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Medicare and the Affordable Care Act: Separating Rumor from Reality

Friday, 22 November 2013 08:45

insuranceBy now, most adult Americans have seen and heard a lot about the Affordable Care Act (ACA), and most are confused about how the ACA will affect them and their insurance coverage. If you are an older American with Medicare coverage, or will be eligible for Medicare coverage in 2014 as an older American, you may be wondering what kind of impact the ACA will have on your Medicare. The simple answer is not a whole lot.

Medicare is federal health insurance coverage for Americans who are (1) eligible for Social Security retirement income and 65 years or older, or (2) under age 65 and entitled to Social Security disability benefits, or (3) of any age with End-Stage Renal Disease. You must enroll in the Medicare program when you become eligible or face late enrollment penalties for as long as you carry Medicare coverage, UNLESS you have other creditable insurance coverage through your employer, your spouse’s employer when you reach age 65, or the Health Insurance Marketplace.

The ACA was passed by Congress in 2010 and some provisions effecting Medicare have already been implemented. Those include:

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Improvement Standard is No More

Thursday, 07 February 2013 09:50

therapyOn January 24, 2013, the federal district court in Vermont approved a nationwide settlement that affects many Medicare-covered individuals. 

It had become routine for Medicare to stop paying for therapy (physical, occupational, and speech) if the individual was no longer showing improvement. The Center for Medicare and Medicaid Services (CMS), which administers the Medicare program, has agreed that the “improvement” standard was improper. 

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Recognizing Excellence

Monday, 28 January 2013 12:07

bradleyHickman & Lowder recognizes "Bradley Bay"

For those of who don’t know, Bradley Bay Health Center in Bay Village offers long-term nursing home care, short-term rehabilitation services, and assisted living.

With an overall score of 97.49%, Bradley Bay scored highest in the State on the 2012 Family Satisfaction Survey.

The Survey was conducted by the Scripps Gerontology Center of Miami University in Oxford, Ohio, on behalf of the Ohio Department of Aging and under the direction of the Office of the State Long-term Care Ombudsman. More than 27,000 family members responded. Of the 948 nursing homes participating, 387 scored above the state average, and 229 scored 88% or better, earning them an additional "quality point" in a reimbursement formula used by the Office of Medical Assistance (Medicaid). (Source: Ohio Department of Aging)

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November is National Family Caregivers Month

Tuesday, 20 November 2012 15:41

As the U.S. population ages, demand for long-term services and supports is growing dramatically.  Family caregivers of older adults are regarded as the backbone of the long-term care workforce (Noelker, 2001), and respite is an important resource for alleviating or preventing the stress they experience and for maintaining older adults in the community.

The Ohio Respite Coalition (ORC) is a statewide collaboration among family members, caregivers, advocates, respite providers, agencies, community groups, and state and local government officials who believe all caregivers could use a break once in a while.

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