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Medicare Advantage

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NEWS
December 7, 2011 | BY JANET TRAUTWEIN
IT'S HARD to believe, but Medicare's open-enrollment season ends today. And this year, as a result of the federal health-reform law, seniors who rely on privately administered Medicare Advantage plans for their benefits will face some big adjustments. Under the Medicare Advantage (M.A.) program, private insurers offer competing Part A Hospital and Part B Physician Care plans, and patients themselves choose which coverage option works best for their health and financial needs. M.A. insurers must provide at least the same benefits as traditional Medicare, but most offer more.
BUSINESS
September 16, 2011 | By Ricardo Alonso-Zaldivar, Associated Press
WASHINGTON - Turning a usually routine announcement into a pointed rebuttal of its GOP critics, the Obama administration said Thursday that premiums for popular Medicare Advantage insurance plans would drop for 2012, while enrollment is expected to rise. That's welcome news for President Obama and Democrats, who are struggling with older voters ahead of a hard-fought election looming next year. Republicans have accused Obama of undermining Medicare to finance his health-care overhaul.
NEWS
April 20, 2011 | By Ricardo Alonso-Zaldivar, Associated Press
WASHINGTON - Millions of seniors in popular private insurance plans offered through Medicare will get a reprieve from some of the most controversial cuts in President Obama's health-care law. In a policy shift critics see as political, the Health and Human Services Department has decided to award quality bonuses to hundreds of Medicare Advantage plans rated merely average. The $6.7 billion infusion could head off service cuts that would have been a headache for Obama and Democrats in next year's elections for the White House and Congress.
BUSINESS
January 4, 2016 | By David Sell, Staff Writer
Injectable insulin, which keeps some diabetics alive and keeps others out of serious health crises, has soared in price in the last few years. "It is out of control," said Carol Hammond, 72, a diabetic who lives in North Philadelphia and survives on Social Security. "My rent isn't too bad, but after paying for insulin, I don't have much left. " Hammond said she skips buying or taking doses because her Medicare and Medicare Advantage health- insurance plans don't always cover the cost of her insulin at the pharmacy counter.
NEWS
April 18, 2015 | By Don Sapatkin, Inquirer Staff Writer
The mind-bogglingly complex American health-care system took a step toward user-friendliness Thursday when the federal government assigned star ratings - 1 to 5, like restaurant and movie reviews - for patient satisfaction at thousands of U.S. hospitals. Many leading hospitals received middling ratings, while comparatively obscure community hospitals and others that specialize in lucrative surgeries frequently received the most stars. In the Philadelphia region, for example, just two hospitals - Physicians Care Surgical Hospital in Montgomery County and Cancer Treatment Centers of America's Eastern Regional Medical Center in Crescentville - scored five stars.
BUSINESS
September 11, 2015 | By Harold Brubaker, Inquirer Staff Writer
Doylestown Health Partners, a joint venture between Doylestown Hospital and about 440 primary care and specialist physicians, entered a contract to manage Humana's 3,200 Medicare Advantage customers in Bucks and Montgomery Counties. Humana, based in Louisville, Ky., agreed in July to be acquired by Aetna for $37 billion. In July, Humana had 8,246 Medicare Advantage customers in the eight-country Philadelphia region. Nationwide, Humana has 1.5 million Medicare Advantage customers, the company said.
NEWS
October 22, 2009 | By Pamela Walz, Samuel Brooks and Rebecca Vallas
Much has been made recently of proposals to reduce excessive Medicare Advantage payments, speciously labeled the "gutting of Medicare. " Insurance companies, along with other private health-care interests, are spending upward of $2 million a day to influence the debate, according to the Center for Responsive Politics. Seniors and their families should not be misled by the latest attempt to derail successful health-care reform. The vote-rich senior population has proven a prime target for such scare tactics (see: Death Panels)
BUSINESS
June 28, 2014 | By Harold Brubaker, Inquirer Staff Writer
  Sometimes, a Good Samaritan turns out to be anything but. That's how Delores Cantz feels about an episode in March, when the 82-year-old slipped and fell while dancing at a party in Warminster. Cantz said that after the fall she got up and walked to a side room, where - to her surprise - a crew from the nonprofit Warminster Volunteer Ambulance Corps was waiting to evaluate her and take her to a local hospital. She refused what she thought was an unneeded emergency-room visit.
NEWS
September 24, 2009 | By Rick Santorum
Nothing is more critical to the success of President Obama's health-care legislation than his promise that no American will have to give up his or her health plan. A related promise runs a close second: that the "government option" will create competition for the private sector, not replace it. Why are these promises so critical? Because, while most Americans are open to fixing health care, they're also happy with their private insurance. One would think Obama would oppose any provision that appears to force Americans into a government plan.
NEWS
June 9, 2014 | By Robert Calandra, For The Inquirer
When it comes to health insurance, Anthony Capone considers himself "on top of this stuff. " So in 2013 when the Mount Laurel businessman turned 65, he pored over Medicare Advantage plans, even visiting a Horizon Blue Cross Blue Shield store to talk details. He eventually bought a Horizon no-premium Medicare Advantage plan. He liked the policy so much he persuaded his then-89-year-old mother to ditch her plan and go with Horizon. So in the fall, Capone was primed to renew during open enrollment until he saw that his no-premium insurance had removed the "no. " The 2014 version of the plan came with a monthly premium of $153.70.
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ARTICLES BY DATE
BUSINESS
January 4, 2016 | By David Sell, Staff Writer
Injectable insulin, which keeps some diabetics alive and keeps others out of serious health crises, has soared in price in the last few years. "It is out of control," said Carol Hammond, 72, a diabetic who lives in North Philadelphia and survives on Social Security. "My rent isn't too bad, but after paying for insulin, I don't have much left. " Hammond said she skips buying or taking doses because her Medicare and Medicare Advantage health- insurance plans don't always cover the cost of her insulin at the pharmacy counter.
NEWS
November 18, 2015
ISSUE | MEDICARE Help kidney patients Harold Brubaker's article on Medicare Advantage open enrollment ("Seniors shopping for private Medicare have many new choices," Nov. 10) might have noted that some 4,700 beneficiaries in the Philadelphia area are not permitted to choose private plans because they have kidney failure, also known as end-stage renal disease. This prohibition may have made sense three decades ago, when private Medicare plans were created, but today it constitutes discrimination, preventing kidney patients from enjoying the maximum out-of-pocket limits that apply in private plans but not in traditional fee-for-service Medicare.
BUSINESS
November 11, 2015 | By Harold Brubaker, Inquirer Staff Writer
The financial pain of a two-week hospital stay 15 years ago for a heart ailment gives Patricia Johnstone a sharp focus when she shops for private Medicare insurance. "The hospital is the main thing I'm concerned about," said Johnstone, 75, who with her husband, Robert, attended a Health Partners Plans information session last week at the Wegmans market in Collegeville. The Johnstones were unsettled when they heard that hospital stays would cost up to $295 a day for the first six days under Health Partners, which is expanding its Medicare business into the Pennsylvania suburbs next year.
BUSINESS
September 20, 2015 | By Joseph N. Distefano, Inquirer Staff Writer
FirstRound Capital, the early-stage venture investment firm, says it has made its largest-ever investment - $4 million - in Clover Health, a Medicare Advantage plan that uses patient data analytics to predict users' health-care spending, encourage preventive care, and reduce hospital visits. FirstRound's investment is part of a package of equity investments and borrowing totaling $100 million, which Clover plans to use to expand beyond its nine-county base in northern New Jersey.
BUSINESS
September 11, 2015 | By Harold Brubaker, Inquirer Staff Writer
Doylestown Health Partners, a joint venture between Doylestown Hospital and about 440 primary care and specialist physicians, entered a contract to manage Humana's 3,200 Medicare Advantage customers in Bucks and Montgomery Counties. Humana, based in Louisville, Ky., agreed in July to be acquired by Aetna for $37 billion. In July, Humana had 8,246 Medicare Advantage customers in the eight-country Philadelphia region. Nationwide, Humana has 1.5 million Medicare Advantage customers, the company said.
NEWS
April 18, 2015 | By Don Sapatkin, Inquirer Staff Writer
The mind-bogglingly complex American health-care system took a step toward user-friendliness Thursday when the federal government assigned star ratings - 1 to 5, like restaurant and movie reviews - for patient satisfaction at thousands of U.S. hospitals. Many leading hospitals received middling ratings, while comparatively obscure community hospitals and others that specialize in lucrative surgeries frequently received the most stars. In the Philadelphia region, for example, just two hospitals - Physicians Care Surgical Hospital in Montgomery County and Cancer Treatment Centers of America's Eastern Regional Medical Center in Crescentville - scored five stars.
NEWS
October 12, 2014 | By Robert Calandra, For The Inquirer
  In June, Anthony Capone said he liked his AmeriHealth Medicare Advantage plan so much he persuaded his 89-year-old mother and aunt to make the switch. Things were going along fine until recently, when the Mount Laurel businessman's renewal notice arrived in the mail. He opened the package and was taken aback. His monthly premium had spiked to $62 a month, a $23 rise. Other fees - in-hospital co-pay (up to $175), Part D deductible ($25), and ambulance ($100) - have also risen.
BUSINESS
June 28, 2014 | By Harold Brubaker, Inquirer Staff Writer
  Sometimes, a Good Samaritan turns out to be anything but. That's how Delores Cantz feels about an episode in March, when the 82-year-old slipped and fell while dancing at a party in Warminster. Cantz said that after the fall she got up and walked to a side room, where - to her surprise - a crew from the nonprofit Warminster Volunteer Ambulance Corps was waiting to evaluate her and take her to a local hospital. She refused what she thought was an unneeded emergency-room visit.
NEWS
June 9, 2014 | By Robert Calandra, For The Inquirer
When it comes to health insurance, Anthony Capone considers himself "on top of this stuff. " So in 2013 when the Mount Laurel businessman turned 65, he pored over Medicare Advantage plans, even visiting a Horizon Blue Cross Blue Shield store to talk details. He eventually bought a Horizon no-premium Medicare Advantage plan. He liked the policy so much he persuaded his then-89-year-old mother to ditch her plan and go with Horizon. So in the fall, Capone was primed to renew during open enrollment until he saw that his no-premium insurance had removed the "no. " The 2014 version of the plan came with a monthly premium of $153.70.
BUSINESS
April 6, 2014 | By Harold Brubaker, Inquirer Staff Writer
Crozer-Keystone Health System and Cigna-HealthSpring are in a dispute over a Medicare Advantage contract that expires April 30. It's not unusual for negotiations between hospitals and health insurers to go down to the wire, but in this case, Crozer, Delaware County's biggest health system, insists HealthSpring, a unit of Cigna, has ended the Crozer contract. "Cigna-HealthSpring terminated our participation when we did not agree to their demand that we accept rates below Medicare rates and significantly below our cost to provide care to their members," Crozer said.
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