Potential Changes in Medicare

Congress is unlikely to consider legislation that would fundamentally restructure Medicare until a new Congress -- and possibly a new president -- are seated in 2013. But politicians have sought to tackle the growth in Medicare costs several times in the past two years, most notably in the 2010 health care law and, then again, in last year's budget deal.

The more immediate pressure is to reduce the deficit by the end of this year to stop automatic 2 percent spending cuts from going into effect in 2013, as required by last year's budget agreement. That will likely entail slowing spending in Medicare, which provides health care to 47 million seniors and disabled people and consumes about 15 percent of the federal budget.

Kaiser Health News answered several frequently-asked questions about the timeline for overhauling Medicare and reducing spending, and the proposals under consideration.

Q. The House passed a budget that included a Medicare overhaul last week. Will it become law?

No. With strictly Republican support, the House on March 29 approved a federal budget for 2013 that included controversial Medicare changes written by Budget Committee Chairman Paul Ryan, R-Wis. Democrats control the Senate, however, and they've said they will not take up a budget resolution this year. That means the GOP document will serve mostly as an election-year rallying point. Republicans will cite it as proof they are serious about reducing the nation's deficit, while Democrats will portray it as an attack on senior citizens and others. On Tuesday, for instance, in a speech before the American Society of News Editors, President Obama called the Ryan Medicare plan a "bad idea" that "will ultimately end Medicare as we know it" and force seniors -- particularly sicker ones -- to bear a larger share of their health care costs.

Q. So Medicare will remain untouched at least until next year?

No. The 2010 health law made some potentially important money-saving changes to the program. It saved $500 billion in Medicare spending over 10 years, in part by cutting rates to private Medicare Advantage plans and by reducing payments to hospitals and other medical providers. It also requires higher-income seniors to pay more for their care. In addition, the law created a yet-to-be-constituted panel of experts, called the Independent Payment Advisory Board, to cap federal spending on Medicare at no more than the growth rate of gross domestic product plus 1 percent.

After the November elections, lawmakers will seek agreement on ways to cut the deficit once again, including through targeted proposals to lower Medicare spending, and if they are unsuccessful, automatic spending cuts of 2 percent will take effect starting in 2013 -- all from payments to hospitals and other care providers.

Q. What about more structural changes, like the ones that Ryan has been pushing?

Ryan has gotten a lot of attention for his Medicare proposals, which are likely to be considered along with other overhaul plans next year, especially if Republicans win control of the Senate or the White House, or both. The latest Ryan proposal was nearly identical to a premium support idea he put forward in December with Sen. Ron Wyden, D-Ore., and to one that GOP presidential hopeful Mitt Romney crafted in November. It would provide a set amount of money for future Medicare beneficiaries -- those currently under the age of 55 -- to purchase either a private health plan, or the traditional government-administered program through a newly created Medicare exchange. That subsidy would replace the guaranteed set of benefits the federal government now provides regardless of costs.

Q. Does Wyden's support mean that other Democrats will get behind it?

Not likely. Even Wyden didn't endorse the House Republican budget because it has stricter spending limits than the plan the two co-authored. Democrats dislike how Ryan's plan would shift risk to seniors, and plan to campaign against it this fall. They point to a Congressional Budget Office analysis of a similar proposal last year that projected that by 2030 a typical 65-year old would be required to pay 68 percent of the total cost of his or her Medicare-covered services. That compares with the 25 percent they would pay under current law.

Also, some critics argue the promise in Ryan's latest proposal that future beneficiaries can choose the traditional, government-run program is disingenuous. They cite the risk the government-run plan would attract the sickest people, driving up its costs, while private plans lured the healthiest, and that medical providers could abandon the program if Medicare cuts their rates to curb costs.

Q. Is there anything that Democrats and Republicans actually agree on?

Both Ryan and President Obama have proposed capping the growth of Medicare to the annual increase in the gross domestic product plus 0.5 percent. Both Democrats and Republicans talk about increasing the eligibility age of Medicare from 65 to 67 and requiring higher-income beneficiaries to pay more.

Q. Where do the presidential candidates stand on Medicare?

Republican presidential hopeful Mitt Romney's plan is similar to the one that the House approved last week, and which both he and competitor Newt Gingrich have endorsed. Rick Santorum, another GOP competitor, also supports Ryan's ideas, but has said he would prefer eliminating the traditional, government-run program and requiring beneficiaries to choose from plans offered by private insurers. Ron Paul would maintain Medicare for current seniors, but would wean younger people away from the insurance program in favor of free-market approaches.

Obama takes a somewhat different tack: His health care law retains Medicare's current benefit structure, but authorizes some efforts to try restraining spending by moving to a reimbursement system that rewards providers based on patient outcomes, rather than on volume. The law also requires higher-income beneficiaries to pay more for their care, and created a panel to make recommendations to cap Medicare's growth if it should exceed a certain percentage of the GDP. Last year, the president rebuked Ryan for his earlier proposal to overhaul Medicare in a speech at George Washington University, saying it was "less about reducing the deficit than it is about changing the basic social compact in America." Obama called for what he said was a "balanced approach" that included spending cuts as well as tax increases.

Provided by Kaiser Health News, www.kaiserhealthnews.org

Eating for Optimum Health

Having been in the health insurance industry for 25 years, I’ve had a front row view of the state of healthcare, and health, here in the U.S. And what I’ve seen has not been pretty.

As health costs have absolutely exploded, so have health insurance rates. At the same time, our nation’s health as gotten progressively worse. The entire country has gotten fat. The average 65 year old now takes 3 prescription drugs daily, and 20% take 5 or more.

What Can I Do About It?

Well, not that much, really. Because it is each individual’s responsibility to make his or her own choices. And I strongly believe in giving people choice.

But with choice also comes responsibility. And if I can encourage people to take greater responsibility – for their health, and for their health care choices – I’ve made a difference.

The Diet of our Ancient Ancestors

I’ve always been interested in health, and what factors lead to optimum health. In 2000 I shut down my insurance business, spent some time traveling with my wife (documented at www.longsstrangetrip.com), and then moved to Fort Collins, Colorado to pursue a master’s in nutrition and exercise science.

It was there that I became familiar with what is now commonly known as the “paleo” diet. The basic concept is that humans evolved over millions of years as hunter-gatherers, and that thus our genes are best adapted to the diet that we would have eaten, up until about 10,000 years ago when agriculture began. The basic diet is fresh meat, fish, vegetables, fruits, and maybe some nuts and eggs.

Getting the Word Out

I decided to join forces with a professor who had studied and written extensively on the topic, to spread the word and make more people aware of this idea. We put out the first issue of The Paleo Diet Newsletter on February 15, 2005.

At the time hardly anyone had ever heard of this way of eating (and most still haven’t, but that’s changing). Publication was erratic for the first couple years or so, but we were putting out some really high quality science based information. Eventually we were publishing our free newsletter on a weekly basis. I had an incredible team helping me, including Pedro Bastos, Maelan Fontes, and Nell Stephenson.

In 2007 we formed a business to promote this way of eating, and I continued to put out our free newsletter. For many people this was a brand new way of eating, and for some it was challenging to make the change. So, with dedicated help from Chris LaLanne (nephew of the early TV exercise guru Jack LaLanne), we started offering Paleo Diet Implementation Programs, in which we coached people how to eat this way over a 6-week period.

People were losing weight, their digestive problems were disappearing, autoimmune symptoms were subsiding, people were reporting better sleep, less pain, and the list goes on. It was an amazing, highly gratifying experience. And the number of people adopting this kind of diet was exploding.

Due to reasons I can’t get into at this time (but will soon), I shut down my activities in this area about a year ago. But the good news is that in the mean time, interest and information on this topic has continued to skyrocket.

Books by Robb Wolf (The Paleo Solution) and Art Devany (The New Evolution Diet) have spread this meme, numerous blogs and brilliant websites have sprung up (such as PaleoHacks.com) and there are even Facebook groups, Meetups, and more.

I’ve seen so many people benefit from a Paleolithic-type diet, that it really excites me to see it getting some mainstream popularity.

The Ancestral Health Symposium

In August there is an event going on called the Ancestral Health Symposium, where some of the leading scientists and thinkers in this field will be speaking. I’ve been planning on going, but just learned that the event is sold out.

Going to this event will enable me to connect with a lot of old friends, and meet new friends, and will no doubt lead to further opportunities. So I need to find a way to go.

Fortunately, Patrik at PaleolithicDiet.com has two extra tickets he’s giving away. Patrik, hopefully you can help me out, and I’ll look forward to meeting you in person. :-)

Oh by the way, Patrik has also just started a free weekly email. If this topic interests you, check it out.

Medicare Advantage open enrollment ends this week

Medicare Advantage Plans can offer HMO and PPO plans, and they often include more benefits than Original Medicare. For example, some pay for dental care, eyeglasses or hearing aids along with standard doctor and hospital services. Some plans even include health club memberships to help you maintain your health.

While the premiums can be low, and even $0 in some cases, Medicare Advantage Plans do have some restrictions. You may be restricted to certain doctors and hospitals unless you require emergency or urgent care. This may be important if you need a specific specialist.

Most importantly, Medicare Advantage Plans have different rules and cover different prescription drugs. It’s important to be sure you understand each plan’s rules so you get the right fit for your needs.

Like a Christmas present, until the end of the year, Medicare Advantage Plans have open enrollment. That allows you to enroll in a plan even with pre-existing health problems, but open enrollment will end on December 31. Find out more with our free Medicare Advantage quote and consultation. Just call us, Medigap Advisors, at 1-866-323-1441, but make that call today before time runs out.

Medicare Advantage Plans, Medicare Supplement Insurance And Open Enrollment

If you have Medicare Supplemental Insurance, you probably remember that magic open enrollment period when you could apply for a Medigap plan without answering any questions about your health. No matter what health problems you may have had, you didn’t have to worry about your application being denied or even being charged higher than normal rates. Well, another one of those special open enrollment periods is now here

If your situation has changed, your premiums have gone up or you just want to be sure you have the best coverage you can get, now is the time to see what Medicare Advantage plans can do for you. From November 15 through December 31, you can switch your Medigap insurance for one of the Medicare Advantage plans available in your area.

Like Medicare Supplement insurance, Medicare Advantage plans are provided by private insurers. Here’s a secret - Medicare Advantage plans may have no premium unless you add Part D prescription coverage. Want to find out more?

At MediGap Advisors, we specialize in helping people just like you unravel the complexity of Medicare so they can get the right protection to fit their needs and their budget. We offer lots of information to help you see what your best choices are at our website - www.MediGapAdvisors.com, but that’s not all! You can also call us at 866 323-1441 to arrange to speak with one of our expert advisors for free. Get the answers to your questions, help comparing your situation to the plans available and a professional opinion on how you can get the best Medicare supplement at the lowest price. Could it be any easier? Just remember you only have a few weeks to make the change so call us today!

Medicare Advantage Plans Can Help You Get More From Medicare

There’s a big difference between Medicare Advantage plans and Medicare Supplement plans, and now is the perfect time to see whether you could get more for your money by switching to a Medicare Advantage plan. Open enrollment lasts from November 15 through December 31, but that doesn’t mean you have time to spare. Medicare Advantage plans are available from a variety of insurers so you’ll want to take the time to get a good idea of all the options available to you.

Unlike Medigap insurance, Medicare Advantage plans replace Original Medicare rather than supplement it. If you join one of these plans, you’ll receive your Original Medicare coverage through private insurers, which typically offer additional benefits over Original Medicare. Medicare Advantage plans may have no premiums unless you add Part D prescription coverage.

To join a Medicare Advantage plan, you must have Medicare Part A and Part B. That means you will have to pay your monthly Medicare Part B premium to Medicare, but remember you won’t have a monthly premium for your Medigap plan after you switch.

As the nation’s leading online specialist in how to get the most from Medicare, we are MediGap Advisors. You can visit us online at www.MediGapAdvisors.com or call our friendly receptionist at 866 323-1441. There’s never a charge for our confidential consultation to help you get the answers you need and the health care you deserve.

Medicare Supplement Insurance Helps When You’re Under 65

Medicare has a lot of out-of-pocket costs, but you may have other options to pay for medical bills that are not covered by Medicare. Medicare Advantage plans and Medicare supplement plans are available in most states to help when you’re under 65 and eligible for Medicare.

If you’ve looked into your Medicare coverage, you’ve seen that it leaves you to pay for co-insurance, co-pay and deductible charges. Should you need hospital care, Medicare has a whopping big deductible of over $1,000. That deductible isn’t an annual expense either.

It’s tied to benefit periods that extend for 60 days after you no longer need inpatient care at a hospital or skilled nursing facility. Since that’s just a couple of months, you could need additional hospital care again in a few months. If you do, that would mean you’d enter another benefit period and have to come up with another $1,000+ deductible.

Fortunately, if you have Medicare and you are under 65, most states offer at least one type of Medicare supplement insurance to cover medical bills that Medicare doesn’t pay. In certain areas, Medicare Advantage plans help, too, and may cost you little or nothing at all for the extra protection.

An annual open enrollment period for Medicare Advantage plans starts on November 15th, but only lasts through January 1. So anyone interested in one of these plans should contact us asap, as we are always *extremely* busy this time of year.

Just visit us online at www.MediGapAdvisors.com or call us today at 866 323-1441 to see how we can save you money.

Medigap Insurance: Two Tips Make It Simpler to Get the Best Deal

When it comes to Medigap Insurance, Medicare Supplement Insurance or Medigap plans, you get the same 10 plans no matter what you call them. These plans must comply with government laws that standardize your benefits and coverage. You can be sure that you’re getting the same basic coverage with a Medigap Plan A, for instance, regardless of which insurance company offers it. That means you can shop for the lowest price on any of the 10 plans without worrying that you’re giving up any coverage at all.

Next, you don’t have to worry about customer service either. All 10 Medigap plans automatically work with Original Medicare and service is consistently high because there’s little room for error. When Medicare pays for 80 percent of a doctor’s fee, Medigap pays for the remaining 20 percent. The Medicare Rights Center reports few problems with Medigap payments. If your Medigap plan reimburses you for Medicare’s Part A or Part B deductibles, you don’t have to worry about meeting any criteria to get your reimbursement.

You can even find Medigap plans that cover expenses that Medicare never covers, such as emergency medical care when you’re on vacation outside of the country. If you’re worried about needing a specialist who won’t accept Medicare’s standard payment rate, Medigap plans can even pay for the difference between doctors’ charges and Medicare’s payments.

You can take a look at what all 10 Medigap plans cover and learn from the nation's leading independent agency specializing in Medigap Plans. You’ll find everything you need to compare, choose and enroll in a plan at www.MediGapAdvisors.com/, but we offer more…just click here to reserve your space for the free, live How to Get the Most from Medicare teleseminar. Could it get any easier than that?