The debate is on within the Democratic Party in the House and the Senate on exactly how to interpret Tuesday night's election results. Should they pull back and rein in spending or totally embrace the liberal wing of the party as well as the young generation that swept them in office?
Those are the choices that are facing many who will be up for reelection in 2010. For most, gut feeling tells them that the political landscape is changing and that the minority base is growing faster than any segment and the those under thirty or sill quite ardent supporters of the Democratic agenda.
Wednesday, November 4, 2009
Wednesday, June 10, 2009
Medicare- Confusing and Costly
Medicare Advantage Regulations
Medicare Advantage is the new name for Medicare + Choice. Medicare advantage includes Medicare Managed Care Plans, Medicare Preferred Provider Organization Plans, Medicare Private Fee For Service Plans, and Medicare Specialty Plans. Medicare typically provides supplemental coverage to supplement what primary insurance carrier will not cover or cover you when you have no insurance coverage. When you select Medicare coverage there is a price you pay. If you have no insurance and you are 65 or older, Medicare is available. However, there are cost that must be paid. If you have no income. Your personal assets must be exhausted before Medicare will pay for any coverage. In fact you can be denied any coverage if you have any personal assets.
The incentive for the elderly with no income is to rid themselves of assets in order to insure coverage by Medicare. The current rules is a five year look back. That means your assets must be sold at least five or more years from the time of coverage request. Even then it is a scary and tentative situation.
Medicare Advantage merely gives you choices of the type of plan you would like to receive. Much like the employer sponsored Group health Insurance plans. There are regulations involved in this coverage.
Regulations
1.)Enrollees must use only HMO Providers Only
2.) Specialty care must be approved in advance ( special request are often turned down)
3.) Medical Coverage request can be appealed (this causes delays and cost valuable treatment time)
4.)HMO can decide each year whether to offer a Medicare Plan
5.)You must be 65 or older to participate in the plan.
6.)To enroll in the Medicare Advantage Program individuals must be entitled to benefits under Part A and enrolled under Part B of the Medicare Program.
7.) People with end stage renal disease (pre-existing condition) or excluded from participating
8.) If end stage renal disease is contacted while enrolled in a Medicare Advantage Plan, the individual can continue and coverage will not be denied.
(Source: medicareadvocacy.org)
Summary
You must be very careful in selecting a Medicare coverage plan. Things to consider would be what is covered under the plan? The cost of the plan. Are you eligible for participation? Will you have to pay a premium for supplemental coverage? What are the pros and cons of standard Medicare coverage vs. Medicare Advantage . What is the out of network cost, should you choose to select a doctor, that is not in the Medicare Advantage Network? How must will the plan actually pay for services and how much will you be responsible for uncovered treatment?
These are just a few the questions that must be answered in deciding between stand Medicare programs and Medicare Advantage. You also must be careful when dealing with private Insurance carrier who try convince you to buy their coverage, knowing that full payment of services will not be covered. There are a number of things to consider. The Medicare system is extremely confusing, before deciding on any plan or program do your homework and confirm any and everything that is said to you.
Case Study
In February 2007 my father experienced a hard and unfortunate fall in his bedroom which resulted in a fractured vertebrae at the base of his neck. While reaching for a weight scale, he lost his balance and ended up striking the back of his head on a bedroom dresser. The fall resulted in paralysis over 98% of his body. He was only able to move his right arm and hand. He had full use of his head , mouth , eyes and ears and sense of smell. It was a devastating fall that resulted in ten months of nursing home care. The fall took it’s toll on his recovery and at his advanced age ( he was 78 years old), he fought an uphill battle for survival. My Father died in December 2007 from complication as result of this fall.
My father experienced many coverage denials from his insurance provider as well as Medicare covered insurance. His new home became nursing homes and assisted living facilities. He operated in and out of the Medicare system, primarily because he had private health insurance. According to his insurance policy, the insurer would only pay for 100 days of coverage per year in a nursing home, a little over three months. Although my father had the choice of receiving his care from a facility covered by Medicare, often the facility was more than 200 to 400 miles away from his home and family in Nashville, Tennessee. The facilities that were available in Nashville were filled and in some cases the waiting list was well over 150-200 people. After exhausting his insurance coverage My father exhausted his retirement income of a little over $100,000 in a period of nine months.
I mention this because of the tremendous and exhaustive difficulties that the elderly face in navigating through the Medicare system. If you have a loved one that has gone through an ordeal similar to my father; you are well aware of what I write. Great preparation and care must be taken to insure that your insurance options are in order to meet future individual demand.
Medicare Advantage is the new name for Medicare + Choice. Medicare advantage includes Medicare Managed Care Plans, Medicare Preferred Provider Organization Plans, Medicare Private Fee For Service Plans, and Medicare Specialty Plans. Medicare typically provides supplemental coverage to supplement what primary insurance carrier will not cover or cover you when you have no insurance coverage. When you select Medicare coverage there is a price you pay. If you have no insurance and you are 65 or older, Medicare is available. However, there are cost that must be paid. If you have no income. Your personal assets must be exhausted before Medicare will pay for any coverage. In fact you can be denied any coverage if you have any personal assets.
The incentive for the elderly with no income is to rid themselves of assets in order to insure coverage by Medicare. The current rules is a five year look back. That means your assets must be sold at least five or more years from the time of coverage request. Even then it is a scary and tentative situation.
Medicare Advantage merely gives you choices of the type of plan you would like to receive. Much like the employer sponsored Group health Insurance plans. There are regulations involved in this coverage.
Regulations
1.)Enrollees must use only HMO Providers Only
2.) Specialty care must be approved in advance ( special request are often turned down)
3.) Medical Coverage request can be appealed (this causes delays and cost valuable treatment time)
4.)HMO can decide each year whether to offer a Medicare Plan
5.)You must be 65 or older to participate in the plan.
6.)To enroll in the Medicare Advantage Program individuals must be entitled to benefits under Part A and enrolled under Part B of the Medicare Program.
7.) People with end stage renal disease (pre-existing condition) or excluded from participating
8.) If end stage renal disease is contacted while enrolled in a Medicare Advantage Plan, the individual can continue and coverage will not be denied.
(Source: medicareadvocacy.org)
Summary
You must be very careful in selecting a Medicare coverage plan. Things to consider would be what is covered under the plan? The cost of the plan. Are you eligible for participation? Will you have to pay a premium for supplemental coverage? What are the pros and cons of standard Medicare coverage vs. Medicare Advantage . What is the out of network cost, should you choose to select a doctor, that is not in the Medicare Advantage Network? How must will the plan actually pay for services and how much will you be responsible for uncovered treatment?
These are just a few the questions that must be answered in deciding between stand Medicare programs and Medicare Advantage. You also must be careful when dealing with private Insurance carrier who try convince you to buy their coverage, knowing that full payment of services will not be covered. There are a number of things to consider. The Medicare system is extremely confusing, before deciding on any plan or program do your homework and confirm any and everything that is said to you.
Case Study
In February 2007 my father experienced a hard and unfortunate fall in his bedroom which resulted in a fractured vertebrae at the base of his neck. While reaching for a weight scale, he lost his balance and ended up striking the back of his head on a bedroom dresser. The fall resulted in paralysis over 98% of his body. He was only able to move his right arm and hand. He had full use of his head , mouth , eyes and ears and sense of smell. It was a devastating fall that resulted in ten months of nursing home care. The fall took it’s toll on his recovery and at his advanced age ( he was 78 years old), he fought an uphill battle for survival. My Father died in December 2007 from complication as result of this fall.
My father experienced many coverage denials from his insurance provider as well as Medicare covered insurance. His new home became nursing homes and assisted living facilities. He operated in and out of the Medicare system, primarily because he had private health insurance. According to his insurance policy, the insurer would only pay for 100 days of coverage per year in a nursing home, a little over three months. Although my father had the choice of receiving his care from a facility covered by Medicare, often the facility was more than 200 to 400 miles away from his home and family in Nashville, Tennessee. The facilities that were available in Nashville were filled and in some cases the waiting list was well over 150-200 people. After exhausting his insurance coverage My father exhausted his retirement income of a little over $100,000 in a period of nine months.
I mention this because of the tremendous and exhaustive difficulties that the elderly face in navigating through the Medicare system. If you have a loved one that has gone through an ordeal similar to my father; you are well aware of what I write. Great preparation and care must be taken to insure that your insurance options are in order to meet future individual demand.
Monday, March 23, 2009
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Tuesday, December 9, 2008
Newspapers Struggle To Find Their Identity
The Chicago Tribune is in trouble because of an over zealous investor. Where does this lead Tribune employees, many of whom are destitute without pensions and working for a company on the brink of total failure. The newspaper industry is in it's final hour across the country, as advertising revenue is falling. All the while bad decisions are being made to keep papers afloat. It is a difficult situation. What happened to the Tribune is just the tip of the ice berg. The Gannett Corporation recently completed a third round of layoffs by cutting 10% of its workforce in it 85 paper newspaper division.
Shrinking advertising revenues are the culprit and the the carnage will continue as every newspaper publisher is cashing in on moving everything to the internet. it will not save them. Primarily because newspaper are not equipped to be a web based entity. There local news content and flavor does little to to help. Today news content can be accessed quickly and easily via the web from a variety of sites, that have very little to do with a standard newspaper or local reporting.
News Content on the web is nationally driven. Newspapers have their place and it is to report on local event in the community. You can't compete with local content on the web; there are simply to many national players in the game that know how to play it. Using a baseball terminology, Newspapers are playing Class A caliber ball in the Major leagues of the internet.
Shrinking advertising revenues are the culprit and the the carnage will continue as every newspaper publisher is cashing in on moving everything to the internet. it will not save them. Primarily because newspaper are not equipped to be a web based entity. There local news content and flavor does little to to help. Today news content can be accessed quickly and easily via the web from a variety of sites, that have very little to do with a standard newspaper or local reporting.
News Content on the web is nationally driven. Newspapers have their place and it is to report on local event in the community. You can't compete with local content on the web; there are simply to many national players in the game that know how to play it. Using a baseball terminology, Newspapers are playing Class A caliber ball in the Major leagues of the internet.
Friday, December 5, 2008
Citizens in St. Louis Are Warned to Take up Arms.
As reported on CNN. A city Alderman in St. Louis, recommends that citizens in St. Louis actually armed themselves, because the Police who were hired to protect them can't, because of lack of funds to pay them. Is this a return to the wild west? But money is drying up and for protective services the the police provide and St Louis is suffering.
The question continues to be raised, what can we do about the economic downturn in America? Your comment are wlecomed.
The question continues to be raised, what can we do about the economic downturn in America? Your comment are wlecomed.
Layoff Are Absolutley Devastating
The Jobs report is out today and it says that this is absolutely the worst job loss ever over 550,000 jobs. It was a dismal day. For many Americans, particularly those who have been laid off. It is not a good feeling to get a tap on the shoulder and told to report to the HR department. But that it the fate of many Americans who are relegated to find employment in a job market that is at best is not good and at worst devastating.
This is what faces Americans and the new President Elect Barack Obama. It is sad situation that we are facing a this time. Companies are laying off on a monthly basis and it will get worse. Senator Barney Frank asked Barack Obama to get in there to take the office of the Presidency right now. This is definitely something he cannot do, via constitutional laws. However the economic meltdown has been devastating to Detroit Automakers. They are seeking bail outs totaling over 43 million dollars.
This is what faces Americans and the new President Elect Barack Obama. It is sad situation that we are facing a this time. Companies are laying off on a monthly basis and it will get worse. Senator Barney Frank asked Barack Obama to get in there to take the office of the Presidency right now. This is definitely something he cannot do, via constitutional laws. However the economic meltdown has been devastating to Detroit Automakers. They are seeking bail outs totaling over 43 million dollars.
Wednesday, December 3, 2008
Cost Of College Education Rises 439%
If today's statistics are any indication the cost of a college education will soon be out of reach for most American. According to an article in the New York Times, The National Center for Public Policy and Higher Education found that college tuition and fees increased an unheard of 439% from 1982 to 1987.White family income rose only 147%. The report also showed that Student Borrowing also increased, doubling from the last decade. The most startling finding is Students from lower income families on average get smaller grants from the colleges they attend than students from more affluent families.
If this trend continues a college education will be out of reach for the average income American. American is the 25- 34 year old age range are less education that older American. This is a startling reality that brings home the importance of legislation make an affordable education available to our young.
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