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GOP Spreads Lies While More Medicare Part D Checks Are Mailed

The Department of Health and Human Services has mailed out a third round of $250 checks to help seniors who enter the Medicare Part D coverage pay gap (the “Doughnut Hole”) for prescription drugs. Meanwhile, the GOP wants to roll back the health care reform benefits and privatize Medicare and Social Security. [...]

Financial Health of Medicare and Social Security Improves

The government actuaries who oversee Medicare and Social Security finished their annual review recently and the trustees issued a report on the financial projections for the programs. The prognosis is far better than it looked a year ago. [...]

Draft Bill Focuses On Medicare Fraud

The government estimates that around 20% of Medicare claims are fraudulent. If true, that amounts to around $75 billion of wastage within the system every year. One of the aims of the Government Accountability Office (GAO) during the formulation of the recent health care reform bills was to focus on the problem and reduce Medicare fraud to help pay for new provisions. A draft bill aimed at addressing the problem, H.R.5044 – “Medicare Fraud Enforcement and Prevention Act of 2010″, was introduced on April 15th. but it received little attention in the wake of the bigger bills. [...]

Things That Every Caregiver Needs To Know

With more than 65 million people in the United States serving as informal caregivers, generally for family members, it’s important that they learn how to find their way through the entangled web of information connected to the cared person’s case. [...]

United States Ranks Ninth In End Of Life Care Index

Sarah Palin has repeatedly lied about the government’s intent to set up “death panels“, regurgitating her claims again last week. She also cited the United Kingdom (UK) as a place where shadowy bureaucrats get to decide whether a sick person lives or dies. She’ll be shocked by the findings of an international study of end of life care. [...]

Cancer Drug May Be Able To Treat Eye Disorder

Age-related macular degeneration ( AMD) is a progressive disease, most common in seniors, that results in a loss of vision in the center of the visual field (the macula) because of damage to the retina. It is a leading cause of sight loss and blindness in patients over the age of 50 in Europe and North America. Researchers in the United Kingdom have suggested that a cheap drug that is currently used to treat bowel cancer should also be prescribed to patients with AMD [...]

Beware Of The Donut Hole Scam

On May 27, 2010, the Obama administration announced that, under the Patient Protection and Affordable Care Act of 2010, four million people who may fall within the Medicare Part D coverage gap (the “donut hole”) will receive a $250 rebate check starting June 15, 2010. The donut hole is the gap between the initial coverage limit and the catastrophic coverage threshold. The good news is that the government has started sending out checks early. The bad news is that scammers are moving in to steal unsuspecting victims’ personal information. [...]

Cutting Medicare Overheads The Painless Way

The General Accounting Office lists Medicare as a “high-risk” government program in need of reform, in part because of its vulnerability to fraud and partly because of its long-term financial problems. Some estimates of the scale of Medicare fraud range as high as $60 billion a year, one seventh of the 2009 federal budget for Medicare! Now there are encouraging signs that new provisions in the health care reform bills could be paying off. [...]

Baby Boomers Can Now Apply for Medicare Online at Social Security Website

More people than ever are choosing to, or have to, carry on working beyond the age of 66, when full social security entitlements are now available. However, you still become eligible for Medicare at age 65, but you have to formally apply for the medical insurance benefits it provides. A new Social Security website makes it possible to apply for Medicare in about 10 minutes. [...]

Another Big Pharma Hit With Fine For Off-Label Marketing

The Food and Drug Administration ( FDA) works with pharmaceutical companies to certify a new or modified drug for use in treating a specific disease or condition. The uses and risks are clearly identified on the drug container label. The pharmaceutical companies are not allowed to market or sell the drug for any unapproved usage, i.e. “off-label”. However, there are no restrictions on what a physician can prescribe a drug for, so there is a great temptation for the “Big Pharmas” to increase their profits by persuading physicians to prescribe their products for as many uses as possible. [...]

Medicare Suspends Fourth Major Health Insurer

The Centers for Medicare & Medicaid Services ( CMS) issued a notice to Aetna Insurance Company earlier this month of its intent to impose an intermediate sanction to ensure that Medicare beneficiaries continue to have access to prescription drugs under Medicare’s requirements. Aetna is the fourth health insurer to be cautioned under new rules tightening up the insurers’ compliance with Medicare terms and conditions. [...]

Ability to Change 2010 Medicare Health Plans Closes on March 31

If you haven’t looked at your Medicare health plan for 2010 you should. You only have a little over two weeks to make changes. People with Medicare coverage are only allowed to change their choice of Medicare health coverage once and it must be within the Open Enrollment Period, January 1 through March 31. Today we take a look at who can and can’t make changes and resources that can help you decide. [...]

1 in 5 Nursing Homes Get Poor Ratings From Medicare

Medicare started releasing star ratings for the nation’s nursing homes in late 2008. They derive the ratings from complaint investigations, standard inspections and other data. There are around 15,700 nursing homes in the United States, caring for over 1.5 million people. Just over 5% of over 65s live in nursing homes and twice as many others are admitted for short periods in a given year. The Medicare rating system awards nursing homes one to five stars. The latest report rates one in five facilities in the one or two star (i.e. “poor”) category. [...]

Patients Who Delay Treatment Pay More

Researchers at Brown University and Providence (Rhode Island) VA Medical Center conducted a study between 2001 and 2006 that looked at the effect of increased Medicare copayments. It involved nearly 900,000 Medicaid beneficiaries enrolled in 36 Medicare managed-care plans. In half of the plans, mean copayments for ambulatory care were almost doubled for both primary and specialty care. In the other half, copayments didn’t change over the study period. The findings are worrying, but there are ways for seniors to minimize their health costs. [...]

Virtual Colonoscopy May Be A Good Solution For Some Seniors

A study by researchers at the University of Wisconsin School of Medicine and Public Health has found that individuals in the 65-79 year old age range who are at average risk of developing colorectal cancer (CRC) are good candidates for screening using Computed Tomographic Colonography (CTC), also known as virtual colonoscopy. CRC is the third most frequently diagnosed cancer and the second leading cause of cancer death in men and women in the United States, claiming nearly 50,000 people each year. [...]

Where Are We On Health Care Reform?

The Wall Street Journal recently published a comparison of the features of the House and Senate health reform bills and President Obama’s stated position on each one. The House bill is stronger than the Senate bill in most respects, but both of them are a very long way from perfect. Thankfully, a lot of the irrelevant diversions, such as the death panel fiasco, seem to be behind us, but it’s not over yet. The public debate will resume on Tuesday, when congress re-opens after the holidays. There are reforms, for sure, but there are some very notable omissions, which is what this article is mainly about. [...]

New Medicare Savings Program Benefits - Make Sure You're Not Missing Out.

Important changes to the Medicare Savings Programs (MSP) and Medicare’s Low Income Subsidy (“Extra Help“) came into effect in January. They include a simplified application process and greater eligibility for these cost reduction programs. MSP support seniors by helping with Medicare costs, such as the monthly Part B premiums and, in some cases, other co-pays, deductibles and premiums. Medicare’s Extra Help can lower the cost of Medicare prescription drug coverage. In this article we describe how to check your eligibility for the new benefits. [...]

Silver Buzz Cafe's 2009

We started this blog on April 9, 2009, not knowing where it would lead us. The goal was to provide a place where seniors, their families and caregivers could find relevant articles and information. Many blogs consist of very short posts, sometimes posted several times a day, rather like an extended form of Twitter. Once we started researching articles we decided to go for more substantive ones and that seems to have paid off. [...]

The Big Pharmas - Part 8 - It's Time To Take a Pill

In this series we’ve looked at the big pharmaceutical companies (“Big Pharmas”), how they bring new drugs to market, their competitors and the many challenges that they face. We’ve also looked at their triumphs and their corporate behavior. There’s no doubt that the Big Pharmas are worried about being able to continue increasing their, already astronomical, profits. Imminent patent expiration, pressure from states and governments to negotiate lower prices and competition from the legal and illegal generic drug manufacturers are all forcing a gradual slowdown in the rates at which their profits are increasing. However, as we’ve seen in the previous article in this series, we aren’t getting value for our money as consumers of their products. In this, the final article in the series, we’ll look at some of the many reforms that have been suggested to rein in the Big Pharmas and get them back to being the responsible corporations that many of them once were. [...]

The Big Pharmas - Part 7 - The Dark Side

A prevailing attitude about the Big Pharmas is that they make excessive profits and rip off consumers. That’s not surprising, as the top fifteen companies made almost $400 billion in revenues in 2008 and they’ve been raising prescription drug prices by around 9% per year, far above inflation levels and increases in Gross Domestic Product. In the early days of the current health reform debate they stayed on the sidelines. However, as it became apparent that there might be more price controls, particularly for Medicare drugs, they have started a strong campaign to limit or defeat the health reform bill, a move that has big implications for seniors. In today’s article we’ll look at that issue and other criticism leveled at the Big Pharmas. We’ve grouped the issues to align with the sequence in which we covered topics, starting with revenues. [...]

Our Government Run Health Services – Part 8 - Summary

In this series of articles we’ve looked at the following US government run health care systems: Indian Health Service (IHS); (State) Children’s Health Insurance Program (CHIP); Medicaid; Medicare; Federal Employees Health Benefits Program (FEHBP); Military Health System (MHS/TRICARE) and the Veterans Health Administration (VHA). Some of these programs are run by the federal government and others are largely run by the states with some federal funding and oversight. There is also a wide range of ways in which care is provided, ranging from programs with their own facilities, such as the IHS, MHS and VHA, to ones such as the FEHBP that recommend private plans that use their own network or regular provider facilities. This article compares the features of the various programs and summarizes the lessons that may be learned from them. [...]

Our Government Run Health Services – Part 7 – Veterans Health Administration

The United States Department of Veterans Affairs (VA) is a government-run military veteran benefit system responsible for administering programs of veterans’ benefits for veterans, their families, and survivors. Although we shall focus on medical benefits here, it also administers burial benefits, disability compensation, education, home loans, life insurance, pensions, survivors’ benefits, vocational rehabilitation and survivors’ benefits. The Veterans Health Administration can prove that it is doing an excellent job and its beneficiaries overwhelmingly agree. Note its scores on the American Customer Satisfaction Index, which were in the low 80s, as compared with the mean of 68 from the private health insurance sector. It’s often held up as America’s model health care system and all of the indicators signal that it deserves that high regard. In this article we’ll look at the background to the VHA, its strengths and weaknesses. [...]

Our Government Run Health Services - Part 4 - Medicare

Medicare is a single-payer health care system operated by the federal Centers for Medicare and Medicaid Services (CMS) under the auspices of the US Department of Health and Human Services (DHHS). Medicare provides health insurance coverage to people who are aged 65 and over, or who meet other special criteria. It also funds residency training programs for almost all physicians in the United States. The federal budget for Medicare for 2009 was $420 billion. We looked at Medicare funding in a four part series – “Medicare Money Mania” recently. In this article we’ll look at the background to Medicare, its strengths and weaknesses. We looked at Medicaid, the means tested government health program for eligible people with low incomes and resources, yesterday, so we’ll also compare and contrast Medicare and Medicaid eligibility and services. [...]

Our Government Run Health Services - Part 3 - Medicaid

Medicaid is a means tested government health program for eligible people with low incomes and resources. Medicaid is jointly funded by the federal and state governments. It goes by a different name in some states, such as Medi-Cal in California. The federal Centers for Medicare and Medicaid Services (CMS), an agency within the US Department of Health and Human Services (DHHS), monitors the state-run programs. It establishes requirements for eligibility and oversees funding, service delivery and quality. In this article we’ll look at its background, strengths and weaknesses. [...]

The Best Ways to Save Money On Prescription Medicine

Earlier this year we described how a Medicare Part D Prescription Drug Plan might save you money. Today we’re going to look at some tried and true ways of reducing the amount you pay for prescription drugs. We found hundreds of Internet sites listing foreign drug stores, most of them of doubtful trustworthiness, and dozens of “Top 10″ lists, most of them listing the same ideas. We’ve consolidated the ideas down into a short list. We’ll describe each idea and then provide you with a checklist of the five most important things you can do to save money without taking risks. [...]

Health Care Reform and Medicare Advantage

One of the proposed ways of reducing Medicare costs that is being considered for inclusion in the health reform bill is to eliminate the subsidies paid to private insurance companies who sell Medicare Advantage plans. The savings will amount to $177 billion over the first ten years. The insurance companies have mounted a huge campaign to scare people, especially seniors, into believing that this will result in drastic cuts in benefits and increased premiums. Remember that independent assessments of the Medicare Advantage program say that it costs the government (i.e. the taxpayer) about 14% more to provide health care service through that plan rather than through basic Medicare and other channels. That extra government money goes into the health insurers’ coffers, not to seniors. We’ll look at how Medicare Advantage came about, how it works, the benefits offered, the potential effect of cuts and what the government and seniors can do to counteract the potential effects of cuts in subsidies. We’ll also look at how you can decide whether or not to enroll in a Medicare Advantage program and how to avoid the many scams that use them to defraud seniors. [...]

Medicare Money Mania - Part 4 - Could Reform Work?

In the past couple of days we’ve looked at how Medicare receives and spends its money and some of the many proposals for changes to the system. Today we’re going to summarize the ideas that are currently on the table and their potential effect. Remember that the annual Medicare budget will start showing at a loss in 2010 and is projected to result in a $72 billion deficit in 2016. The Medicare trust funds won’t be depleted until around 2019 or 2020, but we need to act now to avoid a meltdown. [...]

Medicare Money Mania - Part 3 - Potential Savings

Yesterday we looked at how Medicare is funded, their current and projected budgets and their assets. If no savings are found, Medicare will run at a loss from 2010 onwards and the trust funds will be depleted in 2019 or 2020. In today’s article we’ll first look at the cuts that President Bush and presidential candidate John McCain proposed and then look at the ideas being debated for inclusion in the health reform bill. In a previous article – “Scams That Target Seniors – Part 2 – Health Care Related Scams” we noted that ” Scams centered on health care cost the nation around $250 billion in 2008, with about $50 billion of it directly increasing the cost of our health care.” If most of that $50 billion and a substantial amount of the overspending can be saved we’ll have covered a substantial amount of the projected $72 billion shortfall in 2016. In 2008 Medicare paid the private insurance companies $177 billion in subsidies to support the Medicare Advantage program. All of that could be saved. [...]

Medicare Money Mania - Part 2 - How Medicare Works

Now is a perfect time to look at how Medicare finances work. As the health care reform bill moves to its next phase the industry is closing in on the decision makers. America’s Health Insurance Plans (AHIP) has just launched a highly misleading, multi-state, million-dollar advertisement campaign that claims that seniors will see their Medicare benefits cut under Democrat-crafted legislation. Did you know that we subsidize the health insurance cartel to the tune of $17 Billion a year and get nothing in return? We’ll come back to that later. First, let’s look at how Medicare is funded and where its money is spent. [...]

Medicare Money Mania - Part 1 - Introduction

Back in February 2008, President Bush was about to air a program that would shave the budget of Medicare and Medicaid by $196 billion over five years. Presidential candidate John McCain had a bright idea in June 2008. He promised to balance the federal budget by the end of his first term, in part, through reductions in Medicare and Medicaid. During the recent health insurance reform debate we’ve all heard people mention that Medicare will “go broke” in about eight years unless something is done. There are lots of accusations, rumors and straight lies flying about concerning Medicare and many seniors are becoming very worried, so we’re going to devote three Silver Buzz Cafe articles to looking at the subject. [...]

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