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I actually did a small blog about this last year. Please be very careful when you sign up at the end of December for a Medicare “plan”-”replacement”. PLEASE make sure of the following:
1) ARE your physicians on the plan? Call all of your physicians and ask their office staff!
2) Is the “replacement” insurance actually a legitimate plan??? How long have they been around? There are too many “fly by night” replacements--be careful!
3) Do you have to have to get a referral from your PCP (Primary Care Physician) to see a specialist?
4) Are you limited as to what hospital you can use? A lot of hospitals are not on the Medicare replacements--check into it!!
5) What is your deductible? Is it actually higher than the regular Medicare deductible?
Don’t be mislead by these plans. So many times, they are presented to you as “Medicare” or as a secondary insurance--they are not. Please read everything you are given and ask questions!! Not asking the right questions may cause you to get locked in to a plan that you will be unhappy with.
We see so much of this at the first of every year in a physicians office. A patient will present their Medicare card to us….we contact Medicare for verification of benefits and coverage…only to find out that the patient is actually on a Medicare HMO plan (Evercare, Tx. HealthSpring etc.) When trying to explain this to a patient, they do not understand the fact that they are not actually on Medicare--they signed up for a Medicare “replacement”.
Don’t get me wrong, some of these plans are great and have a lower cost. But do you really want to risk not being able to see your regular physicians, and have to start all over again on choosing a physician? Or better yet, have the insurance company chose a physician for you??
Please, please read all documents you are given. If you have a loved one that is considering getting on 1 of these plans, check out the plan for them. They are dealing with skilled sales people who know what to say in order to get another person on the “plan”. Be careful!!
If the plan offers prescription coverage, make SURE it will cover ALL of your meds. Some of them have HUGE prescription exclusions. You don’t want to pay more for a Rx then you did on your Medicare plan right?
I can not emphasize enough how important it is to thoroughly read the paperwork. It’s a binding contract and should be read over as such!!
We actually HAD to get out anyway New Years Eve-my daughter called (they had been at our home) and said their gate was wide open and both of their labs were GONE!! Now-mind you-these are well trained hunting dogs-their my "grandoggies"! Even though gunfire doesn't bother them, they are terrified of fireworks-and since they live out of the city limits-it was like a war zone over there-folks doing fireworks in the middle of the neighborhood streets etc.-I've NEVER seen anything like it!! The kids just moved into this particular neighborhood a month ago and had NO idea the fireworks would be so bad!!!
Ken and I hopped into my sons truck and drove across town to help them find the grandogs. I stayed at their house with my grandson while they all drove around. Before we got there, my son in law called and said he had found "Aeva"-but Remy was no where in sight.
They searched for a few hours-NO Remy. THe kids told us that she would come home-and the search was "exhausted". Ken and I left-but still drove around looking for Remy. We got a call from the kids about 30 mins. later saying that Remy had wandered into a neighborhood that was very quiet-and a kind homeowner called them. Remy is fine and at home now Thank God!!!
So-to all you pet owners-KEEP THOSE TAGS ON YOUR PETS COLLARS-whether they are an inside OR outside pet!! You never know when they will escape!!!
Okay-now!! Don't "pound" me for this one LOL! BUT-I have noticed that alot of folks who do not BELIEVE in Jesus Christ celebrate CHRISTmas? Why is this??
CHRISTmas is a celebration in the birth of Jesus Christ our Lord and Saviour! This question is asked strictly out of curiousity, I'm not "bashing" anyone-just looking for honest-NON CRITICAL answers LOL!
WHERE'S THE RESPECT????
Nov 10, 2007 | 10:14 PM PST
Category:
Political
This is a story that actually happened yesterday-it's from my church. Some people have NO RESPECT for the veterans-please read this article!
Who knows what would have happened if Pastor Richard Amador of Son Harvest Church hadn’t seen a Harris County mowing crew running down the yellow-ribbon signs along his Highway of Honor.
“How many signs would they have mowed?” Amador said. “We would have lost the whole Highway of Honor.”
The signs are part of the Highway of Honor. They’re put up there before every Veterans or Memorial Day by the American Legion and a local church.
From the week before Veterans Day and Memorial Day to the Tuesday after, signs saying “thank you” to a local members of the service line both sides of FM 2100.
This year, nearly 600 signs dot the roadway.
Amador started the tradition three years ago in honor of the men and women who have made their community proud by serving their country.
“They represent the hero, the family, the community, America,” Amador said. “It’s our veterans.”
The pastor just happened to catch the mowers going about their business Friday, with no respect for the display that stretches for miles from Highlands through Crosby to Huffman.
Amador immediately got in his truck and told the men to stop their mowing. By that time, more than 80 of the 600 or so signs had been ruined.
The most upsetting part of the ordeal, Amador said, was that he got the impression the men were just doing their job. They never stopped to consider their actions before running over the signs. They didn’t take the time to call their supervisor or alter their route, “they just kept mowing,” Amador said.
“It’s obvious there is something different going on,” Amador said. “It’s our Highway of Honor.”
Interviewed by KTRK TV news, veteran Joe Anselmo said he “wanted to grab the guy off the tractor and pinch his head off.” Anselmo, a Past American Legion Commander, saw the crew mowing right over the signs Friday morning. He says he tried to stop them, but the crew didn’t speak English.
Even after the mowers promised to go around the signs, six or seven more were damaged.
William T. Dowden is just one of the residents whose sign was destroyed – the day before Veterans Day celebrations will be held across the community.
Amador said he’s sorry for the families who might drive by, expecting to see their sign only to find it missing, and for residents who will no doubt be upset by the wreckage on display where some of the signs used to stand.
“They’re symbolic to us in the community,” Amador said. “They stand for something.”
But Amador did receive some good news after the upsetting incident. He said the supervisor of Bayou Landscaping, (which contracted the mowers), called him to apologize for what happened and promised to replace the signs, (which cost $10 each).
“So everything is OK,” Amador said. “It had a happy ending.”
I am seeing more and more people that are getting the Medicare "replacement" insurance’s-and not even realizing they have done so! I’m sure you’ve seen the TV commercials on the insurances.
Patients will come in and give you their regular Medicare card, you bill Medicare, and find out that they patient is on a Medicare "replacement" and Medicare will not pay the claim.
After talking to several people that have signed up for these programs, they seemed to think that it would "take over" and pay what Medicare wouldn’t—saying that is the way it was explained to them at a "seminar" they attended! This is NOT so!
If you have a loved one on Medicare, please make sure they understand that should they sign up with Tx. Healthspring, or Texan or Evercare etc.—that insurance is TAKING THE PLACE OF MEDICARE. It is not a Medicare supplement (secondary insurance)!
These insurance’s are GREAT in most cases, but the patient needs to be made aware that some of them are HMO’s and many of their current physicians may not be on the program also.
Do your research before getting away from traditional Medicare!! Help your loved ones research the programs too.
MEDICARE-ACCEPT ASSIGNMENT???
Nov 7, 2007 | 11:07 AM PST
Category:
Political
Working in the medical field, I hear so much "confusion" from our patients and MEDICARE. Here is 1 thing that they really get confused about—if you are on Medicare or know someone on Medicare; you may want to pass this on to them. One thing you need to know, is MEDICARE tells the physicians and other medical establishments how much they can charge—we do not charge our own charges with Medicare!!
One term used by physicians AND Medicare is "accept assignment"-or "do not accept assignment". Here is the quick version on what this means.
When you go to your physician-if they ACCEPT assignment, this means they agree to accept Medicare’s fee for the service rendered-and will not bill you for the difference. For instance: You went in for an office visit and it is a minimal visit—your physician will charge you ONLY what Medicare has told them to charge--$37.64 (maybe). Your physician CAN ask you to pay 20% of that visit—unless you have a secondary insurance-then most likely, they will bill the secondary insurance. If there is a small difference between what Medicare paid and the secondary paid, then the physician CAN NOT bill you—they have to "write off" the balance.
If they DO NOT ACCEPT ASSIGNMENT-then you can and will be billed for the difference between what Medicare pays and allows and the FEES for service are MUCH higher!!
Sounds confusing huh? Imagine how it feels to our srs. When it is explained to them. In a "nutshell" use a physician or medical facility that ACCEPTS Medicare assignment and you will not have to pay out as much money to them!!
ANSWERING MACHINES-GOOD-BAD??
Oct 25, 2007 | 1:47 PM PST
Category:
Political
Oh my goodness! Am I the only 1 that longs for the day when humans answer the phones at any place of business? It seems that every business you call nowadays has an answering machine that gives you instructions on how to contact the human you need--and THEN--the human has a "voice mail"! Personally, I think this answering machines are probably more expensive than paying a few human beings to answer you phone!!
I know here at work, when calling an insurance company, you push this button for english, then another button for medical, then another for medical benefits, another for eligibility and another for pre certification of a procedure! By then, you've spend a good 10-20mins on the phone!! They can't have just 1 person answer all of your questions LOL-you have to talk to 5 or 6 different people to get each question answered-YIKES!!
Now, an answering machine at home is fast and easy-but I think they do not belong in a place of business---except for after hours of course!! Am I the only 1 who is sooooooooooo irritated by this???
Okay--I really don't consider myself an old "fuddy duddy" LOL-but............................we have new neighbors who insist on sharing their "music" with the whole neighborhood LOL! I mean the kind of music that rattles the windows in the house. They seem to enjoy having constant parties too!! Our neighborhood is a quiet, older neighborhood-and there is not a big turnover on selling houses. Everyone has been there for over 20yrs. and is pretty much there to stay---or so we thought!!
Now, with these new folks moving in, doing their partying and playing super loud boomin' music, we don't know what to do!! Yesterday, Ken went over and politely asked them to turn their music down (they were washing their car and had it cranked up--vibrating our windows, waking me up AND the baby!! This particular lady didn't speak much English, but she acknowledged him and turned it down-----for a few hours-----then it started again--oh--and they live across the street too! I can just imagine what it is like for their next door neighbors!! What do you do/would you do??? I've not had this problem in the past, and if it weren't for the baby, I would try to not let it bother me--but it wakes him up everytime the music starts vibrating our windows!! HELP me Bloggersville!
WHAT'S AN ENCYCLOPEDIA??
Oct 12, 2007 | 1:58 PM PST
Category:
Political
I remember using our encyclopedias ALL the time for research papers in Jr. high and High school. Nowadays, children have no idea what a set of encyclopedias are LOL! I wonder how long it will be before there are no more libraries? Are they still used? With the internet, will libraries stay open for many years to come? I think they will become totally computerized very soon! What do you think?? Do you still have an old set of encyclopedias--maybe in your attic LOL?
Isn't it sooooooooooooooo GREAT to see the Mayor of Bloggerville back in town?? I know we have all missed him and it's been hard to carry on in our little town with him around!!! So how did we do Mayor Randy??
I was "enlightened" with this about a year ago and thought it would be interesting to share with the blogger community!!'
When my youngest grandson was born, we of course wanted to put signs, banners and yard decorations out in their yard, announcing the birth of their baby boy.
The more we thought about it, the more we decided against it. There are so many creeps out there that prey on young children and STEAL babies, we felt it was not a good idea to announce a baby boy was in the house-or going to be in their house soon.
It's sad that we have come to a point that we can't even decorate our yards for a baby being born OR for a childs birthday. We have to be so careful and protect our little ones from the preditors.
I always think about those vehicles that drive around with the CHILDS name on the back window, announcing to the world what sport etc. their child participates in!! Some even announce what school their child goes too! This just doesn't seem too safe to me-sooooooooo what's the opinion on BLOGGERSVILLE, Tx.??
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I've been trying to learn sign language for a few years now and I LOVE doing songs utilizing sign language. I was filling out some "recredentialing" applications to insurance companies (at work) and noticed they actually have "sign language" down as a second language now!! I was soooooooooooo excited!!
On the apps they usually list what languages someone/anyone in your ofc. speaks Spanish. I was sooo thrilled to see SIGN LANGUAGE there also. This is a HUGE step forward for the hearing impaired community!! I hope to see more of this!! Ya-Hoo!!
