Monday, July 23, 2012
OBAMA BYPASSING SENATE TO FILL MEDICARE POST
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Submit this storydigg reddit stumble WASHINGTON — President Barack Obama intends to use the congressional recess to bypass the Senate and appoint Dr. Donald Berwick, an expert on patient care who's drawn fire from the GOP, to oversee Medicare and Medicaid, the White House announced late Tuesday.
The appointment was to be made Wednesday, with lawmakers out of town for their annual July Fourth break, White House communications director Dan Pfeiffer said in a post on the White House blog.
The decision means Berwick can assume the post of administrator of the Centers for Medicare and Medicaid Services without undergoing confirmation hearings in the Senate. Republicans have indicated they're prepared to oppose him over comments he's made on rationing of medical care and other matters. Democrats want to avoid a nasty confirmation fight that could reopen the health care debate. Berwick was nominated in April but no confirmation hearing had been scheduled.
"Many Republicans in Congress have made it clear in recent weeks that they were going to stall the nomination as long as they could, solely to score political points," Pfeiffer wrote. "But with the agency facing new responsibilities to protect seniors' care under the Affordable Care Act, there's no time to waste with Washington game-playing."
The decision to use a recess appointment to skirt the Senate is sure to draw fire from Republicans although the tool has been used frequently by presidents of both political parties. Obama last made a batch of recess appointments in March, and along with Berwick he was to make two other less prominent appointments Wednesday, one to a pension board and the other to a science post in the White House, the White House said. The recess appointment will allow Berwick to serve through next year without Senate confirmation.
"This recess appointment is an insult to the American people," Sen. John Barrasso, R-Wyo., said in a statement. "Dr. Berwick is a self-professed supporter of rationing health care and he won't even have to explain his views to the American people in a congressional hearing. Once again, President Obama has made a mockery of his pledge to be accountable and transparent."
The Senate Republican leader, Sen. Mitch McConnell of Kentucky, said "the fact that this administration won't allow the man charged with implementing the president's plan to cut $500 billion out of Medicare to testify about his plans for the care of our nation's seniors is truly outrageous."
Berwick, 63, is a pediatrician, Harvard University professor and leader of a health care nonprofit organization who's drawn support from many quarters, including the American Medical Association, since his nomination to oversee the enormous Medicare and Medicaid health insurance plans for the elderly, poor and disabled.
He's been criticized by Republicans for a number of comments, including telling an interviewer last year: "The decision is not whether or not we will ration care – the decision is whether we will ration with our eyes open. And right now, we are doing it blindly."
Republicans have seized on that to cast Berwick as someone who would deny needed care based on cost, while supporters contend rationing already is done by insurance companies and Berwick simply wants transparency and accountability in medical decisions.
It's just those echoes of last year's acrimonious health care debate that Democrats would prefer not to replay on the Senate floor.
Medicare has been without an administrator since 2006, and the White House says the need to fill the post is critical because of its role in implementing the new health care law. Medicare is to be a key testing ground for numerous aspects of the new law, from developing new medical techniques to trying out new payment systems, and the White House says a permanent leader is key with deadlines in the law approaching.
In addition to his professorship at Harvard, Berwick is the president of the Institute for Healthcare Improvement, a nonprofit in Cambridge, Mass., that works to develop and implement concepts for improving patient care.
Also being appointed Wednesday were:
Wednesday, September 7, 2011
I am turning 65 and do not receive Social Security or Railroad Retirement benefits. When can I enroll in Medicare
I am turning 65 and do not receive Social Security or Railroad Retirement benefits. When can I enroll in MedicareI am turning 65 and do not receive Social Security or Railroad Retirement benefits. Initial Enrollment Period (IEP). You can enroll in Medicare at anytime during this seven-month period, which includes the three months before, the month of, and the three months following your 65th birthday.
The date when your Medicare coverage begins depends on when you signed up.
If you enroll during the first three months of your IEP, coverage begins the month in which you first become eligible for Medicare.
If you enroll during the fourth month of your IEP, coverage begins the month following the month of enrollment.
If you enroll during the fifth month of your IEP, coverage begins the second month following the month of enrollment.
If you enroll during the sixth or seventh month of your IEP, coverage begins the third month following the month of enrollment.
For example, let's say you turn 65 in June. Use the following chart to determine when you can enroll in Medicare and when your coverage would start.
You can enroll anytime in: Your coverage starts:
March June 1st
April June 1st
May June 1st
June July 1st
July September 1st
August November 1st
September December 1st
General Enrollment Period (GEP). If you do not enroll in Medicare or if you refused Medicare when you originally became eligible for it, you can sign up during the GEP, which is from January 1st through March 31st of every year. Your coverage will begin July 1st of the year you sign up. You
will have to pay a Part B premium penalty for every year you delayed enrolling in Medicare Part B.
Special Enrollment Period (SEP). You can delay enrollment in Part B without penalty if you were covered by employer health insurance through your or your spouse’s current job when you first become eligible for Medicare. You can enroll in Medicare without penalty at any time while you have group health coverage and for eight months after you lose your group health coverage or you (or your spouse) stop working, whichever comes first.
For example, let’s say you retire in February. Use the following chart to determine when you can enroll in Medicare and when your coverage would start.
You can enroll anytime in: Your coverage starts:
March April 1st
April May 1st
May June 1st
June July 1st
July August 1st
August September 1st
September October 1st
October November 1st
To avoid a gap in coverage, enroll in Medicare the month before your employer coverage will end
The date when your Medicare coverage begins depends on when you signed up.
If you enroll during the first three months of your IEP, coverage begins the month in which you first become eligible for Medicare.
If you enroll during the fourth month of your IEP, coverage begins the month following the month of enrollment.
If you enroll during the fifth month of your IEP, coverage begins the second month following the month of enrollment.
If you enroll during the sixth or seventh month of your IEP, coverage begins the third month following the month of enrollment.
For example, let's say you turn 65 in June. Use the following chart to determine when you can enroll in Medicare and when your coverage would start.
You can enroll anytime in: Your coverage starts:
March June 1st
April June 1st
May June 1st
June July 1st
July September 1st
August November 1st
September December 1st
General Enrollment Period (GEP). If you do not enroll in Medicare or if you refused Medicare when you originally became eligible for it, you can sign up during the GEP, which is from January 1st through March 31st of every year. Your coverage will begin July 1st of the year you sign up. You
will have to pay a Part B premium penalty for every year you delayed enrolling in Medicare Part B.
Special Enrollment Period (SEP). You can delay enrollment in Part B without penalty if you were covered by employer health insurance through your or your spouse’s current job when you first become eligible for Medicare. You can enroll in Medicare without penalty at any time while you have group health coverage and for eight months after you lose your group health coverage or you (or your spouse) stop working, whichever comes first.
For example, let’s say you retire in February. Use the following chart to determine when you can enroll in Medicare and when your coverage would start.
You can enroll anytime in: Your coverage starts:
March April 1st
April May 1st
May June 1st
June July 1st
July August 1st
August September 1st
September October 1st
October November 1st
To avoid a gap in coverage, enroll in Medicare the month before your employer coverage will end
Monday, June 13, 2011
I am caring for a loved one with Medicare. What are the most important things for me to know
To get the information you need, you will need to talk to your loved one and do some research on your own. You may have to bring up some uncomfortable topics with your loved one, such as end-of-life issues and finances. While it may be difficult to have these discussions, it is important that you talk to your loved one before she has a health crisis to ensure that she gets the best possible care.
If you are caring for a loved one with Medicare, you should know:
•How does Medicare work? How does your loved one get her Medicare benefits? What doctors and services does your loved one’s Medicare provider cover
What are your loved one’s health care needs? What conditions does she have? What medications does she take? What conditions and surgeries has she had in the past?
GO TO box.
•Where does your loved one keep important information? Where does she keep documents like her emergency contact list, the names and contact numbers of her doctors, birth certificate, Medicare card and bank statements?
•What are your loved one’s health care preferences? In the event that she can no longer communicate her wishes, what kind of treatment would she want? Has she legally appointed someone to make decisions on her behalf
Are your loved one’s health care needs covered? Can your loved one pay for her current health care needs? Will she be able to in the future? If she needs it, will she be able to afford long-term care (at home or in a living facility)? What kind of health care and prescription drug coverage does your loved one have
Where can you as a caregiver go for help? What is your right to assistance? What support services are available in your area?
If you are caring for a loved one with Medicare, you should know:
•How does Medicare work? How does your loved one get her Medicare benefits? What doctors and services does your loved one’s Medicare provider cover
What are your loved one’s health care needs? What conditions does she have? What medications does she take? What conditions and surgeries has she had in the past?
GO TO box.
•Where does your loved one keep important information? Where does she keep documents like her emergency contact list, the names and contact numbers of her doctors, birth certificate, Medicare card and bank statements?
•What are your loved one’s health care preferences? In the event that she can no longer communicate her wishes, what kind of treatment would she want? Has she legally appointed someone to make decisions on her behalf
Are your loved one’s health care needs covered? Can your loved one pay for her current health care needs? Will she be able to in the future? If she needs it, will she be able to afford long-term care (at home or in a living facility)? What kind of health care and prescription drug coverage does your loved one have
Where can you as a caregiver go for help? What is your right to assistance? What support services are available in your area?
Saturday, June 11, 2011
Does my state have a program to help me with my prescription drug costs?
Many states offer a state pharmaceutical assistance program (SPAP) to help their residents pay for prescription drugs. Each program works differently.
Many states coordinate their drug assistance programs with Medicare’s drug benefit (Part D). If you do not have Part D but qualify for your state’s SPAP, you will have the chance to sign up for Part D, and may be required to enroll in a Part D plan. If a drug is covered by both your SPAP and your Part D plan, both what you pay for your prescriptions plus what the SPAP pays will count toward the out-of-pocket maximum you have to reach before your Medicare drug costs go down significantly. Your SPAP may also help pay for your Part D plan’s:
premium;
deductible;
copayments; and/or
coverage gap. (Many SPAPs give you coverage during your part D plan’s “coverage gap” or “doughnut hole.”)
Click on the MI Extra chart below to find out if your state has an SPAP, whether you are eligible, how the SPAP works, and how to enroll.
Many states coordinate their drug assistance programs with Medicare’s drug benefit (Part D). If you do not have Part D but qualify for your state’s SPAP, you will have the chance to sign up for Part D, and may be required to enroll in a Part D plan. If a drug is covered by both your SPAP and your Part D plan, both what you pay for your prescriptions plus what the SPAP pays will count toward the out-of-pocket maximum you have to reach before your Medicare drug costs go down significantly. Your SPAP may also help pay for your Part D plan’s:
premium;
deductible;
copayments; and/or
coverage gap. (Many SPAPs give you coverage during your part D plan’s “coverage gap” or “doughnut hole.”)
Click on the MI Extra chart below to find out if your state has an SPAP, whether you are eligible, how the SPAP works, and how to enroll.
Tuesday, April 12, 2011
Medicare Enrollment Periods What do they really mean?
You are able to enroll in or change your Medicare plan during one or more of the following enrollment periods:
•Initial Enrollment Period (IEP)
•Medigap Open Enrollment Period
•Annual Coordinated Election Period (AEP)
•Medicare Advantage Disenrollment Period (MADP)
•Special Election/Enrollment Period (SEP)
This is the time to enroll in Medicare for the first time if you are turning 65. It is your birthday month (unless your birthday falls on the first of the month, then your birthday month is the previous month) plus the 3 months prior to your birthday month and the 3 months after your birthday month.
Medigap Open Enrollment Period is the period of time when an insurance company cannot:
•refuse to sell you any Medigap policy it sells;
•make you wait for coverage to start (pre-existing exclusion may apply)
•ask you any health questions to determine your rate
Medigap Open Enrollment lasts for 6 months. It begins on the 1st day of the month in which you are BOTH age 65 and older AND enrolled in Medicare Part B. This period cannot be changed or repeated.
October 15 through December 7 each year. New coverage becomes effective January 1.
You can do the folowing:
Return to Original Medicare from a Medicare Advantage (MA) or Medicare Advantage with Prescription Drug (MAPD) plan.
Enroll in a MA or MAPD plan
Enroll in a Part D Prescription Drug plan
Change MA or MAPD plans
Change Part D Prescription Drug Plan
January 1st thru February 14 each year. Your Original Medicare benefits will become effective the first of the month following disenrollment from your Medicare Advantage plan. Your Prescription Drug coverage will become effective the first of the month after your application has been received.
You can do the following:
Return to Original Medicare from a Medicare Advantage (MA) or Medicare Advantage with Prescription Drug (MAPD) plan.
Enroll in a Part D Prescription Drug plan if disenrolling from a MA or MAPD plan
Apply for a Medigap (Medicare Supplement) policy (medical underwriting may be required
•Initial Enrollment Period (IEP)
•Medigap Open Enrollment Period
•Annual Coordinated Election Period (AEP)
•Medicare Advantage Disenrollment Period (MADP)
•Special Election/Enrollment Period (SEP)
This is the time to enroll in Medicare for the first time if you are turning 65. It is your birthday month (unless your birthday falls on the first of the month, then your birthday month is the previous month) plus the 3 months prior to your birthday month and the 3 months after your birthday month.
Medigap Open Enrollment Period is the period of time when an insurance company cannot:
•refuse to sell you any Medigap policy it sells;
•make you wait for coverage to start (pre-existing exclusion may apply)
•ask you any health questions to determine your rate
Medigap Open Enrollment lasts for 6 months. It begins on the 1st day of the month in which you are BOTH age 65 and older AND enrolled in Medicare Part B. This period cannot be changed or repeated.
October 15 through December 7 each year. New coverage becomes effective January 1.
You can do the folowing:
Return to Original Medicare from a Medicare Advantage (MA) or Medicare Advantage with Prescription Drug (MAPD) plan.
Enroll in a MA or MAPD plan
Enroll in a Part D Prescription Drug plan
Change MA or MAPD plans
Change Part D Prescription Drug Plan
January 1st thru February 14 each year. Your Original Medicare benefits will become effective the first of the month following disenrollment from your Medicare Advantage plan. Your Prescription Drug coverage will become effective the first of the month after your application has been received.
You can do the following:
Return to Original Medicare from a Medicare Advantage (MA) or Medicare Advantage with Prescription Drug (MAPD) plan.
Enroll in a Part D Prescription Drug plan if disenrolling from a MA or MAPD plan
Apply for a Medigap (Medicare Supplement) policy (medical underwriting may be required
Thursday, April 7, 2011
New Preventive Care Benefits From Medicare
Beginning January 1, 2011, you will pay nothing for -- a one-time review of your health, education -- If youΚΌve had Part B for longer than 12
100% Coverage for*
: ➡
Bone Mass Measurement ➡
Cervical Cancer Screening, including Pap Smear tests and Pelvic Exams ➡
Cholesterol and other Cardiovascular Screenings ➡
Colorectal Cancer Screening (except for barium enemas) ➡
Diabetes Screening ➡
Flu shot, Pneumonia shot, and the Hepatitis B shot ➡
HIV Screening for people at increased risk or who ask for the test ➡
Mammograms ➡
disease
Medical Nutrition Therapy to help people manage diabetes or kidney A few important notes:
•
“Welcome to Medicare”
and counseling about preventive services, and referrals for other care if needed.
Yearly “Wellness” Exam
months, you can get a yearly wellness visit to develop or update a personalized
prevention plan based on your current health and risk factors.
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