Medicare and More - Latest Comments

Re: Are doctors opting out of Medicare?

Hugh J — Fri, 24 May 2013 13:21:39 -0000

Sorry about that. I read the part "some doctors are moving to concierge medicine where they don't take any insurance plans" to mean that the concierge model, as such, was where no insurance was taken as part of its design.

Perhaps a better way to have said it would have been:

"...some doctors are moving to “concierge medicine” where, in a variety of models, they may or may not take medicare or other insurance plans and patients must pay a yearly fee to see the doctor."

I would still maintain that a practice where the patient carries no insurance at all because they're 'self insured' and can pay cash for all their healthcare, would truly be an exception due to the relatively low number of people with those resources.

Re: Are doctors opting out of Medicare?

Denise_Early — Fri, 24 May 2013 11:00:22 -0000

Hugh, I'm happy to know that some doctors who are running concierge practices are still taking Medicare. But other doctors have moved to the concierge model and are not taking insurance. That's why I used the term "some doctors".

Re: Are doctors opting out of Medicare?

Rassam — Fri, 17 May 2013 14:55:57 -0000

We should all be more concerned with maintaing our own health, because the "system" is not. Doctors, Medicare, insurance companies are just concerned with finding disease. They receive payment only when there is illness. There is a massive financial incentive going on here!

Re: Are doctors opting out of Medicare?

Hugh J — Fri, 17 May 2013 12:38:22 -0000

"...some doctors are moving to “concierge medicine” where they don’t take any insurance plans and patients must pay a yearly fee to see the doctor."

This is, as best a careless and at worst, a deceptive statement. My wife and I use a 'concierge' practice. We're both on Medicare as well as using a supplemental plan. The Doctor uses both. I don't know what the writer is talking about here.

There may be Doctors that see people that use no insurance whatsoever but...think about it...how many people are in that category? Even if you're extremely well off, to not have some kind of plan for catastrophic events is not prudent. And If you have enough money to not worry at all, really, how many doctors are needed to administer this category?

This piece addresses an important evolution in healthcare. But it's incomplete and has parts that don't 'pass the smell test'.

Re: Welcome to Medicare Visit

JEngdahlJ — Tue, 07 May 2013 11:11:14 -0000

Current utilization of preventive services is about 60-70% of what is clinically
suggested in PPACA. http://www.healthcaretownhall....

Re: Medicare and Medicaid: Arizona Dual Eligibles

JEngdahlJ — Tue, 23 Apr 2013 10:58:18 -0000

Medicare Advantage allows individuals to choose from a wide
range of competing plans that may offer richer benefits. http://www.healthcaretownhall....

Re: Discount Drug Card vs Part D

Denise_Early — Fri, 29 Mar 2013 18:21:40 -0000

I tried to get some discounted prices using the Coast2CoastRx card. I called a CVS pharmacy and asked if they could tell me what the discounted price would be with the Coast2Coast Rx card.

The CVS pharmacist told me I need a prescription. Then she will create a record for me which will contain the information from the Coast2Coast Rx card. Only then will the system generate a discounted price for a particular medication.

I told her I don't have a prescription and want to know what the cost for Advair would be with the card. But, I said, "I don't have insurance and I don't want to pay for a doctor's visit for a medication I may not be able to afford, so I need to know what Advair will cost me before I spend money on a doctor visit".

She said her system is not set up to work any other way.

So.... what is an uninsured person supposed to do? I'll try other pharmacies and see if I can get some pricing information. I am fortunate to actually have very good health insurance, but the Coast2Coast Rx discount card is for people who do not have health insurance.

Re: Discount Drug Card vs Part D

Denise_Early — Fri, 29 Mar 2013 12:11:20 -0000

I'm just telling people with Part D that they need to ask some questions to get themselves the best deal.

Re: Discount Drug Card vs Part D

Del Rickel — Fri, 29 Mar 2013 07:20:52 -0000

Why do a comparison article without a comparison?

Re: Medicare Part D and Compounding Pharmacies

Denise_Early — Sun, 24 Mar 2013 22:24:19 -0000

Can you explain further? I was told by two Part D plans that as long as the drugs are on their formulary, they can be combined by a compounding pharmacy and will be covered.

Re: Medicare Part D and Compounding Pharmacies

Todd — Sun, 24 Mar 2013 11:30:52 -0000

We appreciate the article on this topic and on Avella. We encourage any patients or healthcare providers to learn more about Avella or contact one of our locations by visiting www.avella.com

Re: Medicare Part D and Compounding Pharmacies

Erika Fallon — Sun, 24 Mar 2013 09:03:07 -0000

Medicare part d will not cover medications compounded from "bulk chemicals", which means unless the formulation is made from an FDA approved, manufactured drug, it will not be covered under any part D plan, by law. Also, E3 is estriol and E2 is estradiol.

Re: Lipitor has gone generic. Don’t get ripped off!

BajaDemocrats — Fri, 22 Mar 2013 09:33:34 -0000

Thanks for the excellent information Denise. My insurance wouldn't cover Lipitor at all, I've been taking a generic for Zocor for several years. In my checkup last Dec. my bad cholesterol count had gone up so my doctor doubled the dose from 20 to 40mg. I have to be careful to take it on a full stomach or I get stomach cramps. I'll ask my doc to give Atorvastatin a try. He's always said Lipitor was the "gold standard" for cholesterol control.

Re: Why is Part D so complicated?

tiponeill — Thu, 21 Mar 2013 15:12:57 -0000

Blame Shrub - Part D is Republican "free enterprise" at it's worst. They don't have these problems in Canada

Re: Why is Part D so complicated?

Denise_Early — Thu, 21 Mar 2013 12:50:59 -0000

Perhaps you should re-read the post.

The doctor is turning 65 soon and is looking at Part D as a consumer. Being a doctor, he also sees how the complicated nature of the program adds cost to the healthcare system.

The doctor is not complaining about getting calls from patients. It is insurance companies that require more and more paperwork and hoops to jump through - and this adds to the cost of running a medical practice.

I revised my post to say I don't hate Part D. I just hate that it is so complicated.

Re: Why is Part D so complicated?

Dennis Byron — Wed, 20 Mar 2013 19:26:30 -0000

How does Part D cost his office anything? He just writes the prescription. Does he mean he doesn't like patients calling him back and asking if they can use a generic instead? Like he does?

(Did you just really make this story up so you can do your usual anti-PartC/D article because the programs cost you insurance guys commissions?)

Re: Medicare and the Arizona State Retirement System

Fraser007 — Wed, 06 Feb 2013 12:50:23 -0000

Great article. Thanks for posting it.

Re: Smaller networks for under-65 health insurance and Medicare Advantage

Denise_Early — Tue, 29 Jan 2013 15:16:59 -0000

With Medicare Advantage plans that are HMOs (which will be the case with small network plans...and most Advantage plans in Arizona) a person cannot go out of network. The plan will not pay the bill if a person gets service from a provider who is not in the plan's network. However, the plans must contract with enough doctors so that every service can be provided. The plan can't say, "We don't have oncology doctors in the network so you can't get cancer treatment". That does not happen. But a person can't be picky about providers if they enroll in a small-network plan.

Re: Smaller networks for under-65 health insurance and Medicare Advantage

Pallottine — Fri, 25 Jan 2013 20:03:19 -0000

Smaller networks. Lower co-pays. That's fine,until you need medical services outside the network. Ouch!

Re: Medicare premium help not yet renewed for 2013

Cathy — Wed, 02 Jan 2013 00:21:05 -0000

Now it's renewed!

Re: Medicare premium help not yet renewed for 2013

Cathy — Tue, 01 Jan 2013 09:41:59 -0000

Extension was included in the "fiscal cliff" deal the Senate passed last night. Let's hope the House passes it today.

[ Section 621 (page 105): http://www.scribd.com/doc/1185... ]

Re: Medicare premium help not yet renewed for 2013

Denise_Early — Sun, 30 Dec 2012 19:07:50 -0000

The 12/14/12 letter sent to people affected by the QI-1 funding delay is on the AHCCCS website. http://www.azahcccs.gov/shared...

Re: Medicare premium help not yet renewed for 2013

Guest — Sun, 30 Dec 2012 18:54:51 -0000

Has anybody seen any news on the funding for the QI-1 program?

Re: Medicare Part D: Should you pick a plan with a deductible?

The Med Diva — Tue, 20 Nov 2012 16:32:12 -0000

As I like to say, you need a PhD to understand Med D!

Re: Durable Medical Equipment and Medicare: Read the small print!

Denise_Early — Sat, 13 Oct 2012 00:31:27 -0000

You need to have your doctor "prescribe" a new wheelchair and submit it to your Advantage plan. I'm not so sure they will know you got a wheelchair through your husband's insurance. It's worth a try to get your doctor to put in the request and see what your Advantage plan says.