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Making the most of your Medicare Archives - Steinlage Insurance Agency

Medicare’s new Durable Medical Equipment rules

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Starting July 1st, 2013, the greater Saint Louis area is now part of Medicare’s new competitive bidding program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). This program should help lower the cost that Medicare pays for supplies like oxygen, CPAP machines, diabetic testing supplies, and much more. What does this program do? This program requires suppliers of Medical equipment to submit blind bids on Medicare covered equipment rather than paying a higher inflated price. Medicare will then use these lower priced bids to set costs on what it will pay which will help the Original Medicare program save money over time. How will this program affect me? If you do not currently use any equipment, than you will not see any change at all. If you currently rent, own, or need Durable Medical Equipment, you may see your current provider discontinue their services, requiring you to find a…

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Medicare: A Bigger Mountain than Everest

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America has always feared socialism.  We like our independence and freedom.  Because of this, it is no wonder that it took 20 years from the initial suggestion of a federally funded insurance program to the actual implementation of this program.  Having been the first president to suggest a national health care program, Harry S. Truman was the first recipient of what is now known as Medicare.  The Medicare program was signed into law on July 30, 1965 by President Lyndon B. Johnson.  Commenting on the landmark bill, President Johnson said, “We marvel not simply at the passage of this Bill but that it took so many years to pass it.” In order to qualify for Medicare, you must fall into one of the following categories:  American citizens age 65, citizens on disability for 24 consecutive months regardless of age, or having end stage renal disease (ESRD).  Currently, the Medicare program…

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10 tips for a 65 year old signing up for Medicare

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Are you turning 65 soon or wondering how to figure out the maze of Medicare?  Congratulations!  Now don’t throw away all those mailings you get from insurance companies everyday (recycle them) and don’t disconnect your phone to stop the unsolicited calls. Click here to register for the Do Not Call List. Here are 10 tips for cutting through the clutter and making this process less painful than a trip to the dentist: 1. Don’t be afraid to ask!   Chances are you know someone who is already Medicare eligible.  Buy them a cup of coffee and pick their brain.  What resources did they use?  Are they happy with their current coverage?  What problems have they had?  Are they satisfied with their current insurance agent or broker?  How have their rates changed in the time that they are Medicare eligible? 2.  Choose an independent agency to help With so many variables,…

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Medicare has Limits on Therapy

By | Making the Most of your Medicare | One Comment

Many people on Medicare do not realize that Medicare caps the amount of therapy a person is eligible for in a given year.  Here is a link for the official Medicare.gov document.  For 2013, Medicare will only approve: $1,900/year for physical therapy and speech therapy $1,900/year for occupational therapy Those are separate figures, meaning you could receive a total of $3,800 worth of services per year. It is important to remember that this is the amount Medicare approves.  Medicare will only cover 80% of this amount.  If you have a supplement, it would pick up the 20% balance.  Because Medicare does not approve services above the $1,900 amount, any therapy provided would be paid out of pocket by the recipient. This is not a new rule but is becoming more common as therapy is prescribed for a variety of illnesses.   Here are a few rules of thumb to keep…

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Hospital billing changes with Medicare

By | Making the Most of your Medicare | No Comments

With Medicare looking to control costs, a controversial billing practice is on the rise.  Seniors who spend days at a hospital without actually being admitted can be left with thousands of bills to pay, which are not covered by insurance. In more and more instances, a person enters a hospital under “observation,” rather than being admitted.  This is true even when a person stays multiple nights in a hospital bed, receiving similar care to their neighbors, and for conditions such as a broken pelvis or chest pains.  Because this person is under observation, rather than being admitted, Medicare is able to pay hospitals far less for comparable treatment.  The trigger occurs because Medicare pays under Part A for someone admitted and Part B for someone under observation.  Part B payments have been substantially reduced in recent years.  Compounding this issue, Medicare is using a growing army of auditors who use…

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