Latest news with #SocialSecurityAct
Health Line
a day ago
- General
- Health Line
What Is the Medicare Beneficiary Ombudsman?
The Medicare beneficiary ombudsman (MBO) is a representative who works on behalf of Medicare enrollees to resolve Medicare-related complaints, ensure access to information, and improve the program. An ombudsman is a person who reviews how an organization operates, investigates complaints, and helps resolve those complaints. They typically work as a client advocate within an organization or business. The MBO serves this function within the Medicare program. Learn more about the services the MBO provides and how to connect. What is the role of a Medicare beneficiary ombudsman? Congress formed the MBO role in 2003. The person in this role assists Medicare enrollees in various areas, including handling complaints, appeals, and requests for information. The general duties of the MBO, as outlined in section 1808 of the Social Security Act, are to: receive and help resolve complaints and inquiries that Medicare beneficiaries and other stakeholders make work with representatives of health insurance counseling programs to provide information and resources to beneficiaries report to Congress on ways to improve the administration of Medicare In addition to addressing complaints, some of the specific issues enrollees may have to address with an MBO include: Appeals: If you disagree with a Medicare payment or coverage determination, you can file an appeal. The MBO can assist you with this process. Enrollment concerns: If you have issues when leaving a Medicare Advantage (Part C) plan or joining a new plan, the MBO can assist you. Claims: If you need to file a Medicare claim, the MBO can help you through the process or troubleshoot issues that arise. What are a beneficiary's rights under Medicare? As a Medicare beneficiary, you have various clearly outlined rights and protections. The MBO exists to help preserve those rights and ensure fair treatment of all Medicare beneficiaries. It can be helpful for Medicare enrollees to periodically review their rights to understand what types of treatment and services they can expect. A Medicare beneficiary's rights include: fair and courteous treatment privacy of personal and health information access to appropriate healthcare professionals for medically necessary services clear, understandable information access regarding coverage, plan options, costs, and more Medicare designs its protections to keep beneficiaries up to date on coverage status and prevent unexpected costs. They come into play when Medicare may not cover a service, or you reach the end of Medicare coverage. A beneficiary's protections include: receiving an Advance Beneficiary Notice (ABN) of Noncoverage for any services that Medicare doesn't cover getting a Notice of Medicare Noncoverage at least 2 days before covered home health services end acquiring a Hospital-Issued Notice of Noncoverage (HINN) for inpatient services that Medicare Part A doesn't cover If you've experienced violations of your rights or protections or have an issue with Medicare noncoverage, you can contact the MBO for assistance. How to contact a Medicare beneficiary ombudsman Not all Medicare-related questions should go directly to the MBO. Other contact points may be more suitable based on your coverage and the nature of your question or concern. If you're a Medicare Advantage or Part D enrollee, contact your insurance carrier with any questions or complaints about your plan. You can generally find contact information for the plan on the back of your insurance card. If you have questions about Original Medicare or need help with issues that a private insurance carrier can't address, you can contact Medicare by phone at 800-633-4227. If you have general questions or would like free, unbiased Medicare counseling, you can contact your local State Health Insurance Assistance Program (SHIP). Finally, if you have questions that the channels above can't resolve, you can direct your query to the MBO. You can do so by contacting Medicare by phone at 800-633-4227 and requesting your case's submission to the MBO. Summary The MBO has a role within the Medicare program to provide customer service and advocacy. The MBO can assist Medicare beneficiaries with resolving complaints and accessing important information. They also work to improve Medicare's administration by submitting an annual report to Congress on its operation. If you have a concern requiring the MBO's attention, you can contact Medicare by phone and explain the situation.
Yahoo
a day ago
- Business
- Yahoo
Monroe County Hospital is considering creating a swing bed program
MONROE COUNTY, Ala. (WKRG) — The Monroe County Health Care Authority, which operates Monroe County Hospital, is proposing a move that would create a swing bed program. UPDATE: Man charged with murder after Saenger shooting The Social Security Act allows small, rural hospitals to use some of their beds for skilled nursing facility beds. These allow patients to transition from acute care to a skilled nursing facility without leaving the hospital, according to the Centers for Medicare and Medicaid Services. In an application, the MCHCA said if approved, it would convert 10 acute-care beds to swing beds at the Monroe County Hospital in Monroeville. The proposed project would require a certificate of need and is estimated to cost $345,000, according to an MCHCA news release. According to the release, those interested in submitting a written statement or appearing before the Certificate of Need Review Board must do so by July 14, 2025, and provide a copy of the statements to Colin H. Luke, Esquire, at Holland & Knight LLP, 1901 Sixth Avenue North, Suite 1400, Birmingham, Ala., 35203. UPDATE: Federal Bureau of Prisons responds to Todd Chrisley's allegations about FPC Pensacola The application number is AL2025-013. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
USA Today
6 days ago
- Business
- USA Today
Average Social Security check to break $2,000 for the first time ever in June 2025
Sean Williams The Motley Fool When the Social Security Act was signed into law in 1935, its purpose was to provide a financial foundation for America's aging workforce. Nine decades later, this mission is still being fulfilled, with the added bonus of also providing protections for workers with disabilities and survivors of deceased workers. Based on an analysis from the Center on Budget and Policy Priorities, Social Security was responsible for pulling 22 million people out of poverty in 2023, which is more than any other social program. Nearly three-quarters of these 22 million people were aged 65 and above. For most retired-worker beneficiaries, their monthly payout is more than just income — it's a necessity. According to 23 years of annual surveys by Gallup, Social Security income helps between eight and nine out of every 10 retirees cover at least some portion of their expenses. Next week, when the calendar officially flips to June, Social Security retired-worker benefits will do something that's never been seen in the program's 90-year history. Who's ready for Social Security history to be made? Every month, the Social Security Administration (SSA) publishes a "Monthly Statistical Snapshot" that intricately breaks down where benefits paid in the previous month ended up. For example, the April statistical snapshot shows that $128.736 billion in traditional Social Security benefits were doled out to 69.378 million people. Retired workers account for nearly 76% of all beneficiaries (52.587 million), with disabled workers (7.156 million) and survivor beneficiaries (5.841 million) comprising much of the remainder. If you're wondering why these three numbers don't add up to 69.378 million, it's because spouses, children and other direct relatives may qualify for benefits on behalf of a retired, disabled or deceased worker. In addition to breaking out how many beneficiaries received a payment, Social Security's monthly snapshot provides the average monthly benefit for each category. Spanning all beneficiaries, the average payout was $1,855.57 in April. But it's the average monthly benefit for retired workers that's just a week away from making history. Last month, retired-worker beneficiaries took home an average check of $1,999.97. However, this average monthly payout isn't static. Every month, new beneficiaries are entering the pool to receive their first monthly Social Security check, and some beneficiaries pass away. Additionally, higher nominal wages paid to working Americans over time, coupled with the impact of near-annual cost-of-living adjustments (COLAs), directly affect the average monthly take-home pay for retired-worker beneficiaries. Due to these factors, the average retired-worker benefit has always risen on a month-to-month basis, based on more than a decade of published SSA statistical snapshots. Sometimes, these increases are pronounced, such as the jump from an average payout of $1,980.86 for retired workers in February 2025 to $1,999.97 just two months later. This $19.11 increase spanning just two months potentially signals a big uptick in workers filing for benefits. More often, the average retired-worker payout grows by $1 to $2 on a month-to-month basis, not including the one month each year when COLAs are implemented. With the expectation that this trend remains intact, the average Social Security retired-worker benefit in May, based on the soon-to-be-reported June statistical snapshot, will surpass $2,000 for the first time in history. It's a psychologically important figure for a program that serves as a financial foundation for many aging workers. A Social Security dollar simply isn't what it once was But uncorking the champagne isn't advisable just because Social Security is making history. While nominal monthly payouts for retirees continue to climb, they've been doing so at a considerably slower rate than the inflationary pressures retirees have been contending with for a quarter of a century. Beginning in 1975, the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) became Social Security's inflationary measure for doling out annual cost-of-living adjustments. With over 200 spending categories, all of which have their own respective weightings, this index can be whittled down to a single figure at month's end, which makes for easy year-over-year comparisons to see whether collective prices are rising (inflation) or falling (deflation). Though everything sounds kosher on paper, the CPI-W has done retirees no favors. As its full name implies, the CPI-W is focused on the spending habits of "urban wage earners and clerical workers." These are typically working-age people who aren't currently receiving a Social Security benefit. More importantly, working-age folks and retirees tend to spend their money very differently. Whereas the former spends more on education, apparel and transportation, seniors spend a higher percentage of their monthly budget on shelter and medical care services than the typical working American. Even though an overwhelming majority of Social Security beneficiaries are aged 62 and above, the inflationary index used to calculate annual COLAs isn't properly weighting shelter and medical care services to their needs. The result? According to a May 2023 analysis from nonpartisan senior advocacy group The Senior Citizens League (TSCL), the purchasing power of a Social Security dollar dropped by 36% from January 2000 to February 2023. A more recent analysis from TSCL points to a 20% loss of buying power for Social Security income between 2010 and July 2024. Even though Social Security retired-worker benefits are breaking above psychological barriers, retirees are more often than not witnessing the buying power of their Social Security income dwindle over time — and that's nothing to celebrate. The Motley Fool has a disclosure policy. The Motley Fool is a USA TODAY content partner offering financial news, analysis and commentary designed to help people take control of their financial lives. Its content is produced independently of USA TODAY. The $23,760 Social Security bonus most retirees completely overlook Offer from the Motley Fool: If you're like most Americans, you're a few years (or more) behind on your retirement savings. But a handful of little-known "Social Security secrets"could help ensure a boost in your retirement income. One easy trick could pay you as much as $23,760 more... each year! Once you learn how to maximize your Social Security benefits, we think you could retire confidently with the peace of mind we're all after. JoinStock Advisorto learn more about these strategies. View the "Social Security secrets" »
Yahoo
25-05-2025
- Health
- Yahoo
Opinion - I am disabled but educated and ready to work — only Medicaid won't let me
I graduated this month with my master's degree in Education Policy and Leadership. I have published peer-reviewed research, co-created a survey instrument with a digital object identifier, served as a graduate task force co-chair, and was admitted to fully funded Ph.D. programs. On paper, I represent the American dream's image of promise and success — driven, capable, and eager to contribute to the future of education reform in this country. But none of those credentials — not the degree, not the publication, not the leadership — have freed me from the grip of a system that punishes disabled people for trying to live. I rely on Medicaid to cover a personal care attendant who helps me complete basic activities of daily living. There is no private insurance plan that will cover this need. Without this support, I cannot get out of bed, eat, or use the restroom safely. And yet, if I earn more than the narrow income limits set by Supplemental Security Income — which is often tied to Medicaid eligibility — I risk losing that care altogether. In a cruel twist of policy, the moment I actually try to participate in society, the very tools I need to participate in society are stripped away. The public debate around Medicaid work requirements ignores people like me. Politicians and pundits focus on 'able-bodied adults' and whether they're working hard enough — but no one talks about disabled adults who want to work, can contribute, and are forced into poverty by the very safety net that is supposed to support them. Medicaid and SSI are deeply intertwined. In most states, including my home state of Florida, eligibility for Medicaid — which covers long-term services like personal care aides — is automatically granted to those who qualify for SSI. But SSI comes with harsh limits: just $943 in monthly income, and no more than $2,000 in assets. A threshold limit is established under Section 1619(B) of the Social Security Act, placing a limit of $42,119 in earned income as a resident of Florida. This is equivalent to earning approximately $20 an hour, less than the average annualized earnings of students who graduated with a bachelor's degree from the state university system in the fall of 2022. According to the Center on Budget and Policy Priorities, nearly 8 million Americans rely on SSI, and about 60 percent of adult recipients have disabilities. Of those, many also depend on Medicaid for home-based and community-based services. Yet the income limits and asset tests have remained largely unchanged since the 1970s, adjusted only slightly for inflation. This creates an impossible situation: I'm educated and ambitious and want to contribute to society. But I'm effectively forced to remain poor — not because I lack ability, but because working too much will leave me without the care I need to live. This is not independence — this is captivity. Democrats often speak about equity, inclusion, and protecting marginalized communities. Republicans champion economic opportunity, self-sufficiency, and personal responsibility. But when it comes to people like me — disabled adults who want to live independently and escape the poverty trap — both parties have fallen short. For Democrats, equity often stops at access. But real equity means creating a system where I can use my education without risking my care. For Republicans, the rhetoric of independence rings hollow when working a full-time job disqualifies me from essential care. The Medicaid work requirement debate misses the point entirely. The issue isn't whether people should work — it's whether the system allows disabled people to work without punishing them for it. If policymakers are serious about promoting work, independence, and dignity, they should start by reforming rules that actively prevent such things. First, decouple Medicaid's long-term care supports from poverty requirements. Second, raise SSI's outdated asset limits. Then create tiered eligibility models that allow disabled adults to contribute while maintaining essential services. We are not fringe cases. We are people trying to live, work, and thrive, but in a country that still hasn't figured out how to make freedom accessible. Carlos Gamez has a master's degree in education policy and leadership from American University. He resides in Lakeland, Fla. and was recently appointed as a self-advocate member of the Florida Center for Inclusive Communities Advisory Committee. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
The Hill
25-05-2025
- Health
- The Hill
I am disabled but educated and ready to work — only Medicaid won't let me
I graduated this month with my master's degree in Education Policy and Leadership. I have published peer-reviewed research, co-created a survey instrument with a digital object identifier, served as a graduate task force co-chair, and was admitted to fully funded Ph.D. programs. On paper, I represent the American dream's image of promise and success — driven, capable, and eager to contribute to the future of education reform in this country. But none of those credentials — not the degree, not the publication, not the leadership — have freed me from the grip of a system that punishes disabled people for trying to live. I rely on Medicaid to cover a personal care attendant who helps me complete basic activities of daily living. There is no private insurance plan that will cover this need. Without this support, I cannot get out of bed, eat, or use the restroom safely. And yet, if I earn more than the narrow income limits set by Supplemental Security Income — which is often tied to Medicaid eligibility — I risk losing that care altogether. In a cruel twist of policy, the moment I actually try to participate in society, the very tools I need to participate in society are stripped away. The public debate around Medicaid work requirements ignores people like me. Politicians and pundits focus on 'able-bodied adults' and whether they're working hard enough — but no one talks about disabled adults who want to work, can contribute, and are forced into poverty by the very safety net that is supposed to support them. Medicaid and SSI are deeply intertwined. In most states, including my home state of Florida, eligibility for Medicaid — which covers long-term services like personal care aides — is automatically granted to those who qualify for SSI. But SSI comes with harsh limits: just $943 in monthly income, and no more than $2,000 in assets. A threshold limit is established under Section 1619(B) of the Social Security Act, placing a limit of $42,119 in earned income as a resident of Florida. This is equivalent to earning approximately $20 an hour, less than the average annualized earnings of students who graduated with a bachelor's degree from the state university system in the fall of 2022. According to the Center on Budget and Policy Priorities, nearly 8 million Americans rely on SSI, and about 60 percent of adult recipients have disabilities. Of those, many also depend on Medicaid for home-based and community-based services. Yet the income limits and asset tests have remained largely unchanged since the 1970s, adjusted only slightly for inflation. This creates an impossible situation: I'm educated and ambitious and want to contribute to society. But I'm effectively forced to remain poor — not because I lack ability, but because working too much will leave me without the care I need to live. This is not independence — this is captivity. Democrats often speak about equity, inclusion, and protecting marginalized communities. Republicans champion economic opportunity, self-sufficiency, and personal responsibility. But when it comes to people like me — disabled adults who want to live independently and escape the poverty trap — both parties have fallen short. For Democrats, equity often stops at access. But real equity means creating a system where I can use my education without risking my care. For Republicans, the rhetoric of independence rings hollow when working a full-time job disqualifies me from essential care. The Medicaid work requirement debate misses the point entirely. The issue isn't whether people should work — it's whether the system allows disabled people to work without punishing them for it. If policymakers are serious about promoting work, independence, and dignity, they should start by reforming rules that actively prevent such things. First, decouple Medicaid's long-term care supports from poverty requirements. Second, raise SSI's outdated asset limits. Then create tiered eligibility models that allow disabled adults to contribute while maintaining essential services. We are not fringe cases. We are people trying to live, work, and thrive, but in a country that still hasn't figured out how to make freedom accessible. Carlos Gamez has a master's degree in education policy and leadership from American University. He resides in Lakeland, Fla. and was recently appointed as a self-advocate member of the Florida Center for Inclusive Communities Advisory Committee.
