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Medicare Extensions For Hurricane Victims

People whose lives have been disrupted by Hurricane Sandy who are receiving Social Security or Disability Insurance and eligible for Medicare, are being allowed to enroll or make changes in their  benefits plan past the usual December 7th, 2012 cut off. The Centers for Medicare & Medicaid (CMS) is giving participants who have been affected by Hurricane Sandy more time to complete their annual enrollment choices in the 2013 Medicare plan selection.

Extra Time For Insurance Enrollment

Each year, millions of people have the opportunity to review their healthcare coverage during the usual Medicare annual open enrollment period during October to December. However, Hurricane Sandy’s incredible damage on the East Coast has caused widespread disruption for many Medicare-eligible individuals, making the services selection process difficult.

The CMS realizes the huge impact and they are allowing beneficiaries additional time to review their options and to enroll in the 2013 service plan year. This includes people whose family members were affected by the storm, especially if those family members help you with your daily healthcare decisions.

The following information from outlines participants who now have more time to enroll for 2013 benefits. If you have been denied coverage or have additional special circumstances, a consultation with a Social Security Lawyer specialized in disability may provide further help.

  1. Who gets extra time for Medicare annual enrollment? Anyone affected by Hurricane Sandy is being provided extra time for Medicare enrollment. This includes individuals living in the affected area as well as those who, “rely on help making healthcare decisions from friends or family members who live in the affected areas,” according to CMS. No proof is required in order to have additional time.
  2. How much time do people have?
    Medicare is urging people to try to make their enrollment decisions before the end of January if they can. Those who cannot should try to enroll as quickly as they can. Officials have not set a new deadline. If you enroll in a new plan, coverage will begin the first day of the month after you enroll. For example, if you enroll on Jan. 14, your plan coverage will begin Feb. 1. You will be automatically re-enrolled in your current plan if you don’t enroll in a new one for 2013.
  3. What action is needed to get more time?
    To enroll in a plan, affected participants should call the Medicare offices at 1-800-MEDICARE and identify themselves as having been delayed by Hurricane Sandy. It is recommended to call once Medicare participants have decided on the plans they want to enroll in for 2013. Medicare specialists are standing by to assist those affected by Hurricane Sandy, and they can help individuals, families and caregivers with choosing and enrolling in Medicare coverage for 2013.


Medicaid Reimbursement Threatened By Unpaid Taxes

medicaidThe Social Security Administration must continually work to revamp programs and eliminate wasted money. With Social Security Disability and Medicaid funds threatened by the turbulent economy, the pressure is mounting for the SSA to find better ways to provide services for less.

Collecting On Debts

One area of recent focus is cutting Medicaid reimbursements for providers with delinquent tax payments.  A recent study found that there are some widespread problems of tax evasion by health care providers in three states, costing the government nearly $330 million. The U.S. Government Accountability Office (GAO) reported to Congress that there are nearly 7,000 Medicaid providers are delinquent in their tax payments. These agencies reportedly received $6 billion in Medicaid reimbursement funds since 2009.

The top providers violating their duties to make tax payments were found in Texas, Florida and New York. These Medicaid providers who are found to be behind on their tax debts could face changes to the amount of reimbursement funds they receive. The GAO has recommended that the IRS revisit their collection policies, which could include increased litigation or penalties for non-payment.



Should You Be Getting Medicaid or Medicare?

medicaidWith health insurance costs being so high, many people who have thought about Medicaid and Medicare in the past are especially interested in getting those benefits now.  If you think you might qualify for Medicaid and/or Medicare, then keep reading to find out for sure!

Who Qualifies?

Before asking this question, it’s important to understand the difference between Medicaid and Medicare.  Simply put, the former is designed for those who are financially unable to meet their health care costs, while the latter is attached to Social Security benefits.  Of course there are many more details, but understanding this broad distinction is what you really need to know!

All the information you need to know about eligibility for Medicaid is on the official Medicaid webpage.  But, here’s the quick summary: if your family lives at 133% of the Federal Poverty Level or below, you are generally eligible.  These are Federal guidelines, but each state sets its own specific policies.  To give you an actual figure, 133% of the Federal Poverty Level for a family of four was $29,700 in 2011.

Medicare benefits are great options for retirees to investigate.  The webpage on eligibility can answer all of your questions in regards to Medicare, but again, here’s a brief summary.  In order to be eligible, you have to be at least 65, and must have worked for 10 years in a job that paid into Medicare.  However, people under 65 with disabilities can also be eligible!

If you qualify for Medicaid and/or Medicare, then you may qualify for disability benefits, too.  Get in touch with us, and we’ll help you determine what kind of disability benefits you may be eligible for!

More Trouble For Social Security Recipients

medicareAs if the disappointing  news regarding the fate of Social Security and disability insurance programs wasn’t ominous enough, a new report suggests that Medicare costs could also be changing over the next few years. With close to 6 million people relying on Medicare benefits for health coverage, the expected increase in costs could be detrimental to many citizens.

Cutting Benefits, Rising Costs

Although the main focus has been on other Social Security programs in recent years, the truth is that Medicare has always been on the edge of disaster. However, further problems are expected as the cost of Medicare premiums is forecasted to begin rising over the next few years. What is more alarming is that this increase in Medicare costs for beneficiaries is not expected to be tempered by a similar increase in benefits, which are expected to remain steady if not decrease over time.

In the past, Social Security program benefits have seen an increase due to cost of living adjustments. It is unclear as to whether these necessary annual inflation will be anything more than 1%, if anything. Meanwhile, Medicare costs are expected to rise by 11%, creating a gap between income and the cost of essential expenses like medical coverage. Current beneficiaries are being advised to begin planning for the increase in cost and develop alternative strategies for maintaining financial balance in the wake of such changes.



Depression Screening Available In Medicare

depressionThe government has been working to expand the services and treatments available for Medicare and Social Security beneficiaries. As times progress, so does illness and more conditions are becoming epidemic in recent years. Alzheimer’s has recently been added to the list of probable conditions that may be covered under the Social Security Disability program, and now depression is getting some much needed attention as well.


Depression is one of those conditions that is often difficult to manage.  Those affected often fight their diagnosis and attempt to self medicate or treat the illness themselves. Family and friends may find it difficult to accept a depression diagnosis and may not even recognize the signs of further problems. Research shows that depression is highly likely to go hand in hand with other illnesses and most people suffering are also experiencing one or more medical conditions. Chronic pain, anxiety, cancer and certain disabilities are commonly occurring conditions alongside depression.

Despite its prevalence, depression is often undiagnosed in certain populations such as the elderly. The elderly are less likely to seek help for their depression and screening tools haven’t been adapted to properly test for the condition. Add in the out of pocket costs for screening and treatment, depression in the elderly can be devastating. However, this past October the Medicare program began covering the costs of annual depression screening for beneficiaries. Medicare recipients can now get screened for free once per year and even receive treatment for a fraction of the cost.



Missing Out On Medicare

medicareMedicare is a health insurance program that is designed to help cover medical costs for those over the age of 65 or with qualifying disabilities. Unlike the highly sought after Social Security Disability benefits, many Americans are unaware of their eligibility or qualifying status. It turns out that there are thousands of Americans in need who are without health insurance simply because they do not know the standards and procedures associated with Medicare benefits.

Get Covered

Every day, more than 11,000 Americans become eligible for Medicare simply by turning 65 years old. While this isn’t the only qualifying mark, it does paint a picture of how many people could be missing out on a very crucial benefit. Anyone already receiving Social Security benefits is most likely already receiving, or at least eligible for, Medicare. However, this doesn’t mean that they are using the program to its fullest potential.

For those who are not already receiving Social Security benefits, applying for Medicare may be well worth the time and effort. While it is difficult to pin down specific requirements for qualifying for Medicare outside of the age of 65, there are a few ways to help determine one’s chances of securing benefits. First, anyone over the age of 65 is automatically eligible for Medicare regardless of their physical condition or disability status. Second, those under the age of 65 must meet certain disability requirements. This is the tricky part as not all disabilities qualify for Medicare coverage. However, meeting the eligibility criteria for disability insurance is a good indicator of chances for Medicare coverage.



More Sentenced For Medicare Fraud

medicare fraudRecent news reports surface around several more individuals who have been charged and convicted of Medicare fraud. As Social Security benefits become tightened and the fate of several programs up in the air, many people are resorting to criminal measures to get help.

Judge And Jury

A Los Angeles woman plead guilty to committing $6.2 million in Medicare fraud. The woman admitted to fraudulently obtaining a physician’s personal information to print phony prescriptions. She and several others used Los Angeles based clinics as the fake front for writing and selling fraudulent prescriptions for pricey medical equipment.  The woman was sentenced to pay the $6.2 million in restitution and serve five years in prison.

Sadly, Medicare fraud comes in many forms such as the case described. As far as consumers are concerned acts such as filing for services never used, billing Medicare for equipment never received or obtaining and selling goods and services are all considered fraud. Securing services through misleading means or by using fraudulent personal information is also Medicare fraud.  Those convicted stand to face serious consequences including jail time.





Social Security Program Gets Quality Boost

MedicareOne of the most utilized and critical programs offer by Social Security launches a new initiative to improve quality for consumers. Medicare announced earlier this week that they will be starting an experiment aimed at improving care for seniors and, hopefully, saving taxpayers money.

The Good News

After being at the forefront of the debt debate, many have worried about the future of social security benefits programs, including Medicare. While not much has been done so far to resolve the problems Social Security programs face, the latest efforts are seeking to change that fact.

President Obama announced that 32 networks of doctors and hospitals around the country will become part of a new program to streamline services. Pioneer Accountable Care Organizations will be a new, coordinated approach to medical care. The program’s main goal will be improving the quality of care received by benefit recipients, while offering network providers financial incentives for participating and improving consumer care. It is estimated that about 850,000 of Medicare’s beneficiaries will take part in the test program that is hoped to result in a new model of healthcare.




Getting To Know Medicaid Benefits

MedicaidWhen people think of social security benefits, they tend to also think of Medicaid and Medicare benefits. While both social security benefits and Medicaid/Medicare are provided by the government, they are very different. In addition to the type of benefits they offer, who qualifies to receive these benefits can also vary quite a bit.

Health Insurance vs. Cash

Medicaid and Medicare are health insurance programs that provides medical coverage to those with limited income or resources. Doctor visits, prescriptions, medical testing and some dental or vision treatments may be covered under these program. The benefits offered by Medicaid/Medicare may cover people with disabilities, the elderly, pregnant women, children or families. To qualify for Medicaid or Medicare a person/family must meet certain income and resource restrictions, meaning these benefits are reserved for those in need.

The biggest difference between Medicaid/Medicare and social security benefits is that Medicaid does not provide cash benefits. It is a medical insurance program only that pays for medical expenses, but does not provide cash directly to the beneficiary. Social Security Disability Insurance and Supplemental Security Income are two social security benefit programs that provide cash to recipients. They each have their own qualification requirements, but both can provide cash to those in need.




Social Security Administration Requirements And Medical Listings

medical conditionsIf you are applying for benefits either through Social Security Disability Insurance or Supplemental Security Income, you will need to furnish adequate documented proof that your medical conditions prevent you from functioning fully in the current economic climate. In order to help streamline the process, the Social Security Administration keeps a listing of qualified medical conditions that will result in an applicant getting disability benefits. However, a list is not nearly flexible enough to encompass all debilitating conditions or make allowances for differing degrees of disability for a single condition. What happens if you do not meet all the checklist requirements for a certain disability?

Other Considerations

Fortunately, the Social Security Administration recognizes this and does make allowances in this regard. If you do not meet the requirements of the listing for your condition, your residual functional capacity is then taken into consideration. Basically, this means that the Social Security Administration will investigate whether or not your condition impairs your ability to work, and whether or not you meet all the listed requirements for a particular condition.

Other things that are considered during the application process for Social Security Disability Insurance or Supplemental Security income are age, past relevant work, and education. The process for applying for either Social Security Disability Insurance or Supplemental Security Income is long and nuanced – and these considerations are part of the reason why it can take up to two years on average to get benefits from either of these programs! Be patient, furnish documents when required, and you’ll get there.

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