Avoiding the Pain of Healthcare Privacy!

By Marc Manor

Everyone loves the Health Insurance Portability and Accountability Act of 1996 (HIPAA), right?  I say that with a little more than a tinge of sarcasm because we all know that HIPAA is a necessary evil when it comes to protecting our privacy and, in many cases, our identity.

HIPAA seems like such a necessary requirement that I am dumbfounded it was not enacted until 1996!  I clearly remember the days early in my military career when we routinely plastered our social security number on everything we owned as a means of identification!  What were we thinking?  To think of all the sophisticated computer hacking that is done to steal someone’s information these days, while for many years, all someone had to do was pick through the garbage!  But I digress! 

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HIPAA is an essential part of the healthcare industry as well as affecting everyone who uses any healthcare service.  These regulations were enacted for your protection, and they are interpreted with only the slightest variation among healthcare providers and insurance companies.  Almost all err on the side of caution and interpret HIPAA with strict adherence.  Those who fail to comply with HIPAA guidelines are subject to fines of up to $50,000 per violation with a maximum $1.5 million annual ceiling. While this measure ensures compliance, sometimes it can make it difficult to have someone else act on your behalf with doctors, hospitals, or insurance companies. 

Medicare Myth Busters: Medicare Supplement (Medigap) and PPO Plans

By Marc Manor

Welcome to a series we call “Medicare Myth Busters”!  So much of what I hear about Medicare comes from word-of-mouth.  We know from our childhood, the game “telephone” can drastically transform an original message to something completely different.  Because I hear Medicare beneficiaries talk, I would like to help separate some fact from fiction on some of the most common Medicare misconceptions that I hear. We will insert the "Medicare Myth Busters" into the regular blog on occasion as we continue to advocate for our Medicare beneficiaries.  The first myth buster in the series is:

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“My Medicare Supplement Plan F is a PPO (Preferred Provider Organization) so I can go to any doctor that accepts Medicare and I don’t need referrals.”

Setting the Course for Your Medicare Voyage

By Marc Manor

You’ve already had that milestone birthday and reached the big six-O; you survived mid-life crisis and now you can access your IRA without being penalized!  So, before you ponder that next milestone birthday at age 70; let’s talk about that big 65^th!  Sixty-Five is really something to be excited about because that is when you will likely become eligible for Medicare. 

Photo by Pineapple Supply Co. from Pexels

Now you have reached the age of eligibility and you can look forward to the Medicare benefits you have been working toward all these years with your hard-earned tax dollars!  You are enrolled in Medicare Part A and B, and you have received that nice red, white, and blue card and are all set to go, right?  Not so fast!  Low and behold there is a fork in the proverbial Medicare road!  Do you stay on Original Medicare or Medicare Advantage (otherwise known as Part C)?

Medicare and Veterans

By Marc Manor

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One day I was in a Veterans Administration (VA) clinic waiting to be helped. I overheard a man complaining that he was charged over $1000 from the nearby military hospital for emergency services.  Of course, I had no way of knowing this man’s VA status or the history of his military service, but he looked to be a Vietnam era veteran.  While I did not really know anything about this fellow Veteran, I could not help but wonder what the circumstances were regarding this bill he received.  He returned to his seat next to me, and I asked him if he tried submitting a claim to Medicare or his healthcare plan.  He said he only received medical care from the VA and he did not have Medicare or any other healthcare insurance.  I did not question him further, but it seemed like he did not understand he could have Medicare while using his VA benefits.

What options do Veterans have when it comes to healthcare after become Medicare eligible in civilian life?

HMO Is Not a Four-Letter Word

 By Marc Manor

In the course of talking to people about Healthcare or Medicare Plans, I sometimes hear the words “no-way!” when the subject of HMOs or Health Maintenance Organizations come up.  In certain circumstances, after hearing why this immediate response was given, I totally understand.  Other times, I think these negative opinions are derived from “urban legends” or based on “what happened to my friend’s friend.”  Anyone could have a bad experience for any number of reasons on any type healthcare plan.  A healthcare plan is not necessarily bad just because it’s an HMO.  It may not be the right fit for some people; however, there are some things you should know before you just write-off a plan just because it is an HMO.