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Different Senior Healthcare Plans in Arizona

When one turns 65, having a reliable healthcare plan becomes a top priority. In fact, people start looking for healthcare plans even before that, so they can take advantage of all the benefits of  Medicare and Medigap   healthcare plans. Normally, people have basic healthcare plans that provide basic Medicare coverage. However, at times, people also opt for additional supplemental plans for senior healthcare Arizona.

Looking at this need, the Arizona Medicare and private medical insurance companies together introduced different supplemental healthcare plans to meet the healthcare needs, particularly for seniors. These plans, that are 10 in number (A, B, C, D, F, K, L, M, and N) focus only on the elderly; and only someone who is aged 65 or above can benefit from any of these plans.

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While the charges for these plans vary from one company to another, it is mandatory that all companies provide the same services under a specific plan. For instance, all of the private medicare companies in Arizona would have to provide basic healthcare and hospitalization coverage under Plan A and B. Similarly, all companies in Arizona would provide Medicare Advantage plans in under Plan D. While the packages and monthly premium may differ from company to company, it is not possible that one company provides certain services under plan C, and some other company provides same services under plan D.

Having a reliable senior healthcare Arizona plan also comes in handy when one travels between different states frequently. Arizona has the largest influx of retired people so the choice of senior healthcare company becomes really critical. Moreover, many seniors are attracted to the idea of spending winters in Arizona, and then move to some other state to spend the summers.

Another reason why one must have supplemental plans is because there is no drug coverage in the basic healthcare plans. Therefore, prescription plans for covering he cost of drugs is often paired with basic healthcare plans.

If you are going to opt for medicare supplement plans, you must do so within the six months starting from the month you turned 65. The advantage of doing so is because if you register during this “open-period”, no company would be able to decline your request. However, afterwards, the companies may simply decline you additional senior healthcare Arizona plans, or ask for extra charges. Let us discuss different services that are covered under different senior healthcare Arizona plans apart from the basic Plans A and B.

Plan C

This is the plan that you should opt for if you want to be “well covered”. This plan offers coverage above the basic benefits and just by adding a little extra to your basic healthcare plans, you can have the security of knowing that you don’t need to worry about additional out of the pocket costs because you have it all covered.

While you have the knowledge that most of your medicare expenses are covered, it is also important to know that the coverage is limited to Medicare-approved charges. This generally results in paying a little extra out of your pocket if you see a doctor who charges a little extra. However, despite this, Plan C may prove to be very useful in unexpected medical conditions.

Under Plan C, while you have all of your basic expenses covered, the additional services that you get include: skilled nursing facility care for yourself, hospitalization deductible for your Plan A, medical and hospital outpatient expenses for your medicare part B, and emergency help in case you have to travel abroad for a medical emergency.

Plan D

Only a few people know that the basic medicare plans do not cover the prescription charges. It is because of this reason that people often find a plan D paired with original plans A and B for the coverage of their medicare prescription and drugs. At times, there are some drugs that are very costly, and can prove to be a great financial burden because of out of pocket expenses. However, having a Plan D proves to be very useful in such situations.

Some companies have different sub-packages under Plan D. There are plans that have less monthly premium, but have a limited list of drugs you can use. There are also plans where you have to pay a little extra monthly premium but the list of drugs that are covered is comprehensive.

Depending upon your needs and requirements, you may select a senior healthcare Arizona plan best matches your requirements.

Medicare Advantage Plans

These are a series of Healthcare Plans formed by partnership between Medicare and Private Insurance companies to provide cost efficient healthcare services to the elderly.

In Arizona, 5 medicare advantage plans exist:

Health Maintenance Organization (HMO)

Under this plan, you pay a specific sum of money and different doctors and hospitals agree to provide you their services in return.

Preferred Provider Organization (PPO)

Under this plan, you can use doctors and hospitals belonging to a healthcare network. To receive additional service outside the network, you need to pay a little extra. However, you don’t need your physician’s referral to visit a specialist.

Private Fee For Service (PFFS)

This package allows you to visit any hospital and doctor of your choice. The services provider in this case, decides how much you have to pay for your visits. By paying the amount of their choice, you can benefit from additional senior healthcare services as well.

Medicare Savings Account (MSA)

MSA is divided further into 2 parts.

You may have a special savings account for health related expenses. Medicare deposits fixed annual premium into your account that remains there if you do not use it by the end of the year.

Under the second type, you get a fixed deposit into your account from which deductions are made from time to time for your medical expenses. Once the deductions are met, your medicare covered services are covered by your healthcare plan.

Special Needs Plan (SNP)

This plan only provides membership to specific people who reside in certain long-term care facilities, or who have certain chronic or disabling conditions. This plan is generally designed to provide Medicare health care and services to people who require special expertise of the plan’s providers, and focused care management.

Physician-Owned Hospitals Rush To Open Doors By 2011

Under the new federal health reform laws, physician-owned hospitals that are not certified by Medicare prior to 2011 will not be allowed to provide services to the program. In addition, the law prohibits existing hospitals from expanding unless the hospital serves a state with a shortage of hospital beds, or a county that is growing at least 50% faster than the average growth rate in that state. In Arizona, four of the top five hospitals named in a 2009 Consumer Reports survey were physician-owned facilities.

Advocates for physician-owned hospitals say that the loss or restriction of Medicare funding for these institutions could reduce the number of Medicare providers or push certain institutions into bankruptcy. In August, The Arizona Heart Institute and Abrazo Health Care announced that they were in talks to be acquired by Vanguard Health Systems as part of a bankruptcy reorganization plan. The Arizona Heart Hospital, which is affiliated with the Arizona Heart Institute, was also in talks with Vanguard.

Part of the concern driving the restriction on physician-owned health care facilities is that these facilities selectively treat patients. More than twice as many relatively healthy patients admitted to physician-owned hospitals undergo surgeries for uncomplicated problems like blocked coronary arteries compared to patients admitted to hospitals with no physician ownership interests. Patients treated at non-physician-owned facilities tend to have more complications that limit or modify surgical options.

Patient advocates complain that physician-owned facilities get better reimbursement from the treatment of uncomplicated disease because they have fewer longer-term care patients, lower nursing costs and more patients with shorter hospital stays. This amounts to unfair competition and sets up a conflict of interest. When physicians own the hospital, they have a larger interest in accepting only those cases that will preserve profits.

About 30 new physician-owned facilities are scheduled to open their doors by December 31, 2010, ahead of the new restrictions. About 45 new physician-owned hospitals are expected to miss the deadline. Healthcare industry analysts say that for these hospitals, failure to get the doors open could be a financial disaster, since hospitals receive about half of their overall revenue from treating Medicare patients.

PHA and the Texas Spine and Joint Hospital are suing the federal government to stop the new rules from taking effect as planned, saying that the reforms unfairly restrict competition for health care providers at a time when significantly more providers will be needed.

Read more about Arizona Medicare Plans.

Medicare Will Now Pay For Smoking Cessation Counseling

Medicare says it will now extend smoking cessation counseling to its recipients citing the cost of providing health care to smokers as one reason for adopting the benefit. A study commissioned by Medicare found that the agency will spend about $800 billion on smoking-related health care over the 20-year period between 1995 and 2015.

Effective immediately, Medicare will pay for up to eight counseling sessions per year for smokers who want to kick the habit. In 2011, the counseling sessions will be offered under Medicare Part A and Medicare Part B at no cost to interested seniors. Medicare already pays for pharmaceutical interventions and counseling for those who have developed smoking-related illnesses, but did not pay for smoking cessation counseling for seniors who simply want to attempt to quit. Studies show that senior smokers are less likely to try to give up smoking, but those who do try are more successful at quitting than younger smokers.

Research has also shown that counseling is highly effective in helping seniors give up a tobacco habit – even a long-term one.  Seniors who undergo smoking cessation counseling are more likely to quit successfully and are more likely to live longer, even after having acquired smoking related illnesses like heart disease.

Only about 10% of seniors are regular tobacco users, compared with 20% of the general population. Despite this, tobacco-related illnesses remain the number one preventable cause of disease and death among Americans. Because many more smokers are not yet Medicare-eligible, the agency expects to see a larger number of smokers and smoking-related illnesses among newly eligible recipients.

Right now, Medicare estimates that about 4.5 million senior Medicare recipients smoke along with another one million disabled Americans younger than age 65 who receive Medicare coverage. The new coverage is part of the Affordable Health Care Act and is extended to all Medicare recipients, regardless of their age.

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