Medicare Supplement

If you are turning 65 anytime soon and want to understand Medicare Supplement Plan F, give us a call.

This is our specialty.

1 (888) 580-0858

 

 

Medicare 2012 Open Enrollment

2012 Medicare Open Enrollment is now complete and we welcome all our new Medicare Advantage MA-PD customers.

You should receive your new ID card within a week.

Your new coverage begins on Jan 1 2012.

Welcome, we are glad to have you.

Questions

1 (888) 580-0858 or email

 

Blue Shield of California to return money to customers

By Duke HelfandLos Angeles Times Staff WriterOctober 13, 2011, 6:14 a.m.

Health insurer Blue Shield of California, which last summer said it would return $167 million in excess profit to nearly 2 million policyholders, now says it will give them an additional $283 million in December.

Policyholders are seeing the first round of money this month through credits on their insurance bills. The next giveback, to be announced by the insurer Thursday, will cut most of the bills in December by more than half.

Individual policyholders will see their December premiums reduced by an average $135. A family of four will get a $420 average cut, but the reductions could be as much as $700.

Chief Executive Bruce Bodaken said the San Francisco nonprofit is trying to help policyholders cope with rising healthcare costs by making good on a pledge to return money when its net income exceeds 2% of its revenue.

“Today’s announcement provides more tangible evidence that we’re putting affordability before profit,” Bodaken said in a statement. “We hope our action will inspire others in the healthcare industry to look for ways to make quality healthcare more affordable.”

Blue Shield’s action comes as insurance companies face the prospect next year of returning millions of dollars collected from policyholders but never spent on healthcare.

Under new federal regulations, insurers must spend at least 80% of consumers’ premiums on medical care and not reserve that income for administrative costs or profit. But with consumers going to doctors less and often skipping treatment during tough times, insurers may not meet the 80% requirement and be obligated to issue refunds.

Some healthcare experts, while not singling out Blue Shield, said they are skeptical of insurers issuing refunds before they are required to do so.

“It certainly seems like a good public relations move to do it proactively than to be forced to do it,” said Larry Levitt of the nonprofit Kaiser Family Foundation’s Initiative on Health Reform and Private Insurance.

Blue Shield said that the money being returned this month comes from excess 2010 profit, while the money announced for December is from extra 2011 earnings.

Employers also will get a break on their December bills under the Blue Shield plan. Firms with two to 50 employees will get an average credit of $220 per worker. Larger companies will receive an average of $195 per employee. Companies that pay part of their workers’ premiums will decide how much to share with them.

Aside from the break on insurance costs, Blue Shield said it also is devoting $12 million for hospitals and physician groups to build stronger collaborations and for other healthcare-related reforms. That is on top of $13 million it announced in June for such efforts.

Copyright © 2011, Los Angeles Times

Top Hospitals 2011-2012

The full report comes from US News via Yahoo.

http://health.yahoo.net/articles/healthcare/best-hospitals-2011-12

Rank	Hospital	Points	Specialties
1	Johns Hopkins Hospital, Baltimore	30	15
2	Massachusetts General Hospital, Boston	29	15
3	Mayo Clinic, Rochester, Minn.	28	15
4	Cleveland Clinic	26	13
5	Ronald Reagan UCLA Medical Center, Los Angeles	25	14
6	New York-Presbyterian University Hospital of Columbia and Cornell, N.Y.	22	12
7	UCSF Medical Center, San Francisco	20	11
8	Brigham and Women’s Hospital, Boston	18	12
9	Duke University Medical Center, Durham, N.C.	18	10
10	Hospital of the University of Pennsylvania, Philadelphia	17	12
11	Barnes-Jewish Hospital/Washington University, St. Louis	16	11
12	UPMC-University of Pittsburgh Medical Center	14	8
13	University of Washington Medical Center, Seattle	13	9
14	University of Michigan Hospitals and Health Centers, Ann Arbor	10	6
14	Vanderbilt University Medical Center, Nashville	10	6
16	Mount Sinai Medical Center, New York	8	6
17	Stanford Hospital and Clinics, Stanford, Calif.	7	6

If you happen to be in the San Fernando Valley, Providence Holy Cross Hospital is very good at handling Medicare recipients.

Medicare and debt ceiling talks

Despite what many politicians (highly emotional) have stated over the last few weeks, Medicare was in no way affected by the debt ceiling negotiations in Washington.

It is highly doubtful that Medicare will be affected by such anytime soon.

Whether you are looking for Medicare Plan F or Medicare Advantage, give us a call for the best price and best options.

 

 

Medicare National Open Enrollment

Just a heads up!

National Open Enrollment for Medicare Advantage will begin several weeks earlier this year.

Stay tuned for details.

 

 

Judges sharply challenge healthcare law

By David G. Savage, Washington BureauJune 8, 2011, 10:37 a.m.

Reporting from Atlanta—

A top Obama administration lawyer defending last year’s healthcare law ran into skeptical questions Wednesday from three federal judges here, who suggested they may be ready to declare all or part of the law unconstitutional.

Acting U.S. Solicitor General Neal K. Katyal faced off against former Bush administration Solicitor General Paul Clement in what has become the largest and broadest challenge to the healthcare law. In all, 26 states and the National Federation of Independent Business joined in urging the judges to strike down the law.

And in an ominous sign for the administration, the judges opened the arguments by saying they knew of no case in American history where the courts had upheld the government’s power to force someone to buy a product.

That argument is at the heart of the constitutional challenge to the healthcare law and its mandate that nearly all Americans have health insurance by 2014.

“I can’t find any case like this,” said Chief Judge Joel Dubina of the 11th Circuit Court of Appeals. “If we uphold this, are there any limits” on the power of the federal government? he asked.

Judge Stanley Marcus appeared to agree. “I can’t find any case” in the past where the courts upheld “telling a private person they are compelled to purchase a product in the open market…. Is there anything that suggests Congress can do this?”

Katyal argued that healthcare is unique and unlike purchasing other products, like vegetables in a grocery store. “You can walk out of this courtroom and be hit by a bus,” he said. And if such a person has no insurance, a hospital and the taxpayers will have to pay the costs of his emergency care, he said.

Katyal argued that Congress could reasonably decide that since everyone will likely need medical care at some time in their lives, everyone who can afford it should pay part of the cost. And he said the courts should uphold the law under Congress’ broad power to regulate commerce in this country.

Judge Frank Hull, the third member of the panel, repeatedly asked the lawyers about the possible effect of the court striking down the mandate, while upholding the rest of the law. She said the government had exaggerated the importance of the mandate. It will affect about 10 million persons at most, not the roughly 50 million who are uninsured now. She said the other parts of the law will extend insurance to tens of millions of persons.

The Atlanta court is reviewing a decision of Judge Roger Vinson in Pensacola, Fla. In January, he struck down the entire 2,700-page law as unconstitutional.

Dubina, from Alabama, was first appointed to the bench by President Reagan and was elevated to the appeals court byPresident George H.W. Bush. Hull, from Georgia, was appointed by President Clinton. The third member of the panel, Marcus, from Florida, was first appointed as a district judge by Reagan, but Clinton appointed him to the appeals court.

Already, appeals courts in Richmond, Va., and Cincinnati have heard legal challenges to the healthcare law, and a fourth hearing is set for September in the U.S. Court of Appeals for the District of Columbia.

The challengers hope that at least one of those appeals courts strikes down the law as unconstitutional. Such a ruling would almost certainly require the Supreme Court to take up the case and decide the issue.

Clement hammered away at the theme that the government mandate to have health insurance was unlike any law in American history. “In 220 years, Congress never saw fit to use this power, to compel to engage in commerce.”

Despite the skeptical questions that greeted the administration’s advocates, the three judges did not clearly signal how they intend to rule.

Hull pointed out that the Supreme Court has upheld laws that involve regulation of economic matters, and the decision of whether to buy health insurance is clearly “an economic decision,” she said.

Katyal said that even the challengers agreed that persons who show up at a hospital seeking treatment could be required to buy insurance on the spot. If so, he said, why can’t the government require they buy it in advance?

A moral alternative for curing Medicare’s ills

By Michael HiltzikJune 5, 2011

Jon Huntsman informed me the other day that I have incurred a moral responsibility.

Huntsman is a former GOP governor of Utah and, until recently, President Obama’s ambassador to China. Back stateside now, he’s joined the throng of Republicans struggling to achieve enough name recognition to attract more than a thimbleful of reporters if and when he announces his candidacy for president. To that end, he issued his moral challenge to me, and to you, in a Wall Street Journal op-edlast week.

The subject was Medicare.

More specifically, it was the proposal by House Budget Committee Chairman Paul Ryan (R-Wis.) to “solve” our budget deficit crisis by handing Medicare over to the private health insurance industry and sticking its elderly enrollees with more of its costs, to the extent that out-of-pocket healthcare costs for the typical retiring 65-year-old would consume half of his or her Social Security.

Ryan and Huntsman call this “saving” Medicare. Huntsman declared in his article that anyone who disagrees with Ryan’s approach has a “moral responsibility” to identify alternatives. Though I’m loath to receive moral instruction from a politician on an attention-seeking binge, this is one challenge I’ll accept.

Let’s begin with the easy part. One of the basic flaws of Ryan’s plan is that he folds Medicare’s long-term fiscal problem into the near-term problem of the federal deficit. But these are two very different things. As Henry Aaron of the Brookings Institution observes, the current government deficit is the result of an enormous tax cut mostly for the wealthy, of paying for two wars by credit card, of the Great Recession, and of spending to address that recession. Recovery will address at least some of that, and restoring income tax rates to pre-Bush levels would go a long way toward managing the rest.

Medicare’s ills are wholly separate, except insofar as ginned-up panic over the current deficit is driving Washington politicos to hack away at the program so they look like they’re doing something.

Medicare’s ills are entwined with our national system of healthcare — how it’s used and how it’s distributed. You’re not going to make a dent in the problem unless you change the underlying system. Ryan’s approach doesn’t lay a finger on that system, except to magnify its inefficiencies and expense.

Not that his solution to the problem of a larger federal bill for Medicare services isn’t simple: He just transfers more of the expense to elderly enrollees. He also proposes to place more of the program in the hands of private insurance companies, which have higher overhead costs than traditional Medicare. The bipartisan Congressional Budget Office has found that by 2022 the costs under private plans would be as much as 34% higher than equivalent services under traditional Medicare.

So Ryan’s double whammy of charging seniors a larger share of a more expensive program doesn’t really “cure” Medicare, any more than one cures a case of tennis elbow by lopping the offending arm off at the shoulder.

To be charitable, the free-market rationale for sticking enrollees with more of the bill is that as consumers with “skin in the game” they’ll be more discriminating about the services and treatments they demand, thus holding down costs. Unfortunately, the consumer-driven model has been widely discredited: Studies suggest that strapped patients forgo not only ineffective but effective treatment, that they lack the expertise to judge what’s necessary and what’s not, and that consumers are vulnerable to multimillion-dollar ad campaigns by drug and device companies pushing them into uninformed decisions.

So what’s the “moral” alternative, Mr. Huntsman wants to know. In fact, plenty of research points to ways to extract excess costs from the healthcare system and to alter its embedded incentives to reward efficient and effective care rather than just lots of care.

Some of these methods were enacted last year as part of healthcare reform, much of which Rep. Ryan proposes to repeal. The healthcare act reduced payments for Medicare Advantage plans, HMO-like plans that have turned into lavish giveaways to health insurers. The act will save $136 billion over 10 years by trimming those government handouts to insurers, according to a CBO projection. Ryan would put insurers in the saddle.

The act also establishes an Independent Payment Advisory Board, or IPAB — 15 presidential appointees, approved by the Senate, empowered to examine Medicare costs if they exceed certain benchmarks and recommend reductions, which would have to get an up-or-down vote in Congress. Ryan wants to abolish the IPAB, even though it doesn’t exist yet and even though Washington dickering already narrowed the types of expenditures it’s permitted to consider. Anyway, the Congressional Budget Office estimates that it could find $16 billon in savings over a decade.

The medical and drug lobbies have beaten down numerous other cost-cutting proposals over the years. Medicare could save $24 billion to $60 billion a year in drug costs, according to various estimates, if it were permitted to negotiate prices directly with drug companies for its Part D pharmaceutical benefit. Pressure from Big Pharma killed any hope of that when the drug benefit was enacted in 2003.

The indispensable key to bringing down healthcare costs, and therefore Medicare costs, is to alter the incentives driving both insurance pricing and doctor and hospital behavior. One idea is known ascompetitive bidding, which would require health plans to bid to provide a minimum menu of Medicare benefits; the government subsidy for Medicare members would be pegged to the cheapest bid. Members who chose a more expensive company would pay the difference out of their own pockets, a requirement that proponents say would force insurers to truly compete on price and quality of care.

More fundamentally, what may be needed to change the cost profile of American medicine is a reorientation of care at the end of life from extending one’s years at all costs to improving the quality of those years. That means less institutionalization, more home healthcare, a more rational appraisal of heroically aggressive therapies. It doesn’t mean rationing or “death panels,” but change in the name of humaneness and dignity.

There’s nothing like it in anything currently on the table or in Ryan’s plan, the alpha and omega of which is to impoverish Medicare patients with no other resources, and hope no one notices that they’re forced to give up not only wasteful but worthwhile treatments.

That’s why Ryan’s plan, which Huntsman professes to “admire,” isn’t “courageous,” as its supporters like to call it, but cowardly. And immoral.

Blue Shield of California to give $167 million back to some customers

Embattled health insurer Blue Shield of California is planning to give back $167 million to some policyholders this year and to return more money in future years.

Bruce Bodaken, chief executive of California’s largest nonprofit health insurer, says that individual policyholders –- but not people with employer plans — will get a 30% credit on one monthly bill this year. That will average $80 for an individual policyholder and $250 for a family of four.

Blue Shield’s initiative, to be spelled out in detail Tuesday, comes during a tough year for the San Francisco insurer. The company has weathered criticism in recent months for big rate increases and Bodaken’s salary -– he earned $4.6 million last year.

Bodaken said the company will continue to return money to policyholders in subsequent years when its net income exceeds 2% of revenue. That was the case in 2010, Bodaken said, and so Blue Shield is now planning to give back the excess.

Bodaken is rolling out the announcement in a carefully orchestrated campaign. He outlined the new initiative in a commentary in the company’s hometown newspaper, the San Francisco Chronicle. He also is briefing reporters and outlining the new effort in a noon speech at the Commonwealth Club in San Francisco.

“We are living in incredibly challenging economic times,” Bodaken wrote in his newspaper piece. “At Blue Shield of California, we believe we have an obligation to tighten our budget, just like everyone else. That’s why we are announcing a new commitment to help our customers get the health care they need at a price they can better afford.”

Bodaken called the company’s “2% pledge” the first of its kind in the country. He said that in addition to the $167 million going back to customers this year, Blue Shield will give another $10 million to doctors and hospitals that coordinate care through so-called accountable care organizations. Another $3 million will go to the Blue Shield of California Foundation to support safety net programs.

10 dumb things you do at the doc’s office

By Elizabeth Cohen, CNN Senior Medical Correspondent

May 26, 2011 7:04 a.m. EDT

CNN) – As much as she would like to, Dr. Lissa Rankin, a gynecologist, will never forget the woman who planned her wedding while lying naked on her examining table.

“Every 15 seconds, her cell phone was going off, and she was answering it!” Rankin recalls. “It was like, ‘That’s not the cake I ordered,’ and, ‘No, it’s the other gown,’ and I said to her, ‘Is this a bad time? Should I come back later?’ “

The bride may have been doing great things for her wedding, but she was sabotaging her own care — and it was a really important visit, as she was newly pregnant.

Talking on your cell phone in the examining room, forgetting what medicines you take and lying to your doctor about your personal health habits are all ways of compromising your health.

“The doctor-patient relationship is like a business partnership,” Rankin says. “We need to work together. Trust me to guide you but be willing to do your part.”

From interviews with a gynecologist, a cardiologist, a rehabilitative medicine specialist, a fertility doctor and an internist, here are the Top 10 things patients do to mess up their own care.

1. You talk on your cell phone.

This is your health we’re talking about. Other calls can wait. Turn the thing off.

2. You lie.

“I need to treat you the best way I can, so if you’re gay, tell me. If you drink a bottle of tequila every night, I need to know. If you’re having an affair and not using condoms, let me know,” says Rankin, who blogs at “Owning Pink.” ”I promise I won’t judge you.”

3. You do a sloppy job describing your pain.

Is it stabbing or burning? Sudden or constant? Tingling or hot? The answers will help your doctor make the right diagnosis.

“You should describe the exact location, how intense the pain was, what provoked it and how long it lasted,” says Dr. Nieca Goldberg, director of the New York University Women’s Heart Program.

The week before your appointment, keep a diary of your pain and your other symptoms, too, advises Dr. Loren Fishman, a clinical professor of rehabilitative medicine at Columbia University College of Physicians and Surgeons. He suggests using this time to also think about the questions you want to ask your doctor and what you hope to get out of your appointment.

4. You don’t state up front all the reasons for your visit.

If your ear hurts, your knee pops out when you run and you have a sty in your eye, state all three concerns at the beginning of the appointment so your doctor can plan your visit efficiently, advises Dr. Howard Beckman, an internist and clinical professor of medicine at the University of Rochester.

5. You don’t state up front your expectations for your visit.

If you have certain hopes or expectations — the doctor will pop that sty in your eye or prescribe antibiotics for your sore ear — say so. The doctor can then explain if your expectations are realistic, and you’ll be happier in the end.

“Sometimes patients are out of proportion to what the reality is, like the 44-year-old woman who hopes to get pregnant in one IVF cycle,” says Dr. Jamie Grifo, program director of the New York University Fertility Center. “If they don’t communicate their expectations, then I can’t address them.”

6. You don’t know what medications you’re taking.

“Patients should bring a list of medications they’re actually taking, not what they believe they are supposed to be taking, or what they think I want them to take,” Beckman advises.

If you take supplements, Rankin suggests you bring them in, since supplements aren’t standardized like prescription drugs, and your doctor will want to see all the ingredients.

7. You leave with unspoken questions and concerns.

If a question’s in your head, ask it, even if you think the doctor is rushed. If you’re worried your headache might be a brain tumor, say it even if you think you sound like a hypochondriac.

8. You don’t bring your medical records or images with you.

Yes, even in this day and age, many doctors rely on the fax machine to send medical records to and fro. Faxes goof up, so unless you absolutely, positively know your doctor has your records and images from another office, bring them with you, doctors advise.

9. You’re too scared to disagree with your doctor.

If your doctor suggests you need an antidepressant and you don’t want to take it, say so instead of nodding your head, taking the prescription and throwing it away the minute you’re out the door. Or if she suggests a medication you can’t afford, just say so.

“I know many of you are programmed not to question your doctor, but we can’t read your mind, so we need you to communicate,” Rankin says. “If the treatment plan I suggest doesn’t resonate with the intuitive wisdom of your Inner Healer, please tell me, instead of ignoring what I suggest.”

10. You don’t comply with the treatment plan.

For doctors, this is the granddaddy of them all. If you’ve followed all the advice above, you should have a treatment plan that makes sense to you and one you’re able to execute.

“Please follow through and do what you’ve agreed to do,” Rankin says. “And if you don’t, please tell me so I don’t mistakenly assume the treatment failed. I won’t jump all over you. I just need to know.”