Share of Cost: Spanish Medicare Fraud; Prevention PSA is on Youtube

Wednesday, Nov. 9th 2011 3:29 PM

The National Hispanic Senior Medicare Patrol (NHSMP) has launched a new outreach and communications campaign, which includes a Spanish language public service announcement (PSA).  The PSA is currently being aired in South Florida through mid-September.

The PSA, titled El Fraude al Medicare es un Delito. Denúncielo. (Medicare Fraud is a Crime. Report It.), is part of the NHSMP’s Spanish language communications toolkit.  It was developed based on a needs assessment conducted to gauge the perceptions of the community and understand why they were underreporting Medicare fraud. NHSMP found that although a majority of seniors could identify Medicare fraud, they didn’t know how to report it or felt overwhelmed by their lack of English skills to communicate effectively.

Read the rest of this entry »

VN:F [1.9.22_1171]
Rating: 5.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: +1 (from 1 vote)
Posted on Wednesday, Nov. 9th 2011 3:29 PM | by Share of Cost | in Social Security | No Comments »

Share of Cost: Medigap Cost-Sharing Changes Meet Diverse Opposition

Monday, Nov. 7th 2011 6:29 AM

A provision in the 2010 federal health care reform law calls for changes in Medigap policies that essentially shift the burden of health care costs more onto the hands of beneficiaries. Several members in Congress have come to the unsubstantiated conclusion that because some Medigap plans (the most popular ones, C and F) cover most of the costs Medicare doesn’t — hence this insurance is referred to as MediGAP, beneficiaries use more services than they need. Therefore, they claim that Medicare pays more health care costs for these beneficiaries than others. To to help reduce these costs and hence the federal deficit, Congress has asked the National Association of Insurance Commissioners (NAIC) to propose changes to these Medigap plans so that beneficiaries pay more out-of-pocket for their health care.  The Congressional Budget Office estimated in March that such changes could save the government $53 billion in Medicare spending over a decade by strengthening incentives “for more prudent use of medical services.”

Read the rest of this entry »

VN:F [1.9.22_1171]
Rating: 5.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: +1 (from 1 vote)
Posted on Monday, Nov. 7th 2011 6:29 AM | by Share of Cost | in Social Security | No Comments »

Share of Cost: Watch Out for the American Opportunity Act Scam

Saturday, Nov. 5th 2011 6:29 AM

Did you know that by calling a special 1-800 number you may qualify to receive $500 from the American Opportunity Act?  By providing your Social Security number, date of birth and other personal information, in just 4 weeks you will receive a Visa Check card ready to be loaded with money.  Sound too good to be true?  Well it is!

Read the rest of this entry »

VN:F [1.9.22_1171]
Rating: 5.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: +1 (from 1 vote)
Posted on Saturday, Nov. 5th 2011 6:29 AM | by Share of Cost | in Social Security | No Comments »

Share of Cost: Consumers Beware of Medicare Advantage Marketing Fraud

Thursday, Nov. 3rd 2011 6:29 AM

Last week Julie Schoen, our California Senior Medicare Patrol (SMP) Project Director, spoke on Medicare fraud on a statewide press teleconference hosted by California’s Department of Managed Health Care (DMHC). Both agencies, DMHC and SMP, are committed to protecting beneficiairies from the sometimes malicious and fraudulent practices of a few insurance agents. While most agents may be trustworthy, DMHC has reports of several who are trying to persuade seniors to switch from their current health plan to the Medicare Advantage (MA) plan they are selling even though it is not in their best interest, and sometimes even without their consent.

Read the rest of this entry »

VN:F [1.9.22_1171]
Rating: 5.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: +1 (from 1 vote)
Posted on Thursday, Nov. 3rd 2011 6:29 AM | by Share of Cost | in Social Security | No Comments »

Share of Cost: Medicare’s Fall Open Enrollment Has Begun ~ Oct 15 – Dec 7

Tuesday, Nov. 1st 2011 6:29 AM

Medicare’s Fall Open Enrollment, officially known as the Annual Enrollment Period (AEP) starts and ends earlier now. From October 15 – December 7, beneficiaries can change their Medicare health plan and Part D coverage and/or return to Original Medicare. Coverage changes become effective January 1, 2012.

Read the rest of this entry »

VN:F [1.9.22_1171]
Rating: 4.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: 0 (from 0 votes)
Posted on Tuesday, Nov. 1st 2011 6:29 AM | by Share of Cost | in Social Security | No Comments »

Share of Cost: California Beneficiaries Hit Hard by Medicare Advantage Plan Pull-outs

Sunday, Oct. 30th 2011 6:29 AM

Almost 151,000 beneficiaries in California are in a Medicare Advantage plan that is pulling out of Medicare in 2012. This means these plans are not renewing their Medicare contracts, their plans are terminating by the end of the year, and beneficiaries enrolled in these plans need to choose a new coverage option for 2012. With a total of 301,912 beneficiaries nationwide affected by such terminations, 50% are in California.  Anthem Blue Cross is the reason for this high percentage of affected beneficiaries. They decided not to renew two regional PPO plans, the Freedom Blue plans, which have 113,709 enrollees or 75% of affected beneficiaries statewide.

Read the rest of this entry »

VN:F [1.9.22_1171]
Rating: 5.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: 0 (from 0 votes)
Posted on Sunday, Oct. 30th 2011 6:29 AM | by Share of Cost | in Social Security | No Comments »

Share of Cost is calculated independently for CMSP and Medi-Cal

Tuesday, Oct. 25th 2011 6:03 AM

SOC policy also applies to County Medical Services Program (CMSP) providers and subscribers. Share of Cost is calculated independently for CMSP and Medi-Cal, however, the same subscriber income is included in both calculations. Therefore, the same medical expenses may be used to clear SOC for both programs.  Providers may apply the same services used to clear a Medi-Cal SOC obligation to clear a CMSP SOC obligation.  Two separate transactions are required.  Clearing Share of Cost for one program does not automatically clear SOC for the other program.

VN:F [1.9.22_1171]
Rating: 5.0/5 (2 votes cast)
VN:F [1.9.22_1171]
Rating: +1 (from 1 vote)
Posted on Tuesday, Oct. 25th 2011 6:03 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost Case Summary

Sunday, Oct. 23rd 2011 6:01 AM

Your Medi-Cal case has been affected by a lawsuit called Sneede v. Kizer.  This lawsuit limits which family members may use medical expenses that are not billed to Medi-Cal to meet their family’s Share of Cost. If you are a spouse or a parent, you have the choice of listing your medical expenses in any case number on the reverse side of this form in which your name appears.  You may list all your medical expenses in a single case number, or you may divide up the expense and list it in two or more case numbers in which your name appears.  However, the total being reported for the single service cannot be more than the original bill.

Read the rest of this entry »

VN:F [1.9.22_1171]
Rating: 5.0/5 (2 votes cast)
VN:F [1.9.22_1171]
Rating: +1 (from 1 vote)
Posted on Sunday, Oct. 23rd 2011 6:01 AM | by Share of Cost | in Share of Cost | No Comments »

Reversing Share of Cost Transaction

Friday, Oct. 21st 2011 6:57 AM

To reverse SOC transactions, providers enter the same information as for a clearance but specify that the entry is a reversal transaction.  After the SOC file is updated, providers receive confirmation that the reversal is completed.  Once a subscriber has been certified as having met the Share of Cost, reversal transactions can no longer be performed.  Reversals may only be performed for partial clearance prior to the time the subscriber is certified as eligible.

VN:F [1.9.22_1171]
Rating: 5.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: 0 (from 0 votes)
Posted on Friday, Oct. 21st 2011 6:57 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Medi-Cal, NICE Consults On Draft Guideline On Food Allergies In Children

Sunday, Oct. 3rd 2010 6:32 AM

NICE has opened the consultation on its draft clinical guideline on the diagnosis and assessment of food allergies in children and young people. Its aim is to support GPs and other health professionals in primary care and community settings in recognising the signs and symptoms of food allergy, by giving clear recommendations on taking allergy-focussed histories to assess the condition.

VN:F [1.9.22_1171]
Rating: 5.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: 0 (from 0 votes)
Posted on Sunday, Oct. 3rd 2010 6:32 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Medi-Cal, Link Between Acetaminophen Use In Adolescents And Doubled Risk Of Asthma

Saturday, Oct. 2nd 2010 6:32 AM

New evidence linking the use of acetaminophen to development of asthma and eczema suggests that even monthly use of the drug in adolescents may more than double risk of asthma in adolescents compared to those who used none at all; yearly use was associated with a 50 percent increase in the risk of asthma.

VN:F [1.9.22_1171]
Rating: 5.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: 0 (from 0 votes)
Posted on Saturday, Oct. 2nd 2010 6:32 AM | by Share of Cost | in Share of Cost | No Comments »

Share of Cost, Medi-Cal, Also In Global Health News: HIV In Cities; NIH Director’s Role In Global Health; Access To Healthcare In Kenya; Food Aid In Ethiopia; More

Saturday, Oct. 2nd 2010 6:32 AM

UNAIDS Calls On Cities To Enhance Response To HIV; China Vows To Step Up Prevention UNAIDS has “issued a call for cities to ‘take the lead in making HIV history’ by enhancing their response to the epidemic,” UN News Centre reports.

VN:F [1.9.22_1171]
Rating: 5.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: 0 (from 0 votes)
Posted on Saturday, Oct. 2nd 2010 6:32 AM | by Share of Cost | in Share of Cost | No Comments »

Hello world! Share of Cost

Monday, Jul. 26th 2010 2:39 AM

Welcome to ShareofCost.com which provides a consumer forum for helping Medi-Cal, Medicaid, Medicare, and other beneficiaries find a dental insurance plan to meet their threshold for Share of Cost.

VN:F [1.9.22_1171]
Rating: 5.0/5 (1 vote cast)
VN:F [1.9.22_1171]
Rating: +1 (from 1 vote)
Posted on Monday, Jul. 26th 2010 2:39 AM | by Share of Cost | in Dental Insurance, Share of Cost | 1 Comment »