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Showing posts with label About. Show all posts
Showing posts with label About. Show all posts

Commonly Held Misconceptions About Medicare and Medicaid

People have become lulled into thinking that once they turn 65, they have no more health insurance worries. They believe that Medicare, an entitlement program which they paid into throughout their working lives, will take care of them during the years when they need health coverage most. Although every United States citizen is entitled to Medicare coverage, and those with low incomes can apply for Medicaid, these are by far not the cover-all health policies that many people think they are. That's why, when they are in a position to make a claim, they often find themselves in a world of hurt.

The first misunderstanding that many Medicare recipients have is that once Medicare has paid everything it's going to pay, Medicaid will kick in to pick up the remainder. This may or may not be true, and only if the person meets the qualifications required by Medicaid. Medicaid is health care for low income or needy individuals. Unless the Medicare recipient meets the financial guidelines, Medicaid will not pay anything. This is why supplementary insurance is so necessary for those who are on Medicare.

Many individuals believe that in order to qualify for Medicaid, all they have to do is transfer their assets to a family member so that they can meet the guidelines. This is not true. Instead, if you try this trick in order to receive Medicaid coverage, you may find yourself faced with a large penalty. The government is prepared for patients trying to beat the system by transferring assets for less than market value to loved ones. When a new application is filed, the state will look at the person's finances for as far back as five years. If they find you've transferred money and property you once had to a sibling or child, you will end up in legal difficulties.

Another misconception that can end up costing you is that Medicare will defray the costs of home or nursing home care. In reality, Medicare doesn't kick in until you've been in the hospital for at least three days. If following your hospital stay you require rehabilitation or skilled care, Medicare will only pay for the first 100 days. Certain patients who require physical therapy or other care may qualify for more Medicare benefits. Home care as well as nursing home care need to be covered by some type of long-term care insurance.

Some people think it's a simple matter to sign up for Medicaid if a need arises. This is also not true. Although the procedure is different in the various states, you will still need to prove you are eligible no matter where you live, and this can take a lot of time. You may be required to produce paystubs, if you are still working, bank statements, proof of age and citizenship, proof of income (social security), and any insurance policies that you own. With Medicaid, it's good to start the process as soon as you meet eligibility requirements so that if you need the assistance, you already have it in place.

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American National Insurance - 12:21 PM

Things You Need To Know About Medicare Part C and Medicare Part D

Medicare Part C is a combination of the Medicare Part A and Part B options, which are categories of the Medicare program. Medicare approved private insurance companies offer Part C, a lower cost option as opposed to the original Medicare plan and offer additional benefits, also covering Part D or prescription drug coverage to a certain extent. In brief, anyone who joins Part C will have complete access to Part A and Part B.

Medicare Part C has its own network, so all the doctors and specialists that you can consult have to be a part of the Medicare plan. Under Part C, there is a primary doctor that refers the beneficiary to medical experts and specialists. One cannot consult doctors of his/her own choice; the beneficiary has to be within the group of medical experts assigned to the plan to avail Medicare services. If one chooses to consult out of this group, the treatment or visit may prove more expensive. Under Part C one co-pays for each doctor's visit.

Part C could also be referred to as the Medicare Advantage Plans. Different insurance companies develop different kinds of Part C plans. Some may include Part D or Prescription Drugs as well. There are a number of Part C plans, and most of them include PPO, MSA, PFFS, HMO and Medicare special needs.

Medicare Preferred Provider Organisation (PPO)

In a PPO, one has the freedom to choose his/her own medical providers (doctors and specialists) out of the network. The beneficiary might have to pay out of network charges but has the freedom to see medical experts without referral.

Medicare Medical Savings Account (MSA)

Under this plan, one can either use the High Deductible Plan, which will not provide coverage until the mentioned amount of deductible is met. The other is that, Medicare provides a savings account that it manages, to its beneficiary, which has a certain sum of money deposited into it exclusively for the purpose of health care costs.

Medicare Private Fee For Service (PFFS)

Here the beneficiary can see any doctor or specialist of choice without referral only if they concur with the terms, conditions and fees of the PFFS.

Medicare Health Maintenance Organisations (HMO)

Each beneficiary has an HMO network and can choose hospital(s) and medical providers from that network alone. One might require a referral from his/her primary care physician in order to see a specialist.

Medicare Special Needs

This plan is usually for persons with special health needs and chronic illnesses. A special plan must include Part A, B and D too.

Most Part C plans should have Part D or prescription drug coverage, but if one already has a separate Part D plan then, s/he cannot buy a Part C plan with drug coverage. An individual will need to buy a Part C plan with no drug coverage.

Medicare Part D

Anyone who is eligible for Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) is automatically eligible for Medicare Part D (Prescription Drugs). This means anyone who has Part D coverage gets the insurance company to pay for a section of his/her prescription medicines, regardless of the cost factor. A beneficiary who is outside the US territory and is in prison, will no longer be eligible to this section of Medicare.

Aanya, is an expert commentator on Medicare and Medicaid related information. For more information about Medicare Part C and Medicare Part D, visit http://www.emedicare.net/


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American National Insurance - 8:47 PM

4 Benefits and 4 Shortcomings You Should Know About HIPAA

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 of the United States was created to benefit the citizens of the country. The act helps protect the health insurance of the workers, gives them the control of their medical and personal information and gives them the right to take legal action in case of suspected anomalies.

While the act has a lot of benefits, it has some drawbacks for the customers. Here is a brief look at the benefits and shortcomings that you should know about HIPAA.

• Benefit 1. HIPAA helps set a national standard in the sector of medical and health information. Before the HIPAA came into existence, the privacy of the medical and personal information depended entirely on the laws prevailing in the state of residence. Under the HIPAA, all states are required to adhere to certain minimum and basic standards. This brings uniformity in the privacy laws across the country. The states may further try and strengthen the laws to protect privacy.

• Benefit 2. HIPAA lets you access your own medical and health records. HIPAA allows the owner of the insurance to access his or her own medical and insurance records. Copies can be made and requests for amendments in the records are allowed. A fee is charged to carry out copying and amendment requests.

• Benefit 3. HIPAA debriefs you of all your rights under the act. The patients are debriefed of all the rights they are entitled under the privacy act. HIPAA training is also available and most organizations who opt for group health insurances have mandatory training for their employees. This helps them stay abreast of all the latest developments and announcements and keeps them aware of their various privacy rights.

• Benefit 4. HIPAA allows you to file complaints against alleged misuse of information or other crimes related to your personal information. If a person suspects misuse of information or violation of privacy, HIPAA has provisions to help file complaints. If the alleged party is found to have violated rules, action can be taken.

• Shortcoming 1. The consent of the consumer to use personal or medical information is not always required. This is true under certain special circumstances and medical emergencies. For instance, during an accident or a medical emergency, the caretaker would not wait for your go-ahead to reveal your personal details.

• Shortcoming 2. Your past medical information may be kept private, not hidden. Your medical history may have to be disclosed if the need arises, or the current medical situation demands it.

• Shortcoming 3. Your medical data may be used for marketing purposes. Pharmaceutical companies are constantly looking for drug reviews, performance and feedback. Your information may be used by them to evaluate, recall or repair some product.

• Shortcoming 4. You cannot sue under the HIPAA. If you suspect some anomalies regarding your personal information, you can lodge a complaint. However, the law does not allow you to sue the allegedly offending party.

While the HIPAA was created to benefit the consumer, there may be some loopholes, which are not in the favor of the consumer. However, the act does bring uniformity in the health insurance sector and helps the consumer in more than one way.

For more information, please visit our HIPAA website.


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American National Insurance - 8:16 AM

4 Basic Points About HIPAA You Need to Know

After the Health Insurance Portability and Accountability Act (HIPAA) was adopted, a lot of things changed for the health industry. The act came into being not only to take care of medical records but also to change the way employees share information about patients. Changes took place in the basic functioning of the health industry. It's been over a decade that the act came into place, and healthcare units had to make a lot of changes to comply with HIPAA. Now they bear fruit, in terms of its effectiveness.

HIPAA basically makes a hospital or a medical unit signs a form by their clients stating which groups or people their medical details can be shared with. This ensures confidentiality and eradicates the risk of information being leaked out. Even within the organization, certain employees cannot access their client's Personal Health Information (PHI).

There are a number of regulations that patients should know about. HIPAA has been created for them:

• As a patient, you need to know who will abide by HIPAA's rules and regulations. Doctors, nurses and healthcare providers, all of them need to be knowledgeable about the Act. Health insurance companies may not share any part of your Protected Health Information (PHI).

• If ever you fall ill, and a number of people need to go through your medical records, you can request that only your doctor be given this privilege. But sometimes a doctor could refuse this request in case nurses or health insurance agents need to access your records for taking care of you better.

• There are regulations even to access your own records. You can have full access to your records, unless your doctor specifies otherwise. There could be some information that could do more harm than heal if reviewed. In case there is a mistake in your records, you are given a specific number of days within which you are allowed to make changes. You also need to explicitly mention where you would not like your details to be shred, such as sales calls or even to certain kind of health agents.

• At your workplace the regulations regarding HIPAA are quite different. An employer is external to HIPAA rules, he may ask for a note from your doctor for various reasons. He is also not bound to keep any medical records private. He can share them with an external company if he needs to. On the other hand, health insurance companies cannot share your records with your employer without your consent.

These are only a few instances of the benefits of HIPAA. A certified employee at a medical unit or a hospital can guide you completely if you are a patient. You need to understand the Act as it has been designed to help you, a responsible citizen of the nation. Speak to your doctor, as he will have complete access to these records. He will be able to guide you and your family, as and when the need arises. It is important to stay knowledgeable about such Acts.

For more information, please visit our HIPAA training website.


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American National Insurance - 10:21 PM

3 Things You Should Know About the Health Insurance Portability and Accountability Act

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 of the United States was brought in to revamp the health care and the medical insurance sector of the country. The act enables the user or the customer to have fair control over his or her personal and sensitive medical information. It protects the health insurance of the customer, even during events like loss of job or loss of existing cover.

With the way of life becoming more and more digitized, storage of sensitive information, sharing of information and maintaining databases has become important. The HIPAA's Privacy and Security Rule were framed to protect the privacy of the consumers and making the healthcare houses and the insurance providers more accountable with regards to the privacy of information. All customers and patients under the HIPAA must be well versed with the Privacy and Security Rule for their own benefits. The circulars and the notices must be read and understood. Listed below are three things one must know about the HIPAA.

• Covered Entities are required to give the customers the Right to Privacy. Covered entities, which are usually insurance firms or healthcare organizations, are the primary insurance providers. It is the responsibility of the covered entities to educate the consumers about the insurance they are planning to take, to educate them of their rights they are entitled to and explain to them about all about the HIPAA. Under the HIPAA, the customer or the patient entrusts the covering house with his personal and sensitive medical information. It is the duty and responsibility of the covered entity to protect the information and not share it with any one else without the consent of the owner of the insurance. The patient is also allowed to access his or her own records and make copies of it.

• Most of your personal and medical information is protected. As per the rules of the act, almost all personal and medical information is protected. This would include your conversations with your healthcare provider, conversations between doctors and nurses regarding your health and your billing information during the medical visit, along with other information which is registered with the health insurance provider.

• You must be aware of all the changes and amendments in the act. Time and again, updates, changes and amendments are made to the HIPAA. It is very important for the covered entity to understand the changes and bring out notifications to educate the customer. The Privacy Officer in the covered entity is required to bring out notifications. Updates may be in the form of emails, flyers, post or circulars. Periodically, a brief of the act should be sent to all the customers. Failure to inform the customer is an offense and the customer has the right to file a complaint under the act.

It is very important for all, the insurance providers, the patients and the healthcare organizations, to understand the HIPAA and its working. The patients need to know that their data is safe and protected and the insurance providers and health care houses need to respect the privacy and take all the necessary steps to protect the information.

For more information, please visit our HIPAA website.


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American National Insurance - 3:06 AM

Information About Medicare Supplemental Insurance Coverage

Many individuals that are intending to enroll for Medicare Part B may not understand that Medicare supplemental insurance plans are quite important. Even when you're completely healthy, you will never know when a visit to the hospital, or the need for extensive diagnostic testing might leave you with thousands of dollars in medical bills. As might be anticipated, if you currently have chronic conditions such as being overweight, diabetes, hypertension, or high cholesterol levels, lacking a Medicare supplement plan could easily cost you way over you ever imagined possible.

No matter how you look at it, increased longevity still takes a toll on your body. This includes creating a higher risk of stroke, heart attack, cancer, and a lot of other severe ailments. Considering that Medicare only pays 80% of their contracted fee schedule for medical care, investing in an acceptable healthcare could be well beyond your budget in case you don't have Medicare supplemental plans to back you up. In fact, if you already have some health conditions, or know of illnesses which have a tendency to run in your family, obtaining Medicare secondary insurance could easily give you peace of mind even though you do not need to use the insurance instantly.

Even though the majority of senior citizens understand the rewards associated with signing up for Medicare Part B, far too many do not look for Medigap insurance or even Medicare advantage plans. Think about a situation in which you just retired, and now have Medicare for health insurance rather than the coverage you had at work. Do you recall when you can just go to the emergency room and pay a $50.00 copy? Sadly, with Part B Medicare, you would pay a lot more. Even if you only have one or two x-rays taken after falling, the total emergency room charge is going to run around $4,000.

In case you have not met your deductible of $110.00 for 2012, you could expect to pay around $910.00 for a single trip to the hospital. Needless to say, if you wind up being diagnosed with a critical medical problem, you may easily wind up with several thousand dollars worth of expenses in a very short time. In case you worked your whole life in order to pay off a mortgage loan and have a little bit of savings, it would be gone in medical expenses unless you get insurance plan to supplement your Medicare.

Today, countless individuals still look forward to registering for Medicare supplemental insurance plans for this coming year since it means they are going to finally have some kind of safety net in case they get sick. While Medicare truly does serve the needs of countless people, the rest of the 20% of medical expenses which get assigned to the patient tends to be too expensive. Without a question, if you're disturbed by the extreme escalation in the cost of healthcare services, then you owe it to your business to shop for Medicare supplemental plans to be able to protect your financial future and guarantee that you are going to be able to choose the types of care that you would like to obtain.

Medicare.gov provides information about the parts of Medicare, what's new and how to find Medicare plans, facilities or providers. Medicare Supplement Insurance fills the gaps in coverage that your basic Medicare Part A and Medicare Part B do not cover.


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American National Insurance - 12:21 PM