On July 1, 2006 the Deficit Reduction Act went into effect. The act required all immigrants to give proof of legal immigration or citizenship when they are applying for Medicaid for the first time. This applies to children, as well. Most legal immigrants cannot receive Medicaid benefits for the first five years that they are in the U.S. Undocumented immigrants can only receive emergency Medicaid services.

Once the bill became law, it also restricted citizens, as well. Medicaid enrollment has declined since the law was enacted, partially because even U.S. citizens are finding it difficult to locate some of the documents required to enroll for Medicaid services. This is because some of the documents need to be original documents, and it can be difficult to obtain original documents in many cases.

As far as Medicaid goes, they receive matching federal funds to help run the program and pay claims. As a result, even if they wanted to assist individuals without documentation it would be a problem for Medicaid both in a financial sense and in a legal sense.

The rules for Medicare and Medicaid are so stringent that CMS has instituted a rule that even requires child welfare agencies to document citizenship for children being placed into foster care. There are some issues where people receive extra time to provide documentation, however, they are limited and must adhere to very specific rules and time frames.

Once an individual has completed the documentation process and is approved for coverage, they will be covered retroactively to the date of the application or to the month of the application depending on the state they are living in and a few other variables. Trust me when I tell you that this can be a true adventure that seems to take forever. Just when you think you have sent in everything that is needed you get a letter or phone call asking for more. Just take a deep breath and send the requested paperwork in. Be prepared for at least a couple of follow-up requests. As long as you comply with the requests, you will get the coverage you applied for and qualify for.

The primary types of identification include a state driver’s license, Certificate of Naturalization, Certificate of Citizenship or a U.S. passport. Secondary types of identification for naturalized citizens include a U.S. Birth Certificate, data verification with Systematic Alien Verification for Entitlements (SAVE) documentation, or documentation and data match with a state verification agency, as well as other documents.

It is important to know the law, your rights, your responsibilities and your entitlements in order to receive the benefits you need. You can research them on the web by going to the CMS website.

Do you buy your prescription medicine through your Medicare drug plan? If you do, you may be paying way too much. In fact, starting in 2005, Medicare started being audited for various payment and billing problems.

The problem is that we are now in 2009, the problems were supposed to have been mostly eradicated, but 84% of the companies who handle Medicare drug plane have overcharged Medicare recipients to the tune of several billion dollars collectively. If you are a taxpayer, you are paying a great deal of this money. To date, it is estimated that insurance companies owe the government/taxpayers about 4.4 billion dollars because of overcharges.

The problem is that Medicare is taking forever for them to figure out just how much the taxpayers are owed. They haven’t done the audit on the audit. Since 2006! They have said that this is a slow and tedious process. Maybe they should have had a different and better system and some controls and auditing in the first place.

Congress is now asking CMS why they are taking so long to perform the correct audits. They would also like to know why the companies that offer Medicare drug coverage have been overcharging their customers and unwitting taxpayers without any self-regulation or auditing.

Medicare is the federal health insurance program for people 65 and older. The optional prescription drug benefit, which subsidizes the costs of medicine for subscribers, was the subject of an intense political debate before Congress enacted the program in 2003.

The program’s nearly 27 million beneficiaries generally pay for the coverage, known as Medicare Part D, through a monthly premium that’s deducted from their Social Security checks. That and Medicare subsidies paid for by taxpayers pay for the $60 billion program.

CMS has contracts with private companies to issue Medicare drug coverage and there has been debate about this for years. Now Congress has told CMS that it must complete these audits, and sooner – rather than later – CMS must explain to Congress how it plans to collect the $4.4 billion that was overpaid.

If you are looking for Medicare Supplemental Coverage, there is a new website to visit called The Medicare Supplement Shop. Their new site compares all the plans in a fair way as far as what they cover, what they cost and how well they perform.

If you log onto www.MedicareSupplementShop.com you will find screens to easily sign into and allows you to click on the plans you wish to compare. In addition to this, there is a phone number (1-888-891-9280) to ask questions if you need further information or feel more comfortable on the phone rather than on a computer.

Some nice features of the website are that it shows browsers how to choose the best plan. The site allows you to take your time to be able to determine which companies cost the least and the most and which companies have the best and most coverage for the money. The site also helps you to figure out which coverage is best for you and will take care of your needs.

There are many sites that claim to help you look at the Medicare supplemental coverage that is available, but most of them are trying to guide you toward buying a particular type of coverage from a specific company.

The difference with The Medicare Supplement Shop is that it truly does compare companies that sell Medicare Supplements and lets the consumer make the decision as to which coverage would suit them best.

The site even has a learning center that can help you understand what to look for in good prescription drug coverage and other supplemental coverage. The new Medicare Supplement Shop website is a good place to search for the right coverage.

Medicare and Medicare Supplements, also called Medigap, have a number of parts and they are not always easy to figure out. Figuring out how all these parts fit together and which ones fit your situation can be extremely confusing. Because open enrollment just ended for Medicare and open enrollment for supplements lasts until the end of March, understanding Medicare is especially important right now. This brief overview will give you information on the basic parts of Medicare and what is covered by them.

Medicare Part A and B make up the original Medicare. Part A basically covers in-patient services including inpatient rehabilitation and inpatient psychiatric care.
Many of the services are covered completely; others will require a copayment from you.

Part B covers doctor’s services and other outpatient services determined to be “medically necessary” for you. It also covers certain tests to determine if you have an illness. There is a deductible, which is $135 for the year 2008, and it also carries some copayments with it.

Medicare Part C is also called Medicare Advantage. The Medicare Advantage Plans are not part of the actual Medicare system, nor are they run by Medicare. They are alternatives to Medicare and are run by private companies. There are a variety of plans that work differently. Some operate as HMO’s others as Fee for Service plans that allow you to go to any doctor as long as the doctor will accept payment from Medicare as payment in full. It is essential to research and find out whether the Medicare Advantage Plan you are choosing will actually fit your medical needs.

Medicare Part D covers Prescriptions. Part D is a portion of original basic Medicare. This coverage is important, and it is urgent to determine what type of Part D coverage you need. You should determine this before you enroll so that you can enroll immediately when you are eligible. If not, there is a substantial late fee. If you enroll in a particular Part D plan and feel it isn’t right for you, every year you will have an opportunity to change between.

As for the supplements which are the Medigap policies, there are 12 policies that cover services that are not otherwise covered. Each supplement covers different things. In addition you can purchase these supplements from private insurance companies, get them from you or your spouse’s employer or from various government programs.

All Medigap Policies are standardized and approved by Medicare. This means that for policies E on through the alphabet, each lettered plan offers the same coverage no matter what company you purchase it from. An insurance company can charge you whatever they choose, so compare companies and rates. In 2009 there are more stringent rules regarding Medicare Advantage and other supplements and there is stricter oversight, as well. Still, prices are varied and it doesn’t make sense to purchase Part E from a company that charges twice as much as another.

Make sure to do your research and determine which Medicare Supplemental Insurance is the best for you and find the best price. If you need more information, check the web at www.Medicare.gov.

Individuals who are Medicare recipients have the confusing job of choosing various supplements and hoping these supplements fit their economic circumstances and help address their health needs. There is now a website that compares ALL of the Medicare supplement plans. The site is called Medicare Supplement Shop and you can find it on the internet at www.medicaresupplementshop.com. Below, we have the reprint of the press release and information regarding this excellent and helpful new site.

Introducing MedicareSupplementShop.com – A Source For Medicare Supplement Plans and Medicare Supplement Information

The Medicare Supplement Shop Web site has officially been launched, giving users the ability and freedom to choose the best and most affordable Medicare Supplement Plans.

(PRWEB) January 14, 2009 — Medicare supplement insurance plans provide peace of mind to seniors who need essential medical services. However, finding the correct plan that fits a person perfectly can be a difficult venture, which is where MedicareSupplementShop.com comes in. We do the work for you by searching the multitude of plans and coverage options that are available in your immediate area and provide you, the customer, with best choices available. The companies and plans that we provide will allow you to keep the same doctors and hospitals of your choice.

The Medicare Supplement Insurance landscape changes every year, making the process of selecting the best Medicare supplement extremely challenging. Another thing to keep in mind is the simple fact that our new president, Barack Obama, along with the newly elected Congress could potentially alter the current health care policies. Therefore, it is better to get a jump start now and understand what kind of coverage will suit your needs and of course, what it will cost you.

A good Medicare supplemental insurance plan will lower your out-of-pocket expenses, giving you more financial freedom. Our Medicare Supplement experts make the process of selecting a good Medicare supplement very easy by offering free advice about the Medicare Supplement plans offered in your state.
We compare all plans and prices to make sure you save as much money as possible while still receiving excellent coverage. Saving money on your Medicare Supplement Plan is a simple task that will start the New Year off in the right direction

If you are a senior on Medicare, no doubt you have recently heard more than your share of information about Supplemental Insurance, and with open enrollment period you have either bought or considered buying a supplemental plan.

The good news is that there are many plans available. The bad news is that with so many plans available, there is a lot of confusion about what each plan covers and which plans are best for you. The worse news is that open enrollment period brings all the sales people out in the open, bringing you more annoying phone calls and more confusion.

The information is very important and it is essential that you do as much research as possible. Once you start researching the supplemental plans, if you call the individual companies or organizations who sell these plans, you will often find double-talk and a great deal of pressure to coerce you into buying particular policies. This practice has become so common that state officials in a number of states have pressured congress to grant them more power to regulate the marketing of these plans, and congress has done so.

Many states feel that not only have seniors received pressure, they have also been pushed into unsuitable plans that will not cover them in ways that these individuals will need. New federal regulations protect consumers from marketing and sales abuses. Consumers are no longer left on their own with no support or assistance in dealing with these issues.

It is a positive thing that the states have successfully pushed to reign in the sale of supplemental policies. It is important to keep your eyes on this issue and for you to take your time to research supplemental policies, feel comfortable with the information and the policy, and don’t allow yourself to be pushed or coerced into buying any coverage that you need.

Private Medicare providers underestimated the profits that they will receive or have received, which will inflate the government reimbursement rate.

The Government Accountability Office (GAO) states that the private Medicare Advantage plans on average reported spending 85.7% of incoming revenue on medical expenses in 2005 but in actuality, they had projected that they were going to spend 90.2%. That may not seem like a lot of extra profit, but it is because millions of Medicare recipients have opted for coverage through Medicare Advantage. This means that when the end of the year, their profits would be higher than projected because their expenses were lower.

This means that when everything was added up at the end of the year, profits for private Medicare Advantage providers totaled over $1 billion more than they had projected. This is a pretty hefty profit, and it is not clear what will happen to that extra profit.

Medicare added prescription drug coverage in 2003. Better incentives were created for private plans to sell insurance to provide that coverage. Though 44 million elderly or disabled people are enrolled in Medicare, about 10 million are enrolled in the additional private plans sold by several companies.

The law says that if the private companies report revenue and profits, lower than a set rate, they can compensate for this by providing extra benefits or reducing costs to the individuals in the program. Critics of the plans say that it has been estimated that these Medicare Advantage plans are paid 13% to 17% more than the government spends treating Medicare patients not enrolled in a private plan.

This situation is being addressed, including how these expenses and savings can be used or applied to go toward fixing the Medicare financial issues that have been the subject of such heated debate during the past few years, as well as these past months leading up to the presidential election.

Many people take more than one or two medications. Often they take two or three. However, researchers at the University of Chicago Medical Center have recently completed a study that shows that many seniors – too many seniors – are taking at least five medications every day. This leaves a person open to a lot of complications.

There are many generic medications and other medications that used to be prescription only that now can be bought over the counter. As a result, many seniors – and other younger people – are taking their 3 to 5 prescriptions, and in addition, some over the counter medications. This has led to harmful drug interactions and too many of these interactions have been fatal.

It is estimated that 1 out of 25 older adults – or 2.2 million – in the United States are having problems with this issue. In fact, 50% of the harmful drug interactions occur from using non-prescription, over the counter drugs and mixing them with each other or with prescription drugs.

Part of the issue has to do with the fact that with Medicare Part D and other prescription drug discount plans and coverage including Medicare Advantage, there are more medications available at a very reasonable price, making it too easy to combine medications that should never be combined.

It is important to discuss all medication with your doctor. Find out what can be taken in addition to your prescriptions without jeopardizing your health. Your prescription drug coverage will be there for you. Simply make sure that you use it wisely and stay healthy and safe through the New Year.

We are at the end of the enrollment period for Medicare Supplements for the year 2008. Most seniors have made their choice and enrolled in the supplement that they feel best fit their needs. Because seniors are now enrolled, it does not mean that they will not have further questions.

Finding the right Medicare Supplement is an important issue which involves an individual’s health and finances. To help seniors understand these supplements and determine if their coverage is appropriate to their situation, as well as answering any questions that come up, there are organizations that offer this information. To address these issues and better accommodate seniors, The American Seniors Association has created a comprehensive website designed to outline and provide Medicare supplement insurance plans that best suit each individual senior. The site has information and comparisons that individuals can customize on the site to see what can fit their situation.

The American Seniors Association is providing a necessary and positive service for seniors by having created this site. There are other websites that do minimal comparisons, featuring only one or two supplements. These sites are somewhat helpful, however, they are designed to lead people to choose and purchase a particular supplement. In fact, some of the sites are actually providing the information because they are developed by the company that is selling the supplement, and that company will be receiving commissions for every supplement sold.

Visiting AmericanSeniors.org enables seniors to quickly access Medicare information. AmericanSeniors.org is committed to providing seniors with individual attention to ensure the right Medicare supplement insurance plan is made.

ASA also provides seniors with services including discounts on a variety of products and services ranging from Prescription Drugs and Insurance Products to Travel and Auto Clubs.

For any information you can find the American Seniors Association on the internet at www.americanseniorsassociation.org.

Many people that have Medicare benefits are confused about Medicare Part D. There are a great many individuals who do not understand Medicare Part D, which covers prescription drugs. It is estimated that at least 40% of individuals that have Medicare Part D do not understand their coverage.

Part D is designed to cover many of the drug/medication costs of individuals enrolled in the plan. Since Part D is not part of the original basic Medicare coverage, there is usually a separate premium charged. An individual can purchase a Medicare prescription drug plan or a Medicare Advantage Plan.

Both types of plan have limits to them, so it is essential that you research the plans that are available and find out which coverage is right for you. With most plans, you will pay a premium and the plan will pay part or all of your prescriptions. There is extra help available to help individuals on very limited income pay their premiums.

Depending on the plan you choose you could be responsible for up to $2,500 in prescription costs. It is important to consider the cost, the amount of co-pays and the amount of coverage you will have. In addition, there are other supplemental plans – often at little or no cost – from organizations such as AARP, Humana and various other companies. These plans cover some costs that Medicare Part D does not. Sometimes these plans offer a discount on prescriptions. It is important to research the differences in coverage thoroughly.

To research Medicare Part D, determine which prescription plan is right for you, and find any other information, visit the official Medicare website at www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) and ask a representative for the information you need. You can also check for supplemental plans by checking the internet and type “Supplemental Prescription Medicare Coverage” into Google or any other search engine, and you will find several pages of plans.

Make sure to do this immediately if you plan to enroll in any plans, since open enrollment for tis year ends on 12/31/08.

We are at the very end of the open enrollment period for Medicare. The end of open enrollment will come to pass on 12/31/08. That will be the last day that you can choose to enroll in the Medicare Supplement of your choice.

This process can be extremely confusing, but there are some straight answers to some of the questions out there. One such issue is the phasing out of Medicare Advantage. There has been quite a rumor going around stating that this phasing out is going to happen. In actuality, Medicare Advantage is not going to be phased out. Instead, the subsidies that the government pays to the insurers that sell the plan will possibly be in the future, but nothing has happened to date.

Because of the rumors, people have a lot of confusion about what they should do with their current prescription drug coverage, such as Medicare Part J. Many people want to know if it is best to keep what they have or change to Medicare Advantage.

Medicare Advantage is sold by individual insurance companies. You can switch to this plan and get your coverage for prescriptions that way, or you can get your coverage through Part D. It is best to determine what is right for you. The most important thing to do is to research the correct information and then get the coverage that is best for your circumstances.

Don’t get caught up in the confusion. Find out what you need and make sure to get it so that your prescription needs are taken care of.

If you are trying to figure out how to sign up for Medicare Part D – prescription drug coverage – you may be somewhat overwhelmed or confused. There are ways that this can be a straightforward process. We will try to outline some steps that will help keep the process simple..

It is important that you get a list of all your medications before you even start the process. Your pharmacist will be able to give you the list of your current medications. Once you have that list, the next step is to call 1-800-MEDICARE or go online to www.medicare.gov. There are people that will help you through the process.

If you are online, click where it says “Medicare Prescription Drug Plans for 2009” and it will take you to a page that has one heading that says “Find and Compare Plans.” Click on that and you will be taken to a page that asks if you would like a “personalized” or “generalized” search. If you have your official Medicare card you can do a personalized search by entering your information from the card. The page will ask you for the information you need to put it.

After you have done this and put your information in, the computer will take you to a page that asks you to list the medications you take. YOU MUST FILL THIS OUT, even if you don’t take prescription medication right now. This is an important page because it can help you find your medication and help you list it, plus, it will tell you if there is a less expensive generic medication. It will also save your information in case you need to come back to it another time.

The next page will ask what pharmacy you want to work with. You can pick a pharmacy that you already use or a pharmacy that is close to home. Once you pick the pharmacy you will be asked to click again. When you click it will take you to the page that is the most important: this is the page that compares plans. It will show the least expensive plans, it will also show how well the different plan rank – for instance one star to five stars to help you know which plans have the best ratings. This page will also try to lower your costs by suggesting generic medications and possibly other drugs that are the same as what you are taking now but less expensive. After that comparison you can click on the various plans and you will be given a month by month cost. You can print all this information out.

After all of that, you will get to the point where you can choose a plan. Before you choose, it is important for you to call the plan’s toll-free number, ask questions such as confirming the coverage of your drugs as well as your copayments. If you feel comfortable, have them send you an application so you can sign up.

If you follow these steps it should take the confusion and the worry out of deciding on your Medicare Prescription Drug coverage and leave you feeling secure about the choices you are making for 2009.

We are at the end of another year, and Medicare recipients have a little less than 2 weeks to sign up for the Medicare coverage they will have for 2009. We have been talking about it and hearing about it for a few months now, and we are getting down to the wire. If you haven’t made a choice yet, we hope this information will help.

Unfortunately, this is something that has to be done, like it or not. Even if you don’t currently take prescription drugs, it is important to sign up when you first become eligible, because if you do not sign up at that point there will be big penalties to pay once you do need some prescriptions. Most of us will need prescriptions at some point – and prescriptions are expensive. There are some, prescriptions that are on the $4 list at several major pharmacies, however, the ones that are not on that list can cost $300, $400, $500 or more per month. If that happens – and it usually happens unexpectedly – you will probably wish that you were paying $50, $60 or $70 per month for coverage instead.
There are some seniors who are covered by a comparable company or retiree prescription plan, or other seniors who have signed up for an all-in-one Medicare Advantage plan. Some seniors have prescription drug access through the Veterans Administration, though they may want to choose an inexpensive Part D plan for drugs the VA does not cover. If you are not a senior who fits in one of these groups, it is important to look at Medicare Prescription Drug Coverage.
If you have recently turned 65 and just started to qualify for Medicare, this will be the first time going through the process of choosing the best plan for you. But every senior, even if you are currently enrolled, you should look at all the plans that are available for 2009. That’s because each year the plans change the prices of the drugs they cover, and may not even include the same medicines in the year ahead.
Make sure to explore what is available and what is best for you. There is a little less than two weeks to make the choice. The time to determine which plan you will choose is now. Once you do your research and find your plan, you can move through the new year without extra worry about your prescriptions.

Most of us think about Medicare when we are feeling ill or having to visit the doctor or hospital. This time of year, until December 31st, during enrollment period, Medicare is on the minds of most Medicare recipients.

There are many types of information that Medicare collects and Medicare provides. In an effort to keep Medicare recipients and their families informed, Medicare tracks is information regarding nursing homes. a few months ago, Medicare released information and created a database that lists the lowest quality nursing homes in the country.

The Nursing Home Compare Website has a searchable database that gives the names of the lowest rated 5% of nursing homes in the United States. In addition to the database, CMS provides a monthly update showing results of nursing home inspections, which keeps the information current and up to date.

CMS is working hard to provide Medicare recipients and others more access and easier access to information regarding nursing homes. Many senators and congressmen are trying to pass bills to disclose even more information regarding nursing homes and the nursing home community. It may take some time to implement these types of bills, but it is an important issue and it is being looked at carefully and pushed forward.

Whether you are actually at the point where you are looking for a nursing home, or you are a relative, friend or caretaker of an individual looking for or needing one, the information that CMS/Medicare has released is essential.

There is much more information at www.medicare.com, including frequently asked questions with answers and links to other sites and further information.

If you are approaching retirement, already retired and on Medicare or just looking for answers about Medicare or nursing homes, take the time to explore the subject in advance. It could help you avoid ending up in the wrong place in a bad situation later on.

The idea of health fairs is not new.  There are heath fairs in cities across the U.S. that provide everything from information about gentle dentistry to on the spot blood pressure and bone density tests, and everything in between.

Health Fairs are sponsored in cities and towns throughout the country to help individuals with health issues. Part of the purpose of these events is to raise awareness about the services how people can get help.  The events usually have several types of screenings available for seniors including blood pressure checks, blood sugar testing, and cholesterol checks. 

Various health care organizations are usually on hand to answer questions. The organizations also include home health care.  There is also information available about assistance to seniors with nutrition programs, assistance with prescriptions and assistance with the Senior State Health Insurance Assistance Program  which helps with Medicaid, Medicare, Medicare Supplements and SSI, health insurance and long term care.

There is usually an ombudsman who checks into complaints and works to help solve problems.  They work with many friends and contacts in the community, so if there is a problem they can’t solve or a question they can’t answer, chances are they can connect you with someone who can answer those questions and walk you through, working with you to fix the problem if at all possible.

There have been more and more programs in communities throughout the country.  To find out if there will be any presentations or a senior health fair in your community, contact your local senior centers, chamber of commerce and your doctor or local hospital.  The information at these health fairs is usually free and you can surely benefit from the information you will receive.