Should ACA Become a Single Payer System Like Medicare?

healthcareI realize this blog is about Medicare, but there are many seniors who do not have healthcare coverage and are just short a few years from enrolling into Medicare, also know as as a single payer system.

Remember, the policies you are seeing at site are for individual plans in the marketplace … not group plans like you would see in a business and there is a big difference.

At first I thought the healthcare marketplace would be offering plans more like group policies you would find in businesses. No, they are all individual plans (generally very expensive even before the ACA). If you are self-employed you are considered an individual and not a small business unless you have employees.

Have you taken a look at the premiums for a policy for people between the ages of 55-64 and what the plans in your area are offering? I researched quite a number of plans in my area and found that the majority of the plans have you self-insure for $6,350 before they pay dollar one. Or, you pay a premium close to $1,000 per month. I guess you pay the $6,000+ one way or the other. Read the rest of this entry

Investigate Other Plans During Medicare Open Enrollment

Investigate-New-Plans-Medicare-Open-EnrollmentHave you started to check out what changes, if any,  your current Medicare plan(s) will have for 2014?

Just the other day, a friend went to a meeting regarding another option for Medicare health coverage for 2014. At first, a little skeptical about going. But guess what?

You guessed it. By attending the meeting she discovered that she would have a $0 co-payment on her prescriptions and that’s going to save her a lot of money each and every month. She is estimating that she will save well over $2000 per year on co-payments alone!!

Although she won’t be able to use her local YMCA for Silver Sneakers, the plan she is joining has their own gym and a trainer. So this is good too.

So what are you waiting for? Take the time and investigate other plans and options for your health care during Medicare Open Enrollment. Read the rest of this entry

2014 Medicare Open Enrollment has Started

Medicare 2014On October 15, 2013 Medicare Open Enrollment for 2014 began.

Have you taken some time to review the changes in your plan(s)? Don’t get caught off-guard in 2014 and find:

  • your doctors have changed
  • the medication formulary has changed
  • medication tier levels have changed
  • co-payments have changed for Advantage and Drug plans
  • premium increases for Advantage or Drug plans
  • other benefits in Medicare Advantage Plans have changed

I could go on-and-on and some or all of this could happen. But it is up to you to review your current plan or at least review the Annual Notice of Changes for 2014.

Over the years I have heard many people complain about increased co-payments or doctor changes when the new year arrives. Why?  because they didn’t take the time during open enrollment to find out the changes for the new year.

This doesn’t have to happen to you.

Read the rest of this entry

Time to choose a Medicare coverage plan – what you don’t know may cost you

Ross Blair File PhotoHere’s is a guest post by Ross Blair, senior vice president, I hope you find it as informative as I have. Please take a moment to share with your friends and family.

Fall is a big time for the Affordable Care Act (ACA) — and if you are over 65, you might be confused about what that means for your Medicare benefits.

This year, the enrollment periods for “Obamacare” and Medicare overlap, which may have you wondering if one is related to the other. The simple answer is no. Medicare is the federal health insurance program for people 65 or older. It also helps with coverage for certain younger people with disabilities and special needs. Lately you may have heard about the state health insurance exchange created by the federal health care reform law. The exchange is designed to help people under the age of 65 who don’t have insurance today.

Read the rest of this entry

Medicare is NOT the Affordable Care Act … ACA is For People Under 65

medicare-workingIt is totally mind-boggling how many different blogs, statements, videos become viral about the Affordable Care Act and Seniors on Medicare. So when I hear statements that to me just don’t make sense, I really need to investigate and sort out fact from fiction.

One recent example was that the Affordable Care Act stated you could only receive palliative care only after age 76. I just shook my head in total disbelief, and still can’t understand why people believe these incorrect messages being sent.  But yet, it continues to go round-and-round. If people really took the time and realized the Affordable Care Act (ACA) is for people under the age of 65 and if you are 76, you are on Medicare!

So if you hear or read someone say you can’t get Palliative care until you are 76 under the Affordable Care Act, remind them that ACA is for people under age 65 and when you are 76 you are on Medicare.

Read the rest of this entry

Medicare.Gov Now Updated for 2014

Although our Government has shut down, Medicare was able to get their website updated with the 2014 information. However, they are warning that some things might not be accurate.

But since open enrollment is really about Medicare Part D, Prescription Drug Plans (PDP) or Medicare Part C, Medicare Advantage (MA), your best bet is to go directly to the private insurance company, like United Healthcare, AARP, Humana, etc., as their sites have up-to-date information for 2014.

Since my last blog, I wrote to many people to find out HOW CMS (Centers for Medicare/Medicaid) allowed First Health Part D Value Plan to implement a 60% increase in premium for 2014. Will let you know the outcome.

Read the rest of this entry

Medicare Open Enrollment 2014 and the Greed Factor

Medicare Part D Premium Increase GreedIt’s just around the corner, Medicare Open Enrollment for 2014 begins on October 15.

Around the 1st week of October you should start seeing the new plans for 2014. And, hopefully you have received your 2014 Annual Notice of Change for your Advantage Plan or your Part D Prescription Drug plan. Make sure you read it. It has a lot of information … co-payments, change in tier levels for drugs, premium increases, formulary updates.

What a shock we got for the 2014 Part D Plan. First Health Life and Health Insurance Company increased the premium from $33 per month to $51.20 per month.

That’s a substantial increase. Plus they are now charging for the generic drugs which during 2012 and 2013 the co-payment was $0.

Well, when I signed my husband up 2 years ago, I knew it would just be a question of time before the “greed” factor would set in with them as this is not the first time they have had staggering premium increases. To me it just boils down to corporate greed. Read the rest of this entry

2014 Medicare Open Enrollment Starts October 15


Reminder:  Medicare Open Enrollment starts October 15 and ends December 7 for 2014.

However, there has been quite a bit of confusion for people on Medicare or those getting ready to enroll because of the media blitz on the Affordable Health Care Act (also referred to as ObamaCare).

Medicare has not changed.

You still go to to review plans for 2014 or enroll if you are now eligible.  On or about October 1 plans for 2014 should be listed on the website. Read the rest of this entry

Confused About Medicare: You Are Not Alone

Medicare is a great program but can be confusing. Why, it’s health insurance.   And to make matters worse, there’s confusion about whether you are in Original Medicare or you are in a Medicare Advantage Plan. And, I’ve heard some people refer to Medicare as AARP.

Well, I got confused talking to my friend the other day on the charges from one of her doctors. I thought she was enrolled in Original Medicare Parts A and B.

We all know that Original Medicare pays 80% and you are responsible for the 20% of the allowed Medicare charge. A Medicare Advantage plan, however, has different co-pays and that depends upon the plan you are in.

My friend received a statement from her doctor’s office and was surprised that they “wrote-off” a substantial amount. And it can be shocking, but most health facilities send their invoices with substantially higher charges than what the allowed Medicare charges are. Read the rest of this entry

Diabetes Fraud Alert from Health and Human Services-OIG

I just stumbled upon the Health and Human Services Office of Inspector General’s website and was surprised to see an alert called: Fraud Alert for People with Diabetes. 

Here’s the alert:

# # #

Criminals who plot to defraud the Government and steal money from the American people have a new target: people with diabetes.

Although the precise method may vary, the scheme generally involves someone pretending to be from the Government, a diabetes association, or even Medicare, calling you. The caller offers “free” diabetic supplies, such as glucose meters, diabetic test strips, or lancets. The caller may also offer other supplies such as heating pads, lift seats, foot orthotics, or joint braces, in exchange for the beneficiaries’ Medicare or financial information, or confirmation of this type of personal information. Additionally, you may receive items in the mail that you did not order.

The call is a scam.

If you receive such a call, OIG recommends the following actions:

1. Protect Your Medicare and Other Personal Information

Do not provide your Medicare number or other personal information. Be suspicious of anyone who offers free items or services and then asks for your Medicare or financial information. These calls are not coming from Medicare, diabetes associations, or other similar organizations. While the caller says the items are “free,” the items are still billed to Medicare. Once your Medicare information is in the hands of a dishonest person or supplier, you are susceptible to further scams. Alert others about this scheme, and remind them not to provide strangers Medicare numbers or other personal information.

2. Report the Call to Law Enforcement

Report the call to the OIG Hotline at 1-800-HHS-TIPS or online at As part of your report, provide the name of the company that called you, the company’s telephone number and address, and a summary of your conversation with the caller.

3. Check Your Medicare Summary Notice and Medicare Bills

Check your Medicare Summary Notice and other medical information to see if you were charged for items you did not order or did not receive. Also, check for items that were billed multiple times, such as glucose meters, diabetes test strips and lancets, and other supplies. Report any irregular activity to your health care provider and the OIG Hotline at 1-800-HHS-TIPS or online at

4. Do Not Accept Items That You Did Not Order

You are under no obligation to accept items that you did not order. Instead, you should refuse the delivery and/or return to the sender. Keep a record of the sender’s name and the date you returned the item(s) to help OIG catch any future illegal billing.

The Department of Health and Human Services, Office of Inspector General (OIG) fights fraud in Government programs. As part of this effort, the OIG relies upon alert citizens to help them catch those who steal from American taxpayers.


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