Great news!

We are really happy to announce that we have a new content partner: Medicare Rights.org

We will now be able to republish Dear Marci, a great column that answers some of the most important Medicare Questions. We will also be publishing other articles from this great organization on this critical subject!

Serality-powered communities can make a page for Medicare Content and we will take care of the rest. The content will just change as the columns and articles will change by themselves. Just set it and forget it!

Here's a sample below. Onward...

Dear Marci,

My provider just asked me to sign an Advance Beneficiary Notice. What does this form do?

—Marjorie

Dear Marjorie,

An Advance Beneficiary Notice (ABN), also known as a "waiver of liability," is a notice that suppliers and other medical providers are required to give you when they offer you services or items that they know or have reason to believe Medicare will determine to be medically unnecessary for you, and therefore, will not cover.

Providers are not required to give you an ABN for services or items explicitly excluded from Medicare coverage. In addition, ABNs apply only if you are in Original Medicare, not if you are in a Medicare private health plan (HMO, PPO or PFFS).

If you do not get an ABN to sign before you get the service or item from your provider, it is not specifically excluded from coverage, and Medicare does not pay for it, then you do not have to pay for it. You may need to file an appeal to show that you should not have to pay.
If the provider does give you an ABN that you sign before you get the service or item, and Medicare does not pay for it, then you will have to pay your provider for it.

There will be an option on the ABN to check whether or not you want your doctor to submit a claim to Medicare for the service. You should always select that you want your doctor to submit the claim to Medicare. If you do not, your doctor isnot required to submit the claim. You should check this option, because Medicare may still pay for the services after all. 

If you sign an ABN but ask your doctor to bill Medicare, and Medicare then denies coverage, you can always appeal.

—Marci

This information is republished with permission from the Medicare Rights Center. For more info visit www.medicarerights.org.

Joe Couglin is the director at the MIT AgeLab. He writes an interesting blog about new thinking on the impacts of aging, social trends and technology on business innovation and public policy. He believes that living longer is an opportunity to design better products for everyone, and not just making them age-friendly. He is an engaging speaker and his blog also gives an interesting peek into the AgeLab and some of the innovations they are working on, including AGNES. AGNES is a suit worn by students, product developers, designers, engineers, and others to better understand the physical challenges associated with aging. In this post he mentions "aging is not for wimps."

The director of the Congressional Budget Office has a blog. In today's post Mr. Elmendorf clearly and rationally explains the effects of two scenarios that are contemplated in his analysis. In the best-case scenario we continue to add to our national debt albeit moderately, and in the less-than-best case we look a lot like Greece does today.

Why? The retirement of the Baby Boomers and the costs associated with current policy commitments.

Douglas Elmendorf writes:

The retirement of the baby-boom generation is a key factor in the nation’s long-term fiscal outlook. It portends a significant and sustained increase in the share of the population receiving benefits from Social Security, Medicare, and Medicaid. Moreover, under current law, per capita spending for health care is likely to continue rising faster than spending per person on other goods and services.

As a result, if current laws remained in place, the federal government’s spending on Social Security and the major mandatory health care programs (Medicare, Medicaid, the Children’s Health Insurance Program, and the health insurance subsidies that will be provided through insurance exchanges) is projected to grow from roughly 10 percent of GDP today to about 15 percent of GDP 25 years from now. (By comparison, spending on all of the federal government’s programs and activities, excluding interest payments on debt, has averaged about 18.5 percent of GDP over the past 40 years.)

So...ALL federal government's programs and activities over the last 40 years have averaged 18.5% of GDP and now Medicare, Medicaid, CHIP, and other insurance subsidies alone are going to be 15% of GDP? That's not going to happen.

Even in the less-likely and more optimistic projection our debt-to-GDP ratio rises from 69 to 84% in 2035. The ratio was 40% in 2008. The euphemistically named "alternative fiscal scenario" has our debt growing to almost 200% of GDP in the same period.

None of this is news. The only thing that everyone agrees on is that a disaster is looming. We know that the root cause is that we are an aging society that has made commitments through laws and policies that are going to be sorely tested as the people who have paid in begin to get paid out.

Separately I read today that congress has an 8% approval rating...8%! The only thing unifying us as a country is that we agree that things are horribly broken and that our government is not solving the problem!

We founded Serality on the premise that the solutions to our problems are going to be solved socially first, then politically and economically. We believe that our generation will figure this out if we have the right tools and information. The communities that use our platform are led by some of the smartest and most committed people I have ever met and they are innovating every day.

The CBO report, the 24-hour news cycle, the political hyperbole all seem to ask us to choose between bad and worse. Even sadder is the idea that we have to choose between old and young. It seems to me that we need to stop allowing the problem to be defined by politicians and special interest groups who only offer bad solutions. We don't have to choose between bad and worse. What is bad for the old is bad for the young...and vice versa. We have to do the whole job. We have to gore a few sacred oxen (taxes, healthcare philosophy, entitlements) but we don't have to abandon our values.

As the bumper sticker said: "When the people lead the leaders will follow." At Serality, we are enabling intentional communities to create real-life solutions for older adults, to combine their resources, and eventually create the political will to change.

Join us!