Medicare – Page 13 – Total Benefit Solutions Inc

HR4302 Bill Passes: Repeals limitation on deductibles for employer-sponsored health plans

April 1, 2014Ed MacConnell

On March 31, 2014 President Obama signed into law Bill HR4302 – Protecting Access to Medicare Act of 2014, sometimes called the “Doc Fix” bill. While the primary purpose of this bill was to prevent the automatic cuts to physician Medicare payments, this bill also included a significant modification to the Affordable Care Act (ACA). This bill included a section that ends the limitations on deductibles that were set at $2,000/individual and $4,000/family within the ACA on small group employer sponsored health plans, and made the effective date retroactive to the original enactment of the ACA. The act states: SEC. 213. ELIMINATION OF LIMITATION ON DEDUCTIBLES FOR EMPLOYER-SPONSORED HEALTH PLANS.… Read More

Crozer-Keystone Health System No Longer In Network with Cigna-Healthspring MAPD Plans

March 24, 2014Ed MacConnell

Please be advised of a change in the Cigna-HealthSpring provider network which may impact some of your customers. Starting May 1, 2014, Crozer-Keystone Health System will no longer be available to Cigna-HealthSpring members for hospital, home health or ancillary (surgery and other similar treatments) services. In a few days, we will mail the attached letter to the affected membership to advise them of this change. Please note that Crozer-Keystone health system primary care and specialty group doctors are still part of the Cigna-HealthSpring network. Only hospital, home health and ancillary services are leaving the network beginning May 1, 2014. Cigna-HealthSpring members currently under an active treatment plan may continue to… Read More

Humana: My Medicare Answers

March 19, 2014March 18, 2014Ed MacConnell

Humana introduces mymedicareanswers.com MyMedicareAnswers.com is an unbiased online community intended to educate, engage and capture conversations around the Medicare decision making process, ultimately offering clear, concise guidance to users – See more at: https://www.mymedicareanswers.com

2014 Updated Medicare Deductibles & Official Medigap Handbook

March 18, 2014Ed MacConnell

Click the link below to download an updated sheet with the Medicare deductibles for 2014. Download also includes the official CMS Handbook Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare. Click this link to download: BA9917ST (04-13)_lo res

IBC: Important Changes Regarding Medicare Part B Exclusion

March 18, 2014September 9, 2014Ed MacConnell

From IBC November 2013: We are writing to let you know that we will be contacting your group customers to communicate the Medicare Exclusion and application of this exclusion to their benefit plan. What is the Medicare Exclusion? The Medicare Exclusion applies to members for whom Medicare would be the primary payer but they have not elected to enroll. These members will be responsible for paying their doctor, hospital, or other medical professional the amount Medicare would have paid and any applicable copayments, coinsurance, and deductibles. In turn, their group health benefit plan will only pay the remaining balance on claims submitted as if the member had enrolled in Medicare… Read More

IBC: Medicare as Secondary Payer

March 17, 2014Ed MacConnell

Medicare Secondary Payer (MSP) requirements determine when Medicare is the primary insurance payer. If your company has 19 or fewer full- and part-time employees, Medicare is almost always primary. If your company is larger, various rules apply to determine whether your group plan is the primary or secondary payer. MSP requirements also apply for Medicare-eligible employees who are disabled or have endstage renal disease. The following information provides a summary of the MSP requirements. This information may help you to correctly target benefits for your Medicare-eligible participants and avoid potentially costly penalties and litigation. You should, of course, also refer to the actual laws and regulations with the assistance of your own legal counsel. Click… Read More

IBC: New Lab Provider Effective July 1-IMPORTANT NOTICE

March 12, 2014Ed MacConnell

Independence Blue Cross (IBC) has selected Laboratory Corporation of America® Holdings (LabCorp), as its exclusive, nationally-based provider of laboratory services, effective July 1, 2014. The change applies to all Personal Choice®/PPO and Keystone Health Plan East product lines, and affects all individual, group commercial, and Medicare members, for services rendered in the Philadelphia five-county area, and in the contiguous counties. Effective July 1, 2014, Quest Diagnostics laboratories will be an out-of-network provider for Personal Choice and Keystone Health Plan East. IBC will continue to contract with certain local and regional laboratories… Click to download the bulletin

Important: Change to PACE and PACENET Income Limits

March 8, 2014Ed MacConnell

Effective February 7, a new law was passed that greatly benefits Medicare beneficiaries who may be eligible for PACE and PACENET. Although the annual income limits will remain the same, the Medicare Part B premium ($104.90 per month for most beneficiaries) is no longer part of the countable income of a Medicare beneficiary. This new law will result in thousands of additional beneficiaries becoming eligible for prescription drug coverage. What this means for beneficiaries Beneficiaries who may have been over the PACE/PACENET income limits by $1,259 or less, may qualify under the new law and should reapply. If a beneficiary reapplies and now qualifies for PACE/PACENET then the beneficiary is… Read More

IBC Group Medicare Security 65 Billing Issues

December 28, 2013December 28, 2013Ed MacConnell

Security 65 Invoices Security 65 groups that are transitioning to our new operating platform effective January 1, 2014 are receiving premium invoices that reflect a zero-dollar balance. These invoices were sent in error and new invoices reflecting the appropriate premium due and membership information are being generated. Please be assured that this was an invoice issue only and did not affect membership. All members are currently active and there is no impact to access of care.

Final Rules on Additional Medicare Tax

December 4, 2013December 3, 2013Ed MacConnell

Effective November 29, 2013, final rules provide guidance for employers relating to the implementation of Additional Medicare Tax.Click here for more information.

Learn about Medicare Medical Savings Accounts

October 31, 2013Ed MacConnell

Medical Savings Account Plans: MSA Plans combine a high-deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. Medicare MSA Plans don’t cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate Medicare Prescription Drug Plan. There are additional restrictions to join an MSA plan,… Read More

Medical Savings Accounts for Medicare Members

October 4, 2013Ed MacConnell

Questions about Medicare medical savings accounts, or Medicare MSA’s? Click here to learn more about: Geisinger Gold MSA Click here for Frequently Asked Questions: FAQs about MSAs Want more information? Have more questions? Is a Medicare MSA plan the right fit for you? Call us today at (215)355-2121 to find out more!

Medicare and You 2014 now available

September 25, 2013September 26, 2013Ed MacConnell

The Medicare and You guide for 2014 is now available. This official government booklet tells you: Summary of Medicare benefits, coverage decisions, rights and protections, and answers to the most frequently asked questions about Medicare. Click here to download your copy. Click here to order a printed version to be mailed to you Have questions about your Medicare coverage or Medicare supplements? Call us today at 215-355-2121

Total Benefit Solutions to offer Health Partners Plans

September 25, 2013September 25, 2013Ed MacConnell

Total Benefit Solutions is proud to announce that we have teamed up with Health Partners Plans for the upcoming 2014 Medicare Open Enrollment. Stay tuned for upcoming announcements regarding the plans, choices and benefits. We are excited about this opportunity to add another quality plan choice to further our commitment to our clients in the Medicare population. .

Reminder to Distribute Creditable Coverage Notice

September 14, 2013September 12, 2013Ed MacConnell

Employers who sponsor a group health plan with prescription drug benefits are required to notify their Medicare-eligible participants and beneficiaries whether the prescription drug coverage offered under their plan constitutes “creditable” or “non-creditable” coverage. This notification must be provided prior to October 15 each year. Click here to download the Medicare Part D Reminder

What’s up with Medicare these days?

August 3, 2013July 29, 2013Ed MacConnell

Let’s face it, even though Medicare provides health coverage for 49 million Americans, the program itself isn’t all that easy to understand. That’s why AARP Illinois State President Merri Dee and AARP Illinois staff member and Medicare expert Courtney Hedderman got together this week for a question-and-answer session with about 1,500 of our members through a tele-town hall. Here are some of the questions asked during the call and the answers. Q: I’ve heard that the new health care law makes changes to Medicare, can you explain those changes? Click here for the story on the AARP Medicare Blog

How the ACA Helps Medicare’s Disabled Beneficiaries

July 29, 2013July 29, 2013Ed MacConnell

The Affordable Care Act, which was passed in 2010 and upheld by the U.S. Supreme Court in 2012, includes numerous provisions that impact people with disabilities through expansions of Medicaid, private health insurance reforms, new care coordination programs and efforts to transition elderly and disabled populations from institutional to home and community settings. The ACA: Click here for the story on Medicare News Group

Medicare: What Will Happen to Doctors’ Fees and Income Under the Affordable Care Act (ACA)?

July 17, 2013February 6, 2022Ed MacConnell

Q:What Will Happen to Doctors’ Fees and Income Under the Affordable Care Act (ACA)? A: Business income has increased for doctors because many people on Medicare are now using free screenings and an annual “wellness visit” provided through the Affordable Care Act (ACA). Through Oct. 6, 2011, the government said, 20.5 million people enrolled in Medicare had received the free screenings or the annual visit, which is also free. Medicare is now offering a 10 percent bonus payment on the fees charged for primary care services, and a 10 percent bonus payment to surgeons who work in areas where there are shortages of doctors. For 2013 and 2014, Medicaid payments… Read More

Is There a List of Providers Who Have Been Excluded From Medicare Because of Fraud?

May 22, 2013February 6, 2022Ed MacConnell

Yes. The Department of Health and Human Services and its Office of the Inspector General excluded a total of 3,131 individuals and entities from participation in federal health care programs in 2012. Click here to read the story.

89 charged in Medicare fraud busts in 8 cities

May 20, 2013February 6, 2022Ed MacConnell

WASHINGTON (AP) — Nearly 100 people, including 14 doctors and nurses, were charged for their roles in separate Medicare scams that collectively billed the taxpayer-funded program for roughly $223 million in bogus charges in a massive bust spanning eight cities, federal authorities said Tuesday. Click here for the story.

CBO: Obama budget would cut $364 billion in Medicare spending

May 20, 2013May 27, 2013Ed MacConnell

President Obama’s budget proposal would save the Medicare program $364 billion over the next decade, according to the Congressional Budget Office (CBO). The CBO largely concurred with the White House’s estimates, which pegged the budget’s Medicare savings at $370 billion. Read the rest of the story here. Read more: http://thehill.com/blogs/healthwatch/medicare/300497-cbo-obama-budget-would-cut-364-billion-in-medicare-spending#ixzz2Tq8qATza Follow us: @thehill on Twitter | TheHill on Facebook

Ed MacConnell & Terry Farber Esq. to speak at Arden Courts of Warminster

May 4, 2013February 6, 2022Ed MacConnell

Questions about Medicare, Medicaid, Long Term Care and Elder Law Planning? Join us for a Q+A session with Edward T. MacConnell CBC, CHRS and Elder Law Attorney Terry Farber on May 16th 2013 at Noon. Location: Arden Courts at Warminster, 779 W County Line Road, Hatboro PA 19040 Call to reserve your seat: Sarah Gawlinski-Greenstein, (215)957-5182 . The presentation starts at 12 Noon.

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