eligibility.   Earlier, we told you about the three parts of Medicare, and you may have wondered why we didn't include the fourth part for Part C. Part C does exist, but it is actually separate from Medicare… in a way. Medicare Part C is what is known as Medicare Advantage. Medicare Advantage is one of the options you have when deciding how to get your Medicare coverage. With Medicare Advantage, you enroll in a private health plan, such as a health maintenance organization, or you may be more familiar with it by the abbreviation HMO, or preferred provider organization, or also known as a PPO, and receive all Medicare-covered Part A and Part B benefits and typically also Part D benefits. Basically, it is an all-in-one coverage plan that bundles the original Medicare options.   President Clinton signed Medicare plus Choice into law in 1997 and it was updated and changed to Medicare Advantage in 2003. Since then, enrollment in Medicare Advantage has grown. Last year, more than 24 million beneficiaries enrolled in Medicare Advantage, and enrollment is expected to grow to 26 million this year.   If you are interested in pricing and Medicare plan options, please visit medicare.gov for more information.   Medicare and Medicaid often go hand in hand, but people tend to get them confused. Medicare is an insurance program, whereas Medicaid is an assistance program. Medicare is also a federal program, while Medicaid is run by state and local governments. With Medicare beneficiaries you usually have to be over the age of 65 to qualify, but there are no age restrictions with Medicaid. Medicaid provides Americans with free or low-cost health coverage to low-income people, families and children, pregnant women, the elderly, and people with disabilities. To see if you qualify for Medicaid, visit healthcare.gov.   If you are having trouble remembering which one is which, remember that Medicare provides care, or insurance plans, while Medicaid aids needy families. Now, we know that Medicaid is no longer just for people with low-income, but the majority of people using Medicaid do have low-incomes and remembering that is easier than trying to say Medicaid comes to the aid of low-income people, families and children, pregnant women, the elderly, and people with disabilities.   Medicare is a federally funded insurance that is open to almost everyone over the age of 65 and it is often more cost-efficient than private insurances. Private insurances, however, have more options and pay scales to choose from. Private insurances offer things that Medicare doesn't, like dental, vision, and hearing. Oftentimes, you may be able to find a plan that will work with Medicare and use it to cover what Medicare will not.     When choosing a Medicare plan, medicare.gov suggests considering costs, coverage, your other coverage, prescription drugs, doctor and hospital choice, quality of care, and travel when deciding between what sort of coverage you need. You can find more information on what you should consider when choosing coverage at medicare.gov.     Cost is a big determining factor when choosing an insurance plan. If you are paying for insurance completely out-of-pocket Medicare is most likely the option for you. If your employer provides insurance for you, they may pay part or all of your monthly premium, even after retirement, but that all depends on your employer. They all differ, as they all have different private insurance companies and plans.   According to Medical News Today, the average monthly premiums for private insurance in 2019 cost families $20,576 per year, the cost for individuals $7,188 per year, and cost for families $6,015 per year after their employer covered part of the cost. Medicare Part A typically has no monthly premiums and Medicare Part B has a standard monthly premium of $148.50, resulting in $1,782 a year.   Private insurance is open to everyone, so if you do not meet the age requirement or one of the other stipulations for Medicare, private insurance is always an option.   If you are interested in signing up for Medicare, visit medicare.gov to start the process. If you are 65 and receiving Social Security, you may have already been automatically enrolled, so make sure you double-check before you try to sign up. There are also only certain times of the year that you can sign up for Medicare, just like with private insurance. Depending on when you are trying to sign up, you may have to wait for the next enrollment period.   Once you are enrolled in Medicare, there are a few things you should do right away. You can find a Welcome to Medicare checklist on medicare.gov or the links in our show notes if you would like to look at the full list. First, you need to decide what Medicare coverage you would like. You can choose from the Original Medicare or Medicare Advantage. If you choose the original Medicare, you can also choose additional coverage to go along with it. Next, you need to give Medicare permission to talk to someone you trust.   If you are getting Medicare for your loved one, you need to fill out the Authorization to Disclose Personal Health Information form so that Medicare can interact with you directly. Then, go online and create a Medicare account at medicare.gov. From here, you can manage your Medicare information anytime, create a list of your prescriptions, view your Original Medicare claims status, pay your Medicare premiums, and more. You can also print an official copy of your Medicare card if you need it. Make sure you tell your doctor about your new Medicare plan and if you have other insurance, make sure to let Medicare know, as well.   During the first year you have Medicare, you can schedule a free “Welcome to Medicare” preventive visit with your doctor. It includes a review of your medical and social history related to your health and counseling about preventive services that may be right for you. During your first year, you should also find out what your Medicare plan covers. You can find out by visiting medicare.gov/coverage or you can use their free app, What's Covered.   If you are on Medicare and you have a limited income, you may qualify for financial help. Visit medicare.gov to see if you are eligible to get help paying your Medicare health and drug costs. You should also get into the habit of filing and checking on your claims to make sure you are not being charged for services you never received.   If you choose a Medicare Advantage plan and would like to change or add on to your plan, you can do that, but make sure you do it within the first three months. If you would like to add or remove drug coverage or switch to an original Medicare plan, as long as you do it within the first three months of having Medicare, you can do so with no penalties or waiting period. If you decide you want to change your plan after the first three months, you can still do that, but only during certain times. Medicare Advantage's open enrollment is from January 1st through March 31st. During this period, you can switch from one Medicare Advantage plan to another, switch from Medicare Advantage to Original Medicare, or enroll in Medicare Advantage for the first time.   The annual open enrollment period for Medicare is in the fall from October 15th through December 7th. During this period, you can change or add to your Medicare plan or enroll in a new Medicare plan. Any changes you make to your coverage will begin on January 1st. There are a few other times you can add or change your Medicare coverage plan like if you reach the age of 65, you lose your insurance, or you move. For more information on Medicare enrollment, visit medicare.gov.   If you or your loved one have questions about Medicare and cannot or do not have access to the internet or a computer, you can call 1-800-MEDICARE, or 1-800-633-4227 at any time. If you have difficulties with hearing or speech, you can also call their TTY number, 1-877-486-2048.   If you or your loved one are struggling to understand Medicare and everything that comes with it, know that you are not alone. Many people don't understand Medicare, which is one of the reasons we have decided on discussing Medicare today. With your State Health Insurance Assistance Program, otherwise known as SHIP, you can get free and personalized health insurance counseling. A trusted insurance agent or broker can also help you understand Medicare and help you go over the options provided to determine the best plan and coverage for you.   Before Medicare and Medicaid were created in 1965, roughly half of seniors were uninsured. Today, both programs cover nearly one-third of all Americans. Without Medicare and Medicaid, a significant number of Americans would be unable to afford the medical care they needed to stay healthy and productive. These programs have saved countless lives since being established. Without them, many seniors would not have been able to afford a stay in the hospital and most likely would have avoided going, even if meant refusing life-saving treatment.   Many seniors worry that their medical expenses will ultimately fall on their loved ones and end up refusing to seek medical help when they need it, but with Medicare, they can seek the help they need and not worry about the financial burden. According to Medicare.gov, Medicare covers 23 types of preventive services, including flu shots and diabetes screenings. Some of these services are free, and for others, you only have a small copayment or deductible to pay, depending on which plan you have.   Medicare can help you and your loved one by providing them with insurance that allows them to seek medical help, but also allows them, and you, peace of mind. If you haven't already, join the millions of families that use Medicare to help ease some of the financial burdens that come with aging. Combined with private insurance, you can make sure your loved one is covered and never has to worry about their medical expenses. When neither you nor your loved one has to worry about the costs, you can enjoy spending time together and making memories with them.   If you have any questions about Medicare, please visit medicare.gov for more information. You can also talk to your insurance agent or broker. They should be able to help you go over your options and find the best coverage for yourself or your loved one. You can also visit Medicare on Facebook and Twitter. They post content regularly that you may find helpful.   We want to say thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode and please make sure to share it with them.   Remember, you can listen to the show on any of your favorite podcast streaming platforms and watch the show on our YouTube channel and make sure to hit that subscribe button, so you'll never miss an episode. Next, on All Home Care Matters we are very excited to share with you that we have some very special guests who will be joining us over the next few episodes. Stay tuned you won't want to miss these interviews!     Sources: https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare   https://www.kff.org/medicare/issue-brief/an-overview-of-medicare/   https://assets.aarp.org/rgcenter/health/fs149_medicare.pdf   https://www.medicareresources.org/medicare-benefits/medicare-advantage/   https://www.hhs.gov/answers/medicare-and-medicaid/what-is-the-difference-between-medicare-medicaid/index.html   https://www.healthcare.gov/medicaid-chip/   https://www.medicalnewstoday.com/articles/is-medicare-better-than-private-insurance#what-private-insurers-offer   https://www.medicare.gov/media/9211   https://www.medicare.gov/blog/medicare-and-medicaid-keeping-americans-healthy-for-50-years   https://www.medicareresources.org/basic-medicare-information/brief-history-of-medicare/   https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/consider-these-7-things-when-choosing-coverage              

This is Stephen Schmidt from the Gazette digital news desk and I'm here with your update for Wednesday, June 9. Wednesday's weather will continue many of the same themes as Tuesday's did: muggy and sunny, with an occasional chance of rain. According to the National Weather Service it will be 91 degrees in the Cedar Rapids area with mostly sunny skies. There will be a 20 percent chance of showers after noon. Besides that, a calm wind will blow at about 5 mph. Under legislation signed into law Tuesday by Gov. Kim Reynolds, Iowa's public colleges and governmental entities are now prohibited from teaching concepts that the Iowa Legislature has deemed divisive --- including that moral character is determined by one's race or sex, or that the United States and Iowa are fundamentally or systematically racist. The governor's office released a statement with the bill signing criticizing Critical Race Theory, an academic discipline examining systemic racism in society that has become a bugbear on Fox News and in conservative think tanks like the Heritage Foundation. The vote on this bill was almost entirely along party lines, with the support of majority Republicans and the opposition of Democrats. The Cedar Rapids City Council authorized the city manager Tuesday to sign off on an agreement to settle a lawsuit filed by Jerime Mitchell and his wife asserting a white police officer recklessly shot and paralyzed Mitchell, a Black motorist, in 2016. The city had prepared to go to trial in April to defend the actions of Lucas Jones, the officer who shot Mitchell, even though the police department had since fired him for a different incident. But on April 19, the day before the case was slated to go to trial, insurance carrier States Insurance agreed to https://www.thegazette.com/crime-courts/cedar-rapids-agrees-to-pay-8-million-settlement-to-jerime-mitchell/ (pay the Mitchells $8 million), without acknowledging fault or liability on the part of the defendants. The settlement was announced the same day a Minneapolis jury began to deliberate the fate of Derek Chauvin, the former Minnesota police officer who jurors later found guilty of murdering 46-year-old George Floyd by kneeling on his neck.  Former Lone Tree Mayor Jon Green, a Democrat, ran away with Tuesday's special election for a seat on the Johnson County Board of Supervisors, picking up 9,718 of the total 14,711 votes cast — about 66 percent. This vote total allowed him to easily beat his two challengers, Republican Phil Hemingway and independent Brian Campbell. Green will fill the seat vacated in April by former supervisor Janelle Rettig, when she resigned suddenly to focus on her health. Later that month, three county officials opted to host a special election to fill out the remainder of her term, which expires Dec. 31, 2022. Wellmark Blue Cross and Blue Shield said it is seeking federal approval to offer Medicare Advantage plans beginning in 2022. If approved by the U.S. Centers for Medicare and Medicaid Services, the state's largest insurance carrier would offer plans under a new affiliate — Wellmark Advantage Health Plan — to Iowans and South Dakotans during this coming fall's annual enrollment period. Officials did not specify when they anticipate federal approval could arrive. Medicare Advantage, also known as Medicare Part C, are health plans offered by private companies with approval from the federal agency. These plans provide both Medicare Part A — which covers hospital and nursing home care — and Medicare Part B — which handles medically necessary services and other preventive health care. The Iowa Ideas 2021 virtual conference will be here before you know it, and we would like you to be our guest on the house. The Gazette is providing free access to this two-day gathering with more than 50 sessions- filled with thought-provoking local, and national speakers-- all ready to engage you on a variety of important and timely Iowa-issues. Join us October... Support this podcast

A whistleblower recently exposed an alleged risk-adjustment scheme that was apparently designed to artificially inflate reimbursement provided under Medicare Part C, aka Medicare Advantage (MA).The accompanying lawsuit alleged that GHC hired an outside vendor to review and “improve” its risk adjustment scores. According to the whistleblower, GHC submitted tReporting our lead story on this matter during the next live edition of Monitor Mondays will be Max Voldman, JD, an associate of Constantine Cannon.Other segments to be featured during the live broadcast include the following:Special Report: Bereavement: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SDoH), will don her case management hat to report on how hospital personnel are dealing with the death of patients in the wake of COVID-19, which has claimed the lives of more than 259,000 here in the U.S. Ellen will also conduct the Monitor Mondays Listeners Survey.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the status of healthcare legislation associated with the current COVID-19 pandemic.

To get insurance for things Medicare typically doesn’t cover, many beneficiaries decide to purchase Medicare Advantage plans, which supplement regular Medicare plans by providing additional coverage for things like vision, dental, and hearing. While Medicare Advantage plans can help seniors lower their healthcare costs, it can be difficult to choose the right plan for your unique needs. In the fourth installment of Seniors Living Healthy, hosts Nick Keene and Zach Haire examine the ins and outs of Medicare Part C, also known as Medicare Advantage plans. Have a listen to learn more about the various types of Medicare Advantage plans are available, why seniors decide to buy them in the first place, some considerations to keep in mind as you begin shopping for a Medicare Advantage plan that’s right for you, why it’s important to reexamine your options every Annual Enrollment Period, and more.

This podcast is part of our series on racial equity in the food system. Today, we're talking with Alison Conrad, a research associate here at the World Food Policy Center. She has just published a research brief on identifying and countering white supremacy culture in the food system. Interview Summary Big picture. What did your research on white dominant culture in the food system reveal, and why does this matter? Well, I think first and foremost, it revealed that whiteness and white supremacy are deeply embedded in the food system, but that their presence goes unnamed and unnoticed by white folks. And it's something that shows up in basic beliefs about the food system. And so you'll hear some of these narratives that I've identified and be like, "Those make sense, "what exactly is wrong about them?" But, in reality, many of these narratives stem from the bigger white supremacy culture that fuels how we discuss what's happening in the food system, how we want to reform the food system, and what we consider healthy food. Tell me what you mean by whiteness and white supremacy culture. Whiteness is a social construct that has very real and violent effects, and it's not just a reference to lighter skin color, but it's an ideology that is based on beliefs, values, and behaviors that have resulted in the unequal distribution of power and privilege based on skin color. Whiteness is invisible to those who benefit from it, but it has this immense power because it's held as a norm. It justifies and binds together the white supremacy system inherent in all institutions of American society. And so as a result, attitudes and behaviors steeped in white supremacy culture can be found in any individual group or organization, whether it's white-led, predominantly white-led, BIPOC-led, or has a predominantly BIPOC staff. So Ali, I love that you've named some specific narratives that show up. Can you talk about what some of those are? I identified eight messages, and these may seem really familiar to you, and it's because many of our core beliefs are driven by a lot of these narratives and they can have an influence on how we go about addressing issues through food policy and programming. First, I'll start with If They Only Knew, and this is really about healthy food and cooking education. It's this idea that if you only knew what healthy food is or how to cook healthy food, then you would go out and buy it and cook it, and therefore be more enlightened and be healthier. It tends to ignore a lot of the more structural issues that come along with what is healthy food and who has access to it? The next one is Vote With Your Fork, which is this idea that we can somehow signal our preferences for healthy food, for more sustainably grown food, through what we purchase and what we buy. And next - some more paternalistic narratives - one of which was that Communities Can't Take Care of Themselves. And this justifies why it's okay not to involve low income and/or black, indigenous, or people of color, BIPOC, in decision-making around programming and policy. The next narrative of Failure to Listen draws off of this and shows how institutions, especially funders or government agencies, push solutions onto communities rather than supporting agendas established by individual BIPOC communities themselves. And next is Build It and They'll Come. This is a food retail sort of market approach to food access and quote/unquote, "food deserts," but it doesn't really address anything around community wealth-building strategies or looking at systemic racism that has to do with what is a food desert and talking about food apartheid. And next narratives are more focused in neo-liberalism, one of which was Pull Yourself Up By Your Bootstraps. It blames poverty and hunger on the individual—that individuals are just simply not working hard enough to get themselves out of poverty and out of hunger. And because of this, we have the next narrative, which is, a Focus on Food Charity, which results in us over-relying on food distribution and charity as the solution to hunger, instead of thinking about creating more sustainable, structural change, like higher minimum wage, increasing SNAP benefits, and really, anything that just goes beyond food distribution and charity. Lastly, one that I find very interesting is how we define Good Food Versus Bad Food. And this tends to be more as universally held belief of what is good, healthy food and what is not, and how that can apply with whiteness and white supremacy. So I think it's really helpful to think of kale versus collard greens as an example. Kale is considered a very common, healthy food. And the other, collards, it's not often talked about, even though they have the same health benefits. This is because collards were considered the food of the poor Southerner and because of sort of like the classism and the racism of that depiction, collards are not seen on the same level as kale. So now that I've gone through these, you're probably thinking, "I've heard some of these before, and "I believe some of these, what exactly is wrong with them?" They tend to put the emphasis on the wrong place and on the wrong things because they stem from this white supremacy culture that's focused on the individual; that's focused on prescribing solutions; that's focused on this neoliberal idea that it's only about personal responsibility. We can't really move to creating longer lasting change if we're continually wrapped up in perpetuating these narratives in the policy and programming that we're doing. We're coming at it from this lens that's not focused on long-term change, and is focused on a lot of these bandaids to a bigger problem than say, addressing poverty or racism. For example, you could take the Vote With Your Fork narrative. It sounds like a great idea. Why can't we signal to companies that we value more sustainably grown food? But the problem is that it leaves out who is able to participate in that, and why are they unable to participate. You have to have some sort of purchasing power in the first place because if we're talking about sustainably grown beef--that's not exactly cheap. And that's going to leave out anyone who can't afford to make that purchasing decision, even if they may value more sustainably grown foods. It ignores this idea that maybe we need to come together as a collective to put pressure on the government to pass laws, to regulate companies, and to help move us along to a more sustainably grown local food system. There's a lot of nuances that go into these narratives, but you have to start by recognizing how they influence policy and programming, even if you're not even realizing that you're doing it, no matter how well-intentioned you might be. You mentioned food deserts and food apartheid. How are those concepts different? Thanks for asking this, Jen, I think it's a really important distinction to make. So food desert is a term that was created by the USDA to define a geographic area without access to grocery stores. The term desert looks at communities from a deficit perspective and it implies that food access and insecurity issues are a natural phenomenon instead of something that was created through generations of divestment. Food apartheid, on the other hand, directs the conversation to systemic racism resulting from policies that created a system where predominantly black neighborhoods on average have fewer grocery stores and poor quality food than predominantly white neighborhoods. And so, food apartheid looks at the food system as a whole and calls out the systemic injustices and inequities that result from racist policies and practices, such as neighborhood redlining. By reframing the issue as food apartheid, food system actors can shift the conversations to systems of injustice in ways to combat them. So Ali, I'm curious, why did you as a white woman decide to pursue this project? That's a really great question. I was worried at first, I will say. I was questioning if I should be the one doing this. As a white person, is this a good place for me? I don't have that experience with discrimination. What does it mean if I try to take this on? And am I taking up space that someone else should be filling in? But I've come to realize that you can't say, "I'm white, I don't really have a stake in this," and therefore it's on BIPOC individuals "or low income individuals," or really any group that's facing discrimination "to advocate for justice and equity." The point of this project is to say we're talking about white narratives. We're talking about systems built on white supremacy, and therefore white folks have to come in and understand how that's impacted their thought processes, their work, and how they're putting out policies and programming that then goes on to influence what happens in the food system. Even if you're not intentionally acting from a white supremacist standpoint, the system is white supremacy, and you have to learn how that whiteness impacts the work that you're doing. Going through that myself, going from a place of not really knowing if this is the right thing for me to do as a white person, to understanding that all white people have to do this. Without addressing the part that we play in white supremacy in the food system, you're not going to understand how that's influencing the policies and programming you're putting out. We can't reform a system that has 400 plus years of white supremacy without confronting white supremacy. Ali, I really think you're bringing up a number of critical aspects in terms of how much whiteness shows up in the work around policy and practice in food systems. But also the fact that everyone has a stake in dismantling racism. That this should not be something that is the work of one group or groups, that there is a role for each individual in identifying the aspects of the work that they can do in dismantling racism. I really appreciate you pulling that out, and for that being such an integral part of this research. So I'm interested to know now, what surprised you the most over the course of this research? Once I had a basis of what the narratives were—I was surprised at seeing how intertwined all of it was. Each individual narrative is really informative, but also looking at them all together and looking at the broader structures of white supremacy culture of that focus on individualism, paternalism, neoliberalism, and seeing how that really is so pervasive in so many types of policy and programming. And now, taking what I've learned and going into other conversations and listening—listening to how other people talk about things. Seeing how that white supremacy culture and that approach is just so embedded and that people don't even realize it. And that if I hadn't done this project, I also wouldn't have realized it. That, in and of itself, is just so helpful to switch the way that you think about things. It is unnamed, and you're not really gonna notice it until it's like a light bulb goes on over your head. And you're like, "Oh wait, that's problematic," or, "That just reinforces trauma on communities "that have had 400 years of white supremacy," "and we don't even realize that we're doing it." One of the narratives that really sort of resonated with me in this way was this idea of, If They Only Knew. I've thought about policies and programs from this If They Only Knew perspective, I've definitely been guilty of perpetuating that. And so realizing that was really helpful. It's not that nutrition education is bad, it just ends up being a replacement for thinking about things like structural inequality that's inherent in the system. Things such as who is able to access locally grown food, who is able to afford quote/unquote, "healthy fruits and vegetables," who is able to get transportation to go to the grocery store, and who has time to cook their meals every day. There's a lot of these sort of nuances that I think we tend to ignore. And a lot of these things have to do with white supremacy and structural racism that's built into the system. The problem with these narratives is that they make it easy to ignore the structural issues and asking- Okay, so what will move us to the point where we're creating a more equitable food system for people to actually access healthy food and more sustainably grown food? And so you really have to start digging into that structural inequality and the racism that creates these disparities. And by just talking about education, you sort of allow yourself to not have to do that. Ali, you point out how hard it is to see these narratives. I'm curious then, what work needs to happen next for individuals and organizations working to improve the food system once they're recognizing these white supremacy culture narratives that continue to show up? Yeah, you make some great points and I'm glad that you've asked this question. As I've sort of alluded to a little bit, it starts with learning. It's learning how whiteness is influencing your work. It's analyzing your thought processes. You can't really make forward progress if you don't understand how you might be contributing to the problem. This involves asking yourself some basic questions to challenge how you're thinking about the food system. So are you discussing at all in your work and in your individual learning how structural racism has impacted the communities you're serving? Are you moving beyond talking about food access and food deserts to have conversations around food apartheid? Have you looked at your budget, either your organization's, or even your own personal finances to see if you're dedicating any money and funding to BIPOC organizations that are already doing work on the ground? We've been socialized to believe a lot about whiteness, about race, about the history of the United States. You really have to start digging in and finding those gaps in your education. You can't make progress without first learning and unlearning, and then as white folks, as white organizations and institutions, to take action to combat it. I think it's important to note that nobody alive today created the current systems of oppression, but they still exist. And many of us benefit from them and perpetuate them. So while we didn't create the system, I want to acknowledge that some individuals and institutions are today still actively working to strengthen systems of white supremacy and further solidify it in laws and institutions and norms. If we don't learn how it's harmful and how we can take action to counteract it, how we're complicit in it, then we are definitely still complicit in continuing to uphold it. I think it's also important to note the power dynamics at play between institutions and communities. Often white institutions and organizations get to come into communities and set the agenda for what is needed and what will happen in those communities. And so organizations need to think about how they can shift from doing the work on behalf of BIPOC communities to supporting community-defined agendas and working with communities. And this really requires organizations to unpack how they are exerting power and influence, and understanding who is benefiting from that power. Is the community really being helped by your programs? Or is your organization the one that's benefiting from having a program in that community? White institutions and organizations can stifle the ability for BIPOC individuals and communities to use their own power to assert their own agendas, and create systems that benefit them, instead of being forced to participate in systems of oppression. So Ali, you've spoke to learning at both the individual level and the organizational level. It sounds like what you're explaining is really about this journey, both of learning and of unlearning. So I'd like to know how our listeners can learn more about white narratives and white dominance in the food system. So our research brief, which is posted on the Duke World Food Policy Center website (wfpc.sanford.duke.edu), outlines the eight narratives that I've gone over today, as well as some examples of how these beliefs play out in policy and programming. We invite you to read our research brief, start internalizing the information there, and thinking about these broad white supremacy cultures. And then look at your own work in the food system and see what narratives do you identify? Do you find others outside of what I identify? Or can you apply the ones that I identified to a different part of the food system that you may work in? We've included a bunch of resources within this brief that can help you with that learning and unlearning process. Bio: Ali Conrad is a Duke University Sanford School of Public Policy Master of Public Policy graduate. Her research focuses on social determinants of health and food access policy. Prior to joining the WFPC, she interned at the Government of District of Columbia Office of the Food Policy Director researching food is medicine in the United States and opportunities in the District for addressing food as a social determinant of health. Before coming to the Sanford School, Ali worked on Medicare Part C and D policy and data analysis at Acumen, LLC after receiving a B.A. in Economics from UC Berkeley. After graduation, she would like to pursue a career working on food policy and its connection to the  built environment and social determinants of health issues.

Medicare has four important parts when you begin your enrollment. It is important to understand the difference between Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D. Medicare Part A and Medicare Part B benefits are the same across the board, but under Medicare Part C, things change based on whether you choose Original Medicare with a Medicare Supplement plan, or a Medicare advantage plan. It is important to understand not only when to apply for medicare enrollment, but also know what your Medicare coverage entails.

Navigating the maze of Medicare enrollment can be extremely difficult. In today's episode, Vince and Jon cover some of the basic concepts of Medicare, including:When to enrollAre you eligible?Medicare Part A and Part B vs Medicare Part CMedicare Part D (Prescriptions)Medicare Supplement Programs or Medigap.With Medicare and health insurance coverage being such a large part of your finances, especially in retirement, Assured Retirement Group has brought in a specialist to cover these areas with their clients.For more info, you can reach Vince Oldre at (952) 657-7470, or find him online at https://assuredretirementgroup.com/

Medicare Part C is a popular option for Medicare beneficiaries. One third of those on Medicare have Part C plans. Some of you may think you don't know what it is, but you probably hear about it all the time. If you are not familiar with how it works, you will want to listen to what my ten years of experience with Medicare can teach you. I am Stephen Beck, and I've been on both sides of the equation. I've been employed by an insurance company, and I've been an Agent or Broker. All together, I have over 25 years of experience in the insurance industry. Most importantly, I enjoy helping people. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/b-medicare-aware/message

https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-c/A Medicare Advantage plan is also known as Medicare Part C, it's offered by private insurance carriers and it's an alternative to a Medicare Supplement. Generally, Medicare Advantage plans are good for people who are healthy, because they don't have as many doctor visits and co-pays for specialists and it's also beneficial for someone who can't afford a Medigap policy because, in reality, some insurance is better than no insurance. These plans, you must have your Part A and B active in order to qualify to enroll. There is one health question, do you have end-stage renal disease. Now, if you do have end-stage renal disease, the standard Medicare Advantage plans won't be available. However, in some areas, there's what's called a Special Needs Plan.Your Medicare Advantage plan will have a card for you, so when you go to your doctor, you will show your Medicare Advantage card instead of your Medicare card. This is because that private insurance carrier is now gonna handle your claims. Some of these plans include routine dental, vision, hearing and even gym memberships. It's important to remember that some of those services are only routine. So if you need dentures, fillings, root canals, you may want to purchase a separate, standalone policy.Now, also with Medicare Advantage plans, you will have a one year trial right through your Guaranteed Issue, meaning that you will have 12 months to have your Medicare Advantage plan and within that time, you can either choose to stick with it or switch to a Medigap policy instead. You will also be protected if your Medicare Advantage plan leaves your service area through Guaranteed Issue, and you'll be able to switch at that point as well.Well, the biggest pro that none of us can ignore is the zero dollar premium. And I know some of the plans do just have a lower premium, I've seen them between $20, all the way up to $100 bucks, depending on where you live. The downside to having a low premium is that you end up with higher out of pocket costs. The way you gotta look at it is either you're gonna pay for it upfront or you're gonna pay for it later. Another thing to think about is when you have a Medicare Advantage plan, you have a more restricted network. As were with the Medigap policy, you can go anywhere where Medicare is accepted. That's not the case for Medicare advantage plans. Additionally, in most cases, referrals are needed to see specialists. So you will have to go to your primary care doctor, pay that copay to then go to the specialist and pay that copay. So all are very important things to think about when you're planning your year ahead. And if you throw in a hospital visit, a lot of them are $100 to $300 a day for the first 4 to 6 days. One pro is that your Medicare Advantage premium can be deducted right from your social security, so it is one less bill you have to worry about manually paying. Another pro is there's national emergency coverage, so if you travel frequently and you have an emergency situation, you do have coverage with your Medicare Advantage plan, however, if you leave the country and have an emergency, you pay for that out of your own pocket.So as you can see, there are a lot of pros to Medicare Advantage plans and there are a lot of cons that you would have to factor in. If you're someone who's confident with your health, who doesn't really frequent the doctors often, this might be a great plan for you.Medicare Advantage vs Medicare Supplements: https://www.medicarefaq.com/faqs/medicare-advantage-vs-medicare-supplement/Best Medicare Advantage Plans for 2020: https://www.medicarefaq.com/faqs/best-medicare-advantage-plans/Join our Facebook group! It's a group dedicated to helping people become educated on Medicare.  https://www.facebook.com/groups/MedicareFAQ/

This week, former congresswoman and current president & CEO of the Better Medicare Alliance, Allyson Schwartz, joins NAHU's John Greene to discuss a wide range of Medicare topics, including this year's AEP, President Trump's executive order on Medicare, the Cadillac and HIT taxes, and more. Congresswoman Schwartz represented Pennsylvania's 13th district for ten years, and now leads Better Medicare Alliance as the foremost advocate for Medicare Part C, more commonly known as Medicare Advantage. (This episode was recorded on Monday, December 9, 2019.)

This week, former congresswoman and current president & CEO of the Better Medicare Alliance, Allyson Schwartz, joins NAHU’s John Greene to discuss a wide range of Medicare topics, including this year’s AEP, President Trump’s executive order on Medicare, the Cadillac and HIT taxes, and more. Congresswoman Schwartz represented Pennsylvania’s 13th district for ten years, and now leads Better Medicare Alliance as the foremost advocate for Medicare Part C, more commonly known as Medicare Advantage. (This episode was recorded on Monday, December 9, 2019.)

Medicare can be confusing for a lot of folks. Part A, Part B, Part C, Part D – some are automatic, some require enrollment; some have premiums, some don't; some have eligibility requirements besides age, some don't. It can get confusing.  To try to take some of the mystery out of Medicare, today 2 Docs Talk about Medicare Part C, also known as Medicare Advantage Plans. Take a listen and decide for yourself if these plans really offer any advantage.

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this "deep dive" episode, hosts Payal Nanavati and Joe Records talk to Barbara Ryland about benefits under Medicare Part C.

In this episode, we are joined by Michelle Keller-Eiler, Clinical Review Specialist at BESLER, to discuss what the growth of Medicare Part C means for providers.  Learn how to listen to The Hospital Finance Podcast® on your mobile device.  Highlights of this episode include: Background on Medicare Advantage plans and what some of the Pros Read More

In our previous episode, certified Medicare specialist Tom Allen and I discussed what Medicare actually is and what it's designed to do. If you haven't listened to Part 1 (episode 6), I strongly recommend you do so now. There are so many nuances to health insurance, and it's very easy to get caught in financially devastating traps if you aren't careful. That's why today, in the second part of our series, we continue our conversation with Tom about Medicare. We discuss why Medicare has become so complicated and confusing, the penalties you can incur for not having coverage, the rise of Medicare Part C (aka Medicare Advantage Plans), Medicare F and G plans, and when to find a Medicare specialist who can help determine the best possible plan for you.   Get Today's Show Notes To get a full recap of today's conversation, including the biggest takeaways, transcripts, and links to all the resources mentioned, visit GuidedRetirementShow.com/7   Learn More about Retirement Planning Find out more about retirement planning and Barber Financial Group, by visiting BarberFinancialGroup.com

Medicare Part C is also known as a Medicare Advantage Plan, and it is not a Medicare Supplement Plan. It is a private alternative to Medicare. If you have a Medicare Advantage Plan, your Medicare Part B premium will go to the carrier that you have your plan with instead of Medicare and this is why there are very low or zero premium plans. As far as coverage, the Medicare Advantage does not work like a Medicare Supplement. It does not cover the 20% that Medicare does not cover. Medicare Advantage Plans replace what Medicare Parts A and B would charge with their own set of co-pays, deductibles and co-insurance. Because Medicare Advantage Plans replace your Medicare, you can no longer go to any doctor or hospital that you choose. Most Medicare Advantage Plans (HMO plans) have a network of doctors and hospitals that you must choose from, however some plans such as PPO plans will allow you to choose any doctor or hospital that you want but you will have to pay more for their services. Here is a breakdown of how the average Medicare Advantage Plan works: · Low monthly premium. Some plans have zero premium. Just remember that there is no such thing as a zero-premium plan. The premium that you would normally pay to your Medicare Part B now goes to the carrier that you have your Medicare Advantage Plan with. · Requires you to pay some bills when you use the Plan. You will have copays, co-insurance and sometimes a deductible. Some plans will not have co-pays and some will, it all depends on the carrier you choose and the area you live in because these plans coverage differs in every state even if it’s with the same carrier. · You have to go to certain Doctors, Hospitals and other Providers. HMO plans have strict networks of doctors and hospitals and PPO plans allow you to see doctors and go to hospitals outside of your network, however you will pay more for the services. · Has a max-out-of-pocket for your protection. Once you have paid a certain amount, the plan will pay the rest of your healthcare cost. For 2019, the average HMO’s max-out-of-pocket is around $6,700.00 and the PPO Plans are around $10,000.00 depending on whether you use doctors and hospitals inside or outside of your network. · Sometimes included added benefits like dental, vision, hearing and even a gym membership. However, keep in mind that these plans do not have to keep these benefits because Medicare does not cover these services so these plans are not required to cover them. · Some of these plans will include Medicare Part D coverage in the plan and some will not. What is nice about a Medicare Advantage Plan is that they protect you from the 20% that Medicare doesn’t pay with an annual maximum of out pocket. Again, the national average maximum of pocket for an HMO plan is going to be around $6,700 and around $10,000 for a PPO plan. If you have any questions regarding Medicare, it’s coverage or its plans, please give our office a call at 1-855-368-4717 or visit one of our pages: Website - https://www.seniorhealthcaredirect.com/ Facebook - https://www.facebook.com/MedicareBob/ Podcast - https://anchor.fm/MedicareBob Twitter - https://twitter.com/MedicareB YouTube - https://www.youtube.com/channel/UCy_avKva4VN0DBEgjP7I43w?view_as=subscriber

In this episode, podcast host and author of “Control Your Retirement Destiny”, Dana Anspach, covers Chapter 10 of the 2nd edition of the book titled, “Health Care.” If you want to learn even more than what there is time to cover in the podcast series, you can find the book “Control Your Retirement Destiny” on Amazon. Or, if you are looking for a customized plan for your retirement, visit us at sensiblemoney.com to see how we can help.   Chapter 10 – Podcast Script Hi, this is Dana Anspach. I’m the founder and CEO of Sensible Money, a fee-only financial planning firm. I’m also the author of Control Your Retirement Destiny, a book that provides a step by step plan on what to do as you transition into retirement. This podcast covers the material in Chapter 10, on managing health care costs in retirement. If you like what you hear today, go to Amazon and search for Control Your Retirement Destiny. And, if you are looking for a customized plan, visit sensiblemoney.com to see how we can help. ————— When it comes to health care costs in retirement, the media scares us with big numbers. One common statistic you see is the lump sum cost for health care for a couple age 65 and older. For example, the Fidelity Retiree Health Care Cost Estimate is frequently quoted by the media. It says an average retired couple, age 65 in 2018, will need approximately $280,000 saved (after taxes) to cover health care expenses in retirement. This sounds scary, but it is almost the same price tag that is quoted as the average cost to raise a child. Most parents don’t have $280,000 sitting in an account when they have a baby, yet they still manage. Health care costs are similar. Let’s look at these expenses annually instead of as a lump sum. $280,000 over 25 years is $11,200 per year, or $5,600 each. When you think of it this way, it becomes a manageable expense that you can plan for. However, this expense does not occur evenly, like a car payment. Instead, the expenses vary depending on what phase you are in. The more you understand what to expect, and how the expenses vary, the better of you’ll be. There are four key areas of planning for health care costs that I’ll cover in this podcast. First, Medicare, which begins at age 65 for most people.Second, the gap years, which occur if you retire prior to age 65 and don’t have any employer provided coverage to bridge the gap until age 65.Third, I’ll talk about one of my favorite savings vehicles, the Health Savings Account.And the last thing I’ll cover will be long term care costs. Let’s start with Medicare. If you’ve worked in the U.S. long enough to qualify (which is 10 years or 40 calendar quarters of covered work), then you become eligible for Medicare at age 65. Medicare has four parts; Parts A, B, C and D. Medicare Part A begins at age 65 and is free. Part A is the foundation of the Medicare program and is often referred to as hospital insurance. Medicare Part B is next, and it is not free. It covers additional services, some medical supplies and some preventative services. You pay a monthly premium for Part B. The amount is announced annually. In 2019, the basic Medicare Part B premium is $135 per month. However, this premium is means tested -so if you have a higher income, you may pay more. Those with the highest incomes pay $460 a month instead of the $135. I’ll cover this means testing in more detail in just a few minutes. Medicare Part D refers to prescription drug coverage that you can add to your basic Medicare Part A and B benefits. As with Medicare Part B, high-income folks pay more. In 2019, the base premium is $33 a month, and the highest income households pay $77 a month. If you add up what is covered in Parts A, B and D, you’ll find there are gaps in coverage. On average, Medicare covers about 50% of your total health care costs. Most people purchase what is called a Medigap or Medicare Supplement plan, which wraps around Original Medicare and helps cover these gaps. A few years ago, a second option became available. This is what is sometimes called Medicare Part C or a Medicare Advantage Plan. It is private insurance that provides coverage in a single plan that includes Parts A and B, and may also include Part D. Some Medicare Advantage plans also include extra services like vision, dental, and hearing. Currently, you must choose between either a Medicare Advantage plan or Original Medicare augmented with a Medicare Supplement policy. You will start receiving information about Medicare six months before your 65th birthday. Most people enroll as soon as they are eligible. But what do you do if you are still working at age 65 and have insurance through your employer? Then, it depends on the size of your employer. In general, if your employer has less than 20 employees, Medicare will become your primary insurance, even if you are still working. You will typically enroll in Parts A & B. If you employer has over 20 employees, Medicare is often the secondary insurance. Usually you enroll in Part A, but may be able to delay Part B. And possibly delay Part D depending on the drug coverage provided. It’s important go get this right, because if you were supposed to enroll in Medicare, but don’t do it in time, a penalty can apply. The penalty for not enrolling in Part A on time is temporary, but the penalty for not enrolling in Part B can mean you pay a higher Part B premium for the rest of your life. We encourage people to talk to their current health insurance provider and consult with an independent agent to discuss options as they near age 65. For those of you who with higher incomes, I am going to spend a few more minutes on the Medicare Part B and D means testing. This premium adjustment for higher income tax filers is called IRMAA or the Income Related Monthly Adjustment Amount. Medicare estimates that IRMAA results in increased premiums for about 5% of the population. Means testing begins when your modified adjusted gross income exceeds $85,000 for single filers, or $170,000 for married filers. These limits are fixed and do not adjust up with inflation. The final premium amount is determined based on your income; the more income, the higher the premium. Those with the highest incomes, over $500k for singles or $750k for marrieds, pay $460 a month instead of the $135 base amount. These IRMAA premiums are determined by looking at your tax return two years prior. If you’re age 65 in 2019, they’ll be looking at your 2017 tax return. But what if your income was much higher two years ago than it is now? We come across these situations on a regular basis. I’ll share two of them. The first is a married retired doctor and the second a single veterinarian. In both cases, they are over age 65, and their income is much lower now than it was two years ago. We suggested each person file for a reconsideration of IRMAA. There are seven reasons you can request a lower IRMAA premium and retirement, or working less hours, is one of those seven reasons. For our retired married doctor this may save them over $5,000 this year. For the veterinary, perhaps $1,000 - $2,000 in savings. How do you go about paying your Part B premiums? If you are not yet receiving Social Security, then you receive a quarterly invoice for your Part B & D premiums. Once you begin Social Security, Part B & D premiums are deducted from your monthly Social Security check. I’ve now covered the basics on Medicare. Overall, when you go right from employer provided coverage to Medicare, the transition is not too difficult. But what about those of you who plan to retire before age 65? You need to plan for the gap years. The gap years occur when you retire before age 65 and have no employer sponsored health coverage. Coverage during this time period can be expensive. Take the case of Doug and Beth as an example. Doug worked for a construction firm and had planned on working until age 65. He was forced into retirement a few years early, at 62, when the economy took a dive. His wife, Beth, was about eight years younger, and had no plans to retire in the near future. With a little rearranging, and through Doug’s use of extended unemployment benefits, their plan absorbed the change. To my surprise, a year later they came in to see if they might find a way for Beth to retire as soon as possible. Beth explained that her take-home pay was only about $1,400 a month and that if she started her pension at age 55, the pension would be $1,300 per month. “What is the point of continuing to work?” she asked. On the surface, her logic made sense, until I explained to them the cost of health insurance. Beth was paying only $54 a month for health coverage; her employer was paying the rest of the premium. Once retired, as neither she nor Doug was yet Medicare age, equivalent health insurance for the two of them would run $1,400 a month. When we factored in benefits, Beth’s job was paying her twice what she had thought. If your employer provides health insurance, it is likely subsidizing the cost, and you may have no idea how expensive it can be if you leave the workforce. When you leave your employer, you have COBRA coverage available for up to 18 months, so if you retire at 63 and a half, that will get you to Medicare-age. Premiums in the $700 - $1,000 per person per month range are common on COBRA, so plan for this in your budget. If you are younger, and you’ll need to cover health care without COBRA, you’ll need to buy insurance from the marketplace exchange. Premiums depend on where you are located and what type of plan you choose. There are four plan types; Bronze, Silver, Gold and Platinum. If you are healthy, the Bronze plan may be your best bet. It offers the lowest monthly premium, but the insurance company pays only 60% of your health care costs. If a health issue shows up, this plan can get expensive quickly. If you have known health issues you can opt for a Platinum plan. You’ll pay a larger monthly premium, but the insurance company then covers 90% of your costs. In Arizona, where the insurance options for marketplace plans have been limited, I have frequently seen premiums in the $1,000 to $1,400 per month per person range. That means a couple could be spending $30,000 a year on health insurance. To me, this sounds astronomically expensive. There is a health care tax credit that is designed to help offset these premiums. Eligibility depends on your Modified Adjusted Gross Income (or MAGI). In 2018 singles with MAGI of less than about $48,000, or marrieds with just under $65,000 of MAGI qualified. Although you may instantly think you wouldn’t qualify for this credit, don’t be quick to jump to conclusions. Health care tax credits are not just for lower net worth households – in many cases qualifying for a tax credit is about planning. Take the case of Jason and Mary. They have over $2 million in financial assets, and a paid off home. They retired in their early 60’s and have a comfortable amount of cash flow coming in, which for them is about $7,000 a month. That is $84,000 a year - but not all of it counts as Modified Adjusted Gross Income. Cash flow does not always equal what shows up on a tax return. With careful planning, we’ve kept them eligible for the health care tax credit for the last three years, saving them almost $20,000 a year in premiums. We were able keep their Adjusted Gross Income low by making the portfolio tax-efficient and being careful about how much in capital gains we realized each year. In addition, each year, we were able to decide if needed funds should come from a Roth IRA or brokerage accounts to minimize what would show up on their tax return. In these gap years, this kind of planning can really pay off. We’ve talked about a few cases where covering the gap years was expensive. On the flip side, I have one client who worked for a Fortune 500 company and retired in his late 50s. His employer provided retiree coverage for the gap years, and he pays less than $5,000 a year for he and his wife. Then at 65, they’ll transition on to Medicare. Unfortunately, these plans on rare. If you have one, count yourself lucky. The important thing about planning for the gap years is making sure you have estimated the cost, and have a plan in place to cover it. Next, let’s talk about one of my favorite savings vehicles, the Health Savings Account or HSA. An HSA can be a great tool to use to help you prepare for the gap years. I love HSAs because when used correctly, you get a deduction when you put the money in, and the funds are tax-free when they come out. This is unheard of! From a tax standpoint, it is one of the best deals out there. To establish an HSA, you must have a high deductible plan that is labeled as eligible to use with an HSA. The basic premise is that you lower your insurance premiums by choosing a high deductible plan. Since you are paying a lower premium you contribute your monthly savings on a tax-deductible basis to the health savings account. You can use the funds in the HSA any time for eligible medical expenses on a tax-free basis. An eligible or qualified medical expense includes things like: Co-pays and expenses that apply to your deductible Dental careVision carePrescriptionsAnd even over-the-counter medications if prescribed by your doctorCertain types of medical equipment can also countAccessing your HSA funds for medical expenses is easy. I have an HSA account that comes with a debit card. When I incur medical expenses, I could use that debit card to pay for these expenses directly from my HSA account with tax-free dollars. Instead, I choose to pay for expenses out-of-pocket so my HSA can accumulate for use in my retirement years. This works well because the funds grow tax free - by letting it grow you get more tax-free growth to use later. And, as you probably know, health care expense can occur suddenly and in lumpy amounts. Having a larger HSA balance to draw out of tax free for these lumpy expenses makes a lot of sense. And, HSA funds can be used to pay premiums under COBRA, premiums for a tax-qualified long-term care insurance policy, and to pay your Medicare Part B & D premiums in retirement. The only downside to an HSA is that you can’t put more in them. As with an IRA, there is a maximum allowable contribution. In 2019, the maximum contribution a single tax filer can make is $3,500 (plus an additional $1,000 catch-up if you’re age 55 or older). And for a family plan the maximum contribution is $7,000 – or up to $9,000 if you and your spouse are both over age 55. One key difference between HSAs and IRAs is the early-withdrawal penalty. With an HSA, a 20% penalty tax applies for early withdrawals if they are not used for medical reasons. For HSAs, an early withdrawal is defined as one that occurs before age 65. For IRAs it is a 10% penalty tax for early withdrawals, and an early withdrawal is one that occurs before age 59½. In conclusion, I call HSAs one of the two superhero retirement accounts. The other is the Roth IRA, which is beyond the scope of what I can cover today. The last topic for today is long term care.Long-Term Care Let me tell you a story about John and Kathy that helps illustrate how long-term care needs work. John and Cathy were in their 70s when they were referred to me by their accountant. They had been married over 50 years, and they brought a smile to my face every time they came in, often still holding hands. As they reached their early 80s, I will never forget them sitting in my conference room one day, sharing with me their heartfelt thoughts on living and on dying. John was fighting a round of skin cancer, and Cathy had Parkinson’s. John said, “We’ve had a wonderful life. Our children are grown and doing well. Now, we’re ready to go. Trips to the doctor and medications. Who wants all that? We’re ready to go.” John had a stroke a year later and passed away quickly. I went to visit Cathy numerous times and eventually met all their children. She was weak and frail and I honestly didn’t think she’d make it more than a year past John’s passing. But slowly a sparkle returned to her eye, and her strength returned. We would talk over a glass of wine, and I would gain the most marvelous insights from this amazing 84-year-old woman. Although Cathy’s strength grew and she was healthy and alert, she needed assistance around the home. Her long-term care policy covered in-home care, so she had a helper who came each day from about 10 to 2 to prepare meals, clean, do, laundry, run errands, help Cathy with bathing and so on. Although we think of long-term care needs as being confined to a nursing home, Cathy’s situation is quite common, and in-home care is an important feature offered by most long-term care insurance policies today. Contrast Cathy’s situation with that of my grandpa. In 2012, I flew to Des Moines, Iowa, for a family reunion put together in honor of my grandpa’s 90th birthday. Grandpa’s short-term memory loss had started to result in things like the stove being left on and forgotten medications. This was my first time to visit him in the care facility the family had located for him. It was a nice place with spacious, living room–like gathering areas, and Grandpa expressed that he was happy there. There were security codes with a double door system to get in and out, and although I realize they are needed for his protection, it was still odd, almost as if we start in a playpen and one day we end up back in one again. Grandpa knew who I was, but other parts of his memory were jumbled up a bit. Other than memory loss, though, he was quite healthy. He spent many years in this care facility before passing away. Grandma had passed away many years prior, so all of Grandpa’s income and assets were able to be used to support his care. If Grandpa still had a spouse at home, though, the financial strain of the situation would have been substantial. You do not know what the future may bring. Will you, like John, go quickly of a stroke, never needing any form of long-term care? Or maybe, like Cathy, you’ll need in-home care? Or will you, like my grandpa, need many years in a full-care facility? And how will such care needs be financed? If you have no insurance, you spend your own funds and assets and eventually if you run out of assets you go on Medicaid. Each state has its own limits on how much income or assets you or your spouse are allowed to retain before becoming eligible for Medicaid. It’s not much that you’re allowed to keep. Or you can shift some of the financial risk by buying a long-term care insurance policy. From my own observations in working with retirees, it seems most people who can afford long-term care insurance find that having it brings them great peace of mind. In our planning process, we use the median length of stay of five years in a full care facility and test to see if you have enough assets to cover this expense. For example, at $200 a day, in today’s dollars, a five year stay in a care facility runs bout $365,000. If your plan could sustain this expense, you may not need insurance coverage. However, the insurance offers other benefits. Those with insurance will often opt for better quality care. It can also make the decision easier on a spouse if they know there are insurance funds to help cover the cost. We recommend people get quotes, evaluate the risk and make an informed choice on how they want to handle the potential risk of a long-term care expense. We’ve now covered Medicare, including Parts A, B, C and D, and you’ve learned that higher income families may pay more for their Part B & D premiums. You’ve also learned the Medicare will not cover all your expenses and so you’ll need a Supplement policy or Medicare Advantage plan. If you’re planning on retiring early, you know you’ll need to budget for the gap years. You’ve also learned about HSA accounts and how they can be used to save for the gap years. And, you have some insight into the various ways long term care expenses can occur, and how you can pay for them. ————— Thank you for taking the time to listen today. Chapter 10 of Control Your Retirement Destiny provides additional examples, and links to many online references that are useful as you are planning for health care costs. Visit amazon.com to get a copy in either electronic or hard copy format. You can also visit sensiblemoney.com, to see how a staff of experienced retirement planners can help.    

I want to start this post by saying that I do not think Medicare Advantage plans (Medicare Part C) are bad. There are many Medicare Advantage plans out there that are very good plans and it really depends on the person’s situation and their needs on whether or not a Medicare Advantage plan is a good choice for them or not. My goal is not to bash Medicare Advantage plans but to educate. Unfortunately, it is all to common that agents will sell a Medicare Advantage plan to someone without fully giving them all of the information and the full effect of their choice. Let’s start by explaining what a Medicare Advantage plan (Medicare Part C) is and how it works. A Medicare Advantage plan is a private alternative to Medicare. Medicare pays these carriers such as Aetna Coventry, Cigna Healthspring, United Healthcare, Humana etc. to provide seniors their benefits more affordably than they can provide them. Medicare then regulates these carriers to ensure that they are doing their job and they are doing it right. Medicare takes the premium that you pay them and goes to each specific carrier and they create a “benefit package”. They then meet with doctors and they come up with a “fee structure” that the doctors will agree to accept, this is why most Medicare Advantage plans are HMOs and PPOs. These are some of the risks to a Medicare Advantage plan: · If you want to upgrade to a Medicare Supplement, you have to medically qualify. If you can not qualify, you are stuck with Medicare Advantage plans. · You have a network of doctors and hospitals. You have to sign an annual contract with the carrier for coverage but your doctor does not. They can drop that carrier anytime and they do not have to check with you first. · Limited to doctors. If you are having heart surgery and the best cardiologist isn’t in your network, your only option is to be stuck with the mediocre doctor or pay more out of pocket for your surgery. · Inability to budget your healthcare costs. If you look at the Summary of Benefits, most plans will read: Lab work $0-$300. You have no way of knowing what your costs will be until the time of service. If you are on a fixed income, budgeting is very important. Especially when it comes to your health. · Limited drug coverage. If you choose a Medicare Advantage plan you are only able to choose their drug coverage. In most cases, the plans with great drug coverage with have limited or more expensive health benefits and vice versa. Whereas, if you opt for a Medicare Supplement, you get the choice of around 25 different drug plans. The only real pros to the Medicare Advantage plans are lower premiums and sometimes carriers will throw in additional benefits such as some dental, vision or hearing. However, they can cancel those benefits at any time because Medicare doesn’t cover those benefits so the carriers are not required to cover them. The cut and dry of Medicare Advantage plans is that you are giving up predictability, flexibility, you have co-pays for most services, you have to get referrals and prior authorizations and possibly the option to upgrade, all for lower premiums. It is so important to research the plans and know all of your options before you make your final choice. None of this information is meant to scare anyone or sway them because as I said, my company sells Medicare Advantage plans. My goal is to educate people on the facts and these are the facts.

I know, I know - Medicare is not a very sexy topic in life. But, what if I told you there was an opportunity to save thousands of dollars in the future by PAYING attention to Medicare right now? By the way - did you know medical coverage in retirement is the largest expense you will all face later in life? And, since I haven’t covered this topic at all on the show, I knew now was the perfect time. I also knew I wanted to bring the best of the best on when it comes to experts in this arena, so I was able to get Danielle Roberts to come on the show. 
Danielle is the go-to expert for all things Medicare for the publications like Forbes, the Huffington Post and Readers Digest. She is also co-founder of the uber popular blog and website Boomer Benefits. But first…. IMPORTANT: This episode is NOT just for those getting ready to hit retirement. There are few things Danielle will share that will save those who are years away from retirement thousands upon thousands of dollars. If you’re like me (35 years old) and you take advantage of what Danielle is talking about in terms of saving money in your later years by starting now, your older self will thank you! Here’s what you can expect from today’s show: • How did Medicare first get started? • How does Medicare Part A work? • What you need to know about Medicare Part B • Why Danielle loves Medicare Part C the most • Medicare Part D: A tip to ask your doctor to save you thousands • How to use your Health Savings Account with Medicare • The average amount a couple pays for medical in retirement • What resources do baby boomers have available right now
 And of course, if you know anyone who already 65 or getting close to it, PLEASE do them a favor and share this episode with them. They will be so glad you did. All the show notes, links and anything Danielle and I mentioned can be found at https://www.moneypeach.com/session123 

The Centers for Medicare & Medicaid Services (CMS) is expected to release its final rule concerning provider-based clinics early in November. The proposed changes are expected to impact compliance and reimbursement. Reporting this developing story during this edition of Monitor Mondays is author, educator, and consultant Duane Abbey, who will discuss how the proposed changes are likely to impact Medicare providers.The broadcast rundown also will include:False Claims Act: Famed whistleblower attorney Mary A. Inman, a partner at Constantine Cannon’s London office, reports that DaVita Medical Group has agreed to pay $270 million to CMS to settle False Claim Act allegations over questionable billing practices that led Medicare Advantage plans to receive inflated Medicare Part C risk adjustment payments.Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron reports on another example of a potentially troublesome issue that could pose a risk to your facility.Legislative Update: In California, there’s a bill on the November ballot (SB 1152) that would amend an existing law by establishing a uniform discharge planning process that takes into account the unique needs of homeless patients. Reporting on this proposition is Marvin Mitchell, director of case management and social services at San Gorgonio Memorial Hospital, east of Los Angeles.Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, reports on all the latest hot topics.Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment.

Medicare Part C is also known as a Medicare Advantage Plan, which is not a Medicare Supplement. It is a private alternative to Medicare. If you have a Medicare Advantage Plan, your Medicare Part B premium will go to the carrier that you have your plan with instead of Medicare and this is why there are very low or zero premium plans. As far as coverage, the Medicare Advantage does not work like a Medicare Supplement. It does not cover the 20% that Medicare does not cover. Medicare Advantage Plans replace what Medicare Parts A and B would charge with their own set of co-pays, deductibles and co-insurance. Because Medicare Advantage Plans replace your Medicare, you can no longer go to any doctor or hospital that you choose. Most Medicare Advantage Plans (HMO plans) have a network of doctors and hospitals that you must choose from, however some plans such as PPO plans will allow you to choose any doctor or hospital that you want but you will have to pay more for their services.

Medicare Part C and Medicare Supplement policies are very competitive in the great state of Arizona. Of course, with more choices there are also more considerations consumers need to think about. This episode is a good place to start. As always, go to Jae's website at www.maximizeyourmedicare.com for Jae's book and sign up for his weekly newsletter too. --- Support this podcast: https://anchor.fm/josh-scandlen-podcast/support

Join Jae Oh and me as we discuss Alabama in our state-by-state analysis of the various Medicare options in each state. Over the course of these episodes, we'll discuss Traditional Medicare, Traditional Medicare with Part D and Medigap, i.e., Medicare Supplements, and Medicare Part C, i.e., Medicare Advantage. Jae Oh, CFP, is an expert contributor on www.mymedicareanswers.com, a website powered by Humana, one of the nation's largest carriers of Medicare plans. Mr. Oh is the author of a top-rated, top-selling book on Medicare, titled Maximize Your Medicare (2018 Edition): Understanding Medicare, Protecting Your Health, and Minimizing Costs, available in print and ebook formats. I highly encourage you go sign up for his newsletter at www.maximizeyourmedicare.com --- Support this podcast: https://anchor.fm/josh-scandlen-podcast/support

In this episode, Christian explains the ever-mysterious Medicare Part C! Christian Brindle is the founder and president of Christian Brindle Insurance Services located in Sandy, Utah. At 28 years old, he is an expert in the industry and has helped hundreds of people with their Medicare needs throughout his career spanning the last 8 years. Christian grew up around the insurance industry, as his father has worked with people on Medicare for over 30 years. Christian has written multiple books specifically about Medicare, including “Medicare Guidance: Picking the Plan For You” and “The Insurance Funnel: 9 Simple Tests Every Insurance Policy Must Pass Before Purchase”. Christian is licensed in the following 33 states, and counting: AL, AR, AZ, CA, CO, FL, GA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MO, MS, NC, NE, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI, WV. If you would like to have Christian help you with your Medicare, please contact his office at 801-255-5340.

The Henssler experts round out the "Money Talks" show answering a variety of listener questions, including some on Jones Lang LaSalle, publicly traded companies run by women, and Medicare part C. They also discuss stocks Hasbro, Dunkin Brands, and Fifth Third Bancorp.

Medicare Part C, known as Medicare Advantage, is a type of plan offered by private insurance carriers who have a contract with Medicare and are required to offer the same benefits as Original Medicare, however, you don’t lose Original Medicare by enrolling in a Medicare Advantage plan. For more information on Medicare Part C & what it entails, download our New to Medicare Guide: https://www.trustedseniorspecialists.com/updated-2017-new-to-medicare For immediate Medicare questions or concerns, feel free to give our licensed agents a call at 1-855-474-6234 TTY 711 or set up an appointment https://www.trustedseniorspecialists.com/schedule-your-appointment

One of the fastest segments of the population is working seniors. This show explores options for these folks as they approach the end of their open enrollment. Topics covered include: Medicare Advantage, Medicare Supplement Plans, Medicare Part-D options, and more on healthreformexplained.com.