How the New Obamacare Website Stacks Up Against the Old

October 14, 2014, 3:08 am

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Filed under: Technology, Health Care, Internet, Barack Obama, Health Insurance

*AP*

By RICARDO ALONSO-ZALDIVAR and CALVIN WOODWARD

WASHINGTON -- HealthCare.gov, the website for health insurance under President Barack Obama's health care law, has been revamped as its second enrollment season approaches. But things are still complicated, since other major provisions of the Affordable Care Act are taking effect for the first time. A look at website and program changes just ahead:

*Old:* 76 online screens to muddle through in insurance application.

*New:* 16 screens -- for the basic application that most new customers will use. But about a third of those new customers are expected to have more complicated cases, and how they'll fare remains to be seen.

*Old:* Prone to crashing, even with relatively few users.

*New:* Built to withstand last season's peak loads and beyond, at least 125,000 simultaneous users. Actual performance still to be demonstrated.

*Old:* Six-month open enrollment season, extended to accommodate customers who had to put up with website glitches or got stuck in line at the last minute.

*New:* Three-month open enrollment season, from Nov. 15 to Feb. 15.

*Old:* Everybody was new to the system.

*New:* As many as 7 million existing customers could be coming back -- adding a built-in crunch factor. If returning customers want to make changes to their accounts they'll have to act by Dec. 15 for those to take effect by Jan. 1. Many will want to do so because it could save them money.

*Old:* Amateur Spanish, to put it kindly.

*New:* HealthCare.gov's Hispanic-oriented website could still use a going-over from a high school Spanish teacher. But one conspicuous mistake in translating the appeal to "get ready" got fixed quickly. Maybe that's a sign of things to come.

*Old:* No way to window-shop anonymously when the system went live.

*New:* Window-shopping for health insurance plans available without first creating an account. But the site still lacks a way for consumers to search for plans by simply entering their doctor's name. Instead, they'll have to follow links to individual insurance company directories. Tip: Double check with your doctor's office to see whether he or she is still in the plan.

*Old:* Subsidies to keep premiums affordable were paid directly to your health insurance plan.

*New:* The government will keep paying your health plan, but this year you will also have to show the Internal Revenue Service that you got the right subsidy for 2014. If you got more than you were entitled to, your tax refund will be dinged. If you got less than you deserved, your tax refund will be fatter.

*Old:* Budget number crunchers for Congress had estimated 7 million people would enroll, but cut that back to 6 million because of website glitches. Eight million actually signed up, beating expectations. In the end, about 7 million were still enrolled.

*New:* The Congressional Budget Office expects enrollment next year to total 13 million -- the new yardstick for HealthCare.gov.

*Old:* Pent-up demand from people denied coverage by insurance companies because of pre-existing medical conditions, or who were just unable to afford it.

*New:* Tougher sell to customers who sat out last year's open enrollment season, even under threat of fines.

*Old:* Fines for staying uninsured the full year start at $95.

*New:* Fines for staying uninsured all of 2015 start at $325.

 

Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 15 hours ago.

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L.A. Times Endorses 2 Statewide Republicans: Peterson and Swearengin

October 14, 2014, 5:48 am

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The Los Angeles Times has released its list of endorsements for the November 4 election, and surprisingly, there are two GOP members that won approval: Pete Peterson, executive director of the Davenport Institute for Public Engagement and Civic Leadership at Pepperdine University, who is running for California secretary of state; and Ashley Swearengin, the GOP mayor of Fresno, who is running for state controller.

The rest of the endorsements were more predictable; the Times opined that Proposition P, which would impose an annual $23 parcel tax to pay for parks and other facilities, should be defeated, saying it would “apply a regressive, flat per-parcel tax, unlike Proposition A.”  On the other hand, Proposition 1, the $7.5-billion water bond, was endorsed by the Times.

Proposition 47, the "Safe Neighborhoods and Schools Act," which would reduce penalties for some common crimes, was endorsed, while Proposition 45, which would require any alterations in health insurance rates to be approved by the California Insurance Commissioner, was given a thumbs-down. Proposition 48, which would allow the state’s compacts with the North Fork Rancheria of Mono Indians and the Wiyot Tribe to proceed, thus allowing a new casino to be built in Madera County, was endorsed.

Candidates for public office who won the endorsement of the Times included:

Gavin Newsome for Lieutenant Governor

Kamala Harris for Attorney General

Sheila Kuehl for the 3^rd Supervisorial district

John Chiang for state treasurer

State Senator Ted Lieu in the 33^rd congressional district

John Morris for LA County assessor

Jacqueline Lewis and Andrew Stein for superior court

Dave Jones for state insurance commissioner

Marshall Tuck for state superintendent of public instruction

Jim McDonnell for L.A. County sheriff Reported by Breitbart 13 hours ago.

Northwestern MutualVoice: 5 Tips To Help Your Parents Get The Medicare Coverage They Need

October 14, 2014, 5:53 am

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Health insurance coverage matters to most people, but it’s especially important as we grow older. If a parent or aging loved ones are approaching age 65, they will soon be eligible for Medicare. Reported by Forbes.com 12 hours ago.

Reimbursement Tracker: New Health Insurance Policy Tool Launched by iData Research

October 14, 2014, 6:08 am

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‘Reimbursement Tracker’ simplifies how med-device stakeholders track and manage insurance policy changes. Subscribers can keep a close eye on Medicaid, Medicare, and hundreds of private insurers across the United States.

Vancouver, BC (PRWEB) October 14, 2014

iData Research announces the launch of Reimbursement Tracker, http://www.reimbursementtracker.com, an insurance policy management solution that enables medical device, dental, pharmaceutical and healthcare professionals to receive real-time policy updates from hundreds of insurance companies and 60,000+ policies across all therapeutic areas in the United States.

“Reimbursement Tracker focuses on what matters to our clients,” explains Kamran Zamanian, CEO of iData. “By receiving real-time updates on reimbursement policy changes, our clients can better mitigate and manage risk to revenue, and optimize reimbursement coverage for their products.”

Many have found that staying up-to-date on the latest policy changes manually is time-consuming and expensive. On the other hand, insurance companies post policy changes to their company website at their discretion. They are not required to inform stakeholders of policy changes on the discontinuation of coverage, CPT code changes, or new product introductions that can affect the market landscape. Policy management tools, like iData’s new Reimbursement Tracker, help alleviate these issues.

Reimbursement Tracker in Detail
Reimbursement Tracker simplifies, coordinates, and tracks changes in reimbursement policies. These policies pertain to codes, review dates, product updates, and scope of coverage for hundreds of U.S. insurers, including Medicaid and Medicare. All information is prepared in one online portal. A searchable database of historical policy updates is also available.

Quick Features:
Real-time updates
Highlighted, easy-to-see policy changes
Email push alerts

Highlight Feature: Client-specific Reporting Dashboard
The Reimbursement Tracker online portal can be customized to a client’s specifications to integrate into company-specific workflows. The reporting dashboard provides an overview of the most recent updates most relevant to a company’s interests, as well as a snapshot of regions affected by those changes.

Highlight Feature: Quick-access Sorting and Filters
Policies can be sorted and filtered by future review dates, keywords, procedures, regions, date of policy changes and insurers.

Full Product Brochure and Demo Available
The Reimbursement Tracker full product brochure is available. Guided demos are also available. Please register or contact RTDemo(at)ReimbursementTracker(dot)com. No download or installation is required for a product demonstration.

About iData Research
iData Research (http://www.idataresearch.com) is an international market research and consulting group focused on providing market intelligence for medical device and pharmaceutical companies. Reimbursement Tracker is a specific product offered by iData Research to satisfy market research industry demand. Reported by PRWeb 12 hours ago.

National Association for the Self-Employed Launches Enhanced Resources for Small Business Community at 34th Annual Meeting

October 14, 2014, 6:08 am

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Association Launches New Website, with Dedicated Health Care Portal, Focusing on Enhanced Member Benefits and Advocating for Entrepreneurs

DALLAS, TX (PRWEB) October 14, 2014

The National Association of the Self-Employed (NASE), the nation’s leading advocate and resource for the self-employed and micro-business community, brought together hundreds of small business owners from across the country in Austin, Texas last month for the association’s 34th Annual Meeting. During the meeting, NASE made a strong commitment to its members and the small business community at-large by announcing newly enhanced resources and benefits to ensure they have the tools and resources to succeed.

During the meeting, NASE President and CEO, Keith R. Hall, called on Congressional leaders and elected-officials across the country to support pro-growth economic policies that will allow America’s entrepreneurs to continue to gain access to capital and grow their businesses.

“At the center of America’s middle class is the over 23 million small businesses responsible for nearly 70% of all new jobs created in our country,” said Keith R. Hall, President and CEO of NASE. “It is vitally important that during this midterm election year, our elected leaders of all political stripes and ideological backgrounds support an economic environment that allow America’s small businesses to grow, expand and keep their doors open. When our country’s small business community thrives, the American economy remains strong.”

As part of the 34th Annual Meeting, NASE also announced the launch of an enhanced website - http://www.nase.org - focused on providing a range of member benefits to help entrepreneurs and their small businesses compete in today’s globally competitive marketplace. The website will allow NASE to grow the association’s ability to provide members access to benefits and resources that too often are only available to larger corporations – placing small businesses on more equal footing with their larger corporate counterparts.

“With open enrollment just around the corner for our nation’s health care system, our dedicated health care portal on our new website is designed for small business owners to navigate the health care market,” continued Hall. “At the heart of our work is ensuring we are providing our members the most comprehensive benefit support available. On top of providing small business owners a voice in Washington, DC, we also want to continue to be a trusted resource on Main Streets across the country. The launch of our newly enhanced website and dedicated health care page will allow us an increased ability to make a real difference in the bottom line of our member businesses.”

One of the key elements of the newly launched NASE.org website is the site’s health insurance benefits section offering small business owners critical information on the health insurance market. Additionally, the site allows small business owners to access to NASE health insurance experts that provides members with the a professional to help guide them through the different health insurance options available exclusively to small business owners and their families. The enhanced health care section of the site is available: http://www.nase.org/business-help/get-help/health/healthcare-reform. Reported by PRWeb 12 hours ago.

What Every Family Should Know About High Deductible Health Insurance

October 14, 2014, 7:32 am

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What Every Family Should Know About High Deductible Health Insurance Reported by ajc.com 11 hours ago.

United States: Health Care Group Newsletter – Fall 2014 - Ostrow Reisin Berk & Abrams

October 14, 2014, 7:27 am

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Health Insurance Marketplaces created under the ACA provide virtual marketplaces where consumers can shop for, compare and buy health plan coverage. Reported by Mondaq 11 hours ago.

California will cancel Obamacare coverage for 10,000 over citizenship

October 14, 2014, 8:01 am

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California's health insurance exchange is canceling Obamacare coverage for 10,474 people who failed to prove their citizenship or legal residency in the U.S. Reported by L.A. Times 10 hours ago.

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How the new HealthCare.gov stacks up with the old

October 14, 2014, 7:53 am

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HealthCare.gov, the website for health insurance under President Barack Obama's health care law, has been revamped as its... Reported by Deseret News 10 hours ago.

GfK MRI Adds Tablet, Health Insurance Data Points with New Release of Trendable Product Use Database 

October 14, 2014, 7:42 am

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NEW YORK--(BUSINESS WIRE)--GfK MRI’s latest release of product insights from its Survey of the American Consumer® includes new data points on tablet sharing, health insurance choices, viewing of out-of-home advertising, and other consumer activities. GfK’s unmatched consumer database is derived from continuous interviews with approximately 25,000 US adults each year. As part of the Survey, respondents record their consumption of some 6,500 products in nearly 600 categories and provide details a Reported by Business Wire 11 hours ago.

Why Some Republicans Think Health Insurance for Undocumented Residents Makes Sense

October 14, 2014, 8:22 am

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Unlike former California Governor Arnold Schwarzenegger, a Republican, Democrats in Congress decided as they worked on health care reform that providing coverage to the estimated 11.5 million undocumented residents in the U.S. would not be a good idea.

Actually, it would be more accurate to say that many of them were unwilling to vote for a reform bill enabling undocumented residents to buy coverage on the state health insurance exchanges out of fear that doing so might jeopardize their re-election chances. The bill that became Obamacare contains language singling out the undocumented as ineligible.

Schwarzenegger wasn't as worried about his political future when he proposed a plan in January 2007 that was similar to the one enacted in Massachusetts under then-Governor Mitt Romney. Schwarzenegger's plan had one notable difference: it would have required every Californian--including all of the state's 2.6 million undocumented residents--to have health insurance (The Massachusetts law does allow the undocumented to receive state-funded care through the Health Safety Net program for low-income persons). Schwarzenegger was feeling pretty secure politically at the time. Just two months earlier he had been re-elected in a landslide, winning 56 percent of the vote to Democrat Phil Angelides' 38.9 percent.

Schwarzenegger's reasoning was that undocumented immigrants who went to hospital emergency rooms for care but couldn't pay their bills were taking advantage of the state's taxpayers.

"In California, the cost of emergency room care for undocumented immigrants is nearly a billion dollars a year," Schwarzenegger's Health and Human Services Secretary, Kim Belshe, told PBS NewsHour's Gwen Ifill back then. "We are required under federal law--hospitals are required, I should say--under federal law to provide services through emergency rooms, which is appropriate and humane. But emergency rooms are the least appropriate, most costly setting. And that is a huge tax burden that California taxpayers are experiencing."

Like Romney's reform plan--and Obamacare--Schwarzenegger's proposal was based on the largely Republican concept of "shared responsibility."

"This is not a proposal that looks only to government to fix the problem, only to employers, only to any one sector," Belshe told Ifill. "It is shared responsibility, beginning with the individual, but supported by government, by employers, by health plans and health providers."

Schwarzenegger's $12 billion reform plan had bipartisan support, as did Romney's, but not quite enough, thanks to an unholy alliance between big insurance companies and employer groups and liberal activists and lawmakers who wouldn't settle for less than a single-payer bill. Insurers didn't like the bill because it would have required them to spend at least 85 percent of their policyholders' premiums on medical care. Single payer advocates were upset with Schwarzenegger for vetoing a bill the year before that would have made California the first state to establish a single-payer system. They reasoned that their chances would be better in the future if Schwarzenegger's proposal went nowhere. A year after the governor unveiled his blueprint, it died in a Senate committee. Lawmakers did pass another single-payer bill in 2008, but Schwarzenegger vetoed that measure too.

Fast-forward six years, and the state's lawmakers are once again considering expanding coverage to the undocumented. And, according to a poll released last week, a majority of Californians want it to happen.

The poll, commissioned by The California Endowment, a private health foundation that supports community-based organizations--and the Center for Public Integrity as well--found that 54 percent of voters favor allowing undocumented residents to either enroll in the state's Medicaid program or buy private insurance.

State Rep. Ricardo Lara (D-Long Beach) said he plans to introduce a bill during the next legislative session that would give low-income undocumented California residents access to Medi-Cal, the state's Medicaid program, and create a dedicated insurance exchange for others who earn more than 138 percent of the federal poverty level. A similar bill was put on hold by a state Senate committee earlier this year because sponsors hadn't included a plan to pay for the coverage expansion. Lara says a financing plan is now being developed.

Almost a quarter of the nation's undocumented residents call California home, and many of the state's businesses depend on them. The Pew Hispanic Center estimates that about one in ten workers in the state is undocumented. Many of them are construction workers and farm laborers. And they pay taxes. The California Immigrant Policy Center recently estimated that these folks pay $2.7 billion in state and local taxes and contribute $302 billion to the state economy annually.

Among the many businesses and organizations supporting Lara's bill is Health Access California, a statewide health care consumer advocacy coalition.

"Immigrants are central to California's economy and our communities, and they need to be fully included in our health system, too," Health Access executive director Anthony Wright told me. "This (expanding coverage to include undocumented residents) is a way to invest in prevention and primary care, improve our health system and lower costs in the long term for everybody."

He added: "It's harder to steer a boat with folks hanging off the sides of the ship." Reported by Huffington Post 10 hours ago.

Kony Receives Global Information Security Certifications for Enterprise Mobility Solutions

October 14, 2014, 8:06 am

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ORLANDO, Fla.--(BUSINESS WIRE)--Kony, Inc., the leading enterprise mobility company, today announced that it has strengthened its security credentials for its mobile application software and cloud services, including achieving SOC 2 (Service Organization Controls), ISO 27001 (International Organization for Standardization) and HIPAA (Health Insurance Portability and Accountability Act of 1996) certifications, which are considered the best-known standards for information security. These certific Reported by Business Wire 10 hours ago.

Why Socialist Scandinavia Has Some Of The Highest Inequality In Europe

October 14, 2014, 10:30 am

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The celebrated social-democratic nations of Scandinavia have some of the highest wealth inequality in Europe.

That's according to Credit Suisse's weighty Global Wealth Report 2014. It's a finding that's likely to seriously surprise some people. The top 10% of wealth holders in three Nordic countries (Norway, Sweden and Denmark) hold between 65 and 69 per cent of those nations' wealth.

In comparison to the other developed economies in Europe, Scandinavian inequality on this measure seriously stands out: they're significantly above British, French, Italian or Spanish levels. Germany and Austria come a little closer, but are still behind. Only finance-dominated Switzerland reaches higher levels of wealth inequality.

The Nordic nations on the list sit in the "high inequality" group, where the top 10% hold 60-70% of the country's household wealth.

In comparison countries that are usually thought to be more capitalist, like the UK, Canada and Australia, are a rung below in the "medium inequality" group, with the top 10% holding between 50-60%. But there's a pretty benign explanation for this big disparity, according to Credit Suisse:

"Strong social security programs, good public pensions, free higher education or generous student loans, unemployment and health insurance can greatly reduce the need for personal financial assets. Public housing programs can do the same for real assets. This is one explanation for the high level of wealth inequality we identify in Denmark, Norway and Sweden: the top groups continue to accumulate for business and investment purposes, while the middle and lower classes have no pressing need for personal saving."

So they're unequal, at least in part, because much of the country's middle class doesn't feel the need to accumulate significant wealth. They don't themselves own, for example, the state housing they live in, so it doesn't appear in the figures. But they might just not feel they really need to. 

*SEE ALSO: Americans Have No Idea How Bad Inequality Is*

Join the conversation about this story » Reported by Business Insider 8 hours ago.

Fitch Publishes Honduran Insurance Dashboard 1H'14

October 14, 2014, 10:59 am

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NEW YORK & SAN SALVADOR, El Salvador--(BUSINESS WIRE)--Fitch Ratings has published a new Honduran Insurance Dashboard. The report highlights the key events affecting the industry as of the first half of 2014. The Honduran Insurance Dashboard discusses the sector's trends in terms of growth rate and underwriting profitability. The report also analyses the expected causes of stable and adequate leverage and liquidity levels. Going forward, Fitch expects an improvement in health insurance' loss ra Reported by Business Wire 7 hours ago.

Ebola.com Owners Hope to Sell the Site for $150,000

October 14, 2014, 12:09 pm

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Filed under: Health Care, Alternative Investment, Internet

*Abbas Dulleh/AP*Health workers in Liberia wait to carry the body of a suspected Ebola victim.

The Ebola virus outbreak in West Africa has been brutal. There have been 8,400 cases, according to the Centers for Disease Control and Prevention, and 4,033 confirmed deaths, and the outlook is only getting more grim, according to the World Health Organization. But the scary statistics could mean a windfall for some foresightful investors who figured that someday, we'd all be worried about this deadly plague.

Nevada-based Blue String Ventures bought the domain name ebola.com in 2008 and hopes to sell it now for $150,000, according to CNBC. "We've had many inquiries on the domain over the years," Jon Schultz, president of Blue String Ventures, said.

Blue String Ventures buys domain names that it thinks will eventually grow in value when companies or organizations suddenly want to be associated with an idea or topic. The firm owns domain names like Fukushima.com, referring to the nuclear plant meltdown in Japan, as well as health- or dietary supplement-related ones, including GreenCoffeeExtract.com and BirdFlu.com

For now, the page ebola.com includes various links. One is to an ebook claiming that nutritional supplements might help cure the disease; another is to a site that sells that supplement.

*Commercial Interest Said to Be Unlikely*

"Having seen the movie 'Outbreak,' I was entranced by the subject and couldn't resist buying the domain," Schultz told CNBC.

Large pharmaceutical firms and smaller biotech startups working on treatments or cures for Ebola have reportedly been approached about buying the site, but so far there have apparently been no takers.

That isn't surprising. Pharmaceutical companies generally focus on diseases with a much larger rate of incidence or where the patients have health insurance or enough personal wealth to pay well for help. Ebola requires government subsidies to combat it, and it likely won't generate commercial interest otherwise.

In case you're interested, ebolacure.com is also taken, although it's owned by a company that uses a service to keep its actual name out of official Web records.

 

Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 6 hours ago.

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Why Hillary Clinton Wants To Make Sure Pediatricians Are Talking About Childhood Literacy

October 14, 2014, 12:50 pm

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Hillary Rodham Clinton wants to make sure pediatricians are encouraging parents to read to their kids.

A new early literacy toolkit unveiled this past weekend by the former secretary of state includes a list of resources and tips for pediatricians who want to talk to parents about the importance of early childhood literacy. The toolkit, developed by the American Academy of Pediatrics, comes several months after the group released its first policy statement regarding early childhood literacy, in which it encouraged pediatricians to promote literacy during health visits.

Clinton announced the creation of the early literacy toolkit during the American Academy of Pediatrics National Conference & Exhibition in San Diego. The AAP has a collaborative partnership with Too Small To Fail, an initiative of the Clinton Foundation and nonprofit organization Next Generation, which seeks to improve the health of young Americans.

"When you ask parents around our country who they turn to with a question ... hands down the No. 1 answer is their pediatrician," Clinton said, when addressing the AAP. "I really think if you want to understand how growing inequality and shrinking social and economic mobility are undermining our fundamental ideal of equal opportunity for all, you have to start with our children."

She continued, "I thank the American Academy of Pediatrics for leading the way on two particular challenges. No. 1, saving the Children's Health Insurance Program, and No. 2, helping to close that word gap ... that puts our most vulnerable kids at a disadvantage by the age of 3 or 4."

The word gap refers to research that shows children in affluent families tend to hear -- and thus learn -- millions more words than their lower-income counterparts even in their first few years.

After a heckler used a bullhorn to interrupt Clinton, the former first lady regained her stride and joked, "You know, there are some people who miss important developmental stages."

The AAP's policy statement released over the summer noted that, "literacy promotion during preventive visits has some of the strongest evidence-based support that it can make a difference in the lives of young children and families."

Dr. Perri Klass, co-author of the original AAP policy statement, told The Huffington Post that "reading promotion has come to be more and more tied to the issues around early brain development, resilience, even toxic stress." Toxic stress is defined as a disruption in brain development that occurs when a child is exposed to frequent hardship.

"People are very excited," Klass, who is currently in California at the AAP conference, told The Huffington Post. "Everything we understand about early brain development, everything we want to foster in terms of parents' time with children, not around screens ... these larger issues are so much on the mind of everyone here." Reported by Huffington Post 6 hours ago.

Covered California clears most of the consumers asked to prove legal status

October 14, 2014, 12:54 pm

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Covered California has cleared most of the individuals asked to prove they are lawful residents in order to participate in the state health benefit exchange. About 98,000 families who signed up for health insurance in the new program this year were asked to show by Sept. 30 that they are citizens or legal residents of the state. The families represent more than 148,000 individuals. The Affordable Care Act does not extend benefits to undocumented immigrants. Fewer than 10,000 families failed to… Reported by bizjournals 5 hours ago.

Poll: Many insured remain worried about paying medical bills

October 14, 2014, 1:44 pm

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A new poll from the Associated Press-NORC Center for Public Affairs Research may help explain why President Obama faces such strong headwinds in trying to persuade the public that his health care law is holding down costs. The survey found the biggest financial worries among people with so-called high-deductible plans that require patients to pay a big chunk of their medical bills each year before insurance kicks in. Health and Human Services Secretary Sylvia Mathews Burwell recently said part of the problem is that many people don’t understand how to buy health insurance, or how to use their plan once they get their cards in the mail. People who are concerned about exposure to big bills can come out ahead financially by paying higher premiums for a plan that features lower out-of-pocket costs. [...] the poll showed that a majority of those with private insurance, 52 percent, would rather pay a higher premium and limit out-of-pocket costs than lower their premiums and potentially face higher out-of-pocket charges. Some people pair a high-deductible plan with a tax-sheltered savings account to pay their out-of-pocket costs — the poll found 40 percent who say they have high-deductible plans also have such an account. On the insurance exchanges, low-income people can receive additional help from the government for their cost-sharing expenses. Reported by SFGate 5 hours ago.

Medigap vs. Medicare Advantage

October 14, 2014, 3:01 pm

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*Medigap vs. Medicare Advantage*

Original Medicare is the familiar program that's been around since 1965. In original Medicare, the government pays Medicare's share of your medical bills directly to doctors and hospitals. You can go to any doctor or hospital anywhere in the country that accepts Medicare reimbursement. That is nearly all of them.

But original Medicare is not free. You will still be required to pay some health care costs out of your own pocket. For instance,  people on original Medicare must pay a  $1,216 deductible for every hospital stay (rising to $1,260 in 2015). They must also pay 20 percent of the cost of most kinds of outpatient treatments, including doctor visits. And unlike the private insurance you're used to from your working years, Medicare does not have any limit on what you can spend out of your own pocket. The bills can mount up quickly, especially if you need costly treatments such as outpatient chemotherapy.

You may have a retiree or TRICARE plan that helps pick up some or all of those costs.

If not, you have two options for limiting your exposure to excessive out-of-pocket costs.

-1. Medicare Supplement (Medigap) plans-

These private plans cover most or all of original Medicare's out-of-pocket costs. If you select this option, you will continue to be covered by original Medicare. After Medicare has paid your claims, it will automatically forward them to your Medigap plan. The Medigap plan will then pay its portion of the bill.Medigap plans do not cover prescription drugs. Therefore you must also purchase a  stand-alone Part D plan if you want drug coverage.

-2. Medicare Advantage
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Anyone on Medicare can choose to receive their Part A and Part B benefits through one of these private health plans instead of through original Medicare. Medicare Advantage plans now cover nearly 3 in 10 Medicare recipients. Most Medicare Advantage plans also include Part D prescription drug coverage.

With a Medicare Advantage plan, you continue to pay your Part B premium as usual. You may also pay an extra premium for the plan. You are not allowed to have a Medigap and Medicare Advantage plan simultaneously.

Medicare Advantage plans typically come with deductibles and co-pays. But unlike original Medicare, they have an annual out-of-pocket limit. That means that once you have paid deductibles and co-pays that add up to the annual out-of-pocket limit, the plan will pay 100 percent of your medical bills for the rest of the year.Medicare Advantage plans work like the managed care plans you may have had during your working years. You will have to receive your care from doctors, hospitals, and other providers within the plan's network.If you have a retiree plan, check with your plan administrator before signing up for a Medicare Advantage plan. It may affect your eligibility for your retiree benefits.

Once you are enrolled in Medicare, you can join, switch, or drop a Medicare Advantage or Part D plan once a year during the annual open-enrollment period, which runs from Oct. 15 through Dec. 7.Here's a chart that summarizes the two choices.

 

*Medigap*

*Medicare Advantage*

*How it relates to Original Medicare Parts A & B*

Private supplemental coverage that pays all or most Part A & B out-of-pocket costs.

Private health plan that provides Part A & B benefits directly in place of Original Medicare.

*Premium*

Average of about $150 to $200 a month. Can vary by age, health history, or both. $0 to more than $100 a month depending on the plan. All plan enrollees pay the same regardless of age or health history.

*Out-of-pocket costs*

Low to none (not counting premium).

In-network medical deductibles and  copays of up to $3,400 to $6,700 a year, depending on the plan.

*Choice of doctors and hospitals*

Any that participate in Medicare.

HMOs: Plan providers only.

PPOs: Any provider,  but out-of-network providers cost more.

*When you can buy*

First six months after you sign up for Part B and are at least 65 years old. After that, in most states you can be turned down or charged extra for pre-existing conditions.

When you first enroll in both Medicare A  and B and annually thereafter during Open Enrollment (Oct. 15-Dec. 7).

*Part D (drug) coverage*

Not included. You must buy a separate Part D plan for this.

Most plans include Part D coverage.*Quality information available*

No. There are no standardized ratings for Medigap plans. Yes. Medicare.gov has star ratings (5 stars are the best). Consumer Reports has Medicare Advantage quality rankings from NCQA.

*Cards in your purse or wallet*

Three. 1. Red, white, and blue Medicare card. 2. Medigap card. 3. Part D card. Usually just one Medicare Advantage card. The red, white, and blue Medicare card can stay in your desk drawer.

*Paperwork*

Little to none. Medigap almost always automatically cuts a check to providers after Medicare pays its share.

Some, because you pay deductibles and copays directly to providers.

 

Get health insurance rankings

Click on the image at right for rankings of health insurance plans nationwide. Use the tool to:

· Choose a plan category such as private HMO or PPO, or Medicare HMO or PPO.
· Choose a state.
· Customize your search to compare plans' scores and their performance in measures such as consumer satisfaction and providing preventive services.

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