Margy Wenham Insurance Services, Inc - Serving California Since 1991

Medicare fraud is a general term that refers to an individual or corporation that seeks to collect health care reimbursement under false pretenses. This can occur when Medicare is billed for services or supplies you never got. Medicare fraud is different than abuse: Medicare abuse happens when doctors or suppliers don't follow good medical practices, which leads to unnecessary costs to Medicare, improper payment, or services that aren't medically necessary. A complaint about the quality of care you got from a doctor, hospital, or other provider or facility isn't considered fraud or abuse. The Centers for Medicare and Medicaid Services estimates that Medicare fraud costs taxpayers tens of billions of dollars every year. Officials reported on October 2, 1012 that ninety-one people including doctors, nurses and other medical professionals were charged criminally after an investigation of Medicare fraud that involved $430 million in false billing in seven cities. The ac...

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First, what is Medicare Supplemental Insurance?  Medicare Supplement Insurance, in some states called MediGap, is a secondary form of insurance designed to fill the coverage gaps in Medicare parts A and B.                    Medicare Supplement plans are issued through private insurance companies, such as Anthem Blue Cross, Blue Shield and UnitedHealhcare.  By far the most popular is Plan F: most consider Plan F to be hassle free as it pays all of Medicare’s deductibles and there are no out of pocket expenses. Because Medicare Supplement plans are regulated by state and Federal laws, all benefits for all options are the same regardless of insurer. The primary difference will be the cost or policy rate the insurers will charge for a particular plan .  Choosing the right agent can result in significant savings on a Medicare Supplement plan.  An agent that represents mult...

The Medicare Open Enrollment period is approaching. This year's Open Enrollment Period is October 15 – December 7.  For most people, this is the only time of year to enroll in or switch your Medicare coverage. At Margy Wenham Insurance Services, we care about your individual needs and are here to help you navigate Medicare. We want to provide you with the most up-to-date information and resources to help you find the plan that's right for you. If you're turning 65, losing employer coverage, retiring or disabled, you may be eligible to enroll now.   If you have any questions, contact Margy at 530-221-0955 or visit our website at www.MedicareSupplementsByMargy.com.

In August some people received a rebate check from their health insurance carrier, but many more did not.  To some this has led to considerable consternation to many – especially in light of the Department of Health and Human Services’ (HHS’s) public claim that Americans receiving the rebate will benefit from an average rebate of $151 per household.  The explanation as to why some but not others will receive a rebate is found in the details of the Affordable Care Act.   Under the federal Affordable Care Act health insurers issuing individual and small group plans must spend 80% of the premiums paid by consumers on health care and activities to improve health care quality.  The percentage of premium income an insurer spends on care and improving quality is called “Medical Loss Ratio” or MLR.  The health insurers MLR is determined separately for each state’s individual, small group and large group markets.  The only health insurers that are required to ...