Medicare Advantage: Is there truly an advantage?

Confused about Medicare Advantage?  You are not alone.   To understand Medicare Advantage it is important to get a sense for the bigger picture, rather than becoming overwhelmed by the complicated specifics and details.   Let’s reduce Medicare Advantage to the basics, so you can be better informed and make better decisions when planning your Medicare.

 

To start, original Medicare is a government program that is part of Social Security, created to help seniors with their healthcare needs.     If you are a senior over the age of 65, assistance is available to provide for your healthcare necessities with what is called Medicare Part A and Part B.  Think of these two parts as the building blocks of a complete personal healthcare program.  While the foundation of Original Medicare is most important to your healthcare, you may want to add additional layers of coverage.  These additional layers of coverage are not provided through Medicare and need to be supplemented by you personally.

 

According to Medicare.com, Medicare Advantage offers additional individual coverage that Medicare does not provide.   It is essentially a package of additional healthcare benefits provided by private companies or insurers, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D). Medicare Advantage Plans still provides you with the important foundation of Medicare Part A and Part B provided by the government, while offering you additional coverage that fills in some of the gaps that exist within Original Medicare. Medicare Advantage offers a variety of different coverage programs, rates, rules, and physician networks.  These many options can be great for people who want more choices and better coverage for their individual needs, however the program details can often be confusing, with additional rules and restrictions.

 

A common analogy that is used to describe Original Medicare is the foundation of a house.  The foundation includes a basic floor, walls, and a roof.  It is a great and important start and provides the framework for your home.  But what if you want a more comfortable home? Like additional rooms? Or a custom kitchen? Or bigger bathrooms?  Well, Medicare Advantage programs allow you to add some important custom features to your healthcare home, like the vision, hearing, dental, wellness programs and prescription drug coverage previously listed. ,

 

It is up to each personal to decide what is right for their individual healthcare needs and Medicare Advantage offers many important options.
If you have questions about your personal healthcare, insurance coverage, or Medicare, you can contact the Medicare experts directly at SeniorQuote by calling 888-278-5126.

Hospital Ratings and Medicare

It wasn’t long ago that all hospitals, effective or ineffective in their patient care efforts, were given equal reimbursements from Medicare. Now, in an attempt to hold hospitals accountable for their quality of care, Medicare has provided both penalties to punish and bonuses to reward hospital within a new Value-Based Purchasing Program. Drawing from both an analysis of quality care and a patient survey after discharge, Medicare calculates in readmission rates to compile a quantitative assessment. As a result of this assessment, hospitals either experience an increase in Medicare reimbursement, or a decrease.

The program strives to lower costs and increase quality of care, but it has its flaws. Many hospitals who serve substantially fewer patients have an advantage over those who have busy waiting rooms. The patient-to-doctor ratio and personal attention is not the same, therefore the surveys from patients tend to reflect this, giving the hospitals with higher patient volumes a lower score. Some healthcare experts are concerned about the influence of low-income areas on a hospitals’ ranking in the Value-Based Purchasing Program, as many penalized healthcare institutions operate within more challenging economic conditions, making it more difficult for them to receive a full Medicare reimbursement.

Overall, patients can expect to see rapid changes in the healthcare industry as hospitals try to make adjustments in order to avoid penalties or continue to invest in effective care to drive increased rewards The quest for quality care has taken form with the implementation of the Value-Based Purchasing Program, and not all hospitals will be treated equally by Medicare’s reimbursement system.

Complete hospital profiles, patient survey results, and ratings are available through www.medicare.gov, or you can contact the Medicare experts directly at SeniorQuote by calling 888-278-5126.

ObamaCare – Will there be “Sticker Shock?”

Just like any event that hasn’t happened yet, many people have   theories for how it will turn out.  Imagine Boston Red Sox and New York Yankee fans debating who would win in a World Series they would continue to argue until the teams actually played.  Right now, the same thing seems to be happening with those speculating about Obamacare and its impact on the cost of healthcare.

“Sticker shock” has been cited by many Obamacare critics who predict that healthcare costs will rise as a result of the program’s implementation, while proponents of Obamacare believe that long-term healthcare costs should decrease.

While the debate will continue for years after the implementation of Obamacare, there are some things that you should consider when reviewing the statements regarding “sticker shock.”  According to the Wall Street Journal, Many believe that the expected rise in healthcare insurance should not pertain to people who already have healthcare provided by their employers The greatest increase is expected to be for those individuals who acquire their own insurance, independent of a corporate employer.   Obamacare is designed to ensure that these independent people will not be discriminated against for preexisting conditions when buying health insurance.  This should mean that  more individuals with pre-existing health conditions will be covered by insurance, As a result, insurance companies will need to cover the higher costs associated for people with pre-existing conditions  which will necessitate  an increase their premiums and require  everyone they cover to pay more into the system.

The actual, individual costs of Obamacare will begin to be realized this year, leading into the comprehensive implementation in 2014.

If you have questions about your personal healthcare, insurance coverage, or Medicare, you can contact the Medicare experts directly at SeniorQuote by calling 888-278-5126.